Hi ! im new to this forum, im looking for some insight and possibly support with my fathers type 2 diabetes, his diabetes is really out of control and I need some advice on how to help, his A1C is 15 and his sugar runs at about 500-HIGH consistently, he only wants to drink sugary juices and soda he eats sugary snacks and waffles and to top it off he is perm disabled due to extreme nephropathy. Ive tried to keep him away from all this but he thinks he will die if his blood sugars start to normalize hes uncomfortable at a 150-300 range and starts to feel hypoglycemic he is in control of his diet and doesn’t/wont change it. lately for the past 3 months he has had uncontrollable diarrhea and nothing helps its to the point he has went from a healthy 250lbs to 118 and is extrreamly malnourished from the inability to keep anything in his body, my question is how long can this continue like this before dka or stroke… the hospital wont admit him and only get his sugar in range before re releasing him how can i get them to keep him???
Blood sugar control is a marathon, not a sprint. Your body needs to get comfortable at one level before dropping to the next level. An A1C of 15 means that his BG’s are averaging about 385 mg/dL, and I can understand that he will get very uncomfortable and feel hypoglycemic below 300. He needs to spend a week or two at an average BG of 325, work his way down for a few weeks to between 275 and 300, and keep working it down slowly but surely. Perhaps a low-carb diet where he can eat what he likes with sugar substitutes.
There are several ways to get him down to a normal level comfortably within a few months if that is what he wants. If he does not, then yes, his life will be short and miserable.
I would seriously look at a program such as:
It works, and they will work with him to adjust his diet and medication to make it happen quickly. He needs help now from a specialist.
yes definitly, at this moment hes drinking about a 12 pack a day to day and a half of full flavor soda and a gallon of juice he says he craves it and cant drink enough… ive never seen someone so thirsty and not be in dka
He needs to get off the juice and any sodas containing sugar now. He can’t go cold turkey as his blood sugar would promptly crash more than 100 points, and he would feel hypoglycemic. Hence, he needs to cut back and frequently measure his blood sugar, and every time he gets used to a lower plateau, he cuts back some more until he is off the juice and any sodas that contain sugar. He will keep feeling better as soon as his blood sugar starts going to a lower plateau. What medication is he on?
novolog fast acting and trulicity but he wont take the later just insulin every so often, hes also on suboxone
I have no clue how suboxone may or may not interact with his treatment, but I think you will find the consensus to get him off the Juice and sodas he is drinking that contain sugar.
If one group pours water on a forest fire (Pump insulin into a diabetic) while another group pours gasoline on the fire (heavy-duty fast-acting carbs found in juice and sugar sodas), the fire and the blood sugar will not come under control.
Maybe try something like this to continue what they started.
But he may also first need counseling on understanding and accepting healthier habits.
Amen to that.
I hate to suggest this but to me it suggest that a large part of his problem is mental. He definitely has an unhealthy relationship to food and drink.
Does he consume any kind of solid food. He is consuming way to many carbs in liquid form, perhaps he feels he needs them.
After losing 130 lbs, has he been tested for T1? C-peptide and/or antibody testing. It’s pretty rare to still have so much insulin resistance at 118 lbs.
If nobody is questioning that, I wonder what other level of care/training he’s getting from his medical team.
My first question is How does this stuff get in the house? Shut down the supplier.
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Hi Sam. Sorry to hear you are going through this. Helping your father through this is going to require making a connection with him and getting him to realize he has to choose to make himself better. I’m not good with that kind of stuff but I do know a couple of things about diabetes that might help you understand what is going on.
Your dad is feeling miserable because insulin is what lets sugar in the blood though cell walls into our cells. So his body is crying out that it is starved for energy and making him crave sugar. Symptoms of high blood sugar are being thirsty, urinating often, and can cause the stomach upset that causes nothing to stay down or go right through. Since you dad is reacting to the thirst by drinking more sugar he’s never going to get ahead of what the body is getting out. I expect he is severely dehydrated based on the weight loss.
I’m a type 1 diabetic, my body makes no insulin. When I was first diagnosed in 1990 I spent almost a week in the hospital recovering from the week and a half I lived feeling a lot like your dad is feeling. Most of the hospital stay was spent in low level agony as they pumped fluids and potassium in me to get my body’s chemistry back to normal. I was so dehydrated the only vein they could get an IV into was on my ankle.
Sometimes diabetics who have lost their sensitivity to low blood sugar can get the sensitivity back by avoiding all lows for several weeks. ADA article I hope the same can work for your dad and after several weeks of normal blood sugar he doesn’t feel bad. Is your dad on medicare? It may be possible to get his primary care doctor or endocrinologist to get him admitted to the hospital for a day or two to get his sugar down and his blood work back in range then sent to a inpatient rehab facility for up to 60 days where is diet can be controlled, he can’t skip his medicine and he can get used to feeling normal again. This isn’t a solution as he still needs to lean how to live at home but it does give him a chance to overcome his cravings.
It’s clear how you want to help your father but it’s unclear to me what your father wants. How old is he? Is he clinically depressed? Suicidal? Do you feel he should be allowed to direct his future even if that is shorter with his unhealthy status? Sometimes, hard questions need to be asked. Loving someone while respecting their destructive choices is one of the hardest tasks of all time.
I think @pstud123 made the crucial point. Your father is in a crisis situation if he has had uncontrollable diarrhea for 3 months and has lost 50% of his body weight. Sustained high blood sugars can lead to cognitive impairment which can clear up once things getter under better control. You might consider taking charge and doing whatever is necessary to get him to an ER. It isn’t a foregone conclusion that he would refuse treatment.
@Sam1330 , I have been hesitant to put my two cents in on your Dad and what you should do. Watching his health decline while he does exactly the wrong things to gain some quality of health is like the loved ones of a person in a destructive spiral of an addiction.
The self treating of false hypoglycemia sensations with sugary foods is much how any addict begins. The feel bad and when they do X the feel better.
It has been mentioned that when in long time hyperglycemia and it drops fast, but still hyper, one can get symptoms of hypoglycemia.
This was my situation my whole life, before diagnosis as type 2. I never was diagnosed with reactive hypoglycemia, but that what it was. I would get the shakes, anxiety and hunger, not normal hunger, a couple of hours after a meal. I would self medicate, which your Dad is doing, with a Coke and a candy bar. This would elevate my blood glucose levels probably very high and cause a secretion of a lot of insulin.
Over time, BG remains high as the Beta cells cannot overcome the elevated glucose levels.
Prior to diagnosis, it is like I was suffering from a brain injury or mental disorder. It wasn’t until I got good BG management and my normal mental abilities that I could recognize just how stupid I was with chronic hyperglycemia.
Going back to the addiction model, for an addict to successfully enter recovery the cons must become worse than the pros. This is the point that some might call a “come to Jesus” moment or reaching bottom.
I was lucky that my bottom was fairly high and became an uber compliant type 2 diabetic. I still had issues with my drug of choice, cigarettes. It took another 12-15 years for me to let that go.
There have been some good advice here on how to wean your Dad from the sugary drinks. We don’t know all the facts. When I was abusing sugar, I had the means to get it on my own.
Let’s take Coca Cola. I was probably drinking anywhere from 10 to 15 12oz cans per day at work. I was really helping a lot of places bottom line.
When my BG levels started dropping, I would feel hypo symptoms, but I was testing my BG, and I knew it was false. I would have some nuts, peanut butter or a bit of cheese and a few crackers.
The thing is, I completely accepted the diagnosis and the risk of diabetic complications the instant I was diagnosed. This is not the response of many in my tribe of type 2 diabetics. Many are in denial, or think that a pill will make things alright as they chase that pill with sugary coffee and a donut.
Non-compliance is probably less by the type 1 tribe, except many rebel during their teen and young adult years.
Where I’m going with this, well I don’t know, Sam. First I think you need to find some personal support for yourself.
I just spent a good bit of time trying to find support groups for the loved ones of noncompliant diabetics. I come up with little, most dealing with how to help the patient manage the disease, but little or nothing on helping the loved ones deal with watching their family members destroy themselves.
Perhaps there could be something like Al-Anon or Al-Ateen, I don’t know. I would suggest a trusted pastor, but many would not be a great fit. If you can get a meeting with a hospital Chaplain, they are trained in dealing with helping people through the denial phase, so one of these gifted people could maybe guide you in helping your Dad to accept his disease and to take steps, hard steps, to achieve better health.
The other thing that strikes me, is your Dad may be suffering from depression. It could be a response to the diabetes or have another cause.
I am sorry that I cannot offer a solution. I, by nature, enjoy diagnosing a problem and repairing it.
I worry about you taking blame for your Dad’s health decline. It is not your fault. Do what you can to help him comply, be positive when he does what is right, don’t get angry or disapproving when he does wrong. Positive feedback works better in people than negative.
Stay strong, Sam, love your Dad, assist him the best you can. Keep this in mind, when you see someone is in a hole and cannot get out, DO, NOT, CLIMB, IN. THE. HOLE! Because now there are 2 stuck in the hole.
A comment on his rapid loss of weight, this suggests that his insulin secreting Beta cells are not up to managing his soaring blood glucose levels or they are giving up the ghost. I suspect his ketones are rising which would suggest diabetic ketoacidosis (DKA) but that is rare in type 2, our risk is hyperosmolar hyperglycemic state (HHS) which can cause unusual weight loss as well.
I hope something I and others wrote is helpful, Sam. It is a very difficult problem for you. Take care of yourself and do what you can for your Dad.
Firstly, if he is depressed, I can certainly recommend a psychiatric hospital stay. He would get regular scheduled, balanced meals and some support for what might have become an addiction for him. I’ve been there and it really helped me get back on track.
Secondly, what’s wrong with diet pop? His body needs the fluids. Or try those “flavoured” water enhancer liquids like Kool Aid that have zero carbs. He needs water.
I feel for you. You’re in a tough situation.
@Sam1330, I strongly second this recommendation! I am an adult-onset T1D and the C-peptide test confirmed the diagnosis right away.
QUesiton, how old is your father and when was he Dx’d with the T2D? I ask about age because there are some MD’s who automatically assume T2D if the patient is an adult. Seems to me he’s in DKA - hence the diarrhea and vomiting. Dehydration is a serious risk. The suggestion to have the anti-body and GAD tests is a very good one. Often when people have been living with very high bg levels, getting down to near normal can feel like a hypo - and lead them to think they need fast-acting sugar. If he has had his T2D Dx for only a few years, it could very well be that he was mis-Dx’d.
I agree with others – he may very well have T1. It is imparitive the he get to a doctor, or better, checked into a hospital. That kind of weight loss is unusual with T2: the patient isn’t making enough insulin to keep their bG’s normal, due to difficenty, resistence or both. But there’s enough to keep his cells from literally starving and consuming fat. With untreated T1, no amount of food will prevent severe weight loss.
If a person goes from normal bGs to 500+ acutely, they will end up in the hospital straight away. If it happens over a long period of time, the body will adapt and continue to function to the degree that it can. But that doesn’t mean they aren’t in severe crisis. He needs to get admitted to a hospital.
Unfortunately, age plays into misdiagnosis. My brother was DX-ed at about age 60. He was told it was T2 and could not possibly be T1. He insisted, over much resistance, having C-peptide and anti-body tests. It was T1. He got a new doc. My other brother was also DX-ed as adult with T1 but didn’t require insulin as his pancreas was still making insulin. His endo put him on a Iow dose of insulin ~ 2u/day, intermediate to long acting. That extended his honeymoon period to over a year. He could have easily been DX-ed T1. He stuck with that doc.
I knew someone with treated T1 who was nearly phobic of hypos and never let their bG get below 200 mg/dl. They ended up with both retinopathy and nephropathy.
I am a big believer in ordering and getting my own tests, especially if I have concerns over my diagnosis. After all, a C-Peptide test, for example, costs less than $50. When you bring your own test results to your doctor’s visit, it shows that you are seriously interested, and the doctor spends time thinking about your concerns rather than just giving an off-the-cuff standard response.