I have a friend with diabetes who absolutely refuses to take care of it. How does untreated diabetes affect her mental state? She seems to be getting increasingly erratic with decisions and thought processes and we’re not sure how that is tied to her condition.

Your friend is very lucky to have you on her side! It is so painful to watch someone you care about make decisions that you know are harmful. It sounds like you are very worried about her.

You don’t say what kinds of things your friend is doing with her diabetes care, so it’s hard to say what impact her choices might have on her mental state. If she takes too much insulin, her blood sugars can go low, and she can become confused, silly, argumentative, or spacey. If she does not take enough insulin, her blood sugars will become quite high, and she can feel very sick, sort of like a bad flu, with stomach aches, headaches, nausea, tiredness. If she goes from taking too much insulin to not taking enough insulin, she can feel terrible all of the time.

Perhaps she will allow you to go with her to her next diabetes clinic appointment. Showing her that you are interested in learning about her diabetes might help. Perhaps you can ask her what things you can do that would help her manage her health in a safer way.

JWB