Worried about my husband

Status
Not open for further replies.
J

judy2302

New Member
Relationship to Diabetes
Carer/Partner
My husband has been a type 2 diabetic for over 20 years, he is 74 now and since February has been blue lighted to hospital 3 times, the last time resulted in a 23 day stay and has been home for just over a week.
Each time he was rushed in to hospital he had a hypo the last time his glucose was 1.1 this was after it measuring 19 five hours earlier. During his stays in hospital they reviewed his medicines and replaced his twice daily dose of 500mg of metformin with a single dose to be given at tea time of 1000 mg. Could this have been the cause of his hypos that resulted in having to call an ambulance. They did tell my husband that his meds were wrong and he has been taken off metformin and linagilptin. His insulin dose has been greatly reduced to 20 in the morning and 16 units at night.
I now have a very different husband, he is incontinent and on two occasions has been feacally incontinent.
The hospital didn't discuss anything with us and his care at home has been non existent, he has a hospital bed downstairs, he is almost completely immobile and may walk using a zimmer frame a couple of times a day, he uses a bottle when he needs to pass urine and I know that he has stage 3 chronic kidney disease. Every single night he wets through his incontinence pads and the inco sheet on the bed, I am washing bedding including the duvet every single day. He appears tired for most of the day and naps a lot, his skin on his legs is covered in scratches and I've noticed today that his face is very blotchy.
On his last hospital stay he was in a discharge/rehab ward while they assessed him they mentioned dementia with lewy bodies but he is completely lucid and his short term memory seems fine. It is the incontinence I find most worrying as I'm thinking is this a result of his kidney disease becoming worse. I have to phone the ward to ask if an incontinence nurse has been booked for us, they didn't confirm or deny but said if it hadn't been done they would put it in place!!!
I just wondered if anyone else recognises these symptoms as being kidney disease. I hope I haven't gone on too long and I will phone the hospital and the district nurses to see if we can get some advice. We do have carers coming in 3 times a day to help with washing and changing him.
 
Sorry to hear about your husband @judy2302 That must be very hard for you both. My guess would be it was the too high insulin dose that caused his hypos. I see from your thread last month that he wasn’t eating. Is he eating now? What insulin does he take (full name including any letters or numbers)?

What’s his blood sugar like? I’m wondering if some or all of the urinary incontinence is due to high blood sugar.

Has he got some kind of follow-up regarding the mention of possible Lewy Bodies Dementia?
 
Can’t comment on the continence issues but reducing twice daily Metformin to a double dose once daily would not be the cause of hypos. It’s a mild drug (especially compared to his other diabetes medication) and does not work to reduce the glucose already in his blood. (As the other medications do). Hypos are almost always caused by having more insulin circulating than the amount of glucose in the blood at that time requires. Has your husband’s eating changed at all? If he’s eating fewer carbs on a fixed doses that would cause it. You really need to get his diabetes team involved more asap
 
HSSS said:
Can’t comment on the continence issues but reducing twice daily Metformin to a double dose once daily would not be the cause of hypos. It’s a mild drug (especially compared to his other diabetes medication) and does not work to reduce the glucose already in his blood. (As the other medications do). Hypos are almost always caused by having more insulin circulating than the amount of glucose in the blood at that time requires. Has your husband’s eating changed at all? If he’s eating fewer carbs on a fixed doses that would cause it. You really need to get his diabetes team involved more asap
Click to expand...

I think the original poster's husband is on insulin as well as Metformin.
 
Hi thanks everyone, this all seemed to start after having a steroid injection at the end of January for arthritis of the spine, followed by extremely high potassium rate. From then on his appetite disappeared, he's lost a lot of weight and had 3 hospital admissions were his weight continued to drop. He is currently on Novomix 30 flexpen and has 20 units of a morning and 16 of a night. His appetite has returned and he is eating much better now and his glucose levels are steadying out at between 8 and 10. Do you really think the insulin could be causing the incontinence?
 
No, the insulin with not enough carbs would probably have caused the hypos. High blood sugar (because of steroids) could greatly increase urinary frequency and might contribute to incontinence.
 
harbottle said:
I think the original poster's husband is on insulin as well as Metformin.
Click to expand...
Yes I realised that. And was saying that the insulin would be causing the hypos rather than any change with metformin.
 
HSSS said:
Yes I realised that. And was saying that the insulin would be causing the hypos rather than any change with metformin.
Click to expand...

Totally agree.
 
Hi, yes his insulin dosage has been reduced quite a lot. I wonder as the steroid wears off if his incontinence will improve?
 
judy2302 said:
Hi, yes his insulin dosage has been reduced quite a lot. I wonder as the steroid wears off if his incontinence will improve?
Click to expand...

I don’t know @judy2302 but it might reduce the volume a bit. You say you’re worried about his kidney disease - I hope you can get some information on that and how he’s doing. You might find your GP surgery can give you that information more easily than the hospital. Of course, the incontinence could be related to his kidneys, but there are other possible causes too, so getting some answers should help you know what’s going on. Not knowing can just add to the stress.

If you contact your GP (or other HCPs) I suggest writing a brief list of the most important questions you have, and have a pen ready to jot down their answers. Even if they give you test results in numbers that mean very little to you, still jot them down. It’s good to re-read and assess things after the stress/rush of a phone call.

I’m glad your husband is eating better now. It sounds like he’s had a very difficult time health-wise. Wishing you both well.
 
judy2302 said:
On his last hospital stay he was in a discharge/rehab ward while they assessed him they mentioned dementia with lewy bodies but he is completely lucid and his short term memory seems fine.
Click to expand...
I don't know whether he has had brain scans (ordinary scans don't show Lewy bodies) but it may have been suggested as a diagnosis by clinical features. Loss of memory is not a feature of Lewy body dementia. Excessive sleeping is a feature, and more specifically a loss of paralysis that should occur when you are dreaming (REM sleep), so acting out dreams may happen, with arm and leg movements, some quite dramatic. The lack of mobility is also a feature, with small steps similar to Parkinson's disease, a related Lewy body condition.

The incontinence will not have been caused by the steroid, or the renal disease, nor, if he has it, the Lewy body dementia. He uses a bottle for passing urine during the day, so he know when he needs to pass urine. Something is presumably preventing him from using a bottle during the night. That issue is something you need to discuss with his carers, because it's a common problem. You can't be expected to be washing bed linen every day.

The important question to ask: is he on any other medication apart from diabetic treatment? Many medications can worsen the symptoms of Lewy body dementia.

And the other important thing to say, is that things will almost certainly get better, once these issues are more sorted by his carers and doctors.
 
Obviously it would be better to get the reasons for the incontinence identified but in the meantime would incontinence underwear be helpful to save the washing all the time. Your district nurse should be able to help, there may even be an incontinence specialist nurse attached to your surgery or trust who would do an assessment of his and your needs.
Also make sure he does not have a urinary tract infection as that can cause urgency and frequency which would lead to accidents.
 
Status
Not open for further replies.
Back
Top