Prolonged Altered Mental Status - Very Concerned Daughter

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Prolonged Altered Mental Status - Very Concerned Daughter


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Old 01-21-2014, 19:18   #1
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Exclamation Prolonged Altered Mental Status - Very Concerned Daughter

Hey Everyone,

My name is Kate and I am posting here out of concern for my mother, who is experiencing very long-term complications after her undiagnosed diabetes reached a blood sugar level of 900.

My mother is 62 years old and was fine over the summer, or at least acted and felt fine. She came out west to visit me and was intrigued by my sister's and my healthy lifestyle. She wasn't ready to make such a drastic change in her diet as we did, but was ready to try a glucose-free diet. And she did. And she stuck with it. And she lost 25 pounds.

My mother was fine the day she left. When she got back to the east coast, she started sleeping a lot - almost 24 hours a day. My father, who knows nothing of medicine, chalked it up to her being jet lagged. My brother didn't know anything, either. After several weeks of this, my father started insisting she get checked for diabetes. My mother refused adamantly and my father complied because he thought he was doing the right thing by respecting her wishes.

After several months of constant sleeping, my brother came home to find my mother unresponsive on the reclining chair. He called my father and by the time my father had rushed home from work, she was babbling nonsense. They rushed her to the hospital, where her blood sugar came back at 900.

Having been diagnosed with diabetes right then and there, doctors prescribed what was necessary. My mother's blood sugar levels went back to normal and her diabetes has been managed since.

My mother's altered mental status (confusion) never went away. It's been almost six months now and despite my medical education (pre-med), I've never heard of a diabetic's altered mental status "sticking", at least not for this long.

I'm posting here out of fear for her life. Because of her confusion, she's become incontinent and sleeps a lot, but not as much as she was. She is riddled with blood clots and on medication for that; however, her lack of exercise is only causing more and more blood clots to form. She won't exercise because of her confusion. She tells my father she isn't going to see the doctor, and my father, who doesn't understand an altered mental status, thinks he's doing the right thing by cancelling her appointments and letting her stay home and sleep as she wishes. He doesn't think it's possible to force her to go. Of course it is. Anyway, if her altered mental status would go away, she'd be 110% willing to race to the doctor's office ASAP and would not be as combative or difficult.

At first she did see a lot of doctors. None of them had an answer as to why the altered mental status hadn't gone away, even with normal blood sugar levels.

My questions here are these:

Has anyone experienced this first-hand, either with themselves or a family member?

Have you ever heard of a diabetic not recovering from the altered mental status?

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Old 01-21-2014, 19:21   #2
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And - can anyone direct me where to go to possibly find answers?

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Old 01-21-2014, 19:26   #3
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Unfortunately I have never read this. However, did they check your Mom for Alzheimers? I don't know if that can come on quite so suddenly.

I hope you find answers. That is a scary one.

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Old 01-21-2014, 19:33   #4
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First tell us what is she eating, and how do you know that her blood sugar has remained low - is somebody testing her after meals? What exactly is this glucose-free way-of-eating you refer to?

If you wish to learn where she is as regards her diabetes, then she should be tested for fasting blood sugar as soon as she wakens for the day, and then she should be tested for postprandial blood sugar at one and two-hour intervals after her meals.

No offense at you being pre-med, but the medical community has a very poor track record in treating diabetes, with its insistence on carbs in the diet, for one thing. But if she has sustained your glucose-free diet since returning home, then perhaps she needs to be tested for GAD antibodies and c-peptide. It is not unheardof for middle-age and even elderly people to present with type 1 or 1.5 (LADA) diabetes.

Your dad needs to stop respecting her wishes if he wants to keep her around any longer. Get her to the doc and find out what the heck is wrong!




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Old 01-21-2014, 19:35   #5
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Thanks for your reply, but she does not have Alzheimer's. Whatever it is, it is related to the onset of her diabetic episode where her blood sugar peaked to 900. That's when the confusion started.

I'm concerned about permanent brain damage but haven't read anything regarding this in diabetic patients. All I've been reading are cases where people reach blood sugar levels as high as 1600 and they have the same sort of confusion, only theirs subsides with treatment and usually in under 24 hours.

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Old 01-21-2014, 19:39   #6
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Perhaps she had a stroke? I'd be suspicious especially with the blood clots. In any case, you all have my sympathy.

Good luck,




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Old 01-21-2014, 19:41   #7
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Quote:
Originally Posted by Shanny View Post
First tell us what is she eating, and how do you know that her blood sugar has remained low - is somebody testing her after meals? What exactly is this glucose-free way-of-eating you refer to?

If you wish to learn where she is as regards her diabetes, then she should be tested for fasting blood sugar as soon as she wakens for the day, and then she should be tested for postprandial blood sugar at one and two-hour intervals after her meals.

No offense at you being pre-med, but the medical community has a very poor track record in treating diabetes, with its insistence on carbs in the diet, for one thing. But if she has sustained your glucose-free diet since returning home, then perhaps she needs to be tested for GAD antibodies and c-peptide. It is not unheardof for middle-age and even elderly people to present with type 1 or 1.5 (LADA) diabetes.

Your dad needs to stop respecting her wishes if he wants to keep her around any longer. Get her to the doc and find out what the heck is wrong!
She stopped the glucose diet instantly upon returning the the east coast. I don't know why, I guess she lost her motivation after leaving us. Or maybe she missed all the delicious food she had grown used to over the years.

My father keeps her on an almost entirely carb-free diet. He does test her three times a day, minimum - once when she awakes because he leaves early for work and has to make her breakfast, then twice more throughout the day. He tests her sugar always before meals and sometimes if she's acting funny.

I'm sorry - did I say glucose free? Ugh. I'm so flustered, I typed the wrong word. I meant gluten-free! Sorry!

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Old 01-21-2014, 20:02   #8
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And has he shared her test readings with you? He needs to be getting postprandial tests. If indeed she is eating low-carb, those are the tests which will tell the tale. But if he leaves her home alone, how does he actually know what she's eating?

My advice is to get her on low-carb/high-fat. If the mental state persists, high fat will help. Grains are the worst offenders for diabetics - they raise blood sugar fast and high. If she's eating a lot of bread or corn or beans, then she isn't eating low carb.

But the priority here needs to be get her to the doctor for assessment. It sounds to me like she's either depressed (which often includes long hours of sleeping or at least remaining in bed) or on a high-carb diet and thus falling asleep due to what I used to call 'carb coma'.





Last edited by Shanny; 01-21-2014 at 20:04.
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Old 01-21-2014, 21:27   #9
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Hugs, Kate!

I watched my father go through understanding he could no longer allow mother to make her own decisions - and he knew she was slipping into vascular dementia.

It is very, very hard and maybe a kind of denial. I suspect your father is also very worried about how your mother will react if he tries to force her to go to a doctor.

I know you are terribly frustrated and terrified...with very good reason.

I take it you are not in a position to go there and try to work with your father? I hope you can find the right words to help your father understand your mother really does need medical intervention.

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Old 01-21-2014, 21:28   #10
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You definitely know this, and you are trying to get through to people (been there, done that) -- she needs to see a doctor immediately.

Perhaps you can speak to her doctor directly. S/he may not give you any answers (may not be able to), but hearing the larger story may move her/him to be more proactive.

If possible, you may want to ask your father for more detail on diet, testing and current treatment regimen. (Please share with us, if you wish.)

Her DKA episode may have triggered other issues beyond her diabetes. Alternatively, any and all of her meds may need to be tweaked; unbalanced or poor prescriptions are also common causes of confusion which are too often overlooked, especially in older patients.

That said, it's not clear to me what kind of levels she had prior to diagnosis, nor what her current levels are. Prolonged highs can result in serious brain fog (been there, done that, too). If she's still running in the 200s - 300s or above, she's never had a chance to get clear, and things will likely get worse as long as this continues.

If she's truly at or near normal, some brain fog may linger. But zero improvement does point to something seriously wrong ... but quite possibly treatable.

We're very glad you found us ... and very sorry that you had to. Please keep us posted!

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