Diabetes and ALS

[Nuts]

OK, I have another question for this group, and as always, I expect I'll get a much better answer here than from Google... Does anyone have experience with Diabetes (so far very well controlled--thankfully) and ALS? Is there any impact specific to that combination (other than more things to deal with) that we should be aware of? For instance, how do you balance keeping calories up when that becomes an issue with keeping blood sugar down, especially as our PALS become less mobile?

 

[maryhahnward]

My husband was diagnosed with diabetes this past fall. In a matter of weeks his glucose level went through the roof. I won't lie, it took some work to figure out how to keep his calories up and at the same time not ingesting all the wrong foods. Initially he lost 30 lbs before the diabetes was diagnosed.

He has 3 moderate sized meals (portion control is key to keeping diabetes in check), two snacks between breakfast and lunch, and two between lunch and dinner and one before bed. He checks his glucose before breakfast and just before his night time snack. He drinks at least a half gallon of water a day or more depending how warm it is. Water helps to cleanse the body of excess sugars and salts.

As much as sugar is a problem so are foods high in salt. Salt helps the body retain fluids including the sugars. Water helps to rid the body of the salts too.

At lunch and dinner he includes vegetables, a fibrous fruit, and a salad. The roughage helps to slow down the digestive process which allows for the body to release insulin more effectively. He takes glyburide with his evening meal.

We keep up the calories by him having snacks like raisins & no salt cashews, whole wheat crackers with peanut butter, Boost which has a good amount of protein (we get the one with the purple cap) and is 190 calories a pop. Before bed, after he takes his sugar measurement, he has some chocolate chip cookies and raisins - he loves this snack and his doc gave him his blessing since his levels have been outstanding for months. His A1C went from 10.6 in early Oct to 4.4 in January.

We also bought a book on the glycemic index of foods. It helped us understand what are 'free' foods and which ones to stay away from.

His ALS doc said he knows of no direct connection between ALS and diabetes.

I hope this helps.

 

[lgelb]

My husband was diabetic before ALS as well. He is quadriplegic now and remains on metformin b.i.d [~8h/16h apart due to his schedule] and Januvia, both of which we crush/dissolve. Interestingly, his last A1C (5.4%) was his best in years, despite becoming a "[Oreo fudge creme] cookie monster," a lifelong love of Ruffles and my cutting his metformin dose by 1/3. His diet, which is nowhere as well-regulated/balanced as the one above, is limited by swallowing difficulty, so raisins and nut butters are out and he won't drink much Boost [we blend our own shakes], but second the cashews; we also shell pistachios (sea salt versions for him). ALS' effects on metabolism are not yet fully characterized and he has many other conditions so YMMV. We don't check glucose and his two major liquids are Diet Coke and coffee. Favorite green veggies are cooked broccoli, brussels sprouts. Our motto is, if he can get it down and wants it, he can have it.

Basically, I would say just keep monitoring like any other condition he started with and make adjustments as needed. With ALS, it's much less likely that he'll die of cardiovascular complications of diabetes per se so you are primarily trying to avoid limb complications, infections, large glucose fluctuations, electrolyte imbalance and so on. You and he will learn what works best as you go, and expect it to change as he progresses.

 

[Nuts]

Thank you both. Isn't it interesting how quickly the things that were once of major importance threaten to take a back seat? On the other hand, healthy eating is healthy eating....