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I have introduced myself in the greeting section.
My name is David and my wife Vicky is 36 and was diagnosed type I about 14 years ago.
We have been together for 20 years and married for 10. She has always been the organised, sensible, calm one.
She had always been unbelievably well controlled (between 4-7 every time) it got the point where she was on such a small amount of insulin that the doctors even half jokingly suggested that she stop injecting just to see what happened. Doctors asked her whether she would consider doing talks on how to control your levels and to speak to newly diagnosed diabetics.
All was well up until a few years ago.
It all started with the introduction of the wonderful DAPNE course….”eat what you want when you want, and if you don’t feel like eating don’t”. It sounded great, she went from being almost scared of sugar and sweet foods to suddenly being able to eat whatever she wanted again…
At the time our two boys were 2 and 4 and Vicky was able to cope easily with them and the new DAPNE regime and juggle a hundred other things too.
However, over the last few years, her amazing control has all but disappeared, her levels are regularly in the teen because she has even not calculated correctly or has forgotten to give herself her injection straight after her food (mostly because someone wants a drink or someone is hurt or not doing as they are told or fighting…you get the idea)…on top of all that her Dad died which certainly didn’t help things.
She is now constantly reminded by her consultant that her levels are far too high and that she has to bring down her HbA1c to avoid complications later ion life. All of which she is well aware of. However, DAFNE doesn’t seem to consider what a full time mum has to go through on a daily basis. If she was still working in an office, she could have her little alarm clock to remind her to eat / inject, or have time at lunch to go meditate or have some quite HER time or attend yoga classes (all of which have been suggested as ways to overcome her high levels and put some structure back into her life) but most of which are nigh on impossible with two young boys.
I have suggested that she scrap DAPNE and try and go back to her old regime, eating at the same time of the day and giving herself a fixed amount at each meal, but she says that the DAPNE course has removed that fear of food and she couldn’t switch back to her old way of thinking. I work quite long hours and am out of the house before they all wake up and normally arrive home from work around 7pm by which time the day is almost finished and I don’t know what I can do to help her. I have suggested ringing at the same time in the morning and in the afternoon to check that she has injected but with best will in the world, either I’m busy at work or she is busy doing mum things.
She is worried and scared that everything is down to her and that if anything happens to her she will only have herself to blame and I just don’t know what else I can do.
Thanks for listening
- Posts: 3
- Joined: January 26th, 2012, 4:55 pm
Really sorry to hear your problems david. Not a lot I can say as I'm a type 2 so don't face the same issues. However, I have faced situations in the past where you need to convince someone close to change a fundamental way they do something. I found that I needed to "take time out" to study it. That is, I convinced my wife we would get someone to look after the kids for a day or two, get away from work and sit down for a day to sort it out. We all get holidays, so for something important it's worth taking one.
We then treated it like a project:-
Define exactly the issue.
What specifics have to be done to solve the problem
What are the consequences of not doing it
What options are there for going about it
choose an option
Construct a detailed plan with time scales
Devise an agreed way to monitor the success or otherwise of the plan
Choose a start date to implement the plan.
Hope it doesn't sound too much like waffle, but if you develop a plan together, she'll own it more and is more likely to stick to it. Perhaps you could make it fun by hiring a room in a hotel for it. Bit of time out you can ill-afford perhaps, cost you can ill-afford perhaps, but if it works? The stakes are high. Even eating pre-Dafne could become an option if you sit down for an entire day like this to work at it.
Type 2, diagnosed Nov 2010. HbA1c then 8.2%. Mar 2011, HbA1c 5.9%.Dec. 2011 5.9%. May 2012 5.7%
150-180grams carbs per day + exercise (mainly golf!). 2x500mg Metformin SR per day.
Support testing for T2s http://www.diabetes.co.uk/petition/
- Posts: 3135
- Joined: January 7th, 2011, 1:32 pm
I am sorry to hear that your wife is struggling.. we have one youngster and she is quite hard enough work! I can't imagine two!
Firstly I am probably repeating what you already know but the cornerstone of managing type 1 diabetes is routine. Test here, inject then, etc.. , etc... clearly with a young family and a hectic life this gets more difficult.
So I am not sure what you have tried but here are some ideas...
1. You talk about mis-calculation of insulin dose.. if your wife has limited time there are blood glucose meters now that will calculate how much insulin you need.. I believe Accu Chek do one and your wife may find that this is more suitable if she's busy.
2. You might try and involve diabetes into your family life... I see no reason why she can't still set the alarms and test with the kids.. perhaps try and make it into a game where they have to go get her tester or be the first to remind mum to test or what have you? I realise this might not always work but perhaps the children will learn to see how important it is that your wife can carry out the testing and will actively help support that process?
3. You can get attachments for pens that tell you when you last injected.. I suspect your wife is getting distracted and then thinking did I inject or didn't i... you don;t want to then inject in case you did and end up going hypo so you wait it out an hour or two and see what your sugars do.. getting the attachment to the pen will remove this worry.
4. She could look at re-balancing her long and short insulin... bit of a speculative one this.. but if she splits her long acting insulin over two doses morning and night and injects more.. as long as she eats during the day then she shouldn't have issues with hypo's... she will need to inject less short acting insulin.. but if she forgets or is busy then at least she has some insulin in her system working itself away and she can then correct with short.. again she may just be better going to a mixtard but as you say she likes the freedom of MDI
Type 1 - Diagnosed 1999 - | Animas Vibe & Dexcom CGM
HbA1c's: 15/05/13 - 27 mmol/mol | 4.6%
- Posts: 733
- Joined: August 23rd, 2010, 10:49 pm
Hi Grazer and Pnue,
Thanks a lot for your messages.
We have actually been trying to work out a sort of plan or action. Vicky went to see her DAPNE consultant yesterday just for someone to talk to and in the hope that she may be able to suggest something we hadn’t though of.
We’ll she didn’t tell Vicky anything that she didn’t already know but the fact that the consultant basically said that it was down to Vicky to try and get to grips with her calculations may have focused her mind a little. She did mention that Vicky may benefit from experimenting a little with her morning and night time Levemir doses and see whether that may help.
Vicky is also going to try and get into the habit of having her injection at the table along with her breakfast spoon or knife and fork, hopefully reducing the chance of forgetting to take it, if and when pandemonium breaks out…
The blood glucose meters that calculates your insulin needs and the pens that tell you when you last injected sound like really good idea and I will definitely mention them to Vicky.
Thanks again and I will let everyone know how things go.
- Posts: 3
- Joined: January 26th, 2012, 4:55 pm
also don't panic. The fact that she had such enviable blood glucose results for so many years will mean that she will have a certain amount of protection from long term complications for a little bit longer* - gives her time to get her head round things again.
*this statement is based on the fact that in the big DCCT trial, those people who had managed to get their hba1c down to 7.3% for the trial itself were still at a lower risk of complications 10 years on, even if their hba1c had crept up again in the meantime.
- Posts: 790
- Joined: May 24th, 2010, 12:34 pm
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