A sad rant: My partner is an uncontrolled Type 2

The man in my life is a Type 2 diabetic. We've been together for about a year. L is a big guy, a pro football player in his youth until he was injured and had to retire. He's about 6'1", 230 pounds, strong-looking. He was diagnosed at least 10 years ago and, apart from taking Metformin with meals when he remembers, he doesn't do a lot about managing his diabetes or his BG. He tests once a day, if he remembers to do it. He talks about limiting things like white bread and white potatoes in his diet. He says it's okay for him to eat multi-grain bread, pasta and all kinds of fruits but he uses artificial sweetener in his coffee. I think he has some neuropathy in his feet and legs. He needs to get up at night to go to the bathroom. He told me, today, that he got up twice last night to have a big glass of water and to go to the bathroom--he was so thirsty his mouth felt parched

The irony in this is that I discovered I needed to see my doctor when I tested my BG with his meter and saw that it was 11.3. I went to the doctor, had formal blood work done and was diagnosed in October. My profile and blood work had been normal for years. Even my doctor, an excellent physician, was surprised that I had so suddenly developed diabetes. I've worked very hard to get under control. I did need to lose weight, and I've only got about 15 pounds left to lose. I look good. I feel good. My A1c last week was 5.9, down from 13.1 in October.

L (my partner) took me to the endocrinologist this morning. The endo is absolutely jubilant about my progress. He says I'm a model patient. He told me that he thinks I should teach other people how to get such good control. He was serious about that and gave me information about where I could take courses or do volunteer work. I'm proud of myself, too: I worked hard. It's paid off. Everyone is different, though. I know that not everyone can get the kinds of results I have so quickly even when they put their all into it. Diabetes treats us all differently and I've been lucky to have been able to manage it.

On the way home from the hospital, L told me how thirsty he was last night. I asked him about his BG, whether he'd tested it. He hadn't tested it in a few weeks but he did when we got home. He was at 23.8 mmol/L. That's 428 mg/dl. It was an hour and a half after he'd eaten breakfast.

I don't tell him what to do. I don't make a big deal out of being diabetic myself. I am pretty rigid about what I will and won't eat, but I'm also a very good cook. No one in my house feels deprived or unhappy with meals or the food that's in the refrigerator. I serve foods that I don't eat or will only taste, but I don't have to do that very often.

I don't think L has had much in the way of education about diabetes and whatever he did receive seems to have been to follow a high carb, low-fat diet--the ADA/CDA regime. I don't argue with him. I figure that we each have to make our own choices about what we will and won't do. I think that food is a deeply personal thing that has a whole lot to do with culture, history, family, comfort and security, and not so much with nutrition a lot of the time.

But I'm feeling despondent this afternoon. I've told L that I'm worried about him. I want him to live a full life for a long time. I told him that I'm afraid that he's teetering on the edge of a heart attack or a stroke. I'm concerned that his high BG may harm his kidneys and his eyes. I'm anxious that he may go into DKA if his BG just keeps going up.

I'm writing this mostly to rant a bit, I suppose. I don't know what to do. I'm not one to nag anyone. I would help L if he wants help, but I'm afraid that he won't change anything.

Thanks for sharing this, Ann. My father-in-law is a T2 on Metformin as well, and I sometimes wonder how he's doing. I know he loves to eat out a lot (having big meals) and takes naps a lot (which could be because of a high BG or possibly because he's self-employed and works himself crazy). He doesn't binge on sweet deserts, but doesn't entirely avoid them either.

I don't know what his BG's or his A1C's are like, but I know (from my mother-in-law) that when he took a two-week trip out of the country, he purposely left his meter at home. That tells me he doesn't use it much. For me, if I would think it's doubly important if traveling abroad where the typical cuisine is different. (Of course, as a T1, I simply don't leave home without my meter. Ever).

I'm not too sure what to do, if anything. My relationship with him is not such that we discuss personal matters. It's hard enough managing my own T1, and to think about looking after my wife's father (who doesn't want to be looked after) seems daunting.

I know this story likely won't help you at all, but you're not alone in wanting to help a T2 who doesn't want to be helped. In your situation, the two of you likely have a much stronger bond than I do with my father-in-law, so I hope he will understand how this affects you, and that you can work together to help improve his self-care.

Thanks, Scott. I'm going to give it my best. I'm e-mailing him tonight in the hope that he may be able to focus on text more easily when reading it on his own rather than listening to me talk too much about it. I'll see how carefully written e-mail with links to Blood Sugar 101 goes!

Hi Ann. I have read several of your posts and I'm amazed at the excellent treatment you have received. Sadly, it is unusual. Is it possible that your partner is secretly worried about your treatment. Tight contol and low carb diets are discouraged for T2s as is insulin use. I also know that A1C results are not automatically disclosed as, with some docs, one must fight to get the numbers.I'm not sure that info from online groups and websites would help when the information is the opposite of the info provided by the CDA. Hopefully, you can convince your partner to see your doctor just once... even if you have to present it as an opportunity to assist you.

You have sat back passively, watching someone who should be a life partner not care of themself. You may think that this is a personal decision that your partner is making, but in your heart you know it is not. If he doesn't take care of himself, it is going to greatly affect your relationship and you.

If your partner doesn't get his head screwed on straight you may well follow him into a dark spiral and spend many many unhappy years. To get an idea of what it is like to have a partner that fails to take care of themselves, you should read WifeofaDiabetic. I can't stand to read much of the blog. It is too upsetting to me.

I think it is time that you rethink exactly how much this is really a personal choice and how much this is about a joint concensus on your future together.

Hi Ann. From your description it sounds like L is on the road (and well under way) to a very unpleasant future. I say this as one who has been down that road and is clawing his way back as best he can. You can not make him take care of his D, but you can help him understand what is happening. And, it seems that you can also lead by example by managing your own D as well as you are. He needs to understand that by leaving his D uncontrolled he WILL develop complications. Loss of vision (or at least impairment) loss of feeling in hands and feet and ED are probably just around the corner. Beyond that more life threatening issues await. These things are a given with uncontrolled BG as many of us have sadly found out. The good news is that avoiding these complications is within his ability to control. If he understands the risk and what he needs to do about it then the choice is his to act or not. He is blessed to have you in his life to help him with his D. BSC is right. Now is not the time to be passive. Share your concerns and knowledge with him. Then keep up your great work on yourself and encourage him to do the same.

Peetie, I have had excellent medical care, it's true. My family doctor is one of the best in Vancouver, as far as I'm concerned. She pays close attention, listens well, is very consultative and not dogmatic in her approach. I am delighted with her and with everyone to whom she's ever referred me. My endocrinologist is as good as my GP. Both doctors support my approach to diabetes and the ways I've chosen to manage it because it's obviously working very well. Here in B.C., patients are entitled to have full access to their medical records. Lab reports are available online.

I got my partner, L, to start seeing my family doctor. He likes her a lot, but I don't think he's been completely honest with her about how he's handling his diabetes because, when I told her that I'd tested my BG on his meter and found it was over 11 (198 mg/dl) which was why I wanted her to order proper blood tests, she was happy to do it and said that L told her his meter may not be working properly and should be replaced. I knew that wasn't true.

BSC, thank you for your straight talk. You're right! L's depression is a problem for me. I've struggled with depression myself for most of my life. I can't afford to get drawn into that dark place. I feel guilty and like I'm being disloyal for thinking that I might not be able to stay in this relationship if he won't take care of himself. I have all kinds of patience for helping him, for hearing about the struggle to take care of himself, for knowing about his successes and challenges, for working out how to be healthy. I think I know how to be a good, supportive partner. But I can't support him to keep on playing roulette with his health. None of the complications that are looming up before him are good.

Randy, thanks for sharing your thoughts, too. I agree with you.

I wrote a long e-mail last night, prodding him to go and read Blood Sugar 101 and to start testing his BG when he wakes up, before and after meals, etc. while recording everything he heats. I will help him understand what his meter has to say and I'll help him learn what to eat and what to avoid. I do know a lot about how to figure this stuff out. And I don't think that having diabetes under control means having to give up everything. It does mean making significant changes, but that can be a great adventure, full of heretofore undiscovered delights.

If he won't make an honest, dedicated effort to get well, there is no future for us. I want a full life. At 53, I'm young enough to have one. I don't want to be a widow anytime soon.

I wrote to L Tuesday night. He didn’t say anything about the e-mail and I wasn’t sure he’d read it. When I saw him this morning, I asked him whether he’d received it. He had and said he’d read all of it and had started reading Blood Sugar 101, too. He says he’s testing his BG a lot, now, too–the way that Jenny describes on the website. Before he came to my house this morning, he said, he was at 20.1 (362 mg/dl). He had a glass of water, went to the bathroom and tested his BG. It was 19 (342).

He says that he hasn’t worked much to change his BG because he simply didn’t know how to do it. He wasn’t given a lot of information when he was dx’d but he went to a hospital course about diet and thought that he would be okay on the high carb, low fat ADA diet. He now knows that the diet isn’t doing him any good.

L is the kind of guy who doesn’t ask for directions and who doesn’t read instructions before assembling things like barbecues. He doesn’t like to read web pages and so he’s not good at research on the Internet. Fortunately, I am. Even more fortunately, he says he’s going to do what he needs to do if I will help him. He asked me to teach him how to get the results I’ve achieved for myself.

I’m relieved. I know that he’s got a long and possibly difficult road ahead of him, but I also know that if he can keep this up for a couple of weeks, he’s going to feel like a different man.

I hadn’t realized before today that he’s taking Glipizide in addition to Metformin. He’s dismayed that these two drugs aren’t lowering his BG. I think that his pancreas is probably worn out from the Glipizide. I also don’t understand why he’s taking a sulfonylurea when he had atrial fibrillation about two and a half years ago. The sulfonylureas increase the risk of heart attack and death. Adding the sustained, high BG makes for a grim cocktail.

He says that he’ll go and see the doctor next week. And, if his BG is still hovering around 20 tomorrow, he’s asked me to go with him to the hospital to see if they’ll give him IV insulin.

I hope he’ll stick with the program. I will help him but he’s got to do the work himself. Fortunately, my worry about his BG seems to have made a big impression on him.

Congratulations Ann. You must have written an excellent email. :D Your comment about the glipizide really touched a nerve. I was very good with the "eat to the meter" approach UNTIL I was put on glipizide. Suddenly I had no control and my numbers were consistently 13-20. The response was always to increase the dose. I developed neuropathy and stopped it on my own. My brother had the same problem. I don't believe that one can control their own bloodsugars while on this drug. When my brother died this November (age 57) the autopsy showed no cause of death. His daughters were told that HE had caused his own death by failing to control his T2 diabetes! I have been ranting about this drug since I came on here last spring. I just read a post from another Canadian who is on this drug and is having trouble managing. I held myself back from responding. You have a doctor who does not believe that diamicron is some sort of magic pill. I hope he will help L get off this drug. When I came on here I was shown the CDA protocols which call for pills until one has an A1C above 9. Then, at the doctor's discretion, insulin can be prescribed. Of course, even then, it is insulin plus pills. When I read that, I knew there was no hope...no advocacy...nothing. Sure enough... my worst fears were realized.

I'm sorry that you and your family have had such a bad experience, Peetie. It sounds like your brother may have died from a major low. Sulfonylureas will cause serious hypos by overworking the pancreas to secrete insulin.

I'm a big fan of insulin and I wish people wouldn't see it as something dire or as proof that we've done something wrong or that our diabetes is worse than someone's who isn't taking it. Insulin can be given in precise amounts, no more and no less than we need, whereas pills tend to be broad spectrum, scattershot things. Taking insulin is not painful at all! I'm a serious needle-phobe--ask the lab techs who do my blood tests! But I have no trouble injecting insulin.

I think L probably needs insulin. I'm hoping that the doctor will recognize it and, at the very least, will take him off of Glipizide.

Sorry for the rant Ann ... the mere mention of that drug just sets me off. I think there is so much brainwashing about insulin ie it is indicative of failure...it is the first step toward complications etc. I think that the research will confirm this because,now that it is combined with the sulfs, it probably will always fail. I honestly can't understand why the so-called experts would continue to believe that a drug that not only causes weight gain but throws out insulin indiscriminatley could possible be an effective treatment for T2. When the beta cell burnout is added to this... well... it just seems to be a direct contradiction of "do no harm".
Best of luck with the appointment. I hope you let us know how it turns out. Joanne

Hi Ann,

How is it all going now? Hope things have improved for L. Joanne