Injecting without testing....should I be worried by this....

[Molly56]

Have noticed that my partner is recently injecting his insulin but has not been testing his bs levels ......(Type 2 on 30 units Novomix 30 twice a day plus metformin and forxiga)....
....how important is it to be testing bs levels before injecting insulin and should I be worried by this.....surely blindly injecting insulin is just a pathway to disaster....

 

[Squire Fulwood]

Have noticed that my partner is recently injecting his insulin but has not been testing his bs levels ......(Type 2 on 30 units Novomix 30 twice a day plus metformin and forxiga)....
....how important is it to be testing bs levels before injecting insulin and should I be worried by this.....surely blindly injecting insulin is just a pathway to disaster....

I should imagine that it's pretty important. I still can't understand his behaviour and it seems to be self destructive.

Maybe other people could comment on just injecting insulin without testing.

 

[Molly56]

I should imagine that it's pretty important. I still can't understand his behaviour and it seems to be self destructive.

Maybe other people could comment on just injecting insulin without testing.

@Squire Fulwood ...I would consider that it is important too...also means that he is not testing before driving so no means of knowing for sure that he is safe to drive...

 

[ButtterflyLady]

@Squire Fulwood ...I would consider that it is important too...also means that he is not testing before driving so no means of knowing for sure that he is safe to drive...

Have you thought about reporting him to the police about the driving? You could do it anonymously and they could pick him up and ask to see his meter. I have no idea if this would work in practice but I think if any of us are aware of anyone with a medical reason for being at risk when driving, we should consider speaking up.

For example, a colleague of mine had a mother developing dementia who refused to give up driving. She contacted her mother's GP who ended up getting the woman's licence revoked. It sounds harsh but it's for the safety of the person and others on the road.

 

[xAoifex]

to be fair to him, if he's on fixed doses then testing before injecting is not as useful as if he was carb counting on MDI. He injects the same amount no matter what, you cant really adjust fixed doses to what you eat (although you should perhaps eat to your fix doses) so testing is not going to achieve a lot. I agree totally with about testing if he is driving (legal requirement in the uk if on insulin) but if he is not prepared and/or educated to match carbs to insulin the testing is a moot point.
IMO you need to know how a meal affects your blood glucose but on mixed insulin you can't readily react to that. If it works for him and his levels are generally in range and he has a decent HbA1c then fine, if he is regularly high or is experiencing hypos (or eating inappropriately to avoid them) then maybe a change in regimen (it will mean more testing and injections) is needed

 

[AndBreathe]

Have noticed that my partner is recently injecting his insulin but has not been testing his bs levels ......(Type 2 on 30 units Novomix 30 twice a day plus metformin and forxiga)....
....how important is it to be testing bs levels before injecting insulin and should I be worried by this.....surely blindly injecting insulin is just a pathway to disaster....

Molly - I am assuming your partner has now informed the DVLA he now uses insulin? Apparently the form to be completed is 14 pages long, so it doesn't strike as something he would do in a single phone call.

If he has he is playing with fire with his current actions. From a presentation I saw a couple of days ago, delivered by a Consultant specialising in diabetes, I understand that at the point of a license renewal, the relevant form requires a number of declarations to be signed, relating to hypos, testing and so on. On the subsequent review of that form, if he is required to attend for a medical or review, his responses and the memory on his meter would be reviewed and any material mismatches would be highlighted.

Any blatant conflicts in the declarations, and his recorded behaviour/performance, as evidenced (or not, where there are gaps) by his meter, not his little book, he will be in trouble, because that is effectively fraud.

Similarly, if he has some unfortunate accident - it needn't actually be catastrophic - but if the police ask to review his testing records, which I understand they can do, then, again, he is potentially in trouble if there are gaps.

If he hasn't informed the DVLA, then he's just running a different shade of the same gauntlet.

If he were to be prosecuted due to the first example, he can face a prison sentence of a number of years. It struck me as not a system to treat lightly.

Molly, he obviously hasn't found a significant enough motivator for him to change his ways. Would the prospect of losing his license or his liberty inspire him at all?

In your shoes, I would be struggling not to report him. He his not only messing with his own life; he is showing absolutely no respect for anyone else or the law.

 

[Mike d]

also means that he is not testing before driving so no means of knowing for sure that he is safe to drive...

An absolute "no no". Take the keys and hand them in. If he killed / injured someone, the guilt would last a lifetime. I could not live with that

 

[azure]

The DV!A have an online form to report concerns about fitness to drive (for you or anyone else reading this thread):

https://emaildvla.direct.gov.uk/emaildvla/cegemail/dvla/en/drivers_med_03.html

 

[phoenix]

I agree with Xoifex above, there is less utility in testing if on mixed insulin, especially if you aren't going to do anything about it. If he is , it still can't be fine tuned, merely adjusted on the basis of the previous days results (and that only really works with consistent carbs) How to do it
But he has to have informed the DVLA and is well advised to also tell his insurance company. The form for a car, motorcycle licence is here and really isn't that onerous (not anywhere near 15 pages) . It's only if he were driving a bus,coach or lorry then it would indeed be more difficult and include extra medicals and checks on the meter memory.
However, they do consult with his doctor and if the doctor doesn't think that he is complying then he might not get the licence.

a final leaflet with all the information about driving that you could perhaps print out for him. http://www.trend-uk.org/documents/Driving leafletAA logo added-V1.pdf

From what you say, I doubt if he's often below the level needed to drive but that's just a guess and he needs to check. ( Personally, I think that it's also probably not good to drive when high but the regulations don't mention that)

edit; hard to do but I agree with using that form if he doesn't comply. I would have considered reporting my elderly father a year or so ago but managed to persuaded him to stop driving

 

[ButtterflyLady]

You could have a rule that if he drives your car, or has you or any children as passengers then he has to test first.

If the insurance cover on his own car is voided, that may be a consequence that bites him and not you.

 

[Bluetit1802]

I was a passenger in a car with a friend who had a hypo. This was back in the 70's. It was a very frightening experience. He drove along a wide pavement, weaving about between lampposts, on the road, then on the pavement. It was dark, and thank God there were no pedestrians or other cars about. He was acting as though he was extremely drunk, but hadn't been drinking. Fortunately there was no collision or incidents, but there could so easily have been. It just is not worth the risk. There are other road users to consider.

 

[Molly56]

Just to clarify and update on a few points raised here...on a positive note.....he has informed DVLA and licence has been approved for 3 years.(not 100% sure form was filled in correctly and shortly after going on to insulin so early days in terms of potential hypos)....he has also informed insurance company...I have removed him from my car insurance and he never has reason to drive my car...if we go out together i always drive....if he goes out alone there is no-one else with him...his bs levels in the morning are generally between 9 and 10 when he does test so not down towards hypo territory....bs levels have never gone down below 5 to my knowledge and if anything tend to be higher in mid teens....

....on a negative note ....he does not carry monitor with him or any means of treating hypo should one occur(refuses to do so / doesn't see why he should have to / doesn't believe he will ever have hypo)...there has been one incident where he felt slightly unwell when out driving on his own but stopped and found something to eat before driving home...I have no idea if this was a potential hypo as he did not test (no monitor in car) but can only hope that it gave him some indication of what could possibly happen....this was about three to four months ago and to my knowledge no repeat ....unfortunately he still sees no need to carry anything with him to treat hypo as he believes he will not ever have one...

Am hopefully going to go to appointment with him on Monday to see diabetic nurse and will see if I can ask some appropriate questions...am hoping that insulin regime or tablets will not be changed even though I don't think the current regime is really providing the control he needs for his diabetes..

..am supposed to be going away on holiday in about 10 days time so want to try and keep the status quo at least for the time being so that there is no potential for extremes of bs levels to be dealing with on holiday....I always thought holidays were supposed to be a restful and relaxing time away from worries and pressure but sadly can't really say that is the case here...may just have to find some ways of getting away and leaving him to it....can foresee long walks on my own along the beach....or separate tables at mealtimes...

Will keep all details about fitness to drive so thank you for links....I think if I have any real concerns I will speak to my GP for advice or the diabetic nurse....I assume that they would have a duty to report if they considered that someone was unfit to drive..I take the point that some will say that I have a duty to do this (actually report to DVLA) but think perhaps a third party making that call would be easier given the circumstances....if I considered that he was a definite danger to himself or others I would of course make that call....

Thank you for all the advice re the mixed insulin....will check this out and if I have any queries make a note to ask the diabetic nurse on Monday or some other time if I don't get there...would be useful to take this away with me just in case it is needed if things go pear shaped whilst on holiday...fingers crossed they don't....

 

[azure]

@Molly56 , there is advice on driving if on insulin here:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/313214/DIABINF.pdf

I hope you have a good holiday

 

[tim2000s]

@Molly56, the best thing you can do is leave him. Report his lack of testing before driving to the dvla and walk out. Given his history he is highly unlikely to be hypo when driving, but do you really want to go on putting yourself through all this pain?

 

[ButtterflyLady]

I was a passenger in a car with a friend who had a hypo. This was back in the 70's. It was a very frightening experience. He drove along a wide pavement, weaving about between lampposts, on the road, then on the pavement. It was dark, and thank God there were no pedestrians or other cars about. He was acting as though he was extremely drunk, but hadn't been drinking. Fortunately there was no collision or incidents, but there could so easily have been. It just is not worth the risk. There are other road users to consider.

I had a similar experience with a medical condition causing driving problems. Before I had any idea that I had severe sleep apnoea, one day I felt sleepy while driving and pulled over for a few minutes to collect myself. Feeling ok to drive, I got back on the road and 2 minutes later the next thing I heard was the car scraping against the guard rail. I had fallen asleep with no warning. Only the car was hurt, thankfully no one else was on the road. I could have killed someone.

This is why I go on about sleep apnoea all the time. And why I have firm views about insulin users testing before they drive.

 

[ButtterflyLady]

@Molly56, the best thing you can do is leave him. Report his lack of testing before driving to the dvla and walk out. Given his history he is highly unlikely to be hypo when driving, but do you really want to go on putting yourself through all this pain?

I agree, and I would add that by "walking out" we mean kicking him out too.

 

[Indy51]

On the whole "kicking out" thing, it may not be that simple - if the UK is anything like Australia, de facto relationships of a certain duration are treated exactly like marriage and splits can entail property settlements and division of assets.

 

[ButtterflyLady]

if he goes out alone there is no-one else with him

except the other road users

I always thought holidays were supposed to be a restful and relaxing time away from worries and pressure

all of life can be like this if we don't live with a self-destructive partner who denies that he is a risk to other road users

if I considered that he was a definite danger to himself or others I would of course make that call....

personally I consider that he is a danger to himself and others at this point... but I respect that this is a call for you to make.

 

[ButtterflyLady]

On the whole "kicking out" thing, it may not be that simple - if the UK is anything like Australia, de facto relationships of a certain duration are treated exactly like marriage and splits can entail property settlements and division of assets.

For sure, I think all three countries have similar laws in this area. But I am talking about looking after one's own mental health and doing what needs to be done. Life is more important than property. I'd rather be poor and happy... and I don't think Molly is in that situation anyway. I was just clarifying that if she owns the house etc she shouldn't have to leave.

 

[Molly56]

Have noticed that my partner is recently injecting his insulin but has not been testing his bs levels ......(Type 2 on 30 units Novomix 30 twice a day plus metformin and forxiga)....
....how important is it to be testing bs levels before injecting insulin and should I be worried by this.....surely blindly injecting insulin is just a pathway to disaster....

Am hopefully going to go to appointment with him on Monday to see diabetic nurse and will see if I can ask some appropriate questions...am hoping that insulin regime or tablets will not be changed even though I don't think the current regime is really providing the control he needs for his diabetes...

Just getting this thread back to the original question ....and as an add on,,,,
....if the diabetic nurse decides to change the regime to MDI at any point will this actually force him into a stricter regime of testing and calculating carb intake..
..as far as I can tell no real account has been taken of carb intake in terms of his current regime other than the initial appointment when they asked what he ate in a typical day and that since the nurse suggested him getting 'Carbs and Cals' (which he hasn't)...
....from what I can see carb intake has definitely reduced from where he was (and is not consistent from day to day depending on food choices) but the amount of insulin has remained almost static...bs levels have reduced slightly but are higher than what many of you would feel comfortable with (generally from 9 to say 15)...
....am partly hoping that insulin regime remains the same as can at least cope with this in terms of little risk of hypos etc but if it does change perhaps that will make him sit up and take more notice of what he should really be doing in managing his diabetes..

On that basis is there anything I should be asking at the diabetic nurse appointment to help support him with this..

..and is there a choice to remain on mixed insulin or does the system mean that a move to basal / bolus is inevitable if it is found that mixed insulin is not achieving the desired results..what are other peoples experience of this....