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

[Mike d]

perhaps that will make him sit up and take more notice of what he should really be doing in managing his diabetes..

He hasn't to date.

 

[azure]

MDI won't force him to do anything sadly. He can still refuse to test or count carbs.

I don't think a move to MDI would be inevitable. Mixed insulin suits some people for various reasons, and he could request to stay on it. You could use his non-compliance as a reason.

As for things to ask the nurse, I'd explain he doesn't test properly and so you/he prefer to keep the doses the same. You could also mention your upcoming holiday and say you don't want changes made before that.

(Although his blood sugars are high, hypos are always possible, especially if his carb intake varies from day to day. Don't be caught out)

 

[ButtterflyLady]

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....

You can ask the nurse whatever you like but his BG control will only improve if he wants to change. You can't do it for him.

 

[phoenix]

If that 9-15mmol/l is at the same time it is totally erratic .The insulin is helping to keep his glucose levels down to a point and that is important. It is though a long way from controlled Look at how the retinopathy team (from my previous link)defines good control on mixed insulin

If your sugars remain controlled, that is 5-6 mmol/l before meals, and less than 8 two hours after a meal, you are likely to be controlled. Good control can be confirmed by the next HbA1c level you have at your doctor's

Control requires self discipline and with that type of insulin a regular pattern of diet and exercise .It is sometimes harder as levels fall because you can't reduce the fast element and the basal element independently . It's when finer adjustment is impossible that MDI is an advantage. There are people that use mixed insulins for decades because it works well for them.
Why ask any questions? . It should be your husband talking to them. If you keep doing it for him then he can continue to sit back and continue to abdicate the responsibility to you.

 

[Enclave]

Your his partner ... not his mum ... leave him to sort this out himself with his diabetic nurse and his conscience .. think he has been ignoring your attempts to help for way to long now. This is his life .. you cannot live it for him !

 

[Molly56]

OK ....not sure I should do this but here goes....just looking at it from another angle this is about self preservation and protecting myself from what the future may hold....from a purely selfish point of view this is about me...

....whatever I can do at this current time to steer him down the right path and manage his diabetes / delay complications will mean that my life will not be impacted by this in the way that it would if serious complications were to step in.....if it got to the point where he needed either part time or full time care then it would be me having to give up work and other activities that I currently enjoy to do this...
....so if I need to ask the questions to understand and point him in the right direction and prevent that from happening then that is what I will do...and am doing....

....in the short term...it will also be me that carries the brunt of any worry when we are away on holiday and he should fall ill....

And just before we start going down the 'packing anyone's bags' route once again....at the moment I don't consider that to be an option....it may come to it one day further down the line so am not ruling it out completely, but not now or in the immediate future....

Sorry if that makes it sound as if I am being really selfish but self preservation is kicking in in terms of protecting my own physical and mental health (an important point mentioned by other members and one I am fully aware of)...and future...so am not trying to do it for him...but for me...

.....don't suppose anyone will understand my motives but have said it anyway....time now to get out in the garden and enjoy the sunshine...

 

[mrspuddleduck]

Hi @Molly56, not sure if I've posted on your threads before but just wanted to say hang on in there. None of us have the right to judge in any way, and I'm sure none of us would try and influence your decisions - bottom line is its your relationship and your family, no one elses. I think the view that you should leave is borne out of caring and frustration for your predicament rather than a judgement of you in any way. Bottom line is I think lots of people want to come round and shake some sense into him!! For me the important thing is that you can come here for advice, information and to safely vent your frustrations, and for that you are well and truely welcome!! Take care, Sue xxxxx

 

[azure]

@Molly56 I understand your need for 'management' for your own sake. Use the info you've been give above and do the best you can. If you can cajole/bribe/persuade or even scare your partner into better control then do what you need to

I know the driving has been mentioned before, including by me above, but once somebody is on insulin, the risk for hypos is there, and I can't stress enough how they can come out of nowhere (poor control, upset tummy, less carbs than normal, change of routine, etc, etc, even no apparent reason at all). When your partner got his 3 year licence (and I'm pleased he did inform them he was on insulin) he'd have had to read/sign about the obligations of being on insulin and the necessity of testing, etc. I'm sure you know the risks, but please, if in any doubt - even the tiniest fraction - tell the DVLA. You can be anonymous and not have your name revealed. Don't rely on the GP. I know their guidelines have been made stricter, but I'm unsure whether they are forced to inform. Better safe than sorry - especially when the lives of others are involved.

 

[Enclave]

I was not trying to sound hurtful .. I am sorry if I did, but at the end of the day we are all trying to give our advice, but it comes down to the fact that in your words ...he will not discuss or listen to you trying to help him. Fact, in your words .. he refuses to read the forums here .. Fact ..in your words he is not wanting to listen or follow the advice of his dbn ...
Don't throw him out .. Just dust around him .. If he needs care ..get the Drs to arrange this .. You are not married ... Give him space .. He's a grown man .. Like the saying says .. You can lead a horse to water .. But you can't make it drink ... Well in your case ... You can lead your partner to his bs test meter ... But you cannot make him test.

 

[Molly56]

I was not trying to sound hurtful .. I am sorry if I did, but at the end of the day we are all trying to give our advice, but it comes down to the fact that in your words ...he will not discuss or listen to you trying to help him. Fact, in your words .. he refuses to read the forums here .. Fact ..in your words he is not wanting to listen or follow the advice of his dbn ...
Don't throw him out .. Just dust around him .. If he needs care ..get the Drs to arrange this .. You are not married ... Give him space .. He's a grown man .. Like the saying says .. You can lead a horse to water .. But you can't make it drink ... Well in your case ... You can lead your partner to his bs test meter ... But you cannot make him test.

@Enclave ....just wanted to say that my comments weren't directed at any particular post...was more just a general observation to everyone as to what my motivations were or sometimes are ....and yes, at times it comes down to being selfish and thinking about myself and self preservation for the future...
....I like the idea of dusting around him so will keep that comment in mind ....thank you for your continued words of wisdom, they are always welcome and often make me stop and think....hope you are keeping well

 

[ButtterflyLady]

OK ....not sure I should do this but here goes....just looking at it from another angle this is about self preservation and protecting myself from what the future may hold....from a purely selfish point of view this is about me...

....whatever I can do at this current time to steer him down the right path and manage his diabetes / delay complications will mean that my life will not be impacted by this in the way that it would if serious complications were to step in.....if it got to the point where he needed either part time or full time care then it would be me having to give up work and other activities that I currently enjoy to do this...
....so if I need to ask the questions to understand and point him in the right direction and prevent that from happening then that is what I will do...and am doing....

....in the short term...it will also be me that carries the brunt of any worry when we are away on holiday and he should fall ill....

And just before we start going down the 'packing anyone's bags' route once again....at the moment I don't consider that to be an option....it may come to it one day further down the line so am not ruling it out completely, but not now or in the immediate future....

Sorry if that makes it sound as if I am being really selfish but self preservation is kicking in in terms of protecting my own physical and mental health (an important point mentioned by other members and one I am fully aware of)...and future...so am not trying to do it for him...but for me...

.....don't suppose anyone will understand my motives but have said it anyway....time now to get out in the garden and enjoy the sunshine...

I've been trying to encourage you to be selfish and look after your own interests so I'm glad you are thinking along those lines. The thing is, if he gets sicker, you are not actually obliged to become his caregiver. You have choices. It sounds like a very unequal relationship, where he can do whatever he likes, and you will be there to pick up the pieces. As long as you continue to show him that you are prepared to do that, he won't listen to a word you say. The only way for you both to be as healthy as possible, is for you to dust around him and really stick to that. If he sees that you won't rescue him and smooth things over and deal with the consequences of his choices for him, then he has a chance to take responsibility for himself.