78-Year-Old Diabetic May Be Hypoglycemic

Question: My 78-year-old mother lives in an apartment adjoining my home. She is diabetic and takes insulin by injection. Lately she's had episodes where she became sweaty and had a terrible headache. The last time she was dizzy, and I was afraid she'd fall. A friend says that mother probably has low blood sugar. Do you think that's the problem?

Answer: The symptoms you describe are associated with low blood glucose, or hypoglycemia. Hypoglycemia is a serious condition that should be discussed with your mother's physician. It results when too much insulin is working and glucose leaves the blood too rapidly, causing the level to drop below the normal range (below 70 milligrams percent, with symptoms usually beginning below 50).

Low blood glucose may be caused by a number of factors, including skipping a meal or snack, extra exercise without eating extra food, or taking too much insulin. Symptoms include palpitation, pounding headaches often in the back of the head, and feeling sweaty, nervous, shaky, dizzy or confused.

If your mother's symptoms recur, test her blood glucose immediately. This can be done at home using a finger-stick to obtain blood and a chemically impregnated strip to estimate the glucose level. Ask her doctor or nurse to instruct you in doing this test.

When these symptoms happen, or if the test shows that her blood glucose is below the normal range, get some glucose into her blood right away by giving her something to eat or drink that quickly changes into glucose, such as milk, orange juice, hard sugar candies or sugar lumps. Special glucose gels and tablets are also available. Check her blood glucose again in 20 minutes, and if the symptoms persist or her blood glucose is still too low, repeat the snack and do another blood-glucose check in 20 minutes. If the problem is not resolved, call her physician.

It is possible that hypoglycemia could cause your mother to pass out. If he feels it's necessary, her doctor can teach you to inject a medication called glucagon that will help her blood-glucose level rise quickly back to normal.

Q: Since dollar exchange rates are so favorable, my husband and I are planning a vacation to Central and South America. We have not been to any countries south of the border in 20 years, because I had diarrhea on our last trip. Will I be more susceptible to diarrhea because I'm older?

A: Age has nothing to do with one's susceptibility to diarrhea. About 2.5 million Americans who travel are likely to come down with the ailment. Diarrhea is caused by infectious microorganisms, chiefly Escherichia coli, which stick to the small intestine and cause the intestine to shed fluid or weep.

Diarrhea is rarely life-threatening and generally ends in a few days, even without treatment. Some related symptoms include abdominal cramps, nausea, bloating, urgency and general malaise.

Recently a panel convened by the National Institutes of Health recommended that travelers not take antibiotics, Pepto-Bismol and other over-the-counter medicines to prevent diarrhea. Their feeling was that most travelers don't come down with the ailment, and all of the medicines can cause side-effects.

We suggest you take Pepto-Bismol, Bactrim or Septra with you, and should you have diarrhea, use it. The medicines usually end most cases in less than a day. Avoid raw vegetables, meat, seafood, unpasteurized milk and other dairy products, and unpeeled fruit. If you cannot peel it, cook it or boil it, forget it. The safest beverages are carbonated. If diarrhea persists, see a doctor.

Copyright © 2019, Los Angeles Times
EDITION: California | U.S. & World