A newbie - very confused carer and need advice

Hi there, glad you have joined up.

My mom has been diabetic for many years (type 2) and on insulin for many years. She moderates her own levels to what she is eating. It takes a while to get this right through trial and error, but she finds it the easiest way to manage her diabetes. She avoids carbs when she wants to lose weight - if she is maintaining, she eats carbs moderately but this includes oat cakes, bread and rice.

You do not say if your mom is overweight at all, which would be helpful to know.

I am suprised that the nurse has given you this advice as, assuming weight isn't an issue, maintaining even blood sugar is the goal. Clearly, when on insulin, you eat for the amount of insulin you are injecting. It is important to try and ensure that the level of insulin doesn't just keep going up and up, but if you are eating a normal, balanced diet, this shouldn't happen.

I was on insulin whilst pregnant and found it hard initially to eat enough food for the insulin I was being told to take and suffering from hypos as a result.

Is your mom suffering from hypos or is she quite balanced?

If the advice you have received is causing problems, it is always worth going back to discuss what is happening.

Hope this helps.

Jane

Hi Welleehell

Welcome to the forum

My god it's brilliant what the nurse has said to your mum. it's a shame she wasn't pointed here sooner.

I'm not on insulin so forgive - but my understanding is she will adjust the amount of insulin needed to cover the carbs in the meal. It seems sensible to me to have less carbs and need less insulin.

For me I would prefer to forgo the carbs and inject less into me but its a personal choice.

Mary x

I'm Type 2 and a confirmed low-carber, which is the diet that the nurse seems to have recommended for your mother - "no starchy carbs". However, I am still producing my own insulin.

Basically, every gram of carbohydrate that you eat is turned into glucose in your blood; insulin helps use the glucose properly, as energy for muscles, and storing the excess as fat. Without the insulin your body can't use the glucose for energy, so it burns fat and muscle instead, causing weight loss. Your mother now needs artificial glucose to cover her carbs, as she's not making her own. Fewer carbs in the diet = less articial insulin, but if your mother likes to eat carbs and won't eat much else, you may need to use more insulin for her.

Sorry if you know all that already!

You do not say how old your mother is, but you do say that it is hard to get her to eat enough. If you are responsible for getting her meals, you should have been given information on how to balance carbs with insulin, so that your mother eats enough carbohydrate to balance the insulin she is taking. There is a course you can go on for this - called DAFNE, I think, but I could be wrong!

I think she should still be eating carbohydrate, but perhaps less than previously, and going to low GI carbs - wholemeal instead of white bread, always new potatoes, brown rice and brown pasta rather than the usual white versions. The important thing is to keep her eating. In your place I think I'd go back to the nurse and ask to talk to her again, as to how you're going to get your mother to eat enough.

Why not ask your question again on the Type 1 forum? I know your mum is now an insulin-dependent Type 2, but if you can't contact another Type 2, the Type 1s are the insulin experts.

Good luck!

Viv 8)

Something similar to DAFNE can be found here http://www.bdec-e-learning.com/ - if you have an hour or two spare you can learn a lot about it from the link.

As Viv says, she should have some carbohydrates. Having access to the glucose that is present in her blood via artificial insulin will make her able to maintain or put on weight again depending on her needs. You can think of insulin as a key that opens the door to the muscles or the storage (fat deposits) - once this key is broke, glucose won't go to where it is needed and the body will live off reserves (fat and muscle). Once a new key is present (injections) this should go back to normal.

So, once you and your mum get familiar with the relationship between amount of insulin, amount of carbohydrates and resulting appetite, weight and of course blood sugar levels, you should see a lot of improvement in her wellbeing.

It can seem worrying and daunting, certainly, but I'd advise you to look at the link and see if you can't pick up on most - I found I needed to read it a couple times, but it wasn't so bad.

Best of luck.

Hi there, glad you have joined up.