How Much Should I Worry?

Type 1 and LADA New to Type 1 Diabetes
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TL;DR : Partner (F19-T1) seems to struggle keeping track of blood sugar, want others’ opinions on how involved I should be. Essential question at bottom

I’ve been with my SO for about 5 months (Commutable long distance ~ 5 hours) and she got her type 1 diagnosis about 7 years ago.

I’m honestly more curious about other people’s experiences at this point, since I myself don’t have any relatives with the condition. She’s very open and comfortable about talking about it, but she has some avoidant tendencies that make it hard for her to consistently monitor her sugar. She has a Dexcom and a pump, and generally gets consistent updates (however, lately it’s been neglecting to notify her or myself about low or high blood sugar episodes), but I’ve noticed she doesn’t bolus before eating, and if she does it’s usually with fairly arbitrary units (she usually always uses 45 carbs before meals).

I’m a bit of a hyper-analyzer, so I don’t want *at all* to impose my limited understanding on her management styles, and I don’t want to be overbearing over her care plan.

She has admitted a few times that she *does* want someone to be on top of her about it, though, so I try to remind her gently when I notice it being high or falling fast. But sometimes she stays above 300 for more than 3 hours, I’d say about 3 or so times per week on average this month but it really varies. She seems to have better weeks than others, but I don’t really know if it’s my place to bring it to her attention when it seems like it’s been high for longer than usual. She’s also complained about easy bruising on her feet, which made my heart sink.

According to her, her most recent endocrinologist appointment seemed to be really positive, so I’m hoping I’m overreacting.

I really love her, and I don’t want to overbear, I love health and pharmacology so this stuff is honestly really fascinating to me in a very non-judgmental way. But it’s her life, and that adds a level of sober dread that makes me question whether being on her butt about it is worse than facing the health complications later. I would take care of her in a heartbeat, but I want her quality of life to be positive. So if I can contribute to her health in any way, it would be a blessing and honor.

I didn’t see many posts in this exact situation, because she’s not borderline neglectful, but I do see (at least according to websites, which yes, I’m not proud of for being my only source other than her to learn about it) glucose patterns that aren’t healthy.

I think my biggest “concerns” for down the road is cardiovascular issues. It’s a reality I’m completely willing to face, but I wanted to get an idea of your guys’ experience. I want to be as sensitive to her needs as I can be, and we’ve had a couple conversations about it, but I wanted to get your guys’ opinion of whether this sounds out of the norm for someone who has type 1.

Anyway. Some people I’ve seen on these types of posts comment things like,
“You said you don’t want to leave, but do you want to keep doing this for the next 10-20 years, depending how long his prognosis is?”
Which is completely valid. And so far, the answer has been, “yes, I would keep doing this for as long as it takes”. Which is why I want opinions on how I can approach this best. I don’t want her to rely on me for her health needs, but I also don’t want to not be a support if she needs it.

Big question:
What are your guys’ normal ranges? How high for how long is normal for you? For those of you with partners, what are protocols and boundaries you have?

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There will never be an easy answer. You have a small slice of what it’s like of seeing BG levels rise and fall. What you have to really remember, is this is a 24/7 thing with us. And everyone is different in how they deal with it. So I can tell you my preference, but it’s not necessarily hers.

I am considered really well controlled. I know I am, but I also have been better. That’s just not what most will be able to achieve for various reasons. But there is a reason they would like Type 1’s to be above 70% TIR (TIR 70-180). The more you are in TIR the less complications. But a majority of type 1’s aren’t even in 70% TIR. It’s hard, it takes work and we have lives we’d like to live as normal as possible. And so many things affect what our results will be.

People struggle with the 70% TIR goal. Some of us are OCD about watching our numbers and doing corrections and some of us would rather follow what a doctor says to fix it and that’s it. Some ignore it the details and just take a shot.

While of course better control is better, not everyone is built to want to, and that makes it difficult because of the health aspects that come with poor control. So striving for better is better for your health but….

The best idea I have is to have a frank discussion with her. My husband stays pretty much out of anything about my care except to know to call me before he leaves with take out so I can prebolus, to wait 10 minutes before he starts spaghetti for the same reasons. He looks at my graph at night, I know this because I had to teach him how to go out of the ap and back in if it wasn’t displaying a reading otherwise he was waking me up to see if I was okay. And he also has woken me up if he heard the alert go off at night and I slept through it (or tried to ignore) the first alert.

If I go above 160 I am taking a correction, that’s me and not a lot of others. I I find I am creeping up I get on my exercise bike to stall it. If you notice she is going higher you can say something want to go for a walk together? Maybe learn carb counting and dosing, she honestly might not have a grasp on the vagaries. But talk to her, because some would not want any interference and some might appreciate the thought!

BTW this site is slated to being shut down unfortunately. Most of the regulars have moved over to FUDiabetes, a very identical site,

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Younger people in particular struggle with control, and if she isn’t already, and can afford it, she should be on automated systems to manage her blood sugar. Not only are blood sugars better that way, so is life satisfaction.

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I would tread pretty carefully. It’s her life. FWIW, bruising easily doesn’t sound diabetes related to me but I’m not a doctor. Something for her to ask a doctor about.
My advice would be to be encouraging about her going in the direction of a pump and automated system. There’s a lot of hassle getting those things set up but less hassle once they are.
But, really, encouraging and supportive are what you’ve got here. Managing her carb counting or dosing strike me as way over the line as is guessing at how well she’s doing.

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if she isn’t already, and can afford it, she should be on automated systems to manage her blood sugar. Not only are blood sugars better that way, so is life satisfaction.

Does your promotion of it imply that you yourself have finally made the jump from injections to an AID? If so, then: when, which one, how did you decide, and how’s it going with your new auto-pump?

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I don’t know where the several comments about using an AIDS are coming from; someone who is using a pump and CGM already may well be using an AIDS but so what?

Lots of people here use MDI and MDI works just fine for them. Many people use a pump and/or a CGM. On balance I’d say CGMs are more convenient than fingersticks but they are certainly a lot less accurate; my CGM just told me I was at 78mg/dL and I only checked because I knew I was going low, the fingerstick gave a 63mg/dL and I was lower that that. One glucose table, all fixed, never went below 70mg/dL according to the CGM (total BS of course.)

As for meal boluses, it’s always 45g, well, sometimes my wife says 40. It’s impossible to tell with most prepared food but most of the time carbs can be ballparked with sufficient accuracy. Talking about AIDS, here is an example that does precisely that:

No carb counting; small, medium or large… Most restaurants don’t have nutrition information but fast food joints do, albeit on the web. Here’s a McDonald’s Cheeseburger happy meal:

It comes in as 89g of carbs, so that’s certainly “large” for me, even though all the things in it are “small” (that’s from Canada, US may be larger.)

After a while we learn to guess and we guess fairly accurately (e.g. I would guess not to eat the above :wink:

This doesn’t need a pump or a CGM, it just needs insulin, preferably a pre-bolus but that can be tricky.

Help certainly doesn’t involve someone else monitoring my blood sugar. My wife does, but it really isn’t that helpful; I know before the CGM does.

Help does involve avoiding things that are difficult. Like iHop and pizza though, again it depends on the T1; help consists of listening to words like, “I’d rather not go there.” and not responding with a question.

Help also comes from things that non-Ds don’t seem to think about. Exercise is really important to maintain insulin sensitivity and it’s regular exercise at that. Binge gyming once a week may be attractive to some people but for me if that is the exercise it will reliably send me insulin sensitive for just 2 or 3 days then back to baseline; a sensitivity roller coaster will all the bad results that this implies.

Regular daily exercise, but it’s hard (for me), I’m not much motivated to spend 60 minutes on a treadmill. I ended up cycling to and from work for most of my working life. I had to get there somehow and it was very slightly less stressful than navigating a busy city at rush hour in a car.

But having a companion while exercising really does help. Once every three days might be enough; rowing twice a week for example (expensive). Hiking on the same basis (at least an hour with at least 500ft of ascent, preferably 1000ft). That old favourite “jogging” :downcast_face_with_sweat:

The medical advice I was given many times is, “Enough to get your heart rate up.” It’s a good metric though obviously some time with the elevated heart rate is required; I figure 30 minutes is enough for me (hence 1000ft of ascent above).

We can probably come up with a list of generic good help but the bottom line is enthusiasm not criticism. It’s nothing to do with diabetes; it is amazing how many people will do stuff they’d never be willing to do on there own when confronted by supportive enthusiasm. My wife learned to swim, then to SCUBA dive (she was scared of water), to ski, to paraglide (once, both of us are scared of heights). She wasn’t a diabetic but she is now and she’s well prepared.

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Here’s the conversation on FUD:

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Everyone with T1D reacts to insulin differently. This is mathematically expressed in our sensitivity/ correction factors which vary greatly. For this reason, it’s not necessarily productive to compare one person’s results with another’s. A very high sensitivity factor can mean frequently hypoglycemia, which must be corrected, and lower time in range despite the most diligentl efforts. I would say that bolusing at meals is a must.

Personally, I do not involve my husband in diabetes management because he is a catastrophic thinker and would not deal well with the ups and downs. I have had T1D 57 years and honestly think I would resent any level of interference or questioning.

I see 300 sometimes and treat it instantly. But I haven’t found a way to permanently ban it.

I applaud your concern but think you must tread very lightly.

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Twenty years ago, when I started dating my spouse, pre-CGM, and her nervousness expressed itself as, “Did you test?”, much more often than I liked. At some point, I stopped admonishing her and just tested. Although I was considered well-controlled, my HbA1c improved.

On one level, yes, she knows little about the management of my blood sugar, but still, she helps me. I always ate healthfully, but I can credit her with improvements to my diet. Although I’ve worked out consistently for decades, her little nudges made fitness a little bit more regular. Although I use a CGM and can see my numbers on my watch, so can she, and I will receive texts from her if my numbers are too high.

Yes, we don’t usually need, or even want, our partner’s involvement, and you are right to urge caution, but having a spouse who cares goes a long way.

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I agree there is no easy answer because everyone’s bodies are going to react differently. I have been a diabetic for 50 years and believe me I started off not taking good care of myself. I then ended up in the hospital and I changed everything I was doing. I became a diabetic when there was no blood sugar testing, no diet soda, etc., and I had to take beef and pork insulin so I have learned a lot in my 50 years of being diabetic.

I am using an Omnipod and Dexcom G7 that works together to control your blood sugar. It will give me insulin when you blood sugar goes above your goal range and less insulin when it is too low. I am currently maintaining a 70% in range and really feel good about that. It took me time to figure out what would work best for me.

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