Long standing Type 2 husband - Lots of questions

[JJ4]

Hubby is see-sawing with his levels, he feels pretty rubbish lately too. He's tired all the time (he has OSA anyway which makes him tired at times) and cranky and often has the shakes.

For instance, when he got in from working a night shift, at 9am, his level was 10.5 (he'd had a Tesco Healthy Living museli type bar and a Slimfast pack of cheddar biscuits). Lots of water to drink. This is high for him, he's usually over 7 but not as high as that, maybe an 8.

Then he had a poached egg on 2 pieces of wholewheat toast and 2 hours later we were driving and he had the shakes so tested and it was 4.4. So he had a chocolate museli bar and some small cheese savoury biscuits, at 1 hour after it was 9.4, then went down to 8.8 at 2 hours.

Anyway, what should the GP be doing? He's only seen the GP at diagnosis and from then on, it's been the practice nurses who say that since his HbA1c is ok (6.7 last time), that all's fine. Despite us telling them he's see-sawing and feeling rubbish.

Hubby who's pretty nonchalant about his diabetes, is now becoming a bit more frustrated and fed up.

We've been on a health drive recently but it's not very strict, just making better choices and yet his levels continue to be pretty erratic so he's despondent. Damned if you do, damned if you don't sort of thing I guess.

Surely there should be more help for him? What should he be pushing for from his healthcare team?

If I'm honest, I don't even understand why if he's on Metformin, his levels are so awful. I know it can't do ALL the work and what you eat affects you but to such a massive swing?

And what happens if you really don't want to do low carb/low sugar/low fat or it's not feasible, then what? What are your other options to push for because as it stands, this is begining to affect our marriage AND he's certainly suffering.

 

[hanadr]

It's pretty normal just to see the nurse unless there's a specific difficulty.
You don't say what treatment your husband is on. That may be part of the problem. Obviously we will try to explain things, but I would recommend he mwke an appointment to see the GP and write down all his concerns to take with him, so he doewsn't get sidetracked and forget something.
Hana

 

[Hobs]

If I'm honest, I don't even understand why if he's on Metformin, his levels are so awful. I know it can't do ALL the work and what you eat affects you but to such a massive swing?

What dose of metformin is he taking and when... also is it of the slow release type?

Standard metformin is usually the first medication offered and only on request is the slow release offered. The slow release type might make a difference, but in general, metformin is mild in its action compared to some other types.

I would not call an HbA1c of 6.7% good .. it is not very high, but tending to high all the same being that we are all aiming for 6.5% max, so a little something extra might be beneficial, and as he is getting swings I feel that a visit to see the Dr in the practice who is well up on diabetes is indicated.

 

[Synonym]

Hi JJ

How long since your husband was diagnosed :?: Did he test to see if his body tolerates all the carbs he seems to be eating :?: You mention him eating muesli bars, cheddar biscuits and wholewheat toast which are things that some of us can't tolerate. The medication only does so much and you still have to be very careful with your diet.

 

[JJ4]

Many thanks for the replies, to answer some of the questions posed:

You don't say what treatment your husband is on. That may be part of the problem.

It is in my sig, I think! :? But he's on Metformin 1500mg per day, Asprin, Simvastatin and Fluoxetine (Prozac).

What dose of metformin is he taking and when... also is it of the slow release type?

I would not call an HbA1c of 6.7% good .. it is not very high, but tending to high all the same being that we are all aiming for 6.5% max, so a little something extra might be beneficial, and as he is getting swings I feel that a visit to see the Dr in the practice who is well up on diabetes is indicated.

He's on the standard Metformin. He takes 500mg x 3. One in the morning, one in the afternoon and one at night. He is a permanent night worker but is awake most of the day so it does suit his meal timetable still.

And I totally agree about his HbA1c result, I have told the Practice Nurse on several occassions and they always argue the toss with me that it's fine. We've had one Dr tell us it's excellent!

I've sat there, with him agreeing and chipping in too, that he sees swings and they just say 'well, your HbA1c is saying it's great overal'. Like banging your head against a wall.

They just don't see the bigger picture that that test is a snapshot and it should be viewed alongside how the patient is doing and feeling and what the BSL are like day to day.

He has also had some high BP readings over his last couple of routine diabetes check-ups which I think, personally, is telling them that something is not right but all they do is take it again and again and even though it either comes down a little OR comes down when they retest in a week, they don't pay it much attention.

How long since your husband was diagnosed :?: Did he test to see if his body tolerates all the carbs he seems to be eating :?: You mention him eating muesli bars, cheddar biscuits and wholewheat toast which are things that some of us can't tolerate. The medication only does so much and you still have to be very careful with your diet.

He was diagnosed back in 2006.

He usually eats white bread but has made the switch which he had thought would see even a tiny difference in how his body reacts.

He's not very good with his diet, I've mentioned on this site before, on other forums, that he hasn't really changed his eating habits. He wants to change to lose weight, not because of his diabetes. He's an intelligent man, just not very motivated which he readily admits.

He doesn't test regularly, infact, he only tested that many times today because first thing, we were trying out a different meter and then because he had the shakes and I told him to see if it really was low because it was unexpected after his breakfast egg and toast.

His eating patterns are erratic because of his schedule of working at night and being awake most of the day. A little different to many diabetics out there in that respect.

 

[Synonym]

Hello again JJ4

I am afraid that you are in for some real frustration until your husband decides to get a grip on his condition for himself as there is only so much that you can do. :roll:

Sue and Ken often post a comprehensive advice sheet for new T2s which really helps to get a handle on the whole thing. The biggest problem is that the normal NHS advice does not really encourage patients to control their own condition so that can be used almost as a get-out by reluctant T2s and so they ignore it. :x

He does need to take control and work out what his food is doing to his body so he needs to test before meals and 2 hours afterwards to see what is safe or what he needs to cut down or out. Many folk have to cope with working odd hours and it can be dealt with by forward planning and being organised. This is not a fad diet - this is his life and what quality of life he wants :!:

Incidentally, in our family the females know that the males won’t deal with things until it ‘goes critical’ as that is just how they are. :shock: We have had to learn to step back and watch – whilst being ready to ‘catch’. This is not easy but sometimes they need to know how boring/frustrating they are being and we also think it can sometimes be an attention seeking thing! It is all SO predictable but we do love them anyway!! :roll: :lol: :roll:

 

[Cowboyjim]

It's bad enough having T2 but standing by your man must be so frustrating and worrying. I am lucky my wife is very good to me but I think I am a better patient... so far... not easy staying on course with all this fun food off limits let alone the staples.
I concur with all the other replies and suggest you try to make a list to sort out your carbs. Get more exercise too! Another toughie for you no doubt.
On another point I suggest you look into the side effects of the statins... I am on them and wonder if they really are doing me more harm than good. Try googling side-effects and you'll see what I mean.
Finally, regards diet, too many things purporting to be healthy simply aren't esp for T2s. I could not eat these salted biscuits because I have high BP too.
ATB 8)

 

[hanadr]

PS
no-one will get their BG under control on Metformin alone, unless there's some control on carb intake.This can be; portion control. GI/GL control or a reduction in total carbs.
Those snacks sound pretty deadly[They would be for me anyway. ]
I personally find it easier to avoid carbs as much as possible. If i snack, it's on nuts, which may seem expensive, but then, how much would he average person spend on snak foods in a week?
I don't need packed lunches, so I avoid the most difficult meals and I LOVE salads.
Hana

 

[catherinecherub]

Hi,
I understand you being frustrated. I think you need to rethink what hubby can eat and cut out the cereal bars and prepacked biscuits etc.
Have you considered reducing portion size of carbohydrate foods and adding more veggies and salads?
Test his responses to potatoes, pasta, rice, bread and cereals. Some may have to be halved in portion size and some may have to be eliminated. There has to be a change in his diet to manage this successfully. If he likes beans, all varieties, these are filling and may work as a substitute for carbs that he cannot tolerate.
Shift work is a pain but it can be done. Pack something for him to take with him and then he wont be tempted to eat the wrong things. Soups, boiled eggs, sliced meats, nuts, cheese with a salad. You could add some beans to these suggestions if his response to them is OK.
Have you tried Bergen Soya and Linseed or Stoneground breads? He may be able to tolerate these.
If he can get his weight down then the BP and Sleep Apnoea should improve. Add some exercise into his day. He doesn't have to join a gym but be more active for 30 minutes a day. You can break this down to two x 15 minutes or 3 x 10 minutes.
It won't happen overnight and small steps will see the desired result I am sure. We all want instant results at the beginning but it does involve a lot of effort and we have to undo our usual eating habits.
Take care and involve him in the food decisions as it has to be something that he likes to eat.

Thinking of you and let us know if you need any help.

Catherine.

 

[Jasonuk]

Hi JJ4, with regards to the sleep apnea,does ur husband have mild. modearate, or servere sleep apnea, has he been diognosed by a health care proffesional? is ur husband on any treatmant for sleep apnea,
why i ask untreated sleep apnea can affect ones metabilsim as in if one is having apneas during sleep, ur body is not getting prober rest and it affects ur whole body
i had a apnea index of 130 a hour meaning i was stopping breathing 130 times a hour that is very servere sleep apnea im on CPAP therapy every time i sleep, i wear a mask which blows air into me to splint my airway open to stop back of my throat collapsing and haveing a apnea- stopping breathing
untreated sleep apnea will make anyones life a misery and will def affect , annoy any other health probs

Jason

 

[JJ4]

Thanks again for the replies.

I know that with diet changes and exercise and therefore weight loss too, he may well see a difference in his levels but if he doesn't want to change then surely there must be something else he can get added to this medications to bring his levels down? Any suggestions?

At the end of the day, if he doesn't want to change, he's not going to and I'm banging my head against the proverbial wall trying to do anythign about that. So all we can do is try and bring his levels down in other ways, right? He's not bothered about adding/changing medication for the record.

I did consider he ask about Byetta for the excess weight but do not know much about the prescribing criteria so I'm not sure he'd get far asking for it to be honest.

His sleep apnea was bad enough to require CPAP. He's been on that for several years now. That used to cause him to fall asleep at any point in the day, or night, but now it's the swings in sugar levels that are causing that it seems.

I know I can't fix his diabetes problems for him, that's not my desire at all. I just want to do something to stabilise his levels and save him from at the very least life-changing complications and at worst, an early death. He has 3 beautiful children, under 6, who need him. As do I.

 

[Synonym]

I know I can't fix his diabetes problems for him, that's not my desire at all. I just want to do something to stabilise his levels and save him from at the very least life-changing complications and at worst, an early death. He has 3 beautiful children, under 6, who need him. As do I.

I'm afraid that he is the one who has to want to take control, you can't do it for him. The only thing you can do is make wise food choices in the meals you serve.

As for the medecine I have never heard of anything that will do it all for you! :roll:

 

[JJ4]

I'm getting quite frustrated now because I know he has to help himself, I get that, I'm an intelligent woman but surely it's not a case of if he's not going to, he can just suffer with these high levels and deal with whatever comes with that situation? End of. I don't believe that.

I know it's not ideal, I know he's an idiot for not taking it seriously and I know he can't expect medication to do it all but my question is, IF he's obviously not going to help himself (and I don't agree he's not doing anything, he is, just not enough or maybe the right thing exactly) then surely he's a right to ask for something extra - medication wise to bring those levels down to non-harmful levels?

I guess I'm just fed up of people telling me about low carbing, exercise, eating better blah blah blah. I get it, HE gets it, even if he doesn't act on that information to the extreme. I just wanted advice and help on what else we can ask the Dr for really.

Basically, as most Type 2's find, he was diagnosed, given pills and sent on his way. Any attempts to get help or point out problems to the practice have been met with eyerolls or patronising explainations or plain brushed off. That's ridiculous and IMO, unacceptable.

He deserves better treatment, however he chooses to handle his diabetes himself. Type 2 is just dismissed as an inconvience illness rather than a serious one with far reaching implications. And he goes regularly for his check-ups and tells them exactly how things are and they just say all is well and send him on his way. All is NOT well though.

Ok, off my soap box now and I apologise if I snapped at anyone trying to help but I feel like I'm not quite making myself heard.

:| :|

 

[sugarless sue]

He could also have his Metformin increased in dosage. The next step up in medication is the Sulphonylureas such as Gliclizide.

To be on Byetta or Victoza you have to first be on the max levels of Metformin and a Sulphonylurea, have poor control and a BMI >35. Some Consultants however disregard this criteria.

There is one thing you may want to discuss with the doctor. Prozac can cause changes in blood sugars, unfortunately a lot of antidepressants have this side effect.

It may be possible to change to another one which may have a lesser effect while still being an effective antidepressant for your husband.

 

[JJ4]

Thank you, Sue. That was most helpful and much appreciated! A starting point and things to consider.

I was wincing opening this thread again after my last post.

 

[Synonym]

I was wincing opening this thread again after my last post.

Hello again.

Sometimes it helps to say what you feel and we all do it because this is a good place to let it all out! :roll:

 

[Herman lausan]

Sorry to hear your hubby is on a (statin) Cholesterol lowering drug. If it were Me , I would stop this drug. Well it is me and I never would take a statin. But I do take Nicotinic acid, a form of Niacin that does the same. But I am on a very low dose 250 mg. when 2000 mg . is recommended. Why such a low dose? Because exercise will lower Cholesterol as well as Blood sugar and High blood pressure. I think the statin is making him feel unwell along with High blood sugars.
I believe that not enough is said about the benefits of exercise. But most people readily will take meds. seem to wave off the exercise.

I had problems with Cholesterol, blood sugars and blood pressure, but when I started to really exercise daily , everything seemed to fall into place.Now HBA1C is 5.5 FBS 96 or 5.3. Cholesterol is normal as well as blood pressure . Last check BP was 125/70 . WoW. All due to exercise . Yes I take Metformin and Amaryl for my diabetes. 2000 mg. metformin and 3 mg. Amaryl. Your husband may not be on enough meds.. You must learn all you can about diabetes. You may find out that the nurses don't really care or Know much about diabetes. And that goes for a lot of doctors.
I live in a country where I can buy all meds. over the counter. This free's me from the burden of what meds. the doctor may prescribe.
I do have a doctor that I can see at anytime. Cost $4 american. We discuss my diabetes and agree on what meds. to take . But I am the final word. He wanted to put me on a statin , and I laughed at him." Never "I Said.I did the right thing.
A couple of years ago I felt like your husband does. No energy , could hardly walk. Until I got a computer and studied Diabetes , I was ready to toss it all in. I prescribed my own drugs and finally added the exercise. Wow ! I feel so much better. Before the doctors would say " Your doing fine" when my numbers were High. And I felt like I was dieing. So again , learn all you can!
And using Glycemic Index diet , I know what to eat and what not.
Good luck

 

[dollydreamer]

hi there
i know how difficult it is to control eating - especially as i have an eating disorder and associated problems binge eating etc., some days i feel ok to control what i am eating and at the same time feel good about myself and the choices i am making then other days its like - i'm on another planet, i feel like **** and don't really care about what i eat except that i really try to binge on 'healthy' food but whats upsetting is the loss of self care on these days, all my good intentions go behind a curtain - i know they are there - but i just cant get to them.
anyway, i'm trying to be referred to a specialist eating disorders clinic but it takes time and i totally agree that there should be more help for people who suffer with motivation problems. thats my trouble i really want to take charge and i am really motivated but i don'tknow maybe its i have been beaten down so many times for so long that my get up and go has just gone !!!!!
All i know is that you have to keep trying and Catherine cherub is right small changes is the right way to go and build on that.
I've been having trouble with my teeth and gums but now i really try hard to clean my teeth morning and night, i know for some people this might seem silly, but its a change that i am making and i am sticking to and its something that i can do irrespective of how good or bad my eating has been that day. and i feel good just focusing on that one thing which i will do until it comes like second nature and then i will add in something else, maybe not to eat after a certain time or something and i will keep going until most of the time my eating is under control and the bingeing is less. its a bit like when i was learning to deal with depression, everything seemed black then one day, came a ray of light and i just stuck with it until in the end that ray of lite outshone all the blackness - so i might be bingeing alot at the moment but those rays of lite are shining thru, its just that like the sun they disappear and i need to find a strategy to cope with this until the sun reappears.
mhhm thats really helping me now.
anyway i do hope you hubby reads these posts and that he can have a look and perhaps find that spark to just have a think about making some changes for himself - it might help if he knows that we all can feel overwhelmed sometimes, but that its part of the journey.
with best regards and good wishes to you both.