Re: A question for a friend



"MaryL" <stancole1@xxxxxxxxxxxxxxxxxxxxxxxxxxxx> wrote in message news:4bd0abd7$0$12439$bbae4d71@xxxxxxxxxxxxxxxxxxxxxx


Her mother (age 81) is T2.
She fell and broke her hip and wrist several weeks ago, and she is now in a rehab/nursing home.

As soon as she was transferred to the rehab/nursing center, she was shifted from oral medication to insulin, and the nursing home does not make any attempt to provide a suitable diet. Everyone gets the same thing - a "one size fits all" approach in dietary management.

if very ill also non diabetic humans become hyper glycemic. This is a reasonable defense mechanism of the body, because the immuun system has to expand his repertoire and number of white blood cells. This system runs on glucose .... :)

So (very) old and or (very) ill patients are supplied with ample amounts of carbohydrate and thus they all get the same nutricious but high carb diet.. Also diabetic patients. The only difference being (of course) a strictly monitored insulin regime.

Talk to your dokter if you have questions. Don't hesitate to ask for the blood glucose log's if you suspect that your mother is not properly looked after. But remember that also for a diabetic there are other priorities if he is (very) old or ill . In this situation a higher blood glucose is a better choise for survival.

Here is an article :
http://www.ncbi.nlm.nih.gov/pubmed/11800522?dopt=Citation
Best Pract Res Clin Endocrinol Metab. 2001 Dec;15(4):533-51.
Alterations in fuel metabolism in critical illness: hyperglycaemia.

Abstract
Hyperglycaemia is common during critical illness and may be viewed teleologically as a means of ensuring an adequate supply of glucose for the brain and phagocytic cells. Under normal conditions, euglycaemia is maintained by neural, hormonal and hepatic autoregulatory mechanisms. Critical illness promotes hyperglycaemia through an activation of the hypothalamic-pituitary-adrenal axis, which in turn increases hepatic glucose production and inhibits insulin-mediated glucose uptake to skeletal muscle. Sustained hyperglycaemia is associated with adverse consequences that demand its control. Appropriate management includes discontinuing causative drugs, correcting hypokalaemia, treating infection and administering insulin. Insulin therapy also appears to be useful for promoting an anabolic response in skeletal muscle. Copyright 2001 Harcourt Publishers Ltd.

PMID: 11800522

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