Checking your blood sugar, taking medications at the right time, and managing your diet can all feel more complicated when you have early-stage Alzheimer’s. But you can likely simplify your care with the help of your endocrinologist, who can guide you.
[9]
For example, your provider may recommend relaxing your blood sugar goals to lower your risk of very low blood sugar and make your daily treatment schedule easier.
[1]
“Simplification is one of the most effective strategies,” says Jaffe. “As memory and executive function change, the goal is to reduce the complexity of diabetes tasks while maintaining safety.”
Medication Changes
Your provider will check your medication list and see if any can be safely removed, says Priyanka Majety, MD, the director of the adult outpatient diabetes clinic for VCU Health System. Some medications come with a high risk of hypoglycemia, including insulin, so your provider may suggest switching to safer options.
[9]
“Switch from multiple daily medications to once-daily or once-weekly medications when possible,” says Jaffe, who also recommends long-acting insulin instead of several short-acting doses if you still need insulin.
Medication Management
Even after your provider has adjusted your medications, your dosing schedule may still feel complicated. Dr. Majety recommends these tips to manage your meds:
- Use blister packs or weekly pill organizers.
- Try timed dispensing devices.
- Keep all medications in one consistent storage spot.
- Avoid keeping medication bottles in many locations.
By following a routine and using these tools, you can prevent missing doses or taking extra medication.
[10]
Simplified Blood Glucose Monitoring
“A continuous glucose monitor (CGM) is often much easier than finger sticks, because it provides automatic readings, alerts signal lows or highs, and caregivers can receive remote data,” says Jaffe. But if CGM isn’t an option, you can still decrease your blood sugar checks to once a day and as needed if your provider says it’s okay.
Blood Glucose and A1C Goals
When you have both diabetes and Alzheimer’s, the goal shifts from “tight control” to “safe control,” says Jaffe. For many people with type 2 diabetes and early Alzheimer’s, a good A1C, or HbA1C, goal is between 7.5 and 8.5 percent, says Jaffe, who adds that this range:
- Reduces the risk of dangerously low blood sugar
- Lessens treatment burden
- Helps prevent emergency department visits and hospitalizations
- Protects long-term health
- Lowers the risk of many infections
Your provider will tailor your A1C goal depending on your current Alzheimer’s symptoms, risk of hypoglycemia, and other conditions, says Majety.
[1]
“Quality of life matters — in cognitive disorders, the goal is not perfect numbers, it’s safe numbers with the least disruption to daily life,” she says.
Nutrition
Many people count the grams of carbohydrate in their meals as part of their diabetes management, particularly if they use insulin. But carb counting can get tricky if you’re dealing with memory issues and confusion with Alzheimer’s.
[12]
You can simplify meals by eating about the same amount at the same time each day, says Majety, who stresses not skipping meals, which can lead to a very low blood sugar.
[13]
You can also ask a loved one to help you keep track, Majety adds.
