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Very concerned over a colleague - advice please

B

Bobby B

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Hi,

I work with a guy who has been diabetic for many years and uses insulin (sorry, I'm not diabetic and don't know the specific terms I should use - is this 'type 1?).

What worries me and my other colleagues is that this guy is having problems with low blood sugar on average about once a month, but occasionally has a couple of episodes a day. He either becomes 'vacant' and drowsy, or on odd occasions has collapsed completely.

All day long he is checking his blood and drinking Lucozade. Is this good management of the condition?
He tells us all that it's how he keeps himself in the correct glucose range but following the little research I've done, it seems that he maybe should only be using lucozade as an emergency measure to correct very low sugar ('hypo' ?).
Our colleague is using 4 medium sized bottles a day which seems excessive (not to mention that he appears to be consuming about 2000 calories a day purely in lucozade).

He's a big guy - about 24st, so when he goes down it's a hell of a job to make him safe and get lucozade into him. You may think it's not really our business to make any comment to him, but we are the ones who have to deal with the results (some people find it quite distressing to see him semi-conscious)

Of course we're also very concerned about his general health. Driving is also a worry to us as his condition seems to be so unstable.

I apologise for my general ignorance and hope I haven't said anything that will offend, but would really like some advice.

Bob
 
Good on you, Bob - he's lucky to have collegues like you.

Sounds to me like he's eating to suit his insulin doses, rather than adjusting his insulin doses to what he is eating. 4 bottles of lucozade is lot of sugar for anyone to be consuming, especially a diabetic (and ESPECIALLY a Type 1).

You'll get plenty of advise here - but you'll have to decide how your going to put it to him. He could get very defensive about it. Good luck with that.

Hope it works out for you guys, and I really hope he gets better control. Sounds like he's going about it all thge wrong way.
 
Boy sounds like he doesn't know how to start to control his diabetes...

Because if he is using 4 bottles of lucozade to find off hypo's he must be injecting one heck of a lot of insulin indeed just for the lucozade!!!!!!

What can you do about it... Sadly not very much apart from trying to presude him to seek medical help with his diabetes quick sharp...

As to the driving, he should stop from driving until his condidition is stable, and if he's not hypo aware then he's breaking the law... At the moment it doesn't mean that he got to suspend his liecnce, just reframe from getting behind the wheel until he's sorted...

However if he's driving a company car or driving on company business then the company has some responsibility, and should stop him from driving with or on company behalf (take the car away)....

About the only thing that can be done if the chap won't listen to reason and seek medical help, is enforcing him into a corner, by taking your concerns and worries to management, they can suspend him from duties until he sorts himself out, they can send him to occupational health (who can then advice him to see his diabetic team to resolve his problems)
 
There's not much you can do to help your co-worker. He has to learn to control his condition himself.He needs to talk to his care team, but you could show him this forum. Be very tactful.
Hana
 
Hi Bobby, are any of you on a sufficiently intimate footing to engage your colleague in conversation regarding his visits to his GP, results of latest tests etc? Casually done you could gain knowledge of his care and control. While I appreciate you are not diabetes savvy [neither are some diabetics :cry: ], you may be able to get him to recognise there is a problem. Often someone standing away from the problem can draw attention to it, and the chap in question, while chatting may realise how serious things are. The simple act of contacting this forum shows how concerned you are, and I wish you well :)
Val
 
Your oppo should be told in no uncertain terms that if he won't manage his health and has an accident whilst driving and the other party suspects he was not in full control he will be in all sorts of serious trouble no matter who was at fault. He probably wouldn't be able to claim on his insurance as he might find it null and void certainly if he hasn't informed them and the DVLA of his condition. With so many intelligent people out of work it makes you wonder how this guy holds his job.
 
Your colleague has to learn to manage his condition, you can't do it for him.

However, if hypos are affecting his work it becomes a health and safety issue. A referral to Occupational Health may be in order. If he is driving for work and you/the manager know about this, then you /manager may have some responsibility in the event of an accident. This must be addressed and the risks with this trumps any concern you might have about being tactful.

It sometimes takes being backed in to this kind of corner, where your livelyhood is affected, that someone is spurred on to finally deal with a problem :)

You could suggest he stops by here. We will help all we can :)
 
Hi Bob

Good choice coming here for advice and you are right to be concerned, it could well be he is not fully understanding the condition even with being diabetic a couple of years. :shock:

You say he checks reguarly which is good but It sounds to me (and I am no medical expert :D ) he knows he is low and drinks his lucozade which is over correcting the problem and when he checks again he is too high so maybe he is injecting more insulin to compensate for this. Which can result in insulin build up and bad hypos.

Taking into account you say you know little about diabetes I will try and explain best I can and for this I am just assuming he is your average type 1 diabetic injecting insulin.

He will probably be taking a long acting insulin which is a background insulin for the sake of argument we will say it works slowly all day and night lowering the sugar levels.

When he gets up in the morning his blood sugar should be reasonably normal because the long acting insulin has kept it that way. He will be eating breakfast and that will push up his sugar levels (BG) so he will take a rapid insulin to bring that down. This will continue to lower his BG for roughly the next four to five hours, so if he has the dose right he should be ready to eat something at lunch, if he has it wrong his BG will go low and usually a digestive biscuit or snack is enough to raise it. (A bottle of lucozade will raise it too much).

At lunch he should be checking his BG, if its higher than it should be he may take insulin to reduce it and cover what he’s having for lunch. (Not forgetting the long acting is still working in the background and if he skipped lunch his BG would continue to drop because of this.) Now say he has lunch, and he does not sound a salad type of chap, so he may take some insulin to cover what he has for lunch, again this will last roughly four to five hours so he will be ready to eat again at tea time and take his insulin. So you get the idea background insulin works all day bringing levels down and rapid insulin lasts for about four to five hours peaks at about two and trails off and is used to bring down BG from eating.

He may be taking too much long acting (background insulin) which is keeping him very low, and when he takes his short acting or rapid insulin he’s taking too much for what he’s eating. Hence the hypos. Or it could be he has cut down on his food intake to maybe lose weight but has not adjusted his insulin accordingly.

Hope the above makes some kind of sense its just to give you a rough idea what its all about, everyone is slightly different depending on what insulin they use and how they manage it. Sorry if you know the above but I am just assuming you don’t and it will allow you to work out the times he hypos, because its my bet it will be roughly around the same times of the day. For example if he takes too much insulin at breakfast say 8am he will by hypo around 10 or 11am. Too much at lunch, hypo around 2pm. If it is random he is probably injecting insulin to bring levels down before previous insulin expires.

Now the problem of tackling it, I actually don’t think it’s that tricky. Someone who ever is the most tactful or gets on with him best should sit down and have a chat with him, he may be grateful for it, often there is no one to talk to and it takes someone else to say, I really think you need to have a chat with your doctor.

One example, sorry to witter on. ! I was working at a place and I suspected one of the managers was diabetic. So one day I left my meter on the table purposely so he would see it. He asked if I was diabetic which I said yes, his answer was, oh good I need someone to talk to. He had been diagnosed for over a year and had no clue how to manage it, at first he said he was fine then it started going wrong but because the doctor said inject x amount at x and y amount at y and if you feel ill or your BG is low drink lucozade.

He thought the problem was him, so your chap could be in the same boat and like most men does not want to admit things are not right, is he the type of chap who likes to think he is in control of everything. He may be as worried as you but feels its his problem. Hypos are horrible.

Have a chat with him you might just find he needs someone to confide in, if you do that and it fails, at least you tried. Maybe he can’t see how bad he has become, I take it he has got worse over the time you have known him for you to be so concerned.

Diabetes can be a real pain and when its balanced lovely jubbly, 8) when its not, you are seeing the result. :(

Good luck.
 
I'd just like to sday thanks a million to you all for taking the time to answer my post. Sorry I've not replied earlier but have not had acess to a PC for the last 24 hours.

I've learnt so much so quickly - really appreicate it.

We're now trying to work out how to tackle the problem in the most tactful way. We work in a small company so we can't draw on large company resources. I am this guys boss 'officially' , though we don't work as an autocratic hierachy, but neverthless I do have a responsibiltiy to take this matter in hand if it's getting unreasonable.

He doesn't drive on company business, or operate machinery etc, and is good at his job so we very much want to work with him to improve things.

He's been diabetic for the best part of 15 years to my knowledge, so It really worries us what long term damage he coud be doing to himelf by not handling the condition sensibly. I understand eye, kidney and circulation problems can be a consequence.

After looking around the forum, I think we should ask him for some proper instruction on what we should do when he has an epsioode. Getting lucozade down someones throat when they are almost unconcious is not a nice thing to have to do (and is messy!). I understand that there are gels you can apply to the gums to get the glucose levels up quickly. This would be much easier for us to administer I think. Would you recommend this?

Will let you know how we get on. We'd like to suggest he takes a look at this forum and get some advice, but he would almost certainly see this thread and work out who it's about. That woud be a little embarrassing.

Thanks again for your help and please do keep comments coming if you have them. We're on a steep learning curve!

Bob
 
Having been diabetic myself for twenty years I have only had about ten hypos that have left me unconcious and about five have been my own stupidity, forgetting to eat, injecting too much insulin etc. Plenty of hypos over the years where I have gone low but thats an occupational hazard. :D and even when I used to work I doubt anyone except me would actually know.

If the guy you work with has been diabetic 15 years he should be managing a lot better than you describe, do you know if he has changed his medication recently? I can't see him having been like this for a long period of time because hypos are not nice and passing out from one is not an experience you want to repeat too often. So you have an idea what its like, think back to when you last had a skin full to drink and you wake up in the morning shaky, ill, unsteady on your feet bit confused. Thats what its like but soon as you eat you are OK.

Personally I really think he needs to seek medical advice, how you tactfully tell him this I don't know but as you indicated in your original post, hes a big chap to be passing out. His lack of control is really not very responsible.

The gel you are thinking of is glucogel and he should be able to get it on prescription from his doctor, although its not supposed to be administered if a person is unconcious, but you are right about putting it around the gums, also using honey would be better than trying to get lucozade down him because he might choke.
 
The advice so far is all good. Been away and only just seen this one.

One thing about Glucogel/Hypostop is that is supposed to be given to conscious patients NOT to someone who is unconscious, as Fuji says. If they are unconscious, place them in the recovery position and call an Ambulance straight away. The gel is also meant to be squirted into the mouth and massaged from the outside into the cheeks of the mouth, not the gums. The gel is absorbed more quickly in that way.

NEVER put your fingers into someone's mouth unless you are prepared to lose a few !! :shock:

This guy definitely needs telling in no uncertain terms that this sort of thing has to change and it is his responsibility to do that. It is not just himself that is being put at risk here. As they say, 'sometimes you have to be cruel to be kind ?'
 
cugila said:
The gel is also meant to be squirted into the mouth and massaged from the outside into the cheeks of the mouth, not the gums. The gel is absorbed more quickly in that way.

NEVER put your fingers into someones mouth unless you are prepared to lose a few !! :shock:
Click to expand...
Ooops, Thanks Cugila for correcting me there. :D

could have been an interesting situation, one guy unconcious and the other with no fingers, secretarys passing out, bit of a monty python sketch I think. :lol:
 
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