Hi, I'm new to the group,so hope my question is OK. My partner has recently been diagnosed with type2 diabetes. He is 77years old,is under palliative care fir lung cancer. He was prescribed Metformin, but after 1 tablet he had horrendous diarrhea. At that time, he was also hospitalised for hypercalcaemia(high calcium levels). Diabetes nurse now suggesting insulin. My concern is that due to the cancer,he doesn't eat any solids food at all. And I mean absolutely nothing. He survives on build up shakes, 4/5 a day. Everything that I read,points to the importance of food,particularly carbs,so I am very concerned about him taking insulin. I feel that lack of solid food probably contributed to the problems with Metformin. The medics don't seem to understand/believe(not sure which) that he really doesn't eat anything. Has anyone come across this issue? Many thanks for reading.
Hi
@westcornwall ,
I'm sorry about the situation that brought you here. Maybe these things'll help: Like others said, it doesn't matter if foods are solid or no... Metformin can have a horrid effect on the gut no matter what, so if it's a no-go, it's a no-go. Right now, being comfortable matters above everything else, and having the runs just makes a bad situation worse. The shakes he's on do contain more carbs than an average diabetic can deal with without some outside help, besides the protein someone with cancer treatment needs, so he shouldn't get hypo's if those liquids are being kept down alright, and he takes them 4 to 5 times a day. Also, I don't know if he's on steroids to be able to breathe easier, through pills, a nebuliser or other method, but those drive blood glucose up, too. If you're concerned about hypoglycemia on insulin: The hospital isn't likely to aim for non-diabetic levels, but rather just keep him from going far too high and becoming uncomfortable with the affects of high blood sugar. Not low enough to be in the normal range or in danger of a hypo, but not high enough to feel ill with that, on top of everything else. What you can try is request a CGM so his glucose is monitored all the time, though if he lays on the sensor, it will give hypo-alarms when he's not hypo. (They're called compression lows). So that is an option to put your mind at ease. The personel might sound like they don't believe he's not eating, but those shakes
are food, in liquid form, so that might explain that: he eats.... He just drinks his food.
My mother was in the same situation. The steroids and inflamed lung tumor drove up her blood sugars, and she got a few units of insulin after every "meal", though she didn't actually eat anymore, save, like you said, those drinks. (Mainly chocolate and strawberry). The main thing is to be comfortable now, and between the medication he's likely on, and the treatments he's received, it wouldn't be a bad thing to keep blood sugars under control a little with a smidge of insulin here and there. We're not supposed to give medical advice on here, but I can tell you this: The insulin isn't likely to be a problem. He'll be monitored by the nurses, and they aren't going to overshoot, the treatment is usually very conservative. Just to keep comfortable.
Hang in there, eh... It's a tough time, and worse ahead, so try and keep an eye on yourself as well. Take that nap, have that biscuit. Make sure you keep upright, because you'll need your strength for a while to come yet.
Hugs,
Jo
