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My Father Is 92 Years Old And Has Wolf White
Question: My father is 92 years old and has wolf white Parkinson Disease, diabetes, atrial fibrillation and is blind . The WWP has not been symptomatic however, over the past few days he has started shaking uncontrollably. I first noticed it while he was walking. It wasn’t like a shivering shake. It was more jerky. His BP has been on the high side ranging from 192/72 HR 74-96. His morning blood sugar low side 122 High side 218
Night Blood Sugar XXXXXXX side 176 high 299. It s usually between 205 & 299. I keep telling my sister that is much too high. She is his caregiver and says that range is a normal nighttime blood sugar for someone his age. She also just guesses how much insulin to give him. Any thoughts would be greatly appreciated.
My sister never checks his blood or gives him insulin before meals. She hasn’t taken him to the doctor in over 6 months. I have been reading up in this and asking the same questions. He takes insulin only. No other diabetic medication. So, if he is to check his BS before each meal and then bedtime, it is a minimum of 4 times a day and the amount of insulin he gets is based on that number? His diet is very high in carbohydrates. She limits the amount of fruits but she gives him potatoes, chips, Mexican Chicharrones, potato salad and when he wakes up during the night she gives him cheese and crackers. I am very concerned that she is making him worse. She doesn’t keep the insulin refrigerated and won’t let me see what kind she’s giving him. Isn’t there a different type of insulin used overnight? What is a hypoglycemic episode and what triggers it?
Night Blood Sugar XXXXXXX side 176 high 299. It s usually between 205 & 299. I keep telling my sister that is much too high. She is his caregiver and says that range is a normal nighttime blood sugar for someone his age. She also just guesses how much insulin to give him. Any thoughts would be greatly appreciated.
My sister never checks his blood or gives him insulin before meals. She hasn’t taken him to the doctor in over 6 months. I have been reading up in this and asking the same questions. He takes insulin only. No other diabetic medication. So, if he is to check his BS before each meal and then bedtime, it is a minimum of 4 times a day and the amount of insulin he gets is based on that number? His diet is very high in carbohydrates. She limits the amount of fruits but she gives him potatoes, chips, Mexican Chicharrones, potato salad and when he wakes up during the night she gives him cheese and crackers. I am very concerned that she is making him worse. She doesn’t keep the insulin refrigerated and won’t let me see what kind she’s giving him. Isn’t there a different type of insulin used overnight? What is a hypoglycemic episode and what triggers it?
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that the shaking while walking doesn't seem to be related to the sugar plasma levels.
It could be related to high blood pressure values or to a neurological disorder.
His blood fasting glucose levels are a little high but not concerning. Anyway, I agree with you on the fact that fasting glucose levels should be checked before giving insulin, in order to make the appropriate dose adjustments to the insulin that should be injected.
It is also true that the insulin given at bed time is different from that administered before each food.
It is slow action and it doesn't depend on the food taken.
Hypoglycemia can be associated to sweating, fainting feeling, blurring vision and even falling or loss of consciousness. It is usually caused by a high dose of insulin given in a patient with low fasting glucose levels or inappropriate food intake.
The diet in diabetic patients is usually low in carbohydrates and in specific portions depending on the type of food.
Regarding high blood pressure, I would recommend discussing with his Doctor on the possibility of making some changes to his antihypertensive treatment ( increase the doses or adding new drugs).
It is also important consulting with a neurologist for a physical exam, if the shaking persists despite a good control of high blood pressure values.
Some blood lab tests are necessary too:
- complete blood count
- thyroid hormone levels
- blood electrolytes
- kidney and liver function tests
- HBA1C levels.
You should discuss with his Doctor on the above tests.
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that the shaking while walking doesn't seem to be related to the sugar plasma levels.
It could be related to high blood pressure values or to a neurological disorder.
His blood fasting glucose levels are a little high but not concerning. Anyway, I agree with you on the fact that fasting glucose levels should be checked before giving insulin, in order to make the appropriate dose adjustments to the insulin that should be injected.
It is also true that the insulin given at bed time is different from that administered before each food.
It is slow action and it doesn't depend on the food taken.
Hypoglycemia can be associated to sweating, fainting feeling, blurring vision and even falling or loss of consciousness. It is usually caused by a high dose of insulin given in a patient with low fasting glucose levels or inappropriate food intake.
The diet in diabetic patients is usually low in carbohydrates and in specific portions depending on the type of food.
Regarding high blood pressure, I would recommend discussing with his Doctor on the possibility of making some changes to his antihypertensive treatment ( increase the doses or adding new drugs).
It is also important consulting with a neurologist for a physical exam, if the shaking persists despite a good control of high blood pressure values.
Some blood lab tests are necessary too:
- complete blood count
- thyroid hormone levels
- blood electrolytes
- kidney and liver function tests
- HBA1C levels.
You should discuss with his Doctor on the above tests.
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Ilir Sharka, Cardiologist
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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