When more medication isn’t always the answer

I thought I would share this with you all because I can see the funny side of it now but of course it is a serious matter.

As some of you may know, I struggle at times to look after my husband who has several difficult to control health conditions.  Last night I panicked when I saw his blood glucose level hitting an all time low of around 54 mg/dL (3.0 mmol/L) if my Freestyle Libre sensor was accurate.  Levels should be above 4.0 mmol/L. This happened because I was told to increase his insulin due to high blood glucose levels.  The cause?  My husband is now eating round the clock, getting up in the night for feasts of the wrong kind and it is becoming exceedingly difficult to control his glucose levels or to safely assess how much insulin he needs.  We are working with a specialist diabetic nurse to try to address this but I fear it has become a habit now due to sleep disturbances.  

Last night I had to quickly bring my husband’s blood glucose up to a safe level by giving him an immediate spoonful of sugar while he was eating vegetable soup.  That didn’t work so I added some honey, then some orange juice!  Then he demanded Amaretti almond biscuits with his vegetable soup, to see if they might help!   Now how can any of this ever be healthy or good for us? 

I hope some of you can relate to this with other health conditions and meds too.  I know I certainly can. 

For diabetic members I attach the Centre for Disease Control and Prevention link on how best to treat low blood sugar.  Stay safe and healthy everyone 

https://www.cdc.gov/diabetes/basics/low-blood-sugar-treatment.html


9 Comments

Controlling blood sugar

by Good Dog - 2024-03-24 15:18:32

Gemita, thanks for the post. It is an interesting subject and one that is likely familiar to many of us older folks. I learned quite a bit from the link that you provided. 

I discovered sometime last year that my glucose levels would sometimes spike and that I needed to take care in an effort to try to avoid being pre-diabetic. Well, since then I have learned how difficult controlling blood sugar can be. I have always had reactive hypoglycemia and usually cannot exercise within a couple hours of eating. My glucose spikes-up after eating and then drops like a rock. Obviously, much worse if it is a high carb meal. There have been many times when I've had to eat a handful of candy in an effort to increase my glucose and feel better, but it spikes up again. It can be a viscious cycle. That 15-15 rule will be really helpful in dealing with that. 

Since realizing the need to control my glucose levels last year, I have tried to alter my diet and cut or reduce the carbs and sugar. I only use sugar substitutes now. What I have found is that while there is a diverse selection of low-carb and low sugar processed foods, none of them are as satisfying as a bag of chips or a bowl of ice cream when I want a snack. Many of them may be safe and taste good, but not always healthy alternatives. My point is simple: sometimes controlling blood sugar requires giving-up one of the few simple pleasures remaining as we get older.  However, I have seen how much damage uncontrolled diabetes can do. So I don't want to go there.

Thanks again!

Sincerely,

Dave

controlling blood glucose

by Gemita - 2024-03-24 17:17:25

Dave I have always had low blood glucose levels, particularly before food and I can get quite shaky with this as well.  I have never experienced spikes in blood glucose levels though.  Your blood glucose levels sound as volatile as my blood pressure at times.

It is absolutely amazing how quickly my husband’s blood glucose can spike after a carbohydrate meal and how high it can go, so the diabetic team clearly had to have words with him.  He is better on protein which keeps him going longer.  He cannot hide what he has been eating anymore because his nightly graphs tell me everything I need to know.  When he doesn’t eat during the night, his morning numbers are almost normal.  I don’t want to keep increasing his insulin levels which clearly carries some risk too and makes management even more challenging.

I know the foods that are slower to hit his blood stream and when he eats these, it can make all the difference.   We can still enjoy carbs if we don’t choose refined ones.  I happen to prefer heavier whole grain breads although we love stonebaked ciabatta type breads too (in fact any “weighty” bread) with avocado, ricotta and other toppings.  Fat is slower to hit the blood stream so it is all about choosing the right combination of foods.  We eat a lot of pulses (lentils, chickpeas, pinto beans) and I love nuts and seeds too. 

You are absolutely correct, low carb, low sugar foods are not nice at all and leave us feeling hungry.  However I don’t think we have to give up everything we love, providing we choose wisely and don't eat too many treats at once

Managing Significant Others

by Penguin - 2024-03-25 06:19:27

It's really hard to manage somebody else's diet as well as your own - particularly with diverse needs.  As a couple it's really difficult not to impose how you want to eat on your partner, or to cook something different for them.  As a family (with children) it's difficult too.  It's also really annoying when the people you're trying to help won't play ball for the benefit of their own health.

 You either become the 'head teacher' and micro-manage everything - thus encouraging  'naughtiness' (sneaking snacks when you're not looking), or allow someone to take the consequences of their own actions. 

Pretty difficult decision when you're the one left dealing with a hypo or other consequences.  I imagine that it could be a source of friction. 

Gemita

by Good Dog - 2024-03-25 07:36:37

You are correct with regard to not needing to give-up "everything" that we enjoy. However, I am one of those people with the inherent misguided philosophy; if a little is good, then a lot is even better. I have to fight that impulse all the time.

It does seem that you have a real handle on your husbands glucose. That is really good for his sake. Although, I can imagine how challenging that is. I am unsure exactly what his motivation may be for eating the wrong foods during evening or night beyong just craving them, but I can tell you what mine had always been. I have always had trouble sleeping, and especially so when going to bed hungry. Given my craving for carbs, I would often load-up on them which was not only satisfying, but also put me right to sleep!  So since I have begun the endeavor to better control my glucose, my sleep has really suffered.

Much like you, I have slowly learned that I can safely eat lots of different proteins. We have a bread bakery near us that makes great whole multi-grain bread loaded with all kinds of seeds baked in a wood-fired oven. So it really is a learning process! In response to your original question: YES, I can relate!

Sincerely,

Dave

 

you've got your hands full

by Tracey_E - 2024-03-25 10:48:00

Other side of the coin, it's a good thing when he's feeling up to being feisty. 

Yes my hands are full

by Gemita - 2024-03-25 13:58:01

Tracey, feisty, yes it has its benefits since it usually indicates a rise in Michael’s blood pressure and I can then take prompt action to calm him.  I know all is well when hubby is breathing normally (not hyperventilating), is happy and relaxed.

Penguin, our diabetic nurse really seemed to get through to Michael during our appointment last week, explaining the dangers of not getting blood glucose under control and the impact it is having on his kidneys and heart.  He promised he would try to stop one night time snack (a bowl of mixed cereal) and only have a banana instead.  It lasted three nights, since he wants to use up all the special offer cereal packs he has been buying, not to mention the Snickers chocolate bars I have found in the wardrobe.  Anyone would think I didn’t feed him.  It is difficult not to get angry at times but it is never the answer.  So what is?  I remind him if he wants to see his great grandchildren (6 and 2 years) growing up and even getting married, then he really needs to take more care.  It usually works, at least for a few days

Dave, yes we can have too much of a good thing.  We love fruit, but one pear, one apple, a handful of grapes, a tangerine say all in one meal is far too much for a diabetic patient.  His current insulin is fairly fast acting and Michael’s blood glucose can fall rapidly during the night, waking him.  We tend to have supper late (8.30 to 9 pm) so that he will not go to bed hungry since he cannot sleep either on an empty stomach.  Like you, by getting up during the night and having something to eat, helps him to get back to sleep almost immediately.  Lack of sleep just pushes up his blood pressure and is bad for his health too.  Oh it is a fine balancing act and I don't always get it right

there is no really good answer

by new to pace.... - 2024-03-25 17:43:52

i have a suggestion since he has trouble remembering, maybe draw a picture of what would happen to him  after consuming those wonderful illegal foods.   Put the picture next to his stash.   Or a picture of yourself next to his stash which would remind him not to consume.

new to pace

Hang in there, you will figure this out

by Elisabet - 2024-03-26 20:55:04

My heart goes out to you; you are in such a difficult situation. It seems that your husband knows the theory, he is just not putting it into practice. So I would concentrate on the latter.

I am not diabetic, so I don't know what is and isn't allowed. If there's a non-sweetened cereal that he could have with milk as snack when he wakes up hungry, maybe you could give the promotional cereal to a food bank and replace it with the better stuff. Or have really filling things, like unsweetened peanut butter and banana sandwiches on good whole wheat bread (not the sweet kind) in the fridge ready for midnight raiding. Replace the snickers bars with diabetic-friendly snacks and don't say anything - sometimes a bird in hand is better than searching through the bushes for something else.

It sounds like the big thing to address is what my endocrinologist calls "sleep hygeine". She had a lot of suggestions, including eating dinner earlier and then just having a snack before bedtime, but what worked best *for me* was adding a small dose of Trazodone at bedtime. The nice thing it doesn't make me sleepy or woozy if I have to get up or get a call (don't ask, lol, my college student would abuse our "call anytime" policy), but I can go right back to sleep without tossing or turning. Your husband might have apnea or something else besides hunger waking him up, and eating carbs is now a learned response. 

One other thing is that I just finished cardiac rehab which was heavy on the Pritikin eating plan; lots of whole foods and attention to amping up the flavor, so you aren't feeling deprived at all. There were a couple of diabetics in the program with me. Most of the recipes, which are pretty simple, are on their webpage blog. Lots of really filling ideas there.

Hang in there; it might take a while but you are going to figure this out.

Thank you both

by Gemita - 2024-03-27 06:06:18

New to  Pace and Elisabet, thank you both for your support and suggestions. I do try to remind my husband that he can still enjoy his food and even eat less healthy foods occasionally but just to be more aware of the dangers of exceeding safe blood glucose limits too often and what it is doing to his general health.  Once his kidney function starts to fail and this has already started happening, I cannot help him with diet alone, so if we can limit the damage that high glucose levels are clearly causing, it will delay or even halt further decline.

Michael’s sleep hygiene has always been poor and this really should have been addressed years ago.  An in hospital, full sleep study would be helpful I feel to get to the bottom of his problems.

Elisabet, our diet is similar to the Pritikin eating plan.  Really healthy diet, varied diet:  fish, some meat, lots of vegetables and fruits, seeds, pulses, with some treats for Michael in between, but somehow he craves all the wrong foods most of the time, like doughnuts, sausage rolls, biscuits, cakes, salami, parma ham, fried foods.  His triglycerides are sky high and so are his blood glucose levels.  I get upset sometimes because I am trying so hard to keep him well while he dreams of tiramisu!

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