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Vascular dementia and type 2 diabetes, has been off glyburide, senseless conversation. Help with medication or late stage of Vascular dementia?

My 89 Father has Vascular dementia and type 2 Diabetes . He has taken glyburide for years to control blood sugar . But within the last 6 to 8 months has been off glyburide becuase blood sugar was being pulled too low in the late night hours. (EMS had to be called at least 3 times) Therefore it was recommended to go off medicine and just try and watch blood sugar levels. We have been told better to be high than too low at this age. So now his levels are 126-136 in the am and 179-199 or sometimes over 250 in the evenings after dinner. But it seems that his cognitive decline has been dramatic during this time. He went from being able to have conversations to now saying things that don t make sense , as well as difficulty with spacial relationship and of course help with all ADL s. My question is: Would trying to go back on glyburide show any benefit or are we just seeing the natrual progression of late stage Vascular dementia?
Asked On : Fri, 18 May 2012
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General & Family Physician 's  Response

People with Dementia & other intracranial insults like a Stroke show significant alteration in their sensorium in response to fever, infection or alterations in their metabolic parameters .While there might be some natural progression in the Dementia there is likely to be superimposed Delirium on his underlying condition. So it will be worth while to check his serum electrolyte levels,other correctable metabolic parameters and any source of infection & also maintain a strict control on his blood sugar.(also checking for urine ketones may be helpful)

If there is any correctable factors you might see an improvement in his general cognition and states of confusion.Going back on Glyburide might not be that helpful as it was precipitating Hypoglycemia. Hope this helps!
Answered: Fri, 18 May 2012
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