Mother in law --- type II diabetic

So MIL and I visited about our diabetes treatments; gosh am I glad I got the knowledge and the training that I did and still do get about the “D”. MIL has been told by her doc that 200 was a normal range for her! HUH? I about went through the ceiling!!! They have put her on restricted diet only, no meds. She is 85 years old — so if her diabetes kills her whatever — I am thinking the doc said this. But this woman is filled with life, vim and vigor. She has dropped 30 lbs, and looks marvelous. Still the 200 scares me… as she aims for that every day. Any ideas on how to get some education to her, without sounding like a know-it-all dil?

What a doctor! She’s lucky to have you. Aiming for 200 should scare anyone!

Find another doctor, or preferably an endo, pronto! She needs real medical care, not someone who doesn’t think she deserves to live because she’s 85. If this was my relative, I’d report this quack.

Can you take her your doctor? Any diabetes ed classes you can attend with her? Some hospitals offer these, or perhaps your doctor can recommend some.

Perhaps written info would also help, something to back up what you can tell her so you don’t come across as a know-it-all. Tons of info you can print off for her about what normal BG is & that BG over 140 causes serious damage.

You didn’t mention her living arangements, mobility and how independant she is, as well as how much time you have to help her. She needs a doctor with a better attitude… Written materials sound like the way to go for starters. A quick google search of "diabetes and seriors"found this among other articles:

Gerri – as a third-party to the proceedings, I’d not be nearly as quick to judge. (Though as an interested party – like Cathy – I’d be just as appalled.) There are a number of subsidiary issues that have not been discussed here, which may be in play.

First is the generational issue. Many people in their seventies and older trust their doctors implicitly. If the doctor says it’s good, it’s good – even if we know better. (One dasn’t question the doctor’s judgment!) They often have longstanding relationships with their doctors and are reluctant to question or change them. Question the currency of the doctor’s knowledge of diabetes care, and it’s like you are putting into question the very existence of G-d.

In that vein, note that many treatment protocols for T2 begin with ILM (Intensive Lifestyle Management – aka, diet and exercise) before oral medications are introduced. I don’t know how long it’s been since diagnosis, but since you’ve mentioned she lost 30 pounds, I’d consider the possibility that the treatment may be working, but may need a bit longer to get into a more realistic (for us) goal range.

A related issue is that there may only be one doctor in the area who will serve your mother-in-law. It could be an issue of insurance, Medicaid/Medicare, or just sparsity of healthcare professionals. If she is in any sort of assisted living facility, she may be restricted to the on-staff medical personnel. This would suggest that she could be in fear of losing her spot, or being more deliberately “killed off by neglect”, if she were to question her care.

For what it’s worth, before I was diagnosed, I thought 200 was a normal blood glucose level. (I may have gotten it confused with what we were told about cholesterol levels?) I had also retained the info we had in high school that correct blood pressure was 100-plus-your-age over 90 – not the “below 115/75” that our doctors aim for today.

Is your mother-in-law self-testing? If so, at what schedule? Often, T2s are told to test no more than once, maybe twice a day. My Other Half’s aunt says she was told to test only three times a week, using only three fingers. She has been offered a meter upgrade many times but has refused. Medicare pays for her meter and strips, so it’s not like the change would pose an issue with out-of-pocket costs. OTOH, My Other Half and I test about 5-6 times a day on average, and that does not change whether or not I have to pay for my strips out-of-pocket. (Our doctor thinks we’re being a bit A-R about it, but it’s not her life we’re talking about!)

Is there a medical-financial issue? The co-pay on many medications, even under Medicaid/Medicare with supplementary insurance, can be a deal-breaker – especially once one enters the “donut hole” in pharmaceuticals coverage. (It is one reason I have not been as insistent with my own mother self-testing.)

There may also be issues with other medications your mother-in-law is taking. Some are known to artificially elevate blood glucose levels; others may be adversely affected by any oral antidiabetic medication. Some may also give artificially high readings with home glucometers. She may also be one of those women whose hematocrit levels are outside the range in which home glucometers will be accurate, and the doctor is adjusting for that. (That last is highly unlikely, but I had to throw out the possibility.)

Aside from all that… maybe if you’re open to discussing your diabetes with her, and where your information comes from (ADA, JDRF, AACE, Joslin… the “experts”), she will ask questions, follow your lead, ask her doctor questions, and set more stringent goals for herself. In the end, it’s her diabetes, not yours, and to mix a metaphor, “You can lead a horse to water…”

Thanks people, but I think I am making this too hard for you.

  1. MIL is VERY mobile, she drives a corvette, has bucks, cooks for herself and others, travels extensively, and up until the last two years we have had a very volitile relationship the “D” has brought us to an equal ground with no children or son to step between that bond.

  2. as I said, BUCKS and ins urance are not an issue.

  3. She lives in a very large city with all kinds of docs, from a to z…but the idea that she trusts this one and only this one is a matter of concern.

  4. I’ve packaged up some things to send her, she is a very good cook and loves recipes. I don’t now the restrictive diet, so can’t tell you what is on it. Absolutely NO carbs, though, she told me that.

5.She is very private about her health, which also makes it very important that WE keep these lines open for both our sakes. She tests four times a day, and is taking metformin and actos…so she’s got some pretty good pills there.

  1. She isn’t exercising at all — and walking would be tough for her…but a bike, now that might work.

But 200 is NOT normal for anyone any age, and that worries me, I can tell her eyes are worse, is that age or diabetes? I don’t know. But I do know one thing for sure, we’ll keep in touch, and I"ll send her my educational things as much as she will take them.

thanks again. MOre ideas?

Gotta love an older lady driving a Vet!

Can you convince her to see her ophthalmologist, or better yet a retinologist? Maybe this route would help.

It’s hard for people to change when they have a doctor they’re comfortable with. Hope you can encourage her to see an endo. Assuming her doc isn’t one since he thinks 200 is acceptable.

She must be eating some carbs.

Maybe a support group for seniors…increase the possibility she will hear your message from others.

p.s. my H is in his late 70’s…asking him to question his doctor is asking for a divorce.

Amen on that score. MIL and I haven’t actually been able to carry on a good meaningful conversation for a long time…so I don’t want to blow the relationship by asking her too many personal questions…taking her to a doc, asking her about her doctoring, etc would definitely mean WW III if not more. So keeping a peaceful family deante’
is highly important. Besides we are both getting her to help me get my dh (her son) to get tested also. Too much family “D” history there!

She is lucky to have you.
My H would never go to anything that was organized specifically for people his age. We’ve been married almost 17 years with a 15 year-old son. He is 27 years my senior and he thinks he is a lot younger than his age…used to be true, not anymore.