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Urgent advise requested

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perplexed.paul

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6
I wonder if you can help me, I've just been contacted by a close friend who has type II, has been diagnosed for many years and is currently controlled with metfomin, sha has always had very real difficulty in accepting her diabetes and is frightened by it.

I have always been concerned by her diet, she eats very badly and will go for days eating hardly anthing, she puts this to having been prescibed insulin 5 years ago when pregnant, and is adamant that prior to this she ate well, when she does eat it is usually totally unsuitable and often includes sweets.

Her life has been very stressful over the last couple of years and this has recently been copounded by the fact that she is waiting to get hosital test results for her little girl.

She has been very tired over the last weeks and today described falling into what sounds like short lasting coma's of about 2 hours duration; I am wondering if what is happening is caused by glucose liver dump, in turn caused by fasting for long periods and an increased level of stress.

I am trying to get her to attend either her diabetic nurse or clinic but at the moment that is not going to happen and I'm it as far as advise and support goes, I am a nurse but with no specialist knowledge of diabetes.

Accordingly I'd be grateful if you could confirm that liver dump is POSSIBLY what is happening and give me advise regarding very small snack type meals that I can try to get her to eat.

I am, of course, going to continue to try and get her to involve her specialists but with little hope at present.

Thanks in advance

Paul
 
I'm hoping a proper expert comes along for this one!!
My initial thought is that she is going really low because of not eating and passing out.Then ,because she is so low the liver is dumping and bringing her round again so the liver dump is not a bad thing!!
She really needs to get herself in control with your help!!Eating regularly is the first thing and eating properly too.Try and stick to reduced carbs with proteins and fats to stabilise her.
It may be a good idea to get her to read and maybe join the forum as well so that we can try and help with the fear of her diabetes,we've all been there and know just what it is like.
She also needs doctor/nurse input to see just exactly what her blood sugars etc are.
 
Thanks for the response.

Having just come off the phone with her I have an update, she's admmitted she doesn't take her metformin because it makes her feel ill, and hasn't for months, I tried to persuade her to go and see her nurse or doctor, she said she has an appointment at the end of June but has a history of failing to attend; I got her to test whilst on the phone and it was 11.5, again she only tested because I asked she normally doesn't bother.

She insists she fine and that she will continue to be fine, I really think she's in total denial, and given she also complained of pains in he upper abdomen, I'm very worried but totally helpless.
 
Paul,hard as it is,she is the only one who can take control of her diabetes.Of course you can be there to support and help her but without her cooperation nothing will happen.She needs to get her levels under control. 11.5 is not good!!High readings like that are the sure road to complications!!
First thing is to make sure she keeps that appointment ,go with her if necessary .She is in denial but let's hope she comes to acceptance before it is too late to help.
 
Hi paul,
I think paul to be honest with you! I think your friend is suffering with depression! Has she ever been checked for post natal depression! She is waiting on test results on child! She must be internal turmoil!
I feel for you as you are her friend! If i was you i would spend some time with herand ask her how she feels and ask her to be honest! Is she a single mum?
I know this sounds mad, upper abdomen pain this could be caused by the high blood sugars! I know that blood sugars in the 11 stage are not good and this in turn will cause major problems with her health!
The problem is that you can only help her if she is willing to help or meet you half way!
I know how she feels, i had a baby who was very sick and i lost my baby he was born 2 months early! Very small, i watched him slowly slip away! Thing is paul to me it sounds like your friend is depressed in a big way!
I know that this sounds stupid but you need to be able to help her focus on the fact that her child needs her! She sounds like she needs a good cry and let all the pain out!
Paul right now she needs a friend more than anything! Have you tried to make a meal and make sure that she eats some food! I can understand the pain she is going through!
I would love to be able to talk to your friend direct is there any chance of you getting her to Pm me?
Don't panic i am not a nutter honest! I am a ex mental health nurse!
Now onto medical issues, you say she misses health appointments, Is there any chance of you or a friend going with her to one of these appointments as she might be affraid of being alone around strangers, she sounds like she needs handling with kid gloves at the minute!
I am thinking that she has depression of some sort! Poor soul!
I hope you are okay and fine with this paul as right now she needs you more than ever! As you were able to get her to test! I think fear is her biggest problem admitting to a problem!
Sandy
 
Hi Paul

I agree with the last poster in that it seems your friend may be suffering from depression which will be exacerbated by her poor diet. Given that she is having 2 hour 'comas' and is in denial about her diabetes, she needs to get expert help much sooner than her appointment at the end of June. If you could persuade her of the need to see a doctor as soon as possible and offer to accompany her, perhaps you could contact her doctor to arrange the appointment on her behalf. The doctor should be able to offer her help with her depression through counselling, as well as her diabetes management. Perhaps appealing to her mothering instinct in the context of needing to be well not only for herself but her child might give her some impetus to start facing up to her diabetes?

A reduced carb diet with protein, vegetables and good quality fats should not only help reduce her BG level but will also help to alleviate the depression. There is a lot of excellent information on this forum about the effectiveness of a reduced carb diet in managing diabetes - in particular look out for posts by Fergus. This approach isn't a one size fits all solution but is certainly something your friend should try.

You are a great friend and your friend is lucky to have you on her side during this very diffocult time.
 
Thank you very much for the infomation and advice.

I seem to making some progress with eating and will try and implement the other very good advice you've given me, but I think it's very much a case of make haste slowly.

Her daughters test results will be available next week and, very hopefully, these will give some reassurrance and lessen the current stress levels, I'm hoping she'll then be a bit more open to focussing on her own needs.

Anyway thanks for the responses.

Paul
 
good luck and keep helping your friend, she is very lucky to have you :)
 
I'd tend to agree. If you could somehow persuade her to do some more systematic testing

you might get a better idea of what was occurring

I used to zone out and be completely unable to keep my eyes open which was put down to "neurosis" and "hypochondria" but which was strangely related to my BG which would go high after eating and then crash a couple of hours later. This had a major negative effect on my depression and other symptoms.
 
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