My mother has Alzheimer’s Disease and diabetes, and because of her Alzheimer’s, we let her eat sweets. I give her Regular insulin on sliding scale and check her blood sugar before she eats. I need to know how soon after she eats do I take her blood sugar. How often do I need to cover her?

When a person is challenged by multiple health problems the diabetes management can be very difficult. To minimize the risk of low blood sugars, the target ranges of blood sugars before and after meals is usually raised a bit to allow for the unknowns that can come up.

At our program, we usually suggest blood sugars before meals in the range of 150 mg/dl [8.3 mmol/L] or so ( not the 80-120 mg/dl [4.4-6.7 mmol/L] as suggested by the American Diabetes Association) and one-hour after meals in the 200 mg/dl [11.1 mmol/L] range (not the 180 mg/dl [10 mmol/L] suggested by the ADA). Eating sweets at meals is not the biggest challenge for you and your mother, as I see it. It is that you’re using a very slow insulin, Regular, to cover food. It might be helpful to discuss with your physician or diabetes educator how changing to a more rapid acting insulin (Humalog or Novolog) and giving it after your mother eats, in amounts that would balance with what she chooses to eat, could make the risk of low and better blood sugar management possible.

You also ask, how often to cover her. I think that you should try to keep her meals four to five hours apart and give the short acting/rapid acting insulin at meal time. You can adjust for any highs or lows at that time and not be giving the insulin too often.

I hope you have a diabetes educator to work with. If not, you can call the American Association of Diabetes Educators at 1-800- TEAM UP 4 for a listing in your area.

KS