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Does insulin or diabetes medication handle two pieces of

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birthday cake at the senior...
Does insulin or diabetes medication handle two pieces of birthday cake at the senior center and snacks, candies chips that are given out on a daily basis plus the government FDA approved food which always has a roll, juice, a cookie? IN other words, do diabetic medication including pills and insulin shots safeguard or guarantee to stop the deterioration to the body that the blood sugar creates like damage to the nerves etc? Where i do not have to worry about the food served at the senior center and what my father is served there during his days? Is the meds or insulin shots a guarantee to eat as one chooses? ANd does insulin shots itself have side effects and if so, what? His morning blood sugar at home is managed at 120 fasting to 160. with and without medication.
Submitted: 1 month ago.Category: Endocrinology
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Answered in 11 minutes by:
11/7/2017
Endocrinologist: Dr Stan, Doctor replied 1 month ago
Dr Stan
Dr Stan, Doctor
Category: Endocrinology
Satisfied Customers: 2,360
Experience: Physician at Stanley L Simpson, DO
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Hello, this is Dr. Stan, thank you for your question. I am U.S. trained,

Board Certified and I have 30 years of patient experience and I am here to help you today.

Thank you for your question.

Insulin and oral medications will control your dad's blood sugar and will help reduce nerve damage caused by diabetes. I can not say they are guaranteed to stop all damage by 100%, but they certainly help, especially since his blood sugars are controlled between 120 and 160. The diet he receives is supposed to have a balanced sugar, fat and protein content that conforms to ADA guidelines. Based on his numbers, his sugar is being controlled with his diet and medication. At 93, he seems to be doing well and I would be happy, as his doctor, to have these results for him.

I hope I have relieved your concerns.

Thank you for allowing me to provide assistance.

I am available to answer any additional questions you may have.

I hope your Dad's medical problem(s) are resolved soon and he feels better. I sincerely ***** ***** I have helped you and that I have earned my 5 star rating today.

Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you.

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Customer reply replied 1 month ago
There is mostly no medication and i use it as needed depending on what he is going to be eating. If it is a carbohydrate meal, then he will have Glipizide 2.5mg. If the whole day is full of uncontrolled FDA or ADA meals or if he goes to the senior center where they provide the bad ADA meals, then i provide a 10 mg time released GLipizide. If he eats at home, he gets zero medication. What i want to know is if he SHOULD have sugar in his diet and if his body is being deprived from functioning properly if he has no sugar at all in his diet? Is he losing muscle mass from not having any sugar? He has melons, strawberries, blue berries, and sometimes kiwis . Other fruits are occasional. Is that what you mean by sugars or do you mean that he needs white table sugar in his diet?
Endocrinologist: Dr Stan, Doctor replied 1 month ago

Your use of medication is unique, but it is working since his blood sugar is controlled. Continue with the treatment you are providing.

Regarding sugar in his diet. He does not need white table sugar. The carbohydrates I referred to are the fruits you are giving him, so continue fruit in his diet. Muscle mass comes from the protein he eats and exercise (walking, stretching, etc.) which comes from meat, fish fowl.

You are doing a great job controlling Dad's blood sugar, so continue your program.

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Customer reply replied 1 month ago
But I'm trying to determine if I'm not providing enough calories and therefor his mood could be the result of not enough calories or frequency or just that he's 18 trapped in a 93 year old body. Which is stil very flexible and active. I made a mistake: he's 92
But I'm concerned if I need to give food if 4 hours passed but his blood sugar reading might be 240 but he says he's not hungry, yet 4 hours passed. (I'm not sure if this happens with or without medication, I think both) What would the rule be if 4 hours passsed ?
Endocrinologist: Dr Stan, Doctor replied 1 month ago

If he's not hungry, ne need to force him to eat. I realize you are trying to manage his blood sugar levels, but I'm starting to get the feeling that his doctor is not involved with his management. You previously said that his blood sugar stayed between 120 and 160. If however, his sugar is going to 240, he needs to be on medication on a regular schedule, not just based on when you are testing him or what he is eating. Please discuss with his doctor to get your Dad on a standardized treatment/diet for his diabetes.

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Endocrinologist: Dr Stan, Doctor replied 1 month ago

Any additional thoughts, questions?

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Customer reply replied 1 month ago
He is with an MD that we started only this year. He was previously on Glip and Januvia. When he was sleeping alot during the day is when i began to get involved 2 years ago. the MD prefers he is on 2.5 but i asked if i can try the time released because of the problem with the food at the senior center. SO he reluctantly gave a script for 10 and we are watching it. He said to track his mood and blood sugar at the same time. If he is depressed, to track it, if he is agitated to track it..etc. He is worried more about it going too low. At home there are healthy low carb higher fat snacks. So it is really just the lunch time meal that throws things off. If i give the size 10 glipizide ... it appears that he is constantly hungry. So i am trying to determine if the GLipizide creates a stronger appetite and hunger sooner? After lunch is his only rise in blood sugar which reads . I thought that a rise after eating for a while is normal . And as long as it goes down before dinner? Do you have a sample or link of what a normal 12 hour reading of blood sugar should be in a normal person? BY the hour?
Endocrinologist: Dr Stan, Doctor replied 1 month ago

Thank you for this additional information. Glipizide does not increase appetite. Blood sugar will go up after a meal and then should return to previous level in about 3-4 hours. So you are correct, blood sugar rises and then goes back to previous levels.

Blood sugars in a normal person without diabetes who is fasting should be between 60 and 99. Hourly blood sugars will vary depending on the time of day and amount of food consumed. This type of measurement would be for a laboratory setting and of no benefit for the average person.

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Customer reply replied 30 days ago
Should Blood sugar in a "normal elderly person also be between 60-99? or does this apply only to younger people. Is the "normal person" referenced from studies done early research perhaps when people did not use processed foods and had a lot of fat in their diets as in sausages and eggs butter they used all the parts of animals, hocks, lard which slows down the digestion of refined carbohydrates? Or as in the Mediterranean diet, lots of cheese, nuts, olive oil poured over food and the carbs they eat are burned off from their daily sustainable activities. Those diets would have low blood glucose i suppose because any glucose gets burned off right away right?
Endocrinologist: Dr Stan, Doctor replied 29 days ago

Even in the elderly, a normal blood sugar is between 60 and 99. I recommend to my patients whi a=re the same age as your Dad, to keep blood sugar (fasting) between 120 and 130.

A Mediterranean Diet contains healthy carbohydrates and fats (olive oil) and will be better used by the body than standard carbs such as those from white flour.

Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you.

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Customer reply replied 29 days ago
are the elderly patients with or without diabetes?
And if so, are they on diabetic medication or managing their diet without?
Endocrinologist: Dr Stan, Doctor replied 29 days ago

Not all of my elderly patients have diabetes. But those with diabetes are all on medication some just oral and some on oral and insulin and some on just insulin.

Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you.

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Customer reply replied 29 days ago
you wrote; "I recommend to my patients whi a=re the same age as your Dad, to keep blood sugar (fasting) between 120 and 130."
Are those patients with diabetes or without?
Endocrinologist: Dr Stan, Doctor replied 29 days ago

The patients I referred to are all Diabetics.

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Customer reply replied 29 days ago
Ohh
So the human species normal young adult and old elderly patients that don't have diabetes would have reading of 60-99 .
Once the person has the physiological handicap of their body not being able to control blood sugar from the food they digest, the best we can hope to keep the morning fasting blood sugar is 120 to 130 ?
So if the diabetic patient that does not take diabetes medication has a morning blood sugar reading of 100, is that dangerous and that person needs to eat more carbs the night before to make sure it is always 120-130?
What is the danger of the elder diabetic has morning fasting blood sugar reading of 80-100? Would that be dangerous?
Endocrinologist: Dr Stan, Doctor replied 29 days ago

1.Yes, your first assumption is correct.

2. No, a younger person should be able to keep their glucose close to 100 with medication, diet and exercise.

3. A morning fasting reading of 100 is excellent and no cause for concern.

4. There is absolutely no danger for an elderly diabetic to have a fasting glucose of 80-100.

Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you.

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Customer reply replied 26 days ago
2. No, a younger person should be able to keep their glucose close to 100 with medication, diet and exercise.Do you mean a younger person can ONLY Keep their glucose at 100 with medication diet and exercise?
If they don't do those three things, they can't keep their blood glucose at 100?
My blood sugar is under 80 -90 and i don't exercise nor take medication. Im over 50
Customer reply replied 26 days ago
I need to open another question to you regarding insulinBut can you clarify first;1.Yes, your first assumption is correct.What assumption, Which sentence are you referring to...
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