Re: Question for T1 folks



Màck©® wrote:
On Sat, 30 Jan 2010 20:58:55 -0800, "Julie Bove"
<juliebove@xxxxxxxxxxx> wrote:


"Ricavito" <newsgroupreader@xxxxxxxxxxxxxxx> wrote in message
news:bf5bc042-1787-4199-8213-4204f1ad5839@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
On Jan 30, 1:38 pm, "W. Baker" <wba...@xxxxxxxxx> wrote:
Ricavito <newsgrouprea...@xxxxxxxxxxxxxxx> wrote:

I have a young family member in her early 20s, who was diagnosed T1
when she was 9 or 10 years old. She was on a pump for some time,
but at some point in the last year or two she stopped using the
pump. Recently, she has had several emergency room visits and
hospital stays. The symptom that led her husband to bring her to
the emergency room was severe stomach pain. On admittance, the ER
found she was in DKA. This has happened on two or three occasions
in the past 4
weeks. The hospital has done tests, MRIs, brought in specialists,
etc. but they have not found the cause of the pain and in both
cases sent her home after a few days with pain meds. She lost her
vision most recently and she seems exhausted. I also know that she
has been in DKA before in the last few years.

I think her also very young husband is attuned to her moods and
knows when something is not right, and he has done absolutely the
right thing in getting her to the ER. But I think he takes his
clues in what to do from her, and may not realize that she might
not be able to communicate well at these times. For example, he
said that a 300 BG reading was okay, chocolate is okay to treat a
low. I don't know if he's just mixed up or got that from her.

They are poor as church mice, but also very independent and maybe
not receptive to some pushy relative interfering, but I am just
very concerned for them both. I feel like I need to speak to him
about getting educated and I'm going to really push that with him,
and will offer to pay for a class or training.

The danger just seems so immediate though, with all has happened in
just a few weeks. I thought I'd take them a few tubes of glucose to
keep around. They both have cell phones and a fairly reliable car,
and they live not too far from emergency services.Can you think of
anything else I could get for them that might help in the short
term?

Ricavito

If she is going DKA it is not glucose tabs she needs as this means
too high and the tabs work for too low! I am not a type 1 but it
sounds like she is not manageing her insulin/eating regemin at all
well. Is she skipping insulin or eating terrible foods because the
are cheap? I don't know and cannot advise, but she needs some kind
of diabetes management education on how to work without the pump.
Did she go off the pump because it was too expensive? If so, she
needs a whole new set of instructions on how to handle her
condition.

Wendy


She apparently is having lows as well, big swings in her BG
apparently. Isn't this what is called a brittle diabetic? I had a
sudden panic that she might go too low in her sleep. This happened
to
a T1 friend some years ago, and she did not survive it.

As to diet, she seems to avoid the obvious, like dessert or sugary
soda. I have observed she seems to prefer bread and fruit and eats
them freely. They are pretty haphard about eating, he can't cook and
she is too exhausted, so I think often she just doesn't eat.

I thought if she was on the pump as an adolescent she would have been
required to have some education in how and what to eat so as to
maximize her control and swings in BG. I don't know why she went off
or what advice she was given at that time but I agree with you that
she needs help in getting through this. I've been checking into some
classes hat she and her husband could attend together.

Another thing I can do is buy them some groceries, and maybe make a
few dishes for the freezer that he could microwave for her.

-----
You are describing a brittle diabetic and while 300 may seem to high
to the rest of us, might in reality not be too high for a person
prone to lows. I was in a diabetic support group with a brittle
type 1 on a pump and she said she was often at that number. What
she did in an attempt to help was to keep some sort of bar in her
pocket. I don't know if it was a Cliff or Luna or something
similar. She would take little bites of it throughout the day.



no he is not describing a brittle diabetic. He is describing an
uncontrolled diabetic. A real brittle diabetic is one who does what
they are supposed to do and still can't maintain control and swings
high to low and back again.

I would want more info from that brittle pumper. Especially how many
times a day she tests. You'd probably find it is not adequate.

Unfortunately, in the past (and maybe still today) uncontrolled diabetics -
especially type 1's - were often labelled as brittle diabetics. And
uncontrolled could be through no fault of their own when you look at the
older type regimens that are still given to some type 1's today. They think
they are doing the right thing by themselves.


.



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