Ask the Doctor: High Blood Sugar Signs; Weight & AD; Preventing Memory Loss

Q: I have recently become the main caregiver for my elderly father, who has diabetes. Can you tell me what symptoms might be signs of dangerously high blood sugar?

A: Excessively high blood sugar (hyperglycemia) can be a medical emergency—if left untreated, it can result in a diabetic coma, while chronic high blood sugar can damage the eyes, heart, nervous system, and kidneys.

Signs of high blood sugar include increased thirst and urination, headaches, fatigue, blurred vision, and a “fruity” smell to his breath. Call your father’s doctor if he mentions any of these symptoms.

Adhering to the guidelines your father has been given for controlling his diabetes is vital to ensure that his blood sugar does not increase above safe levels. This means that he needs to take his medications as prescribed, follow an eating plan that helps keep his blood sugar under control, and get sufficient exercise, as well as testing his blood sugar level as often as his doctor has recommended.

Also be aware that your father’s blood sugar may go too low (hypoglycemia) at times. Symptoms include shakiness, heart palpitations, sweating, anxiety, dizziness, and confusion. If left untreated, hypoglycemia can cause fainting or a seizure. To bring blood sugar levels back up, he’ll need sugar: Give him glucose tablets, a small glass of fruit juice, one tablespoon of sugar or honey, or a few pieces of hard candy. Instances of hypoglycemia should also be reported to his doctor.

Q: I am thin and petite, and a friend told me that being underweight raises my risk for developing Alzheimer’s disease. Is this true?

A: A few years ago, a study made headlines when it suggested that people who have a low body mass index (BMI) have a greater risk for dementia as they age. The data ran counter to other research that linked being overweight or obese with a greater risk. Critics pointed out that the link might operate in reverse, and that study participants’ low body weight might actually have resulted from their dementia. Two more recent studies found no link between having a low BMI and developing dementia. One of the studies recorded decreasing BMIs as early as 18 years before the onset of clinical dementia symptoms, suggesting that people in the preclinical stages of the disease go through cognitive changes that may affect their appetites.

With regard to your weight, if your BMI is 18.5 or lower, it may raise your risk for other health issues, including the bone-thinning disease osteoporosis. Ask your doctor if you need to alter your diet in order to increase your weight. Also, if you haven’t done so already, have a DEXA scan to find out what your bone mineral density is and if you are at an increased risk of bone fracture. Your doctor can also investigate whether your low weight is being caused by an underlying health problem, such as a thyroid or digestive disorder, that can be treated.

Q: Do you have any suggestions for specific activities that can help prevent or delay memory loss?

A: There is no evidence that indicates which specific activities are most effective at preserving memory, regardless of the claims made by manufacturers of some “brain games” products. Studies that have been done on “brain exercises” have found that any activity that stimulates and engages your brain appears to be beneficial. The activities most likely to be recommended in research include reading, writing, doing crossword puzzles, and playing board or card games.

Don’t force yourself to do an activity you dislike. However, if you get bored with your normal activities, try something new—research has shown that learning stimulates the brain. Learn to play a musical instrument, a new board or card game, or a second language.

—Editor-in-Chief Orli R. Etingin, MD

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