My friend is a diabetic and won’t take care of herself?
FBI28 asked:
I have an elderly friend (65 +) who called me the other day to come and get her and take her to the Emergency Room. On the way there she told me her symptoms and I said it sounded like high blood sugar. She said no that she had tested it and it was fine. We got to the ER and I overheard her telling the nurse that her Blood Sugar WAS high when she tested it at home. So they admitted her, gave her some fast acting insulin, asked her about her diet and she totally lied to them. She is a severe diabetic and yet she drinks regular sodas and bread, and what not daily. So i told the Doctor on the side that she had been lying. And afterwards when i got her home and got her her medication I told her that she needed to start looking after herself better. Then a few days ago she wanted a ride to the store, so i did. And she ended up buying 16 (Yes SIXTEEN) twelve packs of sodas. This is none of my business but I’m the one who has to take her to the ER. What do I do???
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I have an elderly friend (65 +) who called me the other day to come and get her and take her to the Emergency Room. On the way there she told me her symptoms and I said it sounded like high blood sugar. She said no that she had tested it and it was fine. We got to the ER and I overheard her telling the nurse that her Blood Sugar WAS high when she tested it at home. So they admitted her, gave her some fast acting insulin, asked her about her diet and she totally lied to them. She is a severe diabetic and yet she drinks regular sodas and bread, and what not daily. So i told the Doctor on the side that she had been lying. And afterwards when i got her home and got her her medication I told her that she needed to start looking after herself better. Then a few days ago she wanted a ride to the store, so i did. And she ended up buying 16 (Yes SIXTEEN) twelve packs of sodas. This is none of my business but I’m the one who has to take her to the ER. What do I do???
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tell her the dangers of being a diabetic, which are going blind, losing her limbs and even death.
Go to this website: for more help
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Unfortunately, speaking as a diabetic, unless she wants to take care of herself, there isn’t a lot you can do except be there for her. You might sit down and tell her how much you enjoy being around her and don’t want her to leave. Just have a serious heart-to-heart with her and make her feel needed. It sounds like she has given up on herself and just doesn’t care anymore. I know the feeling and have had that feeling occassionally. Fortunately I have family who come to my aid and let me know I am loved and needed. So try a little straight talking and see if that helps. Good luck.
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It sounds like she’s stuck in a rut, maybe depressed. Give her some extra support and encouragement and do some research on diabetes to give her good advice. But the only one who can turn this around is her. Don’t feel responsible for her not taking care of herself.
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This is one of the reasons diabetes is such a tricky disease. The mental aspects to caring for yourself, complete and total 100% compliance to your care program, are very difficult especially for people who live alone. You are right to be concerned as a friend. Many times putting pressure on the diabetic can backfire. It’s an extremely difficult position to be put in.
The sad thing is there are diabetics who DO follow everything to the letter and they can still get complications. Keeping your sugars under control reduces your chances of getting complications, but it does not eliminate them. She is really playing with fire. She may be depressed and beyond caring about her immediate future.
Also, I wanted to say that all that soda – well, I’ve seen that before. Before I was diagnosed I started drinking massive amounts of soda. Somehow there’s a vicious cycle of craving more sugar when your sugars are completely out of control. My family has a story of some great-aunt who went batty and ate nothing but ice cream, and after a few months of that she died. There is a dangerous cycle of craving more sugar that diabetics can get into and it sounds like she might be there.
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wow that’s sad
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She probably knows all of the outcomes of diabetes, I’m sure her doctor at one time explained everything to her. The problem unfortuanately is that she doesn’t care. There is nothing you can really do for her, she doesn’t want to be preached at, but you can just be there for her. Continue to be a friend to her.
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There’s not much you can do, unfortunately. Diabetes is frustrating and extremely complicated, and a lot of people just give up because it’s too hard to manage. All the carb counting, dietary changes, having to exercise and monitor BG’s and every bit of food that goes into your mouth is just too much for a lot of people. I’m lucky, I’m good at math and tracking stuff and problem solving comes naturally to me, but I still ate badly for several years when I was first diagnosed. It’s just a really difficult disease to get a handle on, and it’s very depressing, too.
DO NOT give her cautionary tales (“You’ll get your legs amputated if you keep this up!”)…it is the most unproductive thing you can do to a diabetic. And don’t be the “Food Police”, that’s the second worse thing you can do. We know all the risks of complications, we hear it every day. We know we should be eating only healthy food and water all the time, but we want to enjoy life, too, just like anybody else. We badly want to be normal.
So what CAN you do? Try to encourage her to drink less soda simply because she will feel better and enjoy life more with more energy. Let her know a can a day is fine (it’s not great, but it’s better), but that drinking more diet sodas will give her more energy because her blood sugar won’t be so high. Offer to blend regular and diet for her in increasing amounts until she’s used to the diet stuff. Start with a 75%/25% blend for a few days, then 50/50, then 25/75, then full-strength.
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persuade her to eat crookneck squash trust me this will help her if she not going to inject herself with insulin or take her meds other than that she`ll probably continue that type of behavior sugar is an addiction, .o` yeah exchange her sodas with diet drinks while she` not watching if and when possible.
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This is long but needs to be told:
Depression is not generally listed as a complication of diabetes. However, it can be one of the most common and dangerous complications. The rate of depression in diabetics is much higher than in the general population. Diabetics with major depression have a very high rate of recurrent depressive episodes within the following five years. (Lustman et al 1977) A depressed person may not have the energy or motivation to maintain good diabetic management. Depression is frequently associated with unhealthy appetite changes. The suicidal diabetic adolescent has constant access to potentially lethal doses of insulin.
At this point in time, it is well accepted that psychological factors and psychiatric conditions can affect the course of medical illnesses. There is some suggestion that the stress of depression itself may lead to hyperglycemia in diabetics. The interaction between cardiovascular disorders (such as heart attack and high blood pressure) and depression has been extensively studied. Anxiety and depression can also affect other conditions including irritable bowel syndrome, headache and skin diseases. Treatment of anxiety and depression may lead to a better medical prognosis and well as a better quality of life.
For over three hundred years, physicians have suspected an interaction between the emotions and the course of diabetes mellitus. Studies have examined whether stressful events or psychiatric illness might precipitate either Type I (insulin-dependent) or Type II (Non-insulin dependent) diabetes. So far, study results are not conclusive.
Now that we have more accurate methods of measuring glucose control, it has become easier to measure both short-term and long-term effects of emotional factors on blood glucose level. One study found that children judged to have a “Type A” personality structure had an increased blood sugar elevation in response to stress. Children with a calmer disposition had a smaller glucose rise when stressed. (Stabler et al. 1987) A 1997 study suggested that Type I patients with a history of a psychiatric illness might be at increased risk for developing diabetic retinopathy. Those patients with a psychiatric history were found to have a higher average glycosylated hemoglobin. (a measure of long term diabetic control) (Cohen et al. 1997) Children whose relatives made more critical comments had significantly poorer glucose control. Interestingly enough, emotional overinvolvement between family members was not correlated with poor diabetic control. (Koenigsberg et al. 1993) Diabetic adolescents had a higher incidence of suicidal ideation than expected. Those with suicidal ideation took poorer care of themselves. Not living in a two-parent home was associated with poorer long-term diabetes control. (Goldston, et al. 1997)
Recent studies have suggested that effective treatment of depression can improve diabetic control. In a study by Lustman and colleagues, glucose levels were shown to improve as depression lifted. The better the improvement, the better the diabetic control. (Lustman et al. 1997a)
Being diagnosed with diabetes is a major life stress. It requires a large number of physical and mental accommodations. The individual must learn about a complex system of dietary and medical interventions. Lifestyle, work, and school schedules may have to be altered. This can consume a lot of energy for both the individual and his or her family. Just as important, are the psychological adjustments. One must adjust to a new view of oneself. For those who liked to see themselves as invincible, this may be particularly difficult.
Many newly diagnosed diabetics go through the typical stages of mourning. These are denial, anger, depression and acceptance.
Denial: This can be one of the more dangerous stages of the grief process. It may not occur only once. Many individuals cycle back to this phase several times. The honeymoon phase, associated with early Type I diabetes, may reinforce denial. Denial is a common stance for adolescent diabetics.
Anger: It really does seem unfair. The type II diabetic, trying to lose weight, may envy heavier people who seem to enjoy good health. One might erupt at someone who innocently offers a desert. Unfortunately, anger can drastically affect glucose levels.
Depression: Mild depressive feelings are a normal part of grieving and adaptation. As long as they are not pervasive or prolonged, they may not be harmful. However, when the depression lasts a long time, becomes severe or interferes with diabetic management, one should seek prompt treatment.
Acceptance: Individuals achieve different degrees of acceptance and inner peace. Some will need to experience the denial, anger and depression several times as they move through different phases of life and different stages of diabetes. Some people move through a chronic disease to a state of much greater self-knowledge. They may actually say that the diabetes was, in part, a blessing. Through their close attention to diet and exercise, and their close monitoring of stress levels, they have arrived at a deeper understanding of themselves and their relations to others. They realize that for all human beings, life is vulnerable and precious.
Often, individuals with depression do not realize that they are depressed. It is easy to attribute the symptoms of depression to the diabetes. This is particularly difficult since depressed diabetics may have poorer glucose control. Sometimes a spouse or close friend can give good feedback. However, medical professionals or mental health clinicians may be the best ones to determine what is the diabetes and what is due to depression. A psychiatrist has had medical training before specializing in mental health. He or she can sort out the diagnosis, communicate with your regular doctor and help coordinate the treatment of the depression with treatment of the diabetes.
Symptoms of Depression: These are based on the Diagnostic and Statistical Manual of the American Psychiatric Association, 4th Edition. (DSM-4)
Depressed mood for most of the day
Decreased pleasure in normal activities
Difficulty sleeping or significantly increased need to sleep
Weight loss or weight gain.
Feelings of guilt or worthlessness
Low energy level
Difficulty making decisions of concentrating
Suicidal thoughts
Treatment of Depression:
The most important starting point is an accurate diagnosis. There have been major advances in the treatment of depression. There are specific medications and specific psychotherapy techniques that have been shown to help depression. Often individuals do well with a combination of antidepressant treatment and psychotherapy. Be sure that your clinician is willing to take the time to communicate with your diabetes team. Ideally, the mental health clinician should be familiar with your type of diabetes.
Antidepressants: Today, we have a much wider variety of antidepressant medications than were available fifteen years ago. Because we have more medication choices, we can often minimize annoying side effects. The older tricyclic antidepressants can increase glucose levels in non-depressed diabetics. However, when depressed diabetics take them, diabetic control improves. (Lustman et al. 1996) Selective Serotonin Reuptake Inhibitors (SSRIs such as Prozac and Zoloft) are easier to administer and have fewer side effects, so they are more often used as the first line antidepressants. Sometimes they can cause decreased sexual desire. This may be a sensitive issue for some diabetics, especially those who have some sexual difficulty due to their diabetes. This is not a reason to avoid treatment. Keep an open dialogue with your psychiatrist. If the medication does affect sexual functioning, dose adjustment or a switch to another type of antidepressant can usually take care of the problem. Often, treatment of the depression can result in much better sexual functioning. Other types of antidepressants, such as Bupropion (Wellbutrin) or Venlafaxine (Effexor) add to our treatment options. Some people respond to the first medication. Other people may have to try several medications before they hit upon the right one.
Psychotherapy: Recently, researchers have made an effort to do good psychotherapy outcome studies. It turns out that several forms of psychotherapy really do work better than simple “tincture of time.” Cognitive psychotherapy is one of the methods that has demonstrated good results for depression. In this type of therapy, the individual identifies thought patterns associated with a depressive, hopeless outlook. Frequently these thought patterns are based on erroneously assumptions about self and others. The therapist helps the patient monitor such thoughts and to replace them with more effective positive ways of thinking. Cognitive therapy can also be helpful in non-depressed individuals who are having trouble with their diabetic management.
Anxiety and stress can also cause large jumps in blood glucose levels. Panic attacks may resemble hypoglycemic episodes and vice-versa. (When in doubt, treat it as hypoglycemia.) People respond differently to stressful situations. Given the same subjective level of stress, one diabetic may have a different glucose response from another. Because of this, one should monitor blood glucose more frequently during periods of stress. On the positive side, a conscientious diabetic may have a unique barometer of stress unavailable to the general population. There are a number of specific anxiety disorders that are treated differently. As with depression, there are specific medications and therapies that have been shown to work. If anxiety is severe, it is important to identify the specific type, so that one can embark on the right treatment. We will not cover all of these treatments in this article. The following are some general suggestions
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Tell her regular soda is extra bad and will kill her. Drink diet soda.
Keep telling her.