What to do with the Mother-in -law....

I reckon there are many, many people in the same position as yourself. My friend despairs over her sister, another friend over her husband. In their cases the loved one is injecting insulin to balance what they eat and neither will give up favourite foods nor amend their diet in any way. My friends know how I eat and exercise and know the foods their sister/hubby eat is are bad for them. The problem is that we all must really want to change our diet/ lifestyle ourselves because the diabetic life IS hard going and many people see only deprivation in following the lifestyle. Perhaps some other member has an answer

Hi,

Firstly, Metformin doesn't help at all with post meal spikes. It works on the liver, helping to a limited extent in reducing the amount of glucose the liver produces naturally in times of stress, fasting, exercise and so on, and to a limited extent with insulin resistance. It is mainly an appetite suppressant. It also comes with (temporary) side effects in the form of tummy upsets, so needs to be taken with food. It isn't a miracle drug.

The course she was on may not have helped as the dietary advice is the usual NHS rubbish of eat carbs with every meal, low fat, swap to wholemeal. I have read on this forum that some T2s attending these courses were given biscuits and cakes for refreshments!

The only way your MiL can get her levels down and stop this disease from progressing is to cut the carbs (not just sugar/cakes/jam but all major carbs) It will be hard for her at her age to suddenly change her eating habits, but it is all she can do if she wants to avoid more serious medication and insulin. There is no harm in occasional treats, as long as they are occasional.

If she does the testing before meals and 2 hours after first bite she can see for herself what that food has done to her levels and it may frighten her into doing something about it. Make sure she knows what the safe levels are. (never above 8.5, preferably 7.8, post meal)

I wish you luck with this one.

@moodwife I have read on here that people are served biscuits at the DESMOND course tea breaks so it is not surprising that she does not know the way forward for good health. I don't think that missing the odd metformin is too bad as the effects are cumulative rather than instant. Missing it regularly, however, is a symptom of not taking her condition seriously. I don't know what to suggest as she must find the motivation to change herself regardless of how much you care. Best wishes.

ETA: I was distracted while typing, but basically agree with everything Bluetit just said.

I see diabetes as a pretty personal and insular complaint. In that the patient themselves has to take ownership of it and address it for themselves - no one else can do it for you - they can shout encouragement and offer support, but little else. The patient has the biggest stake in the long-term outcomes and the greatest influence over how that is achieved through their day to day management - as you already know for yourself.

If she herself doesn't consider it important enough to remember to take one pill a day (and docs tend to give pills as they expect a greater compliance with that than expecting the patient to stick with a new lifestyle) and even open her meter when given one, then I doubt she's engaged enough in it to put the effort into improving her outcomes. And only she can realistically do that.

If she doesn't already want to help herself, I'm not sure you're going to find it easy changing her mind. To make a tangible difference to her future well-being, she'd have to make greater changes than not putting jam on her toast. But there aren't any immediate signs of high BG, so there's no tangible demonstration that you're doing yourself harm - a bigger number on a device screen isn't in itself of any particular consequence. So it's difficult to know how to motivate someone who doesn't already grasp why it's necessary.

Maybe if some signs were evident after retinopathy or neuropathy screenings, she might see the value in mitigating the future damage.

moodwife said:

she thinks her sight isn't as good as it was

Click to expand...

It's possible that this may be down to higher BG readings alone, not necessarily damage. Changes in levels in both directions certainly have a temporary effect on vision. I've just changed insulins and to a totally different regime and this last week was my best numbers for a month and I've certainly had vision issues for a few days, which I know will be quite short-lived for me.

Maybe that gives you a hook to hang future discussions on. Maybe find her some reading material instead.

Hi moodwife, nice to meet you.
Is your MIL elderly, as they can play the 'I'm old card, I will be going anyway, so I've got to enjoy some perks ' ? You are being a great DIL and you obviously have her best interests at heart, I hope your MIL can get back on track and starts to manage her diabetes.
All the best RRB

Pipp said:

@Robinredbreast
OP mentioned MIL is 77 years of age. Some would consider that elderly. I don't, but elderly is more state of mind, I think.
Seems the MIL does not want to own her diabetes. I have met several like that, tried to help and advise. Stony ground, regrettably. More distressing to watch in someone close, particularly if it is inevitable that one day you have to pick up the carer role.
Sadly, I feel OP will have to watch as MIL doesn't seem to want to be responsible for her own wellbeing.

Click to expand...

Thanks Pipp, I have now seen it, in the first sentence !!

moodwife said:

My 77 year old mother-in-law was diagnosed with Type 2 last autumn and has been to a DESMOND training where she was given a glucometer. She is meant to take Metformin 500 with her evening meal but regularly "forgets". We were visiting on Monday evening and she asked me to show her how to use the glucometer as she had never taken it out of the box since getting it in December (I've been Type1 for 23years and cannot fathom her reluctance). Once I'd talked her through how to test she eventually got a reading. Of 13.3mmols. I was horrified! She then said she hadn't taken her Metformin because she'd forgotten it before her meal and was told "not to bother taking it" if she missed a tablet until the next occasion, is the following evening. I told her to take tablet immediately and drink plenty of water and have warned her that if she doesn't start complying she will certainly have her tablet dose increased and may end up on insulin.
Since diagnosis she has ??stopped taking sugar in tea and ??reduced the amount of cake, biscuits, desserts, jam eaten although anytime I see her she's eating these foods with the words "Well I know I shouldn't but one won't hurt" or "I'll be good tomorrow".
What advice can I give her and how do I give it? I know how Type 1 an insulin work because I've spent more of my life living according to BMs than I did without. I got her the 100 things I Wish I'd Known About Diabetes booklet but I am losing the will to live with her recalcitrance. Please help

Click to expand...

Hi, a thought, what about your partner/hubby, her son, has he spoken to you about his mum and her reluctance, has he been helping or trying to advise, any other siblings or close friends ?

Denial is a very powerful thing.

I totally mishandled my father, and I regret it bitterly.
He was showing clear symptoms of high bg after meals (sleepiness, excess widdling, etc.)
So I prick-tested him and was alarmed.
Told him to get down to docs, gave him my meter, a couple of books, instructions how to test and to avoid foods that sent him sky high.
Then I drove 250 miles home.
He has always been a reasonable, kind, generous man, interested in science, information, health and diet. He was an engineer. I expected him to approach this as he has approached every other issue in his 8 decades - calmly, sensibly, factually and capably.

What I got was silence.

Enquiries about docs and testing were dodged.

2 years later, he has still not gone to docs.
I have tried discussion, explosion, reasoning, dire warnings and acceptance, in rotation. None have achieved anything. Although recently they watched a TV programme about the evils of sugar, and were horrified. Gee Whizz. No visible change in diet though.

His eyesight is deteriorating and I think he is losing sensation in his feet, but he denies both.

He eats 'sensibly', except for 'just one won't hurt' several times a day. And hasn't taken anything on board.
His main technique to avoid testing is 'I forgot and it isn't worth testing now', 'the meters aren't accurate anyway' and 'I don't eat this often, so what is the harm'.

In retrospect, I should have scared the living daylights out of him and driven him to the doctors myself - but unless he had engaged, it would have achieved absolutely nothing.

Moral of the story: you cannot make anyone take responsibility. They have to do it for themselves, in their own sweet time.

But it is heartbreaking to watch.

moodwife said:

There's no acknowledgement of the more insidious and damaging nature of mismanaged Type 2

Click to expand...

I don't have any statistics or data to base it on, but I've always felt that it is mis-managed T2s that suffer more consequences, due, as you say, to the insidious nature of it - and as I said earlier, there aren't always obvious manifestations of it being badly managed, until problems are well established. T1s know within hours if things are awry and usually have the tools at hand to sort it. It's much easier for a T2 to be complacent and turn a bind eye over a prolonged period.

My grandmother went blind (not entirely due to diabetes, but it probably didn't help) and lost her leg at the end, but that was when the only readily available testing was urine dips. When she gave up her flat to go into a nursing home and we cleared it, we filled a large box with all the hidden biscuits and sweets we found, there was an absolute hoard between her mattresses, in carrier bags hidden under coats on coat-hangers, at the back of drawers. She appeared on the surface to be doing things right, but was clearly a closet sweetie eater and sadly, the only person that harmed was herself.

Brunneria said:

But it is heartbreaking to watch.

Click to expand...

Oh my, I can't even imagine what that must do to you.

My parents are both diabetic and until very recently managed it well, but they've both been very poorly and lost their way a little just now, but I'm hoping once the weather improves and they start feeling stronger that they'll get on board again. I've put my foot down about quite a lot with them lately, so I'm cutting them a little slack at the moment, but I'll be back to bullying again soon enough.

I was diagnosed T2 in 2009 and until recently I largely ignored it even though my mother lost her leg and vision as a result of non compliance. Friends and family have nagged me, supported me and challenged me but I just couldn't seem to connect and take responsibility. In January my Hba1c had risen from 49 to 79 in six months. Something just clicked and now I'm doing really well. I don't think anything would have helped me, I had to get there myself. Sugar can be an addiction and addicts have to take responsibility in order to recover. My mum was eating sweets right to the end.

An Oncolgist once told me that his worst patients were non-compliant T2s. He said they were a nightmare.

I think its very difficult at 77 years old to change diet and lifestyle. Something normally would happen to make people change at this age.. A diagnosis of diabetes to many will just be reducing sugar. The majority have no want to actually educate themselves or to change.

I think (only from personal experience with family members) that a significant illness has to happen. Diabetes T2 just isn't seen by many to to be significant.

My mum suffers chronic IBS and is 80. Will she monitor her foods or change them to low FODMAP?-No. Frustrating, as she could be healthier and live with less problems but she still thinks she got to 80 and so be it. The children and family just have to cope with what happens when she can't find a toilet!!

Nagging won't change. Perhaps more frequent visits or a telephone call at night for a month would help.. As it would be a prompt. After 28days of prompts, it should form a habit....