PLEASE HELP! MY FRIEND IS NOT CONTROLLING HIS TYPE 1 DIABETES

Helping other people is not possible unless they want to be helped first and take the steps. At the moment you are playing a "bit part" role in his melodrama. Maybe the right thing to do is walk away. It might be the wake up call he needs. Putting up with his behaviour and taking his problems on yourself is just encouraging the drama.

I doubt he is talking about this forum, because everyone gets their questions answered here. It doesn't sound like he is being honest with himself, let alone with you. I'm sorry but you may need to give him an ultimatum - "either accept help and learn what to do, or you are on your own". I think otherwise you run the risk of him taking you down with him, stress-wise.

Davidgott said:

Can anybody please help? My best friend has been diagnosed with type 1 diabetes for around 4 years but he is constantly having hypos. We have just been on holiday for 4 days and he had a hypo everyday, one of the days we needed to call out the ambulance, he had over injected that much he wasn't responding to anything. It's getting really scary now as he lives on his own and is not helping himself in the slightest. He thinks he knows how to control his diabetes but obviously it's not working. He really needs some sort of support or mentor to help advise him. He won't take any notice of the people that love him, on the day he had a hypo and the ambulance had to come and inject him with glucose, after the medics had left he had 5 lagers in the afternoon, went for a meal, then before he went to bed he had a portion of chips, injected too much insulin and then when he woke up had another hypo. It's getting so frustrating I feel like giving up on him, he said he has been on the forums but nobody has replied to him so I would just like to prove to him there is a massive community out there that are willing to help, if anybody has any views or opinions it would be highly appreciated.

Thanks

David

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David,

I am sorry about your friends hypos. Everyone knows that they are dangerous and cumulative with each one.
My guess, would be the dose of his insuline I am guessing he is taking insulin because he is Diabetic I and insulin is
more likely to make you hypo than the oral drugs.

Hi. It does sound like he is being very cavalier about his insulin injections. Whilst we can offer a lot of advice on the forum to improve that, it can only work if he listens. I am amzed that anyone would be happy to keep having hypos but not take advice to minimise them. If he does want help, we would need to know more about his insulin regime i.e. is it mixed or Basal/Bolus and whether he carb counts for meals etc. I assume he won't listen to his GP or nurse?

Hello there. I am the said person my friend is talking about who apparently doesn't listen to anybody or doesn't care about his condition. Anyway my name is Kevin & I appreciate my friend posting this. I posted a thread on another big website & got no replies & I sent a message directly to a member on here again without any response.

So I am begging anybody to please please help me as I do listen & so badly need your help. The important thing is I have been a type 1 diabetic for 6 years now & my friend & girlfriend are fed up with me because I have too many hypos. I am obviously fed up too as trying to get your BG between 4-7 without hypos just causes me & all around me so much pain. I inject Novarapid at a ratio of 1 unit for every 5g of carbs & 27 units of Lantus at night . I generally have very few nighttime hypos but that said still too many. My problem seems to be that after my first meal of breakfast my sugars are great after 2 hours but if I don't eat the same amount of carbs 2 hours later then I will have a hypo. So I normally have 2 slices of toast & then 2 hours later another 2 slices or if that's not possible because im out then 30g equivalent. When I used to have my nighttime meal 2 hours after my sugars were fine then before bed I would have a yogurt or piece of fruit & I would be fine. The problem now that NOBODY CAN EXPLAIN is for no apparent reason, nothing's really changed ie routine diet exercise but like breakfast 2 hours after ive had my night meal my sugars are fine but NOW I have to eat the same amount of carbs again otherwise I will have a hypo. So I got used to that & then In the last 2 weeks it's gone back to how it used to be. But then it changes wheneve it wants. Before bed I was 6 so as I was withy friend & had a hypo with ambulance the night before instead of injecting the 27 Lantus which has been fine for a longtime I injected 25. The next morning I was 2.5 which shocked me & my friend lost it telling me I'm an idiot. But normally 27 means I wake up with 7-8 so I under injected my 2 so as not to upset my friend & wake up with 8-9 but instead 2.5. His response is you idiot you over injected, well yes I know but that's very easy for you to say. His response is if I had Type 1 like you it would be perfectly controled. How can he say such a thing when he has no experience of managing the disease??? Anyway I'm very sorry to ramble but any Type 1 or type 2's that can help me I would be eternally grateful. Basically my sugars are sky high at 12-14 or more often 1-3 and I go to hospital or wake up on the floor 4 hours later after my body has produced enough sugar to stagger to the fridge to drink coke. Pleased please help me.

Welcome Kevin...

Welcome, Kevin

It sounds like your insulin regime may need overhauling to help prevent the hypos. Have you spoken to your diabetes nurse about them?

Some people do have something called brittle diabetes where their blood sugars can go up and down, and this is hard to control. Other people may have similar problems, but a tweak to their regime can help.

Do you think the problem is your long acting insulin? Do you carb count?

It could also be that your insulin to carb ratio needs adjusting if you're getting hypos after food.

Hi Kevin.

Glad to see you posting here.

Your friend(s) are obviously worried. In life.. There's always two (at least) interpretations on how we see or hear things. As non diabetics they are concerned but they do not live it daily... They can eat or drink without fear. However, they obviously care and TRY to understand and help.

So....lets get to basics.

1) It sounds as if you are getting levels out of the target ranges of 5-8 regularly. Yes or no?

2) it sounds to me as if you are not always hypo aware and on occasions you are reliant upon assistance from others?

3) to help us help you, would you give us a breakdown of a 24 hour of units of insulin, food and activity... Even scanning a picture of a daily log book would help.

Ie for me... (I am odd!!)

9am wake.. 6units levemir 2 units novorapid.. No food 6.0 bg pre drive...

11am test 4.9 (gardening- my job) ate 2 sugar cubes.

13.30. 5.2. Pre drive ate another 2 sugar cubes.

14.54. 6.7bg

17.09 6.2 ate 36g 6 units.

19.00.... Bg

21.00 bg

23.00 bg and basal jab etc...

We need to know your levels when you get up, before eating, 2 hours after eating etc...

Basics: if you are going high or low 2/3 hours after a bolus and eating... Then your bokus is wrong.

You really need to go 5 clear hours between eating and bolusing and doing 2hour testing.

If you are going high or low over night you need to do some over night testing and possibly test at 3am at least...

Glad you are here talking to us.

Your friends obviously care and worry a lot about you. They know you need to look after yourself and they are genuinely concerned because they do not know how to help or say the right things at the right time!!!

It sounds as if we need to go back to some basics with you.

There are different injections wtc to help nowadays. Sometimes splittg your doses of basal can help... But until we know more of actual levels and timings on a daily basis we can only empathise with you but not actually help until we can ask for a bitmore info...

Kevin welcome, it's really impressive that you have come forward. A hard and brave thing to do.

In the first instance I suggest you change your ratios from 1u : 5g of carbs to 1u : 10g. Particularly at the problem times eg breakfast. Avoiding hypos is a higher priority than 4-7 BG range.

Spiker said:

Kevin welcome, it's really impressive that you have come forward. A hard and brave thing to do.

In the first instance I suggest you change your ratios from 1u : 5g of carbs to 1u : 10g. Particularly at the problem times eg breakfast. Avoiding hypos is a higher priority than 4-7 BG range.

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Thank you very much for your reply Spiker. The advice you have given me is exactly the same as my very experienced diabetic nurse. I did what you have both suggested & after testing 2 hours later my BG was 12-14. For this reason I DIDNT LISTEN because I thought she was completely dilutional. My reason for this thinking is yes ok after 4 hours they would be back to 7 so no need to eat the SAME CARBS again ie 25g

Ok so split the difference and try a 1:8 ratio.

The basic principle is to work from a high BG downwards, not from a low BG upward.

kevinmartinuk_ said:

Thank you very much for your reply Spiker. The advice you have given me is exactly the same as my very experienced diabetic nurse. I did what you have both suggested & after testing 2 hours later my BG was 12-14. For this reason I DIDNT LISTEN because I thought she was completely dilutional. My reason for this thinking is yes ok after 4 hours they would be back to 7 so no need to eat the SAME CARBS again ie 25g

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The problem is for 2 hours every morning I will be having BG between 12-14. For this reason I have done the 1 unit for 5g Carbs got perfect between 4-7 after 2 hours and then to have a 2nd identical breakfast after that 2 hours. My question is is there any other way to get good BG after 2 hours without having to re-eat the same amount of carbs ?????

By the way as a T1 you should TAKE NO ACTION on a +2 hr high value. The 2 hr test for a T1 is to check for an impending hypo not a transient hyper. Transient highs are acceptable. Ironing them out is a more advanced phase, after you get the basics right. You key control point is your +4 hr test not the +2 hr. Some advise T1s not to do +2 tests at all. I think that advice is correct if the person is unable to resist reacting to +2 hr highs. (In the absence of a +4 hr high) the only valid reaction is to note that particular food is a spiky one.

Spiker is right... Best to wipe out the hypo's and start from higher.

Goodness knows why nurses don't think of the inbetween ratio's of 1 to 8 or 1 to 9 etc...

The other thing to possibly get if you haven't got one is an accuchek expert meter.. This is great as you can easily adjust bolus ratios and it calculates so easily...it also allows for 1/2 unit dosees.

Don't know if you use 1/2 unit pens but these may be helpful in getting "fine tuned"....

There is some debate about this and I don't want to come across as saying "this is right / wrong" so let me make it clear this is personal opinion. It reflects what some HCPs have taught me, but clearly other HCPs do have a different view. So, my personal opinion is:

T2 target +2 hr value = fine
T1 target +4 hr value and ignore +2 hr value = fine
T1 target +2 hr value AFTER fixing +4 hr value = fine
T1 target +2 hr value while ignoring +4 hr value = wrong, dangerous, misleading.

Spiker said:

There is some debate about this and I don't want to come across as saying "this is right / wrong" so let me make it clear this is personal opinion. It reflects what some HCPs have taught me, but clearly other HCPs do have a different view. So, my personal opinion is:

T2 target +2 hr value = fine
T1 target +4 hr value and ignore +2 hr value = fine
T1 target +2 hr value AFTER fixing +4 hr value = fine
T1 target +2 hr value while ignoring +4 hr value = wrong, dangerous, misleading.

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I don't understand this?? -lol!!

donnellysdogs said:

Goodness knows why nurses don't think of the inbetween ratio's of 1 to 8 or 1 to 9 etc...

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Because of DAFNE, basically. This is the worst and most damaging aspect of DAFNE (which otherwise is mostly great). The insistence on setting ratios as multiples of 0.5u per 10g. This creates huge gaps in the permitted ratios eg between 0.5:10, 1:10, 1.5:10, 2:10. Huge gaps. The DAFNE designers were more arithmetically illiterate even than they assumed us punters all to be.