I'm struggling big time here. How do people handle diabetics with dementia who refuse to do the right thing?

What about a fentynal patch for the pain? Consistent pain relief without taking a pill.

You need to seek medical attention. If she is on medication to control her BS, not eating isn't going to help (which you obviously know). Best of luck and please update us.

Does her diabetes doctor know what is going on? Perhaps she should drop the Lantus until the pain gets straightened out. (NOT on my suggestion! -- talk to the doctor! Tomorrow.)

What is her blood sugar level when she has those symptoms? 82, 51, what? Have you told her diabetes doctor this?

It sounds like all Grandma is eating all day is fast-acting carbs. A glass of juice will bring the bs up quickly, but puts it at risk of crashing down low again. The usual treatment plan for lows is a 5-oz glass of juice or milk (or other fast-acting carb) repeated in 15 minutes if that hasn't brought the numbers up to a safe range. And then to have a sandwich or other small meal including fat and protein. Again, don't act on my suggestions, talk to her doctor! I know she is refusing to eat and that is a real challenge for you. Would she eat some cottage cheese? An egg-salad sandwich? Is there ANY small meal she might consent to eat to keep her bs from crashing?

My mother also could not take morphine and also had constant pain. It took a lot of experimenting but they got her on a good schedule. Once I was in the NH when the med technician came around with a pill for her. They always tell what the pill is for. She said, "this is your afternoon pill for pain." Mom said, "But I don't have any pain." The tech and I both laughed. "Yes, and that is EXACTLY the way we want to keep it!" Your mother needs a good schedule of what she can take to keep the pain at bay.

I sincerely hope that her shot in a few days makes a significant difference! But I urge you to contact the doctor who follows her diabetes as soon as possible. 

Sorry for your grandma. Better to consult her doctor.

I'm in the state of Maine so there is no real pain clinic but we are lucky enough to have a pain management specialist that comes through the hospital that will treat her with a nerve blocker just on a limited schedule. The rehab facility was not honest with her pain level and claims she was not having any pain at all. Since I could not be there 24/7 although I did give up my day for 4 hours a day to see and spend time with her, I wasn't able to see how bad her pain was. It's obvious that their low doses of tylenol were not covering it as I've been even given advil and tylenol just to try to get her something of relief. It was working the first few days but now it's not. Her shot is scheduled for Thursday but that means three more days of this low sugar stuff. Grandma is hard to deal with in the pain office. The doctor is nice enough to open the building 30 minutes prior to her actually opening in order to make sure the building is empty due to grandma's childlike response to her shots. She screams and cries and carries on which upsets the other clients so she always has been nice and schedules them before she opens. That just means even more of a restriction on when she can give the shots. Normally I stay on top of them. I even have fought with the pain doctor and won insisting she gets something more for her pain and I have never seen her in this bad of pain since when she broke her neck. They had her on morphine back then in a rehab facility. She's allergic to morphine so it goes very badly and definitely not something you can give in a home environment where I care for two young children.

I see the doctor tomorrow at 2 pm. She's newly on insulin but is only on one shot, Lantas, so it's all or nothing. She gets her shot in the morning and will normally eat breakfast happy but as she goes through the day her pain gets to be more and more so she starts refusing more and more. By the end of the day she's literally abusive with the hitting and biting and beating up those around her who try to help her. She bit herself in the hand yesterday and left a mark. I'm guessing that's an example of how much pain she's in. Having her get this upset only compounds the issue. She has gone so low as to barely be awake with her arms and legs tremoring and her eyes drooping but never completely out. Normally when she gets to this point she allows me to either put gel in her mouth or give her a cup of juice. So unfortunately all day long I'm sitting here pumping her full of juice or using gel just to keep her alive. It's no way to live.

 Hopefully the doctor has some ideas tomorrow. I'm at my wits end.

Have you discussed this with the doctor who is treating her diabetes? Is she on insulin? Taking oral or injectible diabetes medications? Her doctor must be aware of her non-eating status. The medications will need to have dosages adjusted or perhaps be discontinued until this particular crisis has passed.

How low does her blood sugar get? Does she have symptoms at that level? How do you treat each incident of low bs?

Does she stay hydrated? That can effect blood sugar and feelings of well-being also.

Would she be more likely to drink something than eat? A small milkshake every few hours? A glass of apple juice?

Pain itself can do weird things to blood sugar levels. Treating the pain seems to me to be highest priority here. How soon is she going to get the nerve blocker? Has she been seen at a pain clinic? I suspect that if the pain were managed the other issues would be easier to deal with.

I hope you and Gradma can get the blood sugar managed, and also the pain! Let us know how this is working out.