The annual Christmas morning visitation to/by the Other Half’s family is always a pleasant thing… the catching up, the news, the day’s arrangements of time… After a break, we head out with his parents to return the visit… and the talk becomes more personal, more gossipy…
We’ve learned that one of The Other Half’s cousins was diagnosed with diabetes around the time of a recent knee replacement operation. I had not remembered that her mother also has Type 2 diabetes (has had it about 10 years), and had had a serious (required ambulance evacuation to hospital) low-glucose episode last year, made worse (IMO) by the fact that she was instructed to only perform fasting BG checks (in the mornings). (My own mother still has not been instructed to check her BG at all.) The aunt also has a history of heart disease and IIRC has been dealing with other geriatric issues that the OC has learned are exacerbated by diabetes.
The aunt was told her fasting BG should be “under 200”. Under 200??? That’s higher than those ADA postprandial recommendations many of us consider to be too lax! She’s on 500 mg metformin 4x/day and other than watching sodium, I’m not sure what dietary instructions she’s been given. She uses an old Accu-Chek Easy monitor and is not interested in upgrading or updating, even though Medicare would pay for the upgrade.
The Other Half’s father also tests only once or twice daily, but was given the same fasting-BG goals that would be given to euglycemic (nondiabetic) patients. Again, no real dietary support.
And as near as I can tell, no CDE support, church support, or other support group to keep them informed of new research and recommendations.
It’s one thing to learn about the poor state of diabetes care in the abstract; it’s quite another to see folk close to you receiving such poor care, and not being in a logistical or financial position to do much about it. I could talk myself blue in the face, but I’m not the doctor (who is in the authority position), I’m not there to go to the doctor with them and ask the doctor questions, I’m not the one doing the grocery shopping and meal preparation, and I’m not Medicare which only provides for one BG test per day.
It is said that diabetes and depression are closely linked. It’s more depressing for me to see people take their doctors’ lack of advice and outdated (careless, or Medicare-dictated) standards of care than it is to see a set of high numbers and realize “yeah, that’s probably because I overindulged on Christmas cookies”.
There has to be a useful approach to getting loved ones to take better care of their diabetes. I just don’t know what it is… yet… Until that time, I don’t see a way to not be scared for their lives and their well-being…