January 24, 2001
Other Illnesses, Social Issues: Community Resources
Question from The United Kingdom:
In my role as Welfare Officer for our local Multiple Sclerosis (MS) branch, I have had a call from the husband of a member who has chronic progressive MS, has recently been diagnosed with diabetes, and is taking glipizide [a sulfonylurea pill for type 2 diabetes] twice a day. I am having trouble finding any info regarding dealing with diabetes when you have MS.
She has been given lots of leaflets from the hospital about her diabetes and how to control it with eating and exercise. As she is totally paralysed (this lady only has head movement) exercise is not an option, and the leaflet she has been given recommends 6 meals a day. This is also difficult since she has care givers who visit to help with meals, etc., who visit only twice a day.
The local Health Authority does not appear to be geared up for this sort of situation either, although we are pursing this. I would be most grateful if you can let me know of any experience of diabetes and MS or can point me to a web resource.
I am most sympathetic to your problem. This case sounds very difficult. I am afraid that even a web site will not be enough to take care of this woman. There needs to be coordination between the physician, the primary care giver, and any support services. For instance, her oral agents can be administered regularly, but the real challenge is monitoring her blood sugar and getting her to eat regularly and in sufficient amounts. I think the American Diabetes Association web site is good and has a lot of general information. However, there will not be enough information from any one web site to answer all questions. Another source would be to find one of the larger diabetes care clinics where there would be nurse educators and see if someone can coach you through the issues in this particular situation.
[Editor’s comment: Would it possible to have this woman’s husband attend diabetes education classes? Perhaps, he could be trained to do blood glucose monitoring. In this type of diabetes, twice daily monitoring might suffice. Exercise can play a role in control, but it obvious that it probably cannot be included in this woman’s treatment plan unless there is some form of passive aerobic exercise that can be accomplished. I would consult a physical therapist about this. As far as the meal plan is concerned, once again, maybe her husband could be given some sort of pre-packed meals that he could feed her.
This sounds like a devastating situation and I would think, unfortunately, that your only other option would be some sort of residential care if this woman’s husband is unable to assist. I hope things work out.