August 30, 2003
Behavior, Daily Care
Question from New Orleans, Louisiana, USA:
My husband, diagnosed with type�1 diabetes 26 years ago, has not been taking care of himself as well as he should recently. He knows what he needs to be doing but chooses not to. I am also have type 1 diabetes, and since I’m also a nurse, I know the importance of keeping diabetes in check and keeping complications at bay as long as possible.
Three months ago, he was in the ICU for DKA [diabetic ketoacidosis] from the flu, and I was under the impression that since then he had been checking his sugar on a regular basis, but I was fooled. Since then, he has only checked his blood sugar a total of five times at the most! He will tell me he doesn’t check them because he has had if for so long that he knows what his sugar is, but every time he tells me what he thinks it is, and I check it, he is at least 100 points off! I do my best to tell him about hypoglycemia unawareness because he has recently been experiencing it to the point at which I do not trust him watching our 10 month old son. He also says when I have diabetes for twenty six years not six I can tell him what to do.
I am going with him to his endocrinologist appointment next week and feel obligated to make his physician aware of his noncompliance without hurting our relationship. I don’t want to sound condescending or make him feel like a child even though he is acting like one! Any suggestions?
Answer:
I agree with you on all counts. You are taking the extra step in your relationship by going with him. This is similar to family encounters that occur with substance abuse. Having a number of people present to indicate to him he cannot fool you into believing he is doing what he is not and also getting the feedback from the important parties in his life that his current behavior is not acceptable. There is the possibility he will be angry with you in the short term. However, if it makes a difference in the long term, it is well worth it.
People with long-standing diabetes cannot accurately predict their blood sugars. In addition, without monitoring, they cannot do all the additional adjustments that keep people in good control. You may want to ask him if he is depressed or having trouble dealing with the extra burdens of having diabetes. It is always an option to ignore them, but it never seems to go away. Even some short-term counseling may be helpful.
JTL
