August 16, 2007
Behavior, Complications
Question from Albuquerque, New Mexico, USA:
My boyfriend has type 1 diabetes and absolutely hates needles. I wouldn’t be so concerned if he were doing his insulin properly. I am completely clueless about diabetes and the effects it has on a person’s body as well as their state of mind. I am constantly torn because I do know that by him neglecting to take the insulin properly, his body is deteriorating aside from his mood changes, sudden ill feelings and sudden exhaustion. I need help somehow. He knows that he needs to do it and he can feel the changes in his body, but because he hates needles and hates thinking of himself as “a human pin cushion,” he somehow ignores symptoms until they are so extreme he just does it. I am thankful that he is at least doing some injections, even when his attitude is negative, irritated, depressed, and frustrated the second he pulls the needle out. I also hate needles, but I made a point to have his doctor teach me how to give the shots so that it might lessen some of the nerves that build up when he does it himself. Well, it worked for a while but then he just stopped letting me do the shots. I feel completely helpless. He has been getting leg cramps more frequently and they are pretty severe. I can’t imagine how badly they hurt considering he is a man’s man and his motto is “no pain, no gain.” I am pretty sure the guy could cut off a finger and not notice so when I’m awakened to him falling to his knees in hysterics, my level of concern drastically rises.
Recently, he has been VERY distant and unaffectionate. A complete opposite to the person I fell in love with. We use to have the most incredible sex life and now its nonexistent. He says it’s not me and that he still loves me with everything, but I can’t help but think it’s me. Finally, one day last week he sat me down and told me that for the last couple of days his feet were numb. I almost had heart failure, but he made me swear to keep it to myself. I told him that he needed to do something about this to get it under control because I am not going to be able to sit back and watch him slowly get worse and worse until he kills himself. We have talked about an insulin pump and he isn’t thrilled, but he has at least agreed that it is probably the best way to go about it. One condition is the insulin that goes in it. His grandfather has already committed to paying for the pump itself, but if the insulin needed for the specific pump isn’t the insulin his insurance covers, we simply won’t be able to go that route. He is currently taking NovoLog and Lantus. Do you know if there is a pump that we will be able to continue using the covered insulins? I don’t know what to do, but I couldn’t live with myself if I do nothing. Please help me find a way to get this horrible disease under control.
Answer:
Your story is a very compelling one for rallying people around the goal of eliminating diabetes. It has certainly caused you and your partner pain. Keep several things in mind. People with diabetes have an increased prevalence of depression. It sounds like your boyfriend might be depressed. In addition, there are several ways to go for the treatment of needle phobia. First, there is the pump. The advantage here is that you only have to make one stick every three days. The rest of the time, you push buttons. You will be able to use NovoLog in the pump. I believe you mentioned this was the covered insulin for your boyfriend’s insurance.
There are also older forms of technology, referred to as jet injectors. These instruments use a high speed jet of air to push the insulin into the skin without needles. There is also the choice of inhaled insulin now. Even though inhaled insulin may not be first line coverage for his insurance, a letter from his physician pointing out his problems may allow coverage for this therapy. With inhaled insulin, the rapid-acting insulin is inhaled with meals. Basal insulin is given with an injection. In your situation, the Lantus would still need to be given.
Finally, I think he would qualify for some counseling or help from a mental health provider; this may be a psychologist or a psychiatrist. Either way, diabetes is to formidable an adversary to treat part-time. He is already showing evidence of complications in his hands and feet with diabetic neuropathy.
JTL
