December 23, 2003
Behavior
Question from United Kingdom:
My partner, whom I live with, has type 1 diabetes and has had for over 30 years. He suffers from hypoglycaemia unawareness. He has probably, on average, 5-6 hypos per week and has had for a large part of the time we have been together. He either does not feel most of them and acts normally (with blood sugar levels of around 2.5 mmol/l [45 mg/dl]) or needs assistance to gain full consciousness.
I do not know what to do any longer. I do understand that it must be difficult and challenging to control diabetes, and he wants to keep his blood sugar levels on the lower side to reduce his risk of developing further complications (he has background retinopathy). However, he will not see his Doctor or the Specialist (I think because he fears losing his driving license, although he does always test his blood sugar before he drives). However, it is causing a lot of stress and sometimes I feel I cannot cope with it any longer. Are these feelings normal? Other people seem to cope fine with their partner’s diabetes. I feel guilty and selfish because he is the one living with the disease (he does try his best to control it, although I sometimes feel I need to nag him to test his blood sugar). When I go out, I fear leaving him on his own. He wants children, yet I don’t know if I could cope with working, caring for a young baby and him, and leaving a young child in his care without worrying.
There are other issues that are affecting our relationship besides this and I am under stress from work and other family problems. Some people I have discussed this with are of the view that this is not a big issue. I know that other people have much worse problems. I feel guilty even writing this. What can do if he will not see his GP or Specialist? I have considered leaving him (not just because of the issues with his diabetes but this is certainly not helping), but then I would feel terrible if he had a bad hypo whilst by himself (I know he would not consider moving in with his parents or friends). He also doesn’t have anything (e.g., identity bracelet) that would allow people to know he has diabetes. Does diabetes affect other people’s relationships or is it just me?
Answer:
The concerns you have are frequently stated by other partners of individuals with type 1 diabetes and hypoglycemia unawareness. First, I do not understand his hesitance to seek help with this problem. It is unlikely he will ever make it better on his own. He needs to see a physician with expertise in diabetes who can work with him to intensively avoid hypoglycemia. If he can, there is some evidence that some of the warning symptoms of low blood sugars will return. If he does not seek help, this is unlikely to get better. Very often what is needed in this situation is a restructuring of the insulin regimen. Sometimes this even means using an insulin pump. It also requires frequent communication back and forth with the diabetes care provider and their team.
The stress on other members of the family is well documented. Many people find themselves going out of their way to check up on these individuals. Driving, even for small distances, becomes a major anxiety. If he is fearful of losing his license now, he will surely lose his license if he has an accident with hypoglycemia. It is not uncommon that the treatment of a partner’s diabetes becomes a major issue in the survival of the relationship. If he loves you and worries for your happiness, he should see the diabetes specialist and get proper treatment.
I agree he should have a medical alert bracelet or necklace or card in his wallet.
JTL
