Dealing with a T2 friend

I'm sure this will come off mostly as a rant, but there's a question buried here somewhere. Here goes:

One of my best friends it T2; diagnosed 15 years ago. He is about 100 lbs overweight, and blames an overactive appetite, which has plagued him since childhood. He does enjoy southern cooking, sweet and starchy foods, but is recently at least somewhat conscientious. He's been to several Endos, but any improvements have been temporary at best. He's been on and off about half a dozen oral medications.

My family and I traveled to visit him recently. We talked about diabetes. He mentioned being bothered by his inability to lose weight, and feeling lethargic. He agreed to try following my dietary restrictions during the visit. I eat Low Carb.

He tried, but complained that he was starving, and admitted to eating pizza when I wasn't around. I'd say he met me a little more than half way. I also ate a few things I normally wouldn't have, either.

He takes Levemir, but says he only boluses when eating at home, which is very rare. I questioned him several times about his BG levels. He admitted he hadn't tested for months, insisting it wasn't necessary. On the final day of our visit he was complaining of hunger, right after a good sized dinner. Finally, he tested: 280. I checked his insulin. The Novalog had expired 2 years ago.

Just thinking about the situation makes me shake my head. My friend is the type of guy to help another in need, but can also be extremely stubborn and difficult. I feel like I'm always fighting the urge to nag or berate him. I'm noticing his health gradually deteriorating. He's always sick and rashy. It makes me angry, but mostly sad and worried for him. Does any of this sound familiar? Any suggestions?

Hi Sam, it sounds very familiar to me. I'm not sure what the solution is. I think first and foremost we need to stop being a country and society that thinks all they have to do is take a pill and that is the extent of there efforts. I think too, the medical community really needs to be more aggressive about treating Type 2 diabetes from the very beginning and EDUCATE type 2's regarding diabetes, the need to make changes in diet, and to get some physical activity. Honestly, I wouldn't trade having Type 1 for Type 2 ever. I think by far, Type 2 is more difficult to deal with, more insidious, and is slowly progressive in nature. Given that many Type 2's are not educated or pushed to maintain any decent control, or make good healthy changes, I think many Type 2's from Day 1 are set up for a life of complications and problems. Most type 2's if they test once or twice a day health care professionals are satisfied. If there A1c is 7 it's like holy cow you've acheieved AMAZING control, and even tighter control isn't pushed. I think the best thing to do is offer support, try to encourage him to read many of the excellent books, Maybe he might even need a much stronger insulin like the U-500 but if he does not go to see the endo, and is not testing much at all. That might be a issue that is never discovered. It's hard and fustrating and you want to scream and yell and shake some sense into people. But all we can do is offer support, others have got to want to make a change, have got to want to feel better. Sometimes as sad as it is, it takes a significant health scare to wake someone up to the dangers of uncontrolled diabetes. Hope your friend picks the correct options, and gets this under control. It is hard to sit back and watch.

Sam - That’s tough to watch, especially in a friend that you care about. It’s even harder when you know that some of the things that you’ve learned, like low carb eating, would help him tremendously. One of the things that I’ve noticed by the low-carb T2s that frequent this and other DOC sites, is that they often have A1c’s in the 5% range. It seems that knocking down their insulin resistance a few pegs combined with their natural insulin production gives them very good control. I’ve even read one of their comments about waking up “high” at 126 mg/dL!

I think what may ultimately connect with your friend is to access a T2 peer group of people “just like him” in age, culture, and social status. Getting him motivated to consider that option is a hard nut to crack. When he’s ready, a well timed comment from you could help. You could say that you know it’s possible to feel so much better and younger that you feel now. Attitude is everything and unless he wants to change, you’ll have to be diplomatic. You sound like a good friend.

This sounds like me, not to that extent but it sounds like what I use to be. A lot of T2's can't or will not admit the seriousness of their disease. You can go for years denying it and the doctors will for the most part let you.

The good news here is that he can change things, Hopefully he will before it's to late.

I wrote a blog a few month ago about how to do T2 the wrong way. You can read it here You might want to show it to your friend, maybe he will recognize himself and wake up and smell the coffee.

No real help here, but I do want to suggest you take the T2 off of the definition and just use the "friend" part and treat him as such. None of my friends scrutinize my eating habits, ask what my bg is, or offer advice to be better. And in return, I don't give my friends diet advice diabetic or otherwise, I just enjoy their company! It's okay to be sad, but you can't fix your friend.

This is a nasty one. Whether it's diabetes, heart disease, or you-name-it, it's agonizing to watch someone you care about not taking the action that you know would save them untold grief. And, human nature being what it is, it's pretty well impossible not to torment ourselves with the usual questions: am I doing enough? Could I make a difference by pressing harder? Am I doing too much? Am I driving him further into denial? It's hard. We can all empathize.

Thing is, though . . . you can't motivate another person. That door is locked from the inside. The best you can do is try to arrange circumstances so that they will motivate themselves. (Ask any AA member!)

Like others who have posted, I see elements of myself here. Not to the same degree as your friend, but still. I was never that pathologically overweight, and I never quit testing nor abused my diet quite that much, but for years I basically did the bare minimum and was satisfied with A1c's that I would look on with horror now. But the "aha" moment -- the internal wakeup call -- happened through a combination of circumstances.

One thing that made a difference for me was exposure to more detailed and specific information. Gary's blog, which he refers to in his post above, is superb. Another thing you might try is connecting your friend to tuD. Don't press, just encourage him to join and browse at his own speed. You never know which particular bit of information will be the spark that turns out to be the trigger. You might suggest a couple of groups to join, and track down some non-threatening threads for him to read just to try and get him interested.