Brief Answer: Medications & food habbit needs monitoring.Insulin Detailed Answer: Hi XXXX, Thanks for using XXXXXXX I went through the query and understood your concern. The variation in blood sugar from 20 to 498 may be due to the effect of the medications and her food habits. I want more information on her medications currently taking and also about her food habits which will help in further discussion. Since she is 84 and suffering from diarrhea better to start with insulin therapy based on her blood sugar values and the calories of food intake. This will prevent fluctuations of blood sugar levels and maintain normal values. Now since her sugar level is 498, get checked for urine ketone bodies and you can give her regular insulin subcutaneously to reduce sugar levels. You need to consult your doctor to plan for further management. For diarrhea, if she is dehydrated or suffering from fever / pain abdomen / dehydration or any other problem other than increased frequency of stool then better to consult your doctor for examination once. She requires treatment based on the clinical features. If no other complaints then give her ORS and capsule racecodotril which will prevent dehydration and also frequency. Hope this information helps you. Feel free to ask any further related queries and I will be glad to help you. Wish your mother in law's a good health. Regards

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