How can I help my parent figure out when her blood sugar is too high?

A fellow caregiver asked...

My mom has type 2 diabetes and doesn't seem to know when her blood glucose has soared to harmful levels. What kind of symptoms will she have when her numbers are too high?

Expert Answer

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

Unfortunately, older people with diabetes often don't experience any signs of high blood sugar. Or, confusingly, the symptoms can mimic low blood sugar, such as feeling tired, hungry, or shaky. So the only way you or your parent can accurately assess the situation is by testing her blood sugar.

Seniors commonly test themselves just once a day, usually in the morning, and that's not often enough to have a good handle on blood sugar numbers. Check with your mother's doctor or diabetes educator to find out how often she should test her glucose levels and what her target blood sugar range should be. As a general rule of thumb, your mother should check her blood glucose several times a day, such as before and after meals. She should aim for a before-meal blood sugar level of 90-130 milligrams per deciliter (mg/dL), and a reading of 180 mg/dL or less two hours after a meal, according to the American Diabetes Association.

There are some telltale signs of high blood sugar to watch for: A blood sugar reading that's higher than 240 mg/dL requires an immediate call to your parent's doctor. A glucose level of more than 180 is also considered high, whether it's a onetime event or a routine occurrence, and it also warrants a discussion with your mother's healthcare provider. Other symptoms include frequent urination, increased thirst, blurry vision, and fatigue.

High blood sugar occurs when your parent doesn't have enough insulin in her body or can't use the insulin she does have properly. It can be caused by missing prescribed doses of diabetes medicines, eating too much, or not getting enough exercise. Sometimes medicines your mother takes for other ailments can trigger high blood sugar. Infection, illness, or stress are other culprits -- and in some cases it's not clear what triggers the condition.

Ultimately, if high blood sugar levels are a regular feature of your mom's life, then she may need a change in her diabetes medicines or meal plan. If that's the case, the two of you should talk with her doctor, who can recommend a course of treatment tailored to your mom's specific needs.