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Husband's Diabetes

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traceyb

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Hi my name is Tracey and im a type 2 diabetic but mine is under very good control. It's my husband Bryan that has got a major problem with his Type2 diabetes. He has been diabetic now for 20 years after being misdiagnosed for over 5 years. The major problem is with trying to get his levels down to a reasonable amount so that he can have an operation. Unfortunately Bryan also has AS( bone disorder), MS, fibromyalgia, bone marrow reconversion syndrome, a rare form of non Hodgkins Lymphoma, also a Stent in his heart as he had heart attack 2017. Macular Oedema, OpticNeuritis and also suffers with inflammatory sinusitis(not diagnosed till this month despite an MRI on his head last February2021 and noone telling him about till now). He is on over 20 tabs a day plus Insulin and a cortisteroid. He was asked to get a blood test last week which has come back as his HB1ac as 96, could this be to do with the steroids he is on.
What we wanted to know please is there anything we can do to get this score down. We do watch what we eat and try and keep our carbohydrates level down. We are totally stuck and looking for any advice anyone can give to help/ Thank you.
 
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Hi Tracey, welcome to the forum.
It does sound like a huge number of medical conditions your husband has to deal with. Steroids are certainly well known for raising blood glucose levels.
It maybe that he needs advice from his diabetic nurse or clinic about the possibility of changing his insulin regime to get better control.
What insulins and dose is he taking, is he adjusting the dose for the amount of carbs he is eating.
Hope fully a few people who take insulin will be along with some helpful suggestions.
 
Hi leadinglights, thanks for replying, he is on 24ml of Humulin insulin and also the same at night. He used to have a specialist diabetic nurse but they transferred him back to our GP's and we know that they will complain about it, they always moan about his levels. He once got it down to 68 all the way from 90 and they complained when it went up by 1 point to 69. I don't think sometimes they forget he has all the other health problems including i forgot to say was a Heart Stent.
 
traceyb said:
Hi leadinglights, thanks for replying, he is on 24ml of Humulin insulin and also the same at night. He used to have a specialist diabetic nurse but they transferred him back to our GP's and we know that they will complain about it, they always moan about his levels. He once got it down to 68 all the way from 90 and they complained when it went up by 1 point to 69. I don't think sometimes they forget he has all the other health problems including i forgot to say was a Heart Stent.
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I don't know much about what might be needed but it could be that he needs a bolus insulin as well to cope with the food he is eating.
If he monitors his blood glucose before and 2 hours after meals you could see how well he copes with the carbs he is having.
 
traceyb said:
Hi leadinglights, thanks for replying, he is on 24ml of Humulin insulin and also the same at night. He used to have a specialist diabetic nurse but they transferred him back to our GP's and we know that they will complain about it, they always moan about his levels. He once got it down to 68 all the way from 90 and they complained when it went up by 1 point to 69. I don't think sometimes they forget he has all the other health problems including i forgot to say was a Heart Stent.
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@traceyb What’s the exact name of the Humulin he takes? There are a few different kinds and usually the word Humulin will be followed by a letter or numbers. It’s not clear what one he’s taking from what you’ve said and it will make a difference to the advice you get.
 
I agree about the steroids and Leading Lights' sympathies - I was going to say if he isn't seeing a hospital consultant about his diabetes, he needs to ring his GP and say he needs expert help in reducing his HbA1c level and this is urgent since he needs the operation so can't be left.
 
Inka said:
@traceyb What’s the exact name of the Humulin he takes? There are a few different kinds and usually the word Humulin will be followed by a letter or numbers. It’s not clear what one he’s taking from what you’ve said and it will make a difference to the advice you get.
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It just says Humulin Kwikpen M3 .
 
trophywench said:
I agree about the steroids and Leading Lights' sympathies - I was going to say if he isn't seeing a hospital consultant about his diabetes, he needs to ring his GP and say he needs expert help in reducing his HbA1c level and this is urgent since he needs the operation so can't be left.
trophywench said:
I agree about the steroids and Leading Lights' sympathies - I was going to say if he isn't seeing a hospital consultant about his diabetes, he needs to ring his GP and say he needs expert help in reducing his HbA1c level and this is urgent since he needs the operation so can't be left.
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Hi Jenny, one of our GP's is suppoosed to be a specialist in diabetes but Bryan is not keen on him as he doesn't seem to listen to him. Maybe getting a referral will help. Thank you.
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traceyb said:
It just says Humulin Kwikpen M3 .
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The M3 is the all important bit. It means it is a mixed insulin, with 30% fast acting, so it gets going quickly if you take it before a meal, but then the other 70% is an intermediate acting insulin, so it gradually tails off over a number of hours.
Because of the peak it normally produces at the start, it’s normally taken just before a meal, so twice a day, once before breakfast, and then it covers lunch while there’s still enough working, then it’s taken before the evening meal, which gives a boost to help with the carbs at that meal, then it tails off overnight. It's not the most flexible of regimes, and if he's willing to learn about matching insulin to the carb in the food he's eating, he may benefit from what’s called a 'Basal bolus' or MDI (multiple daily injections) regime, whee the short acting and the long acting insulins are taken separately, and can be adjusted more flexibly. It does mean 4-5 injections a day, which some doctors seem to think will be offputting, but frankly, it’s what a lot of us are on, and once you have to do a couple of injections a day, it’s really no more hassle to do a few more!
 
Sorry to hear about the difficulties your husband is facing @traceyb - and the impact of the steroids on his blood glucose management.

It certainly sounds like he needs more help, and certainly doesn’t need telling off!!

If he were a T1 member of the forum, the shared experiences from other members would most likely involve how they needed to increase their insulin doses to account not just for the food, but also for the BG raising effects of the steroids, and also the BG raising effect of illness itself.

If he is not currently confident to adjust his own insulin doses, then it seems like a chat with a specialist, and/or possibly consideration of a switch to a more flexible insulin regimen could well be worthwhile.

Let us know how things go on, and I really hope he gets supported to reduce those BG levels smoothly so that the operation can go ahead 🙂
 
traceyb said:
It just says Humulin Kwikpen M3 .
Click to expand...

Ok - so it’s a mix of slow and fast insulin. 30% fast, and 70% slow insulin. The difficulty with a mixed insulin is that he can’t increase/reduce one part of that mix eg the fast part, without also increasing/reducing the slow part.

He might find more flexibility with a basal/bolus regime, which is more injections per day but the fast and slow insulin are separate so can be increased/reduced independently without affecting the other type. The fast insulin can also be used to bring down high sugars as a correction dose.

I would suggest he speak to his GP and get some advice. I’m sure he can improve things with the right regime and correct amounts of insulin.
 
Thank you for the replies so far, it was the Diabetic specialist nurse that put him on the Humulin and he was told to take it on a morning before breakfast and then again at bedtime, not before the evening meal. the nurse is supposed to be ringing him Thursday so will let you know what they say. Thanks everyonex
 
Well Bryan saw the doctor about the constant headaches he is having and guess what?? all she wanted to do was talk about his diabetes, his cholesterol and not about the main thing he was supposed to be seeing her for lol. told you they would criticise him about the diabetes, all she did was complain to him and wouldn't even listen to him about the fact he is taking all his meds and insulin and the fact the steroids She gave him for the headaches increased his HB1ac. Bryan is not a happy person at moment. Still got nurse to go this afternoon and he is gonna ask for a referral to the Hospital consultant for his Diabetes.
 
I am sorry to read that your husband is struggling with his diabetes and the care that he is getting.
Regarding the headaches, I find a symptom of sustained high blood sugars for me is a headache. So, you husband's may be a symptom of the diabetes problem.

I hope he gets the hospital referral and the treatment he needs.
 
How frustrating for you both @traceyb :(
 
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