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Advice & Guidance to Help Parent

Discussion in 'Diabetes Discussions' started by annaf1107, Jul 19, 2020.

  1. annaf1107

    annaf1107 · Newbie

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    Hi - I've just joined the forum as I am concerned about my dad who has got type 1 diabetes. He's had it since I was about 5 (so nearly 40 years) and all I've ever known is him managing his medication and dealing with his diet - albeit quite badly. Myself and my siblings have never really got involved as he either doesn't let us or hates being fussed over. He has never really managed his nutrition correctly and he drinks alcohol a few times a week. He is now 62!! He's had some scares in the last few years where his sugar levels have been very low and he has gone into hypo and paramedics were called, the most recent one being last night. I now feel like I need to be involved with helping him to manage things better and he has reluctantly agreed. I have asked him to arrange a review at the doctors but he doesn't like going because he says 'they nag him' but I need a starting point. I will go along with him to the review but I need to know what I'm talking about. So I'm hoping this group can help me to understand things like; what's available to him to alert him when his blood sugars are too high or low (is there a device he can wear as I'm not convinced he will regularly check with the finger prick) and if he does go into hypo, what is the best equipment for us to manage the situation? And anything else you can think of? I am convinced he needs his insulin amounts checking but that will be at the review - however any tips for discussing this would be very useful. Any advice would be greatly appreciated.
     
  2. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    Hi @ annaf1001, Does your father have a freestyle Libre sensor? If his control’s not been good and he’s had more than one bad hypo he may be eligible to have one prescribed. It’s made by Abbott and is now provided to a percentage of T1s who meet the criteria.
    If he’s not prescribed one then if finances will stretch to it he may be able to self fund one.
    The Libre monitors interstitial glucose levels every five/fifteen minutes (it’s getting late and my brain’s ready for sleep). It can be read by a Reader that’s also made by Abbott, or sent to a smartphone app. The Reader or the app, LibreView, will show glucose levels as a graph, and will also allow you to set an ideal range of glucose levels that you’d like to stay within. It gives other information as well that would let him know how he’s doing.
    You can also buy a device called a Miaomiao that sits on top of the sensor. This does more than the Reader or LibreView: the miaomiao transmits the reading from the sensor to a number of apps and the apps can give alarms by sound and/or vibrations if your glucose levels go outside the range you set.
    I have a Miaomiao and I bought a watch, a watlaa, that show my glucose readings and will vibrate against my wrist if I go out of range. It means that I don’t have to have my phone with me all the time. The miaomiao will also transmit to a number of other watches, and a few of them, like the watlaa, are standalones that don’t need a phone communicate with to read the signal from the miaomiao. If your father doesn’t have a smartphone then I think one of these would be the best way to get alarms.
    Quite a few of us use the miaomiao to get alarms. I hope that some of them will also come along and give advice; they may explain it all better than I’ve done. I know that @porl69 uses one.
     
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  3. EllieM

    EllieM Type 1 · Moderator
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    I'm going to assume you're in the UK. If not please say because diabetic care does vary by country.


    Does his GP handle his diabetic review or is it done at the hospital? Most UK GPs are pretty clueless about T1 so he might need a telephone appointment with a DN at the hospital. He may get very very sick if he gets covid so I suspect the medical services won't be offering him many face to face appointments ....

    Most T1s get hypos, and most of us get warning before the hypo gets too bad, so we take sugar (glucose tablets, jelly babies, even water with sugar dissolved in). If he's living with family then it's fairly easy for them to hand him glucose tablets if he is obviously confused, shaky, but if he's on his own then there is equipment which may help. He should always have some sugar by his bed so he can easily take it if he goes low at night.

    Many T1s lose hypo awareness as they get older, some can restore awareness if they keep their levels a bit higher for a while (over 6 mmol/L, normal range for a non-diabetic is 4-8, hypos occur under 4). If you've lost awareness then you really need a cgm.

    Continuous glucose monitors. A tiny needle (thickness of a thread) sticks into your arm via a small patch. The freestyle libre is the cheapest, and you may be able to get your diabetic clinic to prescribe it if he meets various criteria (bad hypos being one of them) but they aren't easy to get. A lot of people self fund. You can buy an add-on transmitter (google miaomiao) to get it to send alarms to your phone. If money is no object then I'd argue that the dexcom is better, it includes the transmitter and it's very hard to ignore it if your blood sugar goes out of range.

    Good luck at the appointment.
     
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  4. Shiba Park

    Shiba Park Type 1 · Well-Known Member

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    As the previous replies have said, there is some great tech these days that can help, but it really addresses the symptoms not the cause.
    I suggest you start with a book like "Think like a pancreas" and good old fashioned food/insulin logs. As explained in the book above, get the basal right, get your carb/insulin sorted AKA 'carb counting' and then the tech (if needed) is fine tuning rather than alerting due to fundamental errors in the insulin dosing.

    I also echo the previous comment about the lacking level of clue amongst GP's about T1...

    Shiba.
     
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  5. porl69

    porl69 Type 1 · Well-Known Member

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    Hi @annaf1107 are you UK based? Is he under a consultant at your local hospital? I would be getting in toutch with his DSN (Diabetic Specialist Nurse) to inquire about the Freestyle Libre.
     
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  6. JohnEGreen

    JohnEGreen Other · Master

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    My brother in law who is T1 always keeps a mars bar or sugary drink handy in case of hypos.
    And there are hypo kits you can buy and glucagon injection kits for severe hypos.

    And as has been said a cgm or libre flash monitoring system would be advantageous to have.

    Though not T1 myself I have one and find it very useful.
     
  7. JMK1954

    JMK1954 Type 1 · Well-Known Member

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    After 40 yrs of living with type 1, I suspect your dad may not be particularly open to a lot of new technology all at once. The hypos at night are the most urgent problem. If a type 1 has been drinking alcohol, a hypo is a lot more likely to occur because the alcohol affects the liver's ability to raise the sugar level in an emergency. Because of this, it is recommended that a carbohydrate snack of some sort is eaten with or after the alcohol and before going to sleep. Being rescued by paramedics is no fun for anyone and can leave you feeling pretty awful. Your dad may be embarassed at what has happened as well. Can you get in something that he really likes - biscuits/crips/ or whatever and tell him after he has had a drink (an alcoholic one !) he needs a snack before he goes to sleep, even if he is not hypo. (He should do a blood test befire the snack, just in case he is already hypo and needs very fast-acting sugar immediately.)
    It shouldn't be too difficult to persuade him he has a reason to eat a favourite snack.


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