Hello all!

I apologize in advance for the long post.

My MIL just came out for a long weekend to visit my husband and me. We had not seen her in about two years and she is 77 years old. She has been "pre-diabetic" (her doctor told her) for about five years. Her brother (now deceased) developed diabetes in his 50's. She never dealt well with her diagnosis and wavers between anger and denial. (The doctor is wrong, etc.)

We are looking for answers to some some bizarre behavior and signs of decline that we witnessed that are troubling.

Here are my observations in a nutshell:

1. Upon getting off the plane informed my husband (her son) she had a 'nasty fall' walking and severely bruised her face hitting the pavement a month ago while traveling. She showed him photos of the bruises on her camera. She kept this secret from us until she arrived. She still had some facial swelling.

2. Out of control obsession with candy and carbs. Picked through all meals even though she said she wanted to eat fish and vegetables but ate all the candy that she could find (hoarded free samples in stores/quickly wandering off to buy candy when we were tending to her husband etc.) Loaded coffee and all drinks with sugar and flavorings. Added syrup/sauces to everything etc. Her husband and her son would try to steer her behavior and she would become combative ~ sticking out her tongue, yelling that people can't control her/tell her what to do/saying she deserved 'a little treat she was on vacation' etc.

3. Ate ravenously when sugar was in front of her. To the point of making a mess, spilling on herself, embarrassing her husband etc.

4. Told me that her 'blood sugars are just fine' when I asked if she had diabetes.

5. Urgent trips to the bathroom. She said it was due to 'leakage.' She seemed to always disappear right after eating.

6. Worst behavior occurred at 4pm (on the dot).

Belligerent temper tantrums and mood swings if she couldn't find candy or if a family member tried to steer her away from eating (to the point she bought and then gorged on a bag of fruit when her husband took away a bag of candy)

Suddenly unsteady on her feet, wavering and almost falling over if she was walking. Almost like she was going to suddenly faint.

Panting as if couldn't get in oxygen. Especially if we were out and about at the time.

Addict like behavior - She needed 'a fix." As soon as she got the sugar fix, her demeanor would change 360. (Of course then she was too full for dinner, but had room for dessert...and then it would lead to a carb/sugar bomb breakfast and this cycle would repeat all over again the next day.)

7. Fading in and out of conversations. Confusing peoples' names/places. When her husband would correct her or he would do the same and mix things up they would yell at each other that the other person was wrong.

8. Going back to points previously made in conversations and fixating on certain things. Repeating stories from years past. Overly concerned with her hairdo. Shopping for goods she then would refuse to buy when found in a store but would start looking for them all over again the next day, etc.

8. Complaints about her feet. She said her shoes she brought on the trip were the wrong ones and were 'too tight'. Her toes hurt. (But yet would not buy new shoes/sandals.)

9. Complaints she is having trouble hearing in one ear.

10. Mood swings. Giddy about the past, angry and spiteful on the present and family members even complaining about grandchildren. Her moods were the worst mid-afternoon. Lashing out at husband over trivial things.

11. Selfish behavior. Only bought grandchildren presents when I reminded her. (Very unlike her. She lives for children and this is all she used to be interested in.) Shopping only for herself. Impulsive buying. Suddenly extravagant then cheap the next minute. She normally dotes on my husband to the point of excluding me from all conversations but it seemed making sure she had access to sugar was her top priority this visit.

12. Complained of 'stomach acid' and was seen taking several tums

13. Uncontrollable flatulence that smelled of rotten fruit.

14. Burping. Runny nose.

15. Looks about 30lbs heavier. Huge abdomen and thighs. (inflammation? water retention? celiac? fructose malabsorption? (She is about 5'2" and says she is 165)

16. Says she can't lose any weight and can't control her eating as she has 'no willpower'

17. Told my husband privately that 'she is never hungry' (?!)

18. Pale (especially for summer)

My MIL was diagnosed with depression a few years ago and briefly took meds but then refused to take them after a few months. I know she is on cholesterol medication.

So I am wondering:

1. Are these symptoms of full blown diabetes?

2. Is she using sugar to increase her serotonin (self medication for depression)

3. What are the ties between diabetes and dementia?

Thank you everyone for any information that you may be able to provide to my husband and me!

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Why didn't you take her to the emergency room??? Lord have mercy. What were you thinking?
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1. The symptoms are consistent with totally uncontrolled sugar levels.
2. Sugar does give her a boost, but she overshoots the mark.
3. Diabetes over time damages kidneys and kidney failure leads to brain failure.
4. She is no longer pre-diabetic. I'm willing to bet her HbA1C level is well past the borderline of 6.0 Ask her MD to order it, a simple blood test.
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You need to get her to a doctor (if you can) and get her blood sugar checked by an A1C test. That will tell a doctor what her sugar has been like for the past 90 days. Diabetes can cause some of those symptoms, but it sounds like there's more going on to me - I'd wonder about some kind of dementia. Do the best you can to get her to a doctor for a full work-up. It doesn't sound like she's going to want to do good luck!
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Blood sugar changes, particularly lows, can make people act bizarre. It may be that things you are seeing are highs and lows of sugar. If she craves sweets and is frequently urinating, it is a strong indicator she is diabetic. She is probably also taking in a lot of fluids.

I agree with others to make an appointment for her right away. Complications of uncontrolled diabetes can include blindness, kidney disease, artery disease, metabolic dementia, and death. People who control their blood sugar can live good lives, though the medication can be irritating at times.

Something many have learned is that denial doesn't make diabetes go away. It is something that has to be addressed or it can be deadly.
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Yes, it is dementia and/or diabetes and/or ?? It is clear that MIL has some kind of medical condition crying out for intervention. She needs a complete medical workup, preferably from a geriatrician. My guess is that she has full-blown out-of-control diabetes. What else she might have is harder to guess.

Ideally she sees a doctor in her own community, who can followup with her care. But if you haven't seen her in two years I'm guess she lives some distance away. Taking her to see a doctor while she is visiting you would make it more likely that she actually goes, and I suppose all her findings could be sent to a doctor back home.

Whether she sees a doctor near you or near her home, I think it would be a good idea to present the doctor with a list of your concerns before the visit. Be sure to include her diagnosis with depression and the fact she is no longer taking her meds.

You can also get a home-test kit for the A1C test, if that might be more acceptable to her. If the number is high (as no doubt it will be) that might give you more ammunition to convince her to see a doctor. But that assumes she is thinking logically, and there is evidence to the contrary. I think going directly to a doctor is a better approach, but this is another option.

I'm not sure what you could take her to an ER for (Maggie?) but if she does have any incident that would justify that while she is with you, that is another way to ensure that a doctor sees her!

By the way, many people do not deal well with a diabetes diagnosis and waver between anger and denial. This is not unusual, but doesn't usually last 5 years, especially when symptoms start confirming the diagnosis.

How is FIL with her symptoms? Is he concerned? Would he be on your side (which is of course her side but she's not likely to acknowledge that) in terms of getting her to a doctor, and following up?

And in terms of "nobody can tell me what to do" she is absolutely right. She has got to decide for herself that avoiding the dreadful complications of diabetes is worth some effort. Nobody can "make" her do that. But she should at least make her decisions from real information, and not just from denial. I sure hope medical professionals get involved.

Is she back home now? Is your husband her only child? Keep us updates as this plays out. We care! And we learn from each other.
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BTW, when I finally went to the ER for symptoms that turned out to be diabetes but which my doctor kept trying to treat as "anxiety" I fully expected to wind up on the psych ward, as did my family. Very high blood sugar over a period of time can make you absolutely whacko. Loopy. Alter your personality. (It is not permanent when the blood sugar issues are treated.) So that is what I'd deal with first. When the diabetes is under control, that would be time enough to deal with the other changes you observe.
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What difference does it make? She needs to see a doctor yesterday. I would have taken her to the ER. The fact that she gets worse at about 4:00 pm every day would also concern me. Get her to the doctor stat.
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