March 31, 2003
Daily Care
Question from the United Kingdom:
A relative of mine has type 1 diabetes treated with a pump, and I gather she has hypos quite often. She checks her blood sugar regularly, but the hypos come as quickly as a blink of the eye, and she gets no warning they are coming.
I was visiting this weekend, and she had seizure whilst we were together. I am positive I witnessed a ‘grand mal’ seizure, but she seems adamant that she did not. I tried to broach the subject with her and discovered she has not even told her consultant about these hypo episodes and does not intend to do so. She lives on her own, still drives, and has asked me not to tell the rest of the family. I am extremely concerned for her safety and well being. What can I do or say to encourage her to seek medical advice?
Answer:
I really understand your concern for your relative regarding the risks of hypos. It seems likely that she has what is known as hypoglycemia unawareness.
Besides learning to detect subtle symptoms, I’d check how and why she has been given a pump since she doesn’t look like to be a likely candidate. An insulin pump is a patient-demand device mainly, and she seems not to have accepted her diabetes.
If possible, talk to her consultant about a referral to a diabetes team where a psychologist might be of greater help.
MS
Additional comments from Craig Broadhurst:
I agree that pump therapy would not be my choice for this individual. Also, silence may lead to horrible results. This is one promise I would break.
CMB