Moving on….Starting on insulin....positive signs of improvement ...glimmers of hope...

[angelicbaby]

Maybe you can explain to the HCP when you visit them in the next few days to discuss insulin, the same way you try to explain to us. Ask them to send him on a DAFNE, DESMOND OR X-PERT course or if there is a newer equivalent immediately. i believe these courses are designed to make even the most thick headed understand diabetes and how to control it. This is all up to him now. Apart from ensuring there is food in the house low in carbs, you are not the deciding factor in how he manages this condition. If he cannot grasp how to help himself, he will spend a long time regretting decisions he has made. There is a poster on this forum who tells us he is almost at the end of his diabetic journey, and reading his story is sobering. Maybe your husband needs to see it too.

 

[donnellysdogs]

A suggestion of Mollys OH attending a course would be a good suggestion to get raised.

He wouldn't have to go by himself.. Lots of these course allow partners etc...

Only problem would be if the instructors are carb loading ones.. But the concept of increasing knowledge from someone else would be something that he may accept easier than Molly telling him.

 

[CollieBoy]

A suggestion of Mollys OH attending a course would be a good suggestion to get raised.

He wouldn't have to go by himself.. Lots of these course allow partners etc...

Only problem would be if the instructors are carb loading ones.. But the concept of increasing knowledge from someone else would be something that he may accept easier than Molly telling him.

Perhaps some of the posters from the area adjacent to Molly could advise if their recent encounters with trainers have been "carb loaders" or not!

 

[Arab Horse]

Perhaps some of the posters from the area adjacent to Molly could advise if their recent encounters with trainers have been "carb loaders" or not!

Not sure where you live Molly but my Desmond course in August last year in Bury St Edmunds, Suffolk, was the standard diabetic plate i.e. 40% carbbs, cut the fat off meat, no cooking oil, oily salad dressing, Flora rather than butter, skimmed milk etc. I spent months getting nowhere until I started using this site and learned from others that what I was doing was all wrong. I went by myself but most of the others there had someone with them, we had to bring a packed lunch, tea and coffee provided. I had assumed that they would look at the packed lunches and comment but they left the room and we ate what we had brought (and I was surprised to see some crisps, biscuits etc!

 

[AndBreathe]

A suggestion of Mollys OH attending a course would be a good suggestion to get raised.

He wouldn't have to go by himself.. Lots of these course allow partners etc...

Only problem would be if the instructors are carb loading ones.. But the concept of increasing knowledge from someone else would be something that he may accept easier than Molly telling him.

To be honest, I don't think it would matter a jot to Molly's OH if the course were carb loading or not. In fact, if he will not give up carbs (and this seems to be his current stance), then such lecturing would just switch him further off. From what Molly says, her OH considers with insulin he'll be able to stop testing every day. It is my belief he thinks he'll do the odd injection, carry on as otherwise is normal for him, and all will be well.

If at least he were treating at least one half of his condition with respect (i.e. eating or medication/testing) he'd be better off. I currently "see" he neither eats appropriately, nor does he monitor his underlying condition or take medication suited to his current (partly self inflicted, in my view) needs.

If anything could make him take action on at least one of those fronts, it would be a massive success, in my view.

 

[Arab Horse]

Molly, I think you are a saint. I know I would have lost patience with him a long time ago; it really isn't fair of him to load all this stress on you. I think when you go to the meeting you need to make sure that the doctor knows exactly how uncooperative he is with regard to diet, testing, exercise and anything else he won't do and should. He is also wasting a lot of NHS resources helping him when he won't help himself. To be blunt, the only upside financially is that he won't be around as long as he might have been if he continues as he is doing. maybe he should read this!!!!

I don't mean my comments unkindly but diabetes IS SERIOUS and the consequences of years of high glucose levels are awful so it is time he woke up to that fact. and started to take responsibility for his health instead of loading all that worry on you.

Good luck with the appointment and I really hope it is the wake up call he needs.

 

[Molly56]

Good suggestions about the course ...I was aware from reading the forum that these courses were available but assumed that they were offered to those who were newly diagnosed......being Type 2 for something like 15 to 20 years he has as far as I am aware never been offered a course and certainly not in the last 3-4 years whilst I have been on the case....

Will wait and see what is mentioned at the appointment and gauge from what is decided / suggested about insulin regime whether to ask about courses at this point.....personally I doubt very much that he would agree to attend one anyway as it is not his sort of thing...when he used to have to attend courses for work he would find every excuse in the book as to why he shouldn't go / deemed them a waste of time but will have to see if he has a change of attitude...

It may be best to see what support is offered from the diabetic team and then ask about courses at a later date once he has got over the initial changeover on to insulin.....I expect there will be plenty to get our heads round at the appointment / over the coming weeks....

On a positive note.......Just every now and then there is a small glimmer of hope that he is not in total denial and does accept that he needs to do something about this....there was one today but it was only there for a fleeting moment and then gone again....

....it did give me a brief opportunity to explain that when he is on the insulin it will mean continuing to test and ask him how else will he know how much insulin he needs to take / the risk of having hypos if incorrect dosage taken etc / not being able to drive if hypos a problem......hopefully it made him stop and think....

I did ask him the question "how much do you know about insulin" and suggested he should read up a bit about it....but doubt he will.....am of the mind to basically set the scene where I can over the next couple of days but leave it to the HCP to explain it all on Wednesday.

...until I know what insulin regime they will be suggesting I don't want to overcomplicate matters with all the different permutations of what it could involve or tell him the wrong thing .....or worse still, frighten him off completely and risk him just deciding not to attend the appointment.....he MUST go to that appointment....

Anyway, thanks to the forum I have some better idea of what lies ahead.....no doubt I will be back with a whole long list of questions once I know where this is heading....

 

[Molly56]

Just 2 days now until appointment with community diabetic team to discuss moving on to insulin.....feeling a little apprehensive not knowing what will be suggested and what response that will have.....been trying to make small suggestions as to what will be involved to prepare the ground as they say.....with small glimmers of understanding and hopefully some signs of compliance for what lies ahead...will just have to wait and see...it could so easily go the other way depending on what mood he is in....

Have been trying to get my head round things over past few weeks, hence my questions on the forum ....so many different scenarios have been suggested that I have started to confuse myself at times.........and so many questions in my head to ask....

Not sure how it will work being a HCP that he has not met before....and not sure how much of his diabetic history they will have to hand as this move to insulin is dealt with by the community team (outsourced by GP) rather than the diabetic nurses at the GP practice he has seen over recent times.......am never sure just how much information is shared between these different groups......on past experience and other hospital clinics I would say not a lot as it seems you always have to go back to the beginning and start explaining the whole medical history from scratch....

Just hoping Wednesday's appointment goes smoothly and he comes away with the right answer for him

(and for us, as ultimately I will be involved in some way, though I am going to draw the line on sorting out his insulin.....he must know and understand what he needs to do himself...and I will need to make this crystal clear and stick to it....)....

...am feeling nervous about it already and I am not the patient....I sometimes think that perhaps it would be easier if I was....

 

[angelicbaby]

I imagine (never been there myself) that moving from tablets to insulin will be like becoming a diabetic again. You will be monitored for a month or so and have to show that you understand how to manage the food/insulin regime. I was able to manage myself very quickly with tablets so was left to my own devices by my HCP very quickly, however if your other half cannot show them that he understands how to control his condition (and this is where you come in - you CANNOT help him in any way) then they have to spend more time with him. You will not be doing him any favours by hiding his problems from them, Maybe someone on this forum has taken the move from tablets to insulin and can help you with the strategies used by the HCP's but to be honest I would rather be having this conversation to your husband himself.

 

[Molly56]

Finally the day came yesterday when he had his appointment with the community diabetic team to discuss moving on to insulin….generally all went well and he seemed co-operative about moving on to this additional medication…

So the verdict was …..to keep taking existing tablets (Metformin 2000mg per day and Gliclazide 320mg er day) but to add in insulin as additional medication…
Insulin prescribed is Humulin1….to be taken once a day starting at 10 units and increasing by 2 units if blood sugar levels remain above 8 for more than 4 days….

Current HbA1c is 86 or 10%....the target is to get this down to 60 or below (7.5%)

So that is the theory….will have to wait and see what happens in practice…

It has been suggested that given his ‘normal routine’ he is to take the insulin in one dose when he takes his morning medication….this is generally at about 11am before he goes out for his usual lunch….I do have a few minor reservations about this such as how quickly insulin will work and fact he won’t be eating for up to an hour after taking it but did explain this to nurse and she seemed to think this would be ok…

He has been told to test his blood twice a day and before driving….whether this will happen we will have to see…my guess is not….he was also told to inform DVLA and insurance company …have printed off forms last night for him as his computer won’t link to printer but whether he fills these in correctly or not will be down to him….

Anyway I will collect prescription when it is ready and then will just leave him to get on with it…..need to make a conscious effort to step back and make him deal with this and make any mistakes himself….I will of course observe quietly and answer questions if asked but ultimately this is down to him…

I seem to remember the nurse saying that he needs to phone in with blood sugar readings in about a week …..or if he doesn’t ring them then she will give him a call……there again I need to leave this to him but if I have any major concerns I can always contact them myself via the helpline…

Will obviously be a testing time over the next couple of weeks…..hopefully many of my fears may be unfounded but will just have to wait and see….

Final point…..hypos were mentioned and explained, which is obviously a cause for concern….his thought is that he will not have a hypo…there again we will have to wait and see though I fully expect that as blood sugar levels fall he may well have hypo like symptoms as his body adjusts…

Trying to keep calm and relaxed as I steer through these uncharted waters…..I fully understand that this is just the starting point and that insulin regime will change over time but this is where we are here and now….

 

[Arab Horse]

Thanks for the update; hope all goes well, fingers crossed.

 

[Molly56]

Just thought a quick update was in order as some definite signs of improvement and hope…..

Over the last couple of days there have been some noticeable signs of progress….first of all he has accepted the idea that he has to do something about his diabetes and that the insulin is the next step….

….a more positive sign is that he has also been talking about what he needs to do and is taking steps himself to find out what he actually needs to do…..he has read through the information provided by the nurse and we have actually talked about what he will need to do…

.....to me this is definite progress as he would always blank any attempts to talk about it in the past….

…he has also been looking up information on the internet about insulin pens and has even been looking at videos on Youtube about how to inject……he also found ones about the top 10 things to eat to lower blood glucose levels and top 10 things not to eat …..so is beginning to think more about diet and how this will help…..he even suggested last night that he will be ditching his evening bowl of porridge!

I collected his insulin prescription yesterday and this is now with his other medication so it is now just up to him to decide when to start and get on with it….

Am hoping that this new found interest in dealing with his diabetes will continue…..only the coming days will tell….

 

[Mike d]

Just hope that this is NOT temporary Molly.

 

[Molly56]

Just hope that this is NOT temporary Molly.

@Mike D .....my thoughts too.....am not expecting miracles.....but any progress is better than no progress....

 

[Arab Horse]

Nice to see some positive signs, long may it last. The consequences of it not are very bad for him and for you.. Good luck.

 

[angelicbaby]

I'm confident that if he starts to see an improvement with his Blood Glucose he will be spurred on to get it further under control. Maybe now is the time to introduce him to this (or another) forum where he can collect advice from fellow diabetics who are living successfully with their condition. We will never know who he is or that he is related to you. He will just be another newbee looking for advice. Please consider.

 

[iHs]

Years ago diabetic internet forums didnt exist and most insulin dependant people managed ok with seeing their hospital consultants and reading copies of Balance magazine. The situation turned bad when diabetics were discharged to the care of a GP and the bolus basal regime was introduced which no one knew how to use correctly until DAFNE courses and online BDEC. At the moment, there isnt any real need for Mollys OH tolook at forums as all he will have to do is eat the correct amount of carb as and when he should and that can be detrrmined by info given by dsn and bg testing. He should be ok with testing bg x 4 per day and eat carb the little and often way to stabilise the insulin's effect with the oral med on bg bg. If he eats too much carb, his bg will go higher and if he eats too little, then the hypo feeling will come.

If Mollys OH does decide to post to a forum, it might be wise for Mollys threads to be deleted so that OH wont put 2 and 2 togrther and work out who the threads relate to as it will cause relationship bust up and pack yr bags time.

 

[donnellysdogs]

Years ago diabetic internet forums didnt exist and most insulin dependant people managed ok with seeing their hospital consultants and reading copies of Balance magazine. The situation turned bad when diabetics were discharged to the care of a GP and the bolus basal regime was introduced which no one knew how to use correctly until DAFNE courses and online BDEC. At the moment, there isnt any real need for Mollys OH tolook at forums as all he will have to do is eat the correct amount of carb as and when he should and that can be detrrmined by info given by dsn and bg testing. He should be ok with testing bg x 4 per day and eat carb the little and often way to stabilise the insulin's effect with the oral med on bg bg. If he eats too much carb, his bg will go higher and if he eats too little, then the hypo feeling will come.

If Mollys OH does decide to post to a forum, it might be wise for Mollys threads to be deleted so that OH wont put 2 and 2 togrther and work out who the threads relate to as it will cause relationship bust up and pack yr bags time.

@iHs OH of Molly has beentold to test 2 times one day and to test at 2 different times the next day.

Personally I do not think this is correct or enough for someone remaining on the rablets he was on and also having insulin thrown on top.

There is nothing better than seeing initially at least how foods affect your levels.... And this necessitates in more testing. Not just two tests a day. Personally I see that as absolute lunacy.

 

[donnellysdogs]

Also, he may well just start to feel odd for a hypo and may well not think to test as he's been told just twice a day...

 

[iHs]

Years ago, diabetics didnt test bg levels, ibecause meters werent developed so everyone just used clinitest tabs and Clinistix.
I am sure Mollys OH will pick up on the hypo feeling as not being ok and treat with some glucose or carb to see if the feeling goes. If it goes, thrn he will know that he has acted correctly. It will be for the dsn to discuss driving a car and the DVLA requirement and the necessity to bg test.
Not sure how strong in action Humalin 1 is but as long as he keeps to eating carb food in the correct quantities, then he should be ok. I am sure Molly can buy the SD codefree meter and teststrips without robbing the bank and do 2 more tests if worried.