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Living with diabetes has many challenges, but so does living with someone who has diabetes. That’s the topic of our next web chat 'When Your Loved One Has Diabetes: How to Nurture not Nag,' Noon to 1 p.m. Wed., May 25. Debra Sievers, a diabetes clinical nurse specialist at Florida Hospital Diabetes Institute, will field questions from both sides, and help participants find a happy healthy ground to living together with diabetes.

If you live with a diabetic, join us to find out how to walk that fine line between offering support and being a pest. Learn to recognize the warning signs of blood sugar that's too high or low. And discover how to tactfully handle times when your loved one does something you know isn't good for his or her condition. If you have diabetes, and your partner is driving you nuts, this is your chance to air what you do and don't appreciate.

When your loved one has diabetes: How to nurture not nag

(05/25/2011)

  

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12:03

Orlando Sentinel Health:  Living with diabetes has many challenges, but so does living with someone who has diabetes. That's the topic of today's web chat. Wednesday May 25, 2011 12:03 Orlando Sentinel Health

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Orlando Sentinel Health:  Debra Sievers, a diabetes clinical nurse specialist at Florida Hospital Diabetes Institute, will field questions from both sides, and help participants find a happy healthy ground to living together with diabetes. Wednesday May 25, 2011 12:03 Orlando Sentinel Health

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Orlando Sentinel Health:  Welcome everyone and thank you for joining us. Wednesday May 25, 2011 12:03 Orlando Sentinel Health

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Orlando Sentinel Health:  Mike has our first question today: Wednesday May 25, 2011 12:03 Orlando Sentinel Health

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Orlando Sentinel Health:  Spouse diagnosed with Type II diabetes in 2007. Today, blood suger varies widely (hypo to hyper) throughout the day despite medications prescribed by PCP. Has lifelong bad experiences with 5 (different) endochronologists (prior to diabetes). SO, won't go see a diabetic endochronologist. Spouse knows her situation is serious. What can I do? Wednesday May 25, 2011 12:04 Orlando Sentinel Health

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Debbie:  Has she or both of you attended diabetes education or seen a certified diabetes educator (RN or RD)? Wednesday May 25, 2011 12:05 Debbie

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[Comment From Mike P Mike P : ]  No Wednesday May 25, 2011 12:05 Mike P

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Debbie:  When blood sugars vary widely it is often related to meal planning and timing of medicines and exercise with meals - education really helps with that. Wednesday May 25, 2011 12:06 Debbie

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[Comment From Mike P Mike P : ]  Note: She is very skilled and diligent at counting carbs and taking reading at the appointed times. She's even included non-traditional (pickles & vinegar) methods to stabilize blood sugar. We eat exactly at the same time every day. She takes her medications on time every day. Wednesday May 25, 2011 12:08 Mike P

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[Comment From Liz Liz : ]  Hi, Mike P and Debbie, as the wife of a Type I, may I suggest that you look for recommendation for endo from other patients... finding a good endo was a lifesaver for my husband. Wednesday May 25, 2011 12:09 Liz

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Debbie:  I'm glad to hear she is testing BG and being consistent with timing. I still would recommend a consultation with a CDE. An individualized assessment is often very helpful to determining what is happening Wednesday May 25, 2011 12:11 Debbie

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[Comment From Laura Laura : ]  What is the one thing a family member or loved one can do to support someone with Type 2 diabetes? Wednesday May 25, 2011 12:11 Laura

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Debbie:  Comment from Liz - I agree - finding a good endocrinologist who you feel comfortable with is very important to self-management. Finding a style you are compatible with. Wednesday May 25, 2011 12:12 Debbie

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Debbie:  Laura - listen respectfully. This is cliche, but so important. Ask them what their feelings are about diabetes and ask what kind of support do they want from you. Of the support you give, what did they find helpful and what they did not - do not take their response personally. Wednesday May 25, 2011 12:14 Debbie

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[Comment From Mike P Mike P : ]  Yes. I've offered to help her find an endo that has a good reputation, but she is unmoved. Wednesday May 25, 2011 12:14 Mike P

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[Comment From Tampa Tampa : ]  Once a diabetic suffers from neuropathy, can it be reversed? Especially once they are no longer diabetic? Wednesday May 25, 2011 12:15 Tampa

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Debbie:  Tampa - it depends how long they have had diabetes, the degree of BG control. In early stages it has been found to be reversible to some extent with tight BG control - but is very individualized. Not sure about the diagnosis of 'no longer diabetic'? Wednesday May 25, 2011 12:17 Debbie

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Debbie:  Mike P - have the two of you discussed her feeling about having diabetes - her fears or concerns. What did she not like about her previous 5 endocrinologists? Wednesday May 25, 2011 12:17 Debbie

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[Comment From Liz Liz : ]  I like the title of this chat - nurturing, not nagging. My husband is a bit of a rebel probably from being diagnosed with Type I when he was 17. I had to learn to not impose my way of doing things on him. Wednesday May 25, 2011 12:19 Liz

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[Comment From Mike P Mike P : ]  Diabetes: Mostly. Previous Endos: Somewhat. It is upsetting to describe what she went through while they tried to figure out what was wrong. Wednesday May 25, 2011 12:20 Mike P

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Debbie:  It is important to understand that the person with diabetes and the family can experience Guilt, Blame, Financial, Loss of “normal lifestyle”, fears after diagnosis and why education and a trust relationship with health care providers (doctor, nurse, dietitian )are so important Wednesday May 25, 2011 12:20 Debbie

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Debbie:  Liz - you are correct. We a family sometimes want to help so much we want to 'fix' everything for the person or do it for them - this undermines their ability to be self sufficient and feel 'normal' - though I do not like that term. As person with diabetes is like a person with glasses. Wednesday May 25, 2011 12:22 Debbie

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[Comment From Cathy Cathy : ]  My dad is Type II diabetic that was able to use pills for 8 yrs, but just in the last year was told he had to go to insulin shots. He gives himself shots 4-5 times per day, but is still having "crashes" almost nightly, usually between 3-5 pm. He is eating properly, but still having these episodes. Is it possible that the pills were better to control his disease and should he ask the doctor to switch back? Wednesday May 25, 2011 12:22 Cathy

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Debbie:  Cathy - Is he checking his blood sugar at least 4-5 times per day since that is the frequency of his insulin? Has he shared this information - low BG's and his BG results with his physician. There is a mismatch between his insulin levels and food intake (which determine glucose level in the blood) Improtant to balance the 2 in the blood stream at the same time. Wednesday May 25, 2011 12:25 Debbie

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[Comment From Tampa Tampa : ]  My partner got a new pancreas so is no longer diabetic. Since the transplant has been a miracle of no blood pressure issues and is on little other meds. Was wondering if the rest would correct as well. Wednesday May 25, 2011 12:27 Tampa

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Debbie:  It is also common for oral pill for diabetes to become less effective as type 2 diabetes progresses. The need to go to insulin can be due to progression of the diabetes or change in diabetes lifestyle changes - it can be difficult to stay on the lifestyle plan. Wednesday May 25, 2011 12:28 Debbie

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[Comment From justinspaces justinspaces : ]  I was diagnosed with type 2 diabetes 10 years ago but never managed it and lived in denial. Last month I was hospitalized for an appendectomy with complications and I am now controlling my blood sugar correctly for the first time with insulin and diet. For the first time in years my blood sugars are 90-160. However, I am now getting EXTREMELY blurry vision for the last few days. Could this be an effect of my controlling my sugar levels and will it go away? Wednesday May 25, 2011 12:29 justinspaces

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Debbie:  Tampa - OK - understand. Sounds like the transplant was successful. The person would need to discuss the neuropathy with their physician to determine how severe it was - is severe, not much reversal would be expected. However, also important to investigate other causes of neuropathy such as side effects of some medications, vitamin deficiencies and others. Sometimes when diabetes is present, we have a tendency to blame all problems on it ... a neurologist could investigate further. Wednesday May 25, 2011 12:31 Debbie

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Debbie:  Justinspaces - Congratulations on controlling your BG now. It is never too late! Do you wear glasses? If so, they may have been adjusted to the changes in the lens of your eye that occurs with high BG's and now that your BG is lower your prescription has changed. Wednesday May 25, 2011 12:33 Debbie

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[Comment From justinspaces justinspaces : ]  No, I have never worn glasses Wednesday May 25, 2011 12:33 justinspaces

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Debbie:  Justin - have you consulted with your opthalmologist for an eye exam? Wednesday May 25, 2011 12:34 Debbie

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[Comment From justinspaces justinspaces : ]  My vision just went blurry about 5 days ago. I would occasionally suffer from floaters and spots in the past before I controlled things but they would go away Wednesday May 25, 2011 12:35 justinspaces

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[Comment From justinspaces justinspaces : ]  I have not. I don't have medical insurance and nobody will help me. Wednesday May 25, 2011 12:35 justinspaces

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Debbie:  Since this is a sudden change and you have had floaters before, I strongly recommend you call an opthalmologist today. These are significant symptoms. Wednesday May 25, 2011 12:37 Debbie

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[Comment From Terryl Terryl : ]  My mother suffers from type 2 diabetes and she lives in NY. While she presents well over the telephone, when she visits we can tell she's mismanaging her diabetes. My sister and I (her only two children) would love for her to move to Florida. She suffers from neuropathy as well. Wednesday May 25, 2011 12:37 Terryl

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Debbie:  Justin - you might try calling 211 - the community help line and ask if they have referral sources for an eye doctor for a diabetes eye exam. Some eye physicians participate in a program which provides eye exams for people with diabetes without insurance. Wednesday May 25, 2011 12:39 Debbie

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[Comment From Terryl Terryl : ]  We want to be "helpful" and not make her feel like we're nagging but she gets annoyed and does not want to talk about it. Wednesday May 25, 2011 12:39 Terryl

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[Comment From justinspaces justinspaces : ]  Thanks big Debbie Wednesday May 25, 2011 12:42 justinspaces

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Debbie:  Terryl - it is especially difficult when a family member lives far away. Have your tried asking her about her feeling about having diabetes - what she find frustrating or difficult without trying to provide alot of solutions. Ask her what kind of support she would like from you and your sister. She may need someone just to listen. Does she have any support people (i.e. friends) where she lives. Another thought - did she move there are did you and your sister move to Florida? Is she unhappy about the separation of her family? Wednesday May 25, 2011 12:43 Debbie

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[Comment From Guest Guest : ]  I have two sons who were both diagnosed with Type 1 Diabetes this past year. Fortunately, they have both embraced proper management (to the degree a 15 yr old and 8 yr old can), but as a mom, I am always concerned about the horror stories of loss of limb, eyesight, etc. Are there specific warning signs, and pro-active measures outside of good medicinal, dietary and physical activity levels, that I should ensure that I look for, and that they take? Wednesday May 25, 2011 12:46 Guest

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Debbie:  That is a major change for your family. Congratulations on the effort your sons have taken at such young ages - sound very mature for their age. I understand your concern. A very important measure to determine risk for long-term complication that you describe is the A1c test. The goal is less than 7% for most people with diabetes - with younger children is can vary. The symptoms of complications are often silent for a longtime so the A1c test is the measure (For example - in the same way in which blood pressure control is used to measure a person risk for a stroke). The good news is that long-term complications occur very slowly. There are annual tests that can be used to monitor the silent symptoms - a good pediatric endocrinologist is invaluable. Wednesday May 25, 2011 12:51 Debbie

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[Comment From Terryl Terryl : ]  Yes Debbie, I do believe that she is unhappy about her separation from her family, however, I think she's most comfortable in NY where mass transit is readily available. Wednesday May 25, 2011 12:52 Terryl

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[Comment From guest guest : ]  I have a daughter. Her sugar most of the time running low, she feels scared and getting depressed. Wednesday May 25, 2011 12:54 guest

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Debbie:  I understand. Does she have a good relationship with her doctor in NY? Does she have access to a diabetes educator or diabetes program where she can discuss her feelings about diabetes. Sometimes a person will not talk to a family member about their health problems - mothers often feel they should not burden their children. There are alot of family dynamics involved. Wednesday May 25, 2011 12:55 Debbie

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Orlando Sentinel Health:  Tony has our final question today Wednesday May 25, 2011 12:56 Orlando Sentinel Health

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[Comment From TONY TONY : ]  I have pulled way back on my meds since I dropped to 46 recently. My wife had a very time bringing me back. She is usually very successful when I become hypo. My numbers seem to be better and I have not had a hypo incident since. Was afraid to sleep after that for several days. When speaking with my niece that is married to a diabetic and knows several other diabetics. She said that she was told that people that used Glipizide has BG's all over the place. I take Actos, Glipizide and Metformin. Since speaking with her I have dropped the Glipizide and things do seem to be improving. What are your thoughts? Thank you very much. Wednesday May 25, 2011 12:56 TONY

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Debbie:  Guest - how low is her BG? Have your discussed this with the physician? Her feeling scared and depressed is understandable - she probably feels she is losing control of her life. Needs to see her physician to evaluate her diabetes management and plan to avoid these low BG's which can be done. Wednesday May 25, 2011 12:57 Debbie

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Debbie:  I would encourage you to discuss any changes in your medication with your physician. Let him'her know what is going on. It is very impoartant to be on a consistent meal plan (portions and timing of meals) when on glipizide. Wednesday May 25, 2011 12:59 Debbie

1:01	[Comment From TONY TONY : ]  Thanks very much. Wednesday May 25, 2011 1:01 TONY

1:01	Orlando Sentinel Health:  If you missed any part of this event, you can replay it! Just go to http://orlandosentinel.com/healthchat to see all of our recent and upcoming events. Wednesday May 25, 2011 1:01 Orlando Sentinel Health

1:01	Orlando Sentinel Health:  Thank you for joining our chat and to Debra for sharing her expertise. Wednesday May 25, 2011 1:01 Orlando Sentinel Health

1:02	Orlando Sentinel Health:  You can learn more at the Florida Hospital Diabetes Institute website http://www.floridahospitaldiabetes.com/ Wednesday May 25, 2011 1:02 Orlando Sentinel Health

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