Hi,

I'm new here, and I'm hoping you all will be able to advise, give information/support, etc.

My fiance's dad, Jay, is a Type II diabetic, age 78. He was put on insulin about 1 1/2 years ago and took that as permission to no longer monitor his diet. He's very stubborn, in an infuriatingly good-natured way. He likes to play dumb and pretend that things are too confusing for him so he can do what he wants.

He woke up last week Tuesday with severe nausea, dizziness and vomiting. He was taken to the hospital with elevated blood pressure and elevated blood sugar. They tested him for strokes, heart and arterial function, etc. and everything was okay. He fell trying to use the bathroom Wednesday morning and cut his head and nose and bled like crazy because of the blood thinners he was on for the hypertension.

He is still hospitalized a week later, mostly because of two things: One, they can't get his blood sugar to go down to acceptable levels. He was on short-acting insulin, but I guess he was injecting it 5 or 6 times a day. They have been trying short-acting and long-acting stuff in different combinations. On Saturday his blood sugar was over 400, and yesterday it was 324. What does it mean that it stays so high and will they be able to get it lowered? Also, they are having him do lots of therapy - physical, occupational, speech. He may have had mini-strokes. His nurse thought the initial dizziness and nausea may have been due to swings in his blood sugar as well.

They are talking about releasing him tomorrow, but my fiance and his mom are starting to stress about how to provide him with the monitoring/care he'll need. He's not supposed to drive for a while, which will drive him crazy. They're getting him a walker with wheels, handbrakes and a seat, and are planning to modify the toilet, shower, etc.

I guess I mostly want to understand the continued elevation of his blood sugar, and anything about getting him to do what he needs to do would be helpful. This is a man who buys bags of candy and tries to hide them, who drove last winter two states away to try to get better medical treatment for diabetes in Minnesota and didn't call or answer his cell phone the whole time, etc. but he's very sweet and loveable at the same time. I sort of want to throttle him, you know? :rolleyes:

Thanks for any help,
DaisyD

DaisyD

Your friends father is not rare, not at all. The sad thing is people who do what they can to fight the treatment are the ones you see on the stats for serious problems. I know someone just like that. After a while it becomes only the problem of the family with the person who will suffer first hand not caring anymore, if they ever did. I do not have any suggestions on how to change a hard head. It is their own body and they seem to feel it only hurts them, not true ans I am sure you can see for yourself.

Type 2 are insulin resistent. More insulin in does not mean the body will utilize it. It is the person eating and eating and eating. You see here a lot of people who feel diet is not critical to your treatment. Well, you cannot correct candy and the carbs that most foods contain. The sugar alcohol approach is just kidding yourself. Carbs are carbs. To contain your blood sugars you MUST give your system a break. In your friends case it is very unlikely he will do what has to be done. Sad as it is to say it.

For those who will say don't be so negative - people need positive advice here. Ther e is nothing you can do if the person is only going to go behind your back and eat sugar rich food. Nothing. A perfect diet cannot make up for 'cheating', especially if the person does not see it as cheating.l

But if he's been in the hospital for a full week on a diabetic diet, shouldn't that, combined with the insulin, help his numbers drop? Or is it that the damage he's done through eating the wrong things is enough to cause his blood sugar to stay permanently elevated?

DD

Daisy,
If he sis a type 2 diabetic, it's possible that he is VERY insulin resistant and that, combined with the inactivity of being hospitalized, might be making it more difficult to get his numbers down. There are some medications that help reduce insulin resistance, and they may need to add those (in addition to the insulin he's getting.)

It's also possible that stress is helping to keep his numbers elevated, and that would include the physical stress of all his body has recently gone through, as well as the emotional stress he may be feeling (especially if he's worried about "losing control" of his life, which with his stubbornness may be an issue!)

Since he went in with nausea, dizziness and vomiting, I wonder if he was, perhaps, in diabetic ketoacidosis? You might want to ask if he was tested for ketones at the time and if it was positive. If so, this might be his "wake up" call...eating candy and refusing to take care of his diabetes will cause him to lose more control than if he were taking better care of himself.

Ruth

P.S. I do hope he's out of the woods, though, and that things improve. Sometimes it's very hard to teach an old dog new tricks, but we love those old dogs anyway!

Thanks for the replies.

I found out since last posting that he'll be released tomorrow (Wednesday) at noon, even though his blood sugar is still too high. Apparently, and this is news, his team of doctors have decided that even though his brain scan looked clean, he probably had a minor stroke somewhere in the back of his brain. It explains the dizziness and the slight left-side weakness he was experiencing. They ruled out a stroke when he was first admitted to the hospital, so this was something of a surprise.

I wish I knew more about the names of things, but apparently before this happened he was using a medication (I don't know if it was a type of insulin or something different) where he was supposed to run a blood sugar test and then vary the amount of what he took in response. And he wasn't varying it. He was just taking the same amount each time no matter what his blood sugar level was.

He's going to need to be on 24-hour care for a while until he improves and he won't be able to drive until then. We all HOPE this will provide major motivation.

Daisy

Daisy,
What you described regarding his medication sounds like a sliding scale of insulin. Usually, the higher the blood sugar, the more insulin is taken; while the lower the blood sugar, less insulin is taken. It's often given something like this (this is just an example...each person's sliding scale is highly individualized) Also, this is usually used before meals and at bedtime.

Blood sugar below 120 10 units
bs 120-150 12 units
bs 150-200 14 units
200-250 16 units

Etc.

If he was taking the same amount of insulin each time, he probably also has not been testing his blood sugars. You might want to ask his doctor to refer him to a diabetes education class. High blood sugars put him at increased risk for further strokes, heart attack, etc. His doctor needs to have a serious talk with him and perhaps he himself needs a diabetes support group?

Ruth