Help with parent having frequent hypos

[Tootybanooty]

Hi, I would just like some advice if possible. My father, now in his late 60s has been a type 1 diabetic for the last 40 years and my whole life. He'd have occasional hypos during my childhood and adolescence and we got used to spotting the signs and trying to help. Sometimes they'd be bad ones and we'd be worried for him. But he never really liked to talk about them afterwards, almost as if he was ashamed he'd had them.


The problem now is that since he retired about 4 years ago, his hypos have become more frequent and more severe, several involving ambulance call outs as my mum has found him and been unable to bring him back.


It's almost like the loss of routine has thrown him off. It's becoming a constant worry for my mum who now worries about leaving him alone for any length of time. He is still not keen on talking about these hypos which is frustrating as they are affecting the whole family now but he gets very defensive whenever the topic is brought up.


I wondered if anyone has any advice on how to broach this and how to try and get through to him. We're worried for him but me and my other siblings are similarly concerned for my mum who isn't in the best of health either and struggles to deal with his hypos.


Thank you!

 

[badcat]

Not sure if this makes sense or not as Im type 2 rather than type 1
Since I retired the reduction in stress has affected a number of conditions inc diabetic control positively leading to a reduced need for meds. Could something similar have happened? Have his meds been reviewed since he retired?

 

[Diakat]

Has he lost his hypo awareness? This is when you as a diabetic stop recognising the signs of a hypo yourself so don't know to treat before it gets really bad. This sounds likely from your description. So, does he test his sugars at all? Does he drive? What insulin is he on? Does he have regular appointments with his diabetes team and does anyone accompany him?

 

[catapillar]

If he's had more than 1 severe hypo in the last 12 months he shouldn't be driving.

If he has lost hypo awareness he shouldn't be driving.

There are insulin adjustments that can be made in an effort to avoid hypos and regain awareness. Is he under an endocrinologist consultant for this kind of support? What insulin is he on? Do you have access to glucagon to treat unconcious hypos at home while waiting for the ambulance?

In terms of broaching the subject with you defensive father, you might approach it as a discussion about diabetic technology rather than about his hypos. If hypo awareness is a problem then it's worth considering CGM like dexcom which will alarm when blood sugar is dropping or hits a low. Alternatively there is the freestyle libre, a flash glucose monitor which will give trend lines and tell you if blood sugar is rising or falling. CGM and libre can be used to avoid severe hypos because if the lines are dropping, you can take action to avoid a hypo before it gets there. So the discussion would be more along the line of oo why do you try this new wizzy bit of tech, than you should try this because we are worried about you.

 

[diamondnostril]

Hi @Tootybanooty . . .

I feel for your situation . . .

So much of family life is specific to the personalities involved, their interactions and their history. It's difficult for any responders here to zone in on THE piece of advice which is really helpful, because we can't know these details. I hope you get plenty of different suggestions, and some among them are helpful for you.

From me . . .

I can easily talk about Hypos with my girlfriend, but I cannot easily talk about them with my Mum. I know that they both care for me very much and have my best interests at heart, but I have a totally different feeling when talking to one or the other. When talking to my girlfriend I have a nice feeling that she truly understands my point of view. I love this, and am happy to have the chat. When talking to my Mum I have an awful feeling that what she sees through her eyes is a 9-year old boy who cannot take care of himself. I hate this, and will always avoid the chat. (I'm 43).

From your Post, it sounds like you have never been able to find the right person or the right way to talk with your Dad about the topic? (if there is one, at all). It may be worth asking him, baldly, if the way that you talk with him is annoying to him? or if there is another style or another person that he would prefer?

It's just my opinion, of course, others will advise differently. But when I read your Post I feel like understanding WHY he does not talk (or gets defensive) about the Hypos is the most important thing. It might be that you can directly ask - how can I/somebody talk about this in a way that is OK for you?

By the way, I can totally relate to your statement about loss of routine. Routine is crucial to my management of T1. I'm a freelancer, and in those times when I'm not working my management is much more difficult. An unplanned/unstructured day leads to spontaneous decisions which are nearly always not wise for my T1. I find it's also to do with self-esteem - I feel more useful and in control of my life when I have tasks (paid or unpaid) and people or processes are relying on me. I will automatically take more care of myself in that situation; a matter of pride. Even if you don't find a solution to the communication problem, such a change might be helpful, if he is willing and circumstances allow.

Best Wishes & Regards
Antony

 

[Pinkorchid]

I am T2 just on a low dose of Metformin so really don't know much about hypos. But it seems to me his medical team should be the ones helping him with the hypos maybe with a medication review

 

[ringi]

Due to the "loss of routine" is his carb intake now different each day with different amounts at different times? When working did he eat all meals at the same time with about the same carb intake with each meal?

Also, does he have anything to live for, or does he now see life as never-ending "nagging" from lots of different people?

Given his age and hence the lower risk of problems with high BG developing in his life, is he trying to keep BG too low?

 

[azure]

@Tootybanooty Has he had any advice from his diabetes team? Are they aware of his increased hypos?

As it seems to be related to his stopping work, perhaps his insulin needs looking at? Can you tell us a little more about his insulin regime? Which insulins does he take and when?

How to broach the subject with him is a difficult one as he might be feeling embarrassed or guilty at the trouble he's causing. I'd choose a time when you and he are relaxed and try to mention it in a conversational way, maybe not mentioning the hypos to start with. You could discuss how his life has changed since stopping work maybe? Or could you carefully lead the conversation to a general chat about advances in Type 1 management eg pumps and CGMs? That might give you a chance to carefully lead on to his hypos.

If you're really concerned for his health, could you mention it to his team in confidence and then they can raise the subject next time he's seen?