How do you overcome denial

[Ian Griffiths]

Hi all,

As a concerned member of a family with a 75 yr old grandmother (gran#1) who has been type-1 for 30+yrs. We have accepted her 'received wisdom' how she 'manages' her condition; yet, I've always held a deep-seated concern that she is basically, in denial!

On my sister's husband's side, another grandmother (gran#2) was also type-1, yet her lifestyle and dietary choices were the complete opposite to gran#1. Gran#2 would exercise, monitor her intake like a demon possessed. Precise measures, ratios calculated, timings precise, regular testing, etc. She passed away recently at 90 - with NO link to diabetes or her lifestyle.

Gran#1 on the other hand... well! No exercise that raises her heartbeat above 100bpm, no control, very little testing, and a very 'sweet-tooth'. The stock answer she gives to justify is that she balances her levels by her food intake and injects depending on what she 'thinks' she's eaten, i.e. cookies, cake, pastries, ice-cream. And yes, she mainly suffers hypo's, which are pretty regular (fortnightly).

Gran#1 is a key support for our family (emotionally, intellectually and life-experience wise) so I would LOVE to understand which one of the two approaches is valid when living with diabetes type-1; or are they both valid and there is variation in the condition?

I'm not content to accept gran#1's explanation of 'managing the condition' without some independent authoritative input.

Q1: Is it valid to eat sugar-based foods (cakes, etc) and moderate injections accordingly?

Q2: If not, is there a formally recognised 'guide' how to live with diabetes to stay healthy (optimise)?

I'm coming late to the party and feel incredibly guilty for not asking for help earlier

Concerned newbie

 

[Robin]

Hi Ian. There's no simple answer to your question ( is there ever).
Most of us on here try to do the best job we can, but there may be wide variations in how to set out to acheive this. Some people thrive on micromanaging the condition, setting tight goals, restricting their diet, because they would feel uncomfortable if they weren't in complete control. For others, this approach would set them on the path to depression!

Its difficult to know what's going on with Gran#1. It's perfectly possible to build in cakes (or other sweet or carby things) into a diabetic diet, and adjust insulin accordingly, depending on which insulin regime she is on. (If she's on MDI, multiple daily injections,) so Gran #1 may be doing this...or she may feel burnt out, and think that with advancing years, it's just not worth bothering any more. Certainly, the message we get from our doctors is that we can eat a normal diet, if we adjust our insulin to fit. Not that it's easy to do! I certainly have hypos at least once a fortnight, simply because there are so many variables, (and I tend to be one of the 'write everything down and calculate' brigade). You only need to worry if she can't feel them coming on, or needs help treating them.

Regarding exercise, this is something everyone should be doing, diabetic or not, but some people are more natural couch potatoes than others! Exercise doesn't have to be formal, though, housework, gardening, walking to the shops, all count.

Does she have appointments with a specialist diabetic nurse, or doctor, to discuss her diabetes, and do you know what they say? Is she showing signs of diabetic complications? If not, she may feel she can continue as she is. It does vary enormously, and can be luck of the draw, (or the genes) some people who have tight control, still develop complications, others who are more relaxed and are content with higher numbers get away without.

 

[everydayupsanddowns]

Managing type 1 diabetes is possible in a number of ways, and with a variety of outcomes. Some strategies are more likely to be successful, but it is a very individual condition and there is no ‘one size fits all’ set of rules that can be followed.

From what you have said Gran2 seems to have been following the modern approaches to intensive insulin therapy, while Gran1 is making some more unusual decisions which may make effective management more challenging, but are not necessarily impossible to get right.

Regular hypoglycaemia is never a good sign, but again this is a term with a broad range of experiences and definitions. If Gran1 is needing help to recover from hypoglycaemia from a third party with any regularity that’s a real concern, but if it’s just a short term dip into the high 3s every so often which is self-treated without fuss then that is very different.

Without regular monitoring it is very difficult to get a picture of what is going on with a person’s Diabetes after a while, because some of the sensations (eg low blood glucose) can get dimmed over time.

Not sure if that helps, but it sounds like having an open conversation to express your worries might be a good step?