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Living with a partner with uncontrolled type 2 diabetes

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Thanks for both the short & long versions, It was me that suggested he was depressed, there is a strong association between diabetes and depression.

I have the book 'Reversing Diabetes' by Dr David Cavan, very good. It covers what is called Diabetes Distress, which is the accumulation of several emotions, Fear , Resentment, Isolation, Guilt, Confusion & Helplessness all leading to depression. You did seen to dismiss the suggestion of depression, but he will never move forward if he is depressed and from what you have said it seems he has all the classic signs.
Get the book it's worth a read, or at least google, depression & diabetes.

He hasn't, done anything so far where he could have helped himself, it's progressed because of that very reason, this will not change even though now he has to inject as the underlying problem is his acknowledgment and that he has to want to change things, this has not happened which is exactly what is described in this book, The Diabetes Distress Vicious Circle Having diabetes leads to diabetes distress, which leads to poor diabetes control, which leads to poor health problem which leads to Diabetes Distress, and the circle continues, which then makes you depressed.
Neil
 
Hi Molly. Sorry to hear that he's now possibly on insulin but it's what was expected so no surprise really. I also commented a while back he seems depressed. Did you manage to speak to the DN about his state of mind and his attitude toward the diabetes? He hasn't accepted anything as yet about the diabetes as far back as I have read in this thread so will he accept it now that he's being put on insulin?
I don't mean this to sound harsh because it's not meant in that way at all, but if you've found hearing about the complications he has and the future scary, then that's possibly how he's been feeling all along too. Hearing that can send you in two directions, either fight it and do everything you can to have a future or
not think about it, give up completely and wallow in depression. It may seem to everyone else that your stubborn, selfish etc but deep down your dying inside. It's very frightening and even worse you know what you're doing to those you care about but you can't snap out of it. No one can understand it unless they have gone through it themselves.
I've been there and with lots of help I came out the other side. It's not a place I ever want to go again.
I could be completely wrong but Im sure your Partner is depressed and no amount of sidestepping the issue hoping that he will see sense, is going to make things better. It's gone on for too long now. Until he opens up and gets the help he needs it's going to be an endless battle for you and will cause you so much stress too.
It's very easy for someone looking in and reading some of your comments to say that he doesn't care etc. I'm sure he does, but right now he can't see any way out.
Thinking of you x
 



@daddys1 …I do agree that depression is part of the problem…if it appeared that I dismissed this then I apologise…

@Pip16 …..yes, his state of mind was mentioned briefly by the DN and it was suggested that this was a matter to discuss with his GP

He is already on anti-depressants (Sertraline) plus also his medication for neuropathic pain is essentially an anti-depressant (Duloxetine)….however perhaps this needs reviewing to see if there is a better one as clearly this is not doing enough and my plan is to make an appointment with his GP as soon as practical in the next couple of weeks to get this looked at…

@daddys1 …I have known about the link with diabetes and depression for some time but will look into it and may also buy the book you mention…

@Pip16 ….am not sure that ‘scary’ was really the right word that I wanted to use but it seemed right at the time when I typed it…whether he is scared by the prospect of what is ahead or whether he knows what is ahead I don’t know as he refuses to talk about it….my guess is that he still has his head in the sand but I really don’t know…

If I had one wish it would be that he does talk to someone about it as I think that this is what he really needs - perhaps a third party as he won't / chooses not to discuss it with me - but as to whether that will ever happen I don’t know…
 
My dear Molly. How can he begin to take charge when you do absolutely everything for him. Please, for his sake, don't keep him stupid. Allow him to take control of his condition. Support him, but allow him to help himself. It frightens me that it is you doing all the medical calculations as if he were a four year old. Give him his power back. If he fails, his DN needs to step in. I don't mean to sound dismissive for all you have done - you have been wonderful. But he needs to learn himself now.

Sent from the Diabetes Forum App
 
A very big HERE HERE
 
@angelicbaby .....point taken.....I hope that he will take control and once we get to see the specialist diabetic nurse in a couple of weeks to explain the insulin I hope that he will be ready to take on board what he is told and he can work it out for himself....or at least he can do it and I will be there to support him.....in the meantime I am just trying to understand the basics of what is involved now that we have reached this point ....
 
Hi Molly
I've no doubt the word scary was the correct word to use. Anyone faced with a serious illness will be scared as will the carer/partner. But as I said earlier, that persons reaction on hearing that news can go both ways.
I think if the DN has said it's a matter for the GP then that appointment should be made ASAP and not given a few weeks at all. You could call the GP and explain beforehand his situation with excuse to your partner the doctor needs to review his meds, so he has made the appt. Once he's in there with the GP then he can take it from there.
Duloxitine is an antidepressant but used in lower doses as pain relief. The gp should be reviewing him regularly anyway especially on that medication. When I started on amitriptyline for pain I was seen every month then every couple of months to make sure my body was handling it ok. Likewise when I was on a antidepressant my GP was phoning me to make sure I was ok, and seeing me regularly over the month or so I was taking it.
If it were me I would be concentrating on getting his state of mind sorted before asking advice on taking the insulin because until he gets himself out of the hole he is in will he be actually taking the insulin or will you be giving him a quick jab when he's not expecting it.
I'm sorry if this seems as though it's all being put on you but from what you've said about his family you're all he has and you're the only one who can help him get to where he needs to be. X
 
Just to say that things seem a little more positive today in terms of general mood etc...seems more upbeat than the last week and more amenable....not sure why....but a definite improvement ...

It was suggested by the diabetic nurse that we keep a record of blood sugar levels whilst waiting for appointment with specialist nurse about the insulin....reading when he got up was 12.3 and before dinner was 12.6...both high I know but lower than the 16.0 and 25.6 of last week..

Whilst I was at work he had been to his first physio appointment (following referral from hip / knee consultation last week)...seems he got on well with the physio who assessed the issue as relating more to muscular pain...has a sheet of exercises to complete and seems keen to do them...this is progress in my book as shows a willingness to do something about it.......next appt with physio in early January / follow up with hip / knee consultant in mid Feb...

Feeling a bit emotional myself but think that is just the relief that now something is being done and that though I know there may well be tricky patches ahead at least for today there is something positive to report...

@Pip16 ....I will make that appointment with the GP as soon as possible but getting an appointment with the GP we normally see is like gold dust......I often check online first thing in the morning as this is the easiest way I have found to make appointments but there was nothing available on the system when I looked this morning....he could see someone else but this particular GP knows what the situation is and I often see him myself if I am feeling particularly under pressure, partly to get myself checked out (recent blood tests for me normal / no action required) but also to brief him on the situation as this is the root cause of my stress.....anyway his mood seems a bit better today but will still look for earliest appointment...
 
Am just trying to get my head around the carbs situation…..have been looking at some of the foods that he (we) eat to see how to best manage this into the future……thought it would be useful to note the carb content and sugar content so have started a small notebook…..that way I can suggest ditching some of the high carb items in favour of some lower carb alternatives….

So just to check I am getting this right ….basically all carbs translate into sugars so regardless of the sugar content on the label it should be the carb content that I need to be aware of…

If so then I have discovered a few horrendous no-nos ……such as the individual pie that he had bought for dinner tonight…the beef one contained 63.7g carbs of which 9.7g was sugar and the chicken one contained 55.4g carbs of which 5.9g was sugar….if he had checked these when he picked them off the shelf (and I doubt it) it would only have been the sugar he noted ….tried to explain that all carbs = sugar but still don’t think he gets it…

Will not be buying those again, that’s for sure and made sure that I didn’t put any potatoes on his plate, just cauliflower, carrots and broccoli…

Anyway, blood sugar levels before dinner was 17.9 …reluctantly taken…so no idea of post dinner levels…...but will be high after the pie

Received letter today to make appointment for diabetes care team…presumably to discuss insulin…..tried to phone for appointment but annoying system which goes straight to answerphone, asks you to leave number and they will call back……...so annoying……..and so inconvenient as not always convenient to take callback….also appointment line only available from 9am to 1pm…
On a personal level I need to make sure that the appointment fits in with my work commitments so whilst he could make the appointment it is easier for me to make it so that I can make sure the timing is appropriate for me….he can make any day / anytime…

Will try to call back on Monday morning but failing that I will drop in to make the appointment….this was the service that my GP told me could provide support for partners and carers so can drop in on the basis of getting more info for my own needs….

Hope we get a reasonably prompt appointment as letter suggested that appointment would be offered within 18 weeks……18 weeks….…that’s four and a half months …..no sense of urgency there then….but perhaps was just a standard letter….

In the meantime will continue to monitor and get back to diabetic nurse if any issues….I asked and she did say that I could contact her if I had any worries or concerns so will take up offer if and when I need it…
 
Hi Molly

Till you get a proper log book for testing etc.. It is a good idea just to write down a diary of the foods ate in a day and the carb values if you can..

It will give a consultant/dsn a good idea of the timings of insulin (depending on what OH is given) etc... The more detail in this short diary the better.. Ie if there's physio it could cause levels to lower.. Rather than if OH sat in a chair all afternoon.

It is total carbs you look at and would be counted... The higher the sugar content.. The worse it is for making bloods go up very quickly and suddenly dipping downward....
But.. Total carbs is what you count.

There is an excellent carbs n cals book you can buy... Pocket size on is great for going out.. It shows you pictures of pasta say on a plate.. A portion.. And a large portion with carbs value approximately. It is good and is available from Amazon for about £7.99.. Or there is an app I think.

You will be amazed just how many carbs is in a pie or just a sausage roll etc....

Good on you for ditching the spuds!!!

Molly, please carry on with your 'me' time.

Christmas is a hard time to get your head wrapped around carb counting and insulin..... So don't panic... He has been ill and in denial for 10+ years... Better late than never, and Xmas is a very hrd time to consider foods.....so don't let this be everything to consider......

Look after yourself
 


@donnellysdogs ..thanks for the useful advice …

Have been looking at best way to record and calculate carbs and have downloaded myfitnesspal onto my ipad as recommended by a number of forum users…first of all to use for myself as it may help to address the food issues that I have been having of late and as you rightly say I do need to look after myself. After seeing how easy it is to use I do think that perhaps this may be a very useful way of him taking control of his own food intake when it does actually come to him having to calculate his carbs and insulin….he does have an ipad which he does use on a daily basis so I could show him how to download and use this…

In the meantime until we get to the appointment I have also managed to set up another myfitnesspal account on my pc using a second email address that I have access to…this means I can keep a record …as far as I can…of what he has eaten …partly as I said before to see if there are any food choices that we need to adjust for more carb friendly dishes…I think it best to leave it until we have the appointment and everything is explained to him as to what needs to be done before expecting him to keep a food diary…

Saying that I guess it is worth asking when I make the appointment what information they need so that he can take the appropriate info with him to his first appointment......such as blood sugar readings etc

As you say perhaps there is no desperate sense of urgency in getting the appointment especially before Christmas but I do worry about the deterioration (clearly parts are not now working how they should) and particularly the high blood sugar levels in high teens and mid twenties (as taken before evening meal)….I did tell the diabetic nurse about this at the recent appointment and how he would be reluctant to attend A&E / what do I do in an emergency / how high should it before before I push panic button but don’t think she exactly reinforced the seriousness of this to him….will just have to hope that a crisis doesn’t develop over the next few weeks before he gets to see someone…

On top of this he is still reluctant to test / doesn’t see the point….sometimes I can tell this is due to high blood sugar levels and his mood at the time so can only suggest it…...no point in forcing the issue and having an argument as he will only be more reluctant to test......there again I am hoping that the diabetic team can be more insistent on this issue.

Am trying my best with the ‘me time’ but concentration levels are not at their best…have got a number of part finished bags and lots of ideas but just lack the motivation at times to focus …will have to set myself a target (presents for Christmas!) and then perhaps I will get them done..
 
Molly

Once OH starts using insulin, he will definately need to bg test otherwise the insulin could cause bg to lower too much or not be high enough. I am hoping that he will just start a basal insulin. If not.... twice daily insulin and eating certain amounts of carb at set time slots and testing bg to determine how much carb needs to be eaten to keep bg ok. MDI or bolus basal might be a bit too much to take on board in the beginning but can be started at a later time once he gets used to using a pen and bg testing a bit more.
 
Hi Molly, I think your hubby needs to work things out for himself. You have tried to do it for him and obviously it doesn't work.
 
My fitness pal is great until you find out what insulin regime he may get put on. It certainly helps with calculating carbs...

However, he must take realisation really that he is going to have to "tow the line" with insulin.

I really would try at some point to explain this to him... He will be able to eat what he likes eventually as long as he takes his own injections and does his own blood tests...(please try to veer off you doing the injections for him) otherwise you really are being nothing more than an unpaid carer.

He needs to realise that he has brought injections on by not eating lower carbs and doing bloods before and after meals.... He still has time to change.. But I think, like you we all recognise he won't.

Please Molly, tell hom now that you are not going to do his injections...

Well done by the way with cutting the potatos....

I so hope Molly that you do get your concentration back to you. If he had an ounce of self esteem he would be looking up firness pal etc for homself, instead of you. We all see that you are in the driving seat again, but I so hope you can get him to take some control of steering toward health himself.

Yes, a contingency plan for high levels in their 20's really should have been given by the DSN to you. If you are listed as his carer at the GP it maybe worth while asking for the DSN to contact you regarding this.. As it is you that will have to deal with it....

You can always ask for a care plan to be put in place.... By GP and hospital... This has to be requested by Patient or their Carer....

Get some quality time for yourself Molly... Best wishes....
 
Molly my friends wife with depression has finally after 18mths been allowed to carb count, mind you this is also her first (one month ago) consult post diagnosis and that's only cause l was going nuts and her hub finally pushed for it the dr and dn were not bothered as she was in and out psych ward and basically annoyed she "missed" appointments....don't get me going on the godawful diabetic care in the area.
However till now she was doing 2 inj one morning and one night regardless of what she ate. However she has always wanted to get things under control when not under depression and unable to think.
I am still pushing for her to do more than 8 to 10 tests a day but not getting there with that she feels it is a waste!

The following may seem harsh but.....I have a feeling that may be best for your partner to do the 2 injections a day, because quite frankly l doubt he would be trusted with carb counting.
He isnt a fool and he knows what carbs means just chooses to ignore it he is a carb addict just as others are addicted to medication or cigarettes or booze all have an excuse.
He will, once he has grasped insulin means eating more goodies be in heaven and shovelling it into his gob and jabbing needles into himself regardless of you...
And when the insulin fails to work after a fairly short time because there is only so much the body can take just hand him a shovel cause he may as well did his own grave.
 
I suspect he will not take any notice of anything anyone tells him. I may be a cynic.
 

Doing 2 injections per day still means counting the carb in food. Years ago all insulin dependant peeps counted the carb, its nothing new. When I was first diagnosed, the BDA helped my mum no end over the phone and sent out leaflets showing how much carb was in a slice of bread and a potatoe etc. Nowadays, the carb info is listed on the food packaging so no need really for Carbs & Cals or fitnesspal and not everyone has a 'smart' mobile phone
 
Agree except packaging....veg? Outside eating... mollys OH goes out when he gets up for something to eat I believe when Molly not around...pies, rolls etc in cafe's don't have carbs on them.. OH won't have a clue!!
 
Nope iHs she didn't carb count she was given an AM and PM dose at hospital discharge and took that no matter what she ate drank or anything in fact carbs other than the standard don't take sugar were the only diet or medical advice given..
As l stated it is only in the last 6 weeks to a month that she has started to count AND to do her own injections..
In fact you saying that on that 2inj/day she would carb count is a shock because l and they never knew that. yes it would make sense but welcome to the black hole of the area we live in.... oh and she is under the "specialist" not the local dr. You know the irony... the info for the best treatment areas or results in the UK... well ours is up the top end group if that isnt scary it should be.
 
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