For admonishing DM - diabetes and having cake as a meal

[StationHouse89]

DM has been diabetic for last few years. Terrible diet. Very little exercise. On metformin. Doing things together over the weekend her meals would often consist of a massive piece of cake, hot chocolate with cream and marshmallows etc etc. I got frustrated with it and pointed out how terrible for her condition this is - to me it seems pointless to me to be taking medication then doing this to yourself. She seems quite put out. AIBU?

I have type 1 diabetes.
For the poster above talking about their nan with type 1 and eating unhealthily: with type 1 one can theoretically eat anything, including 'unhealthy' things, you just have to know how much insulin to take for it. Some things are more complicated to get the insulin right for than others (pizza is notoriously one of them), but nothing is actually off limits.

Type 1 also means that, to get the insulin dosage right, you have to know how much carbohydrate is in absolutely EVERYTHING you eat. If you get it wrong, you risk having dangerously high or low blood sugar.

And so, because of that, I know that different foods can be quite unexpected in terms of how much carbohydrate they contain. Cake, for example, is often surprisingly low - if you were faced with eating an equivalent weight of chocolate cake and baguette, the cake will have less carbohydrate unless it has a lot of icing as well.

Would you judge her and want to admonish her for ordering pasta? Gnocchi? Risotto? A filled baguette? A baked potato?

Because all of those 'healthier' options would probably contain more carbohydrate than what you described her as eating. Often significantly more.

How about eating a cupcake? Would a sugar free cupcake be better and less worthy of admonishment?
(Because the sugar free one is actually no better at all.)

How about a piece of fruit? It may well contain more carbohydrate than a cupcake.

Don't get me wrong, I think she's doing the wrong thing and long term she is likely to suffer for it, but eating the 'right' food for type 2 is actually quite complex, so restrictive that it is difficult to maintain long term, and is often poorly understood both by the diabetic and those around them.

As someone who has been, against my will, been given all sorts of - usually wrong - dietary advice or judgement from family, friends and strangers for YEARS now, no you should not admonish her.

She is an adult, it is her life, and it is unfortunately also highly likely that what you think are the 'right' options for her are also actually wrong.

Your mother is an adult and as such she can eat whatever she wants to.

YABU

My mum was type 1 and she drank too much whiskey but actually had a good diet. Apart from when she was younger,she often didn't eat enough.I never told her what to do because we didn't have that sort of relationship. I did learn how to help her recover from low blood sugar levels though.If your mum will listen to your advice, then maybe you can help her realise she's putting her health at risk .My mother went on to have a toe amputated due to complications with her diabetes.

but when those 'choices' potentially have an impact on other people, it's very selfish. If her putting her health at risk will force OP into a caring role when this could be avoided, I would say that should not be 'her choice'.

She's a grown woman and can make her own decisions on what she wants to eat, and her health in general.

You don't have to like it, but you definitely don't get to dictate it.

Careful you don't sprain yourself with that reach there. There is nothing to indicate the OP would end up as a carer even if her mother eventually did need care.

My relative, probably a similar age to yours, started with toe amputations a few years ago and more recently a leg amputation. All down to the damage done by not taking type 2 seriously. Physically sound of mind and energy but in a care home due to no mobility.

Maybe show her some amputation stats and photos if she doesn't realise what could be her future?

Well raising it when she's enjoying her cake is like raising a sex issue in middle of a shag.

You bring it up later at a neutral time, else she will feel defensive which is counterproductive

Admonished is a very school ma'm choice of word. Are you bossy by nature? It is ultimately up to her, you also have to keep in mind the way she ate on the weekend may not be how she eats day to day.

Type 1 is completely different and you can basically eat what you want as long as you take the correct amount of insulin. I so, so wish they had different names.

Has she been put on a diabetes course? It can be hard to get your head around the lifestyle and diet changes you need to make. Sometimes a support group is helpful. My doctor put me on 2 courses. One specifically for diabetes, and the other was a healthy living course

My DM does the same thing. She gets very aggressive if you comment on it. I dont appreciate being abused in public so Ive stopped bothering commenting on her shit diet. She has diabetes in her family. Complications of it have killed her mother and 2 brothers, she has been diabetic for nearly 30 years and under the diabetes clinic. She knows having ice cream and cake for dinner isnt healthy. She still does it. Shes terrified of getting dementia or ending up in a home. She still does it. I suspect because its so commonplace in her family she thinks its just something that happens when you age and there's nothing you can do about it. Im paranoid about getting it ( also because I think its inevitable) so have quite a healthy diet. She sees it as almost a personal affront that I havent got it, whereas my dbro has it, and she said ' oh you can get free prescriptions now!' Hes managing it with diet and metformin and also tries to tell her but shes having none of it.

I have diabetes. No, she shouldn't eat cake for lunch, but it's useless nagging someone.

Just commented to say that post menopause, my craving for sugar is uncontrollable. Strong and constant. It’s really hard work to not eat the stuff. No one ever told me about it. It was a total surprise. And I’m not 60 yet. I worry about my future eating habits, sometimes.

DMIL (so not a relation, biologically) is the same. I have had to have words with her sons when they castigate her. It’s not her fault (and she’s got forgetful now, too). They just try to make sure that she gets good food into her as often as possible.

My mum had type 2 diabetes from.her 60s, and ate cake and lived pretty healthily until the last few months of her life, and she died aged 85. She managed it well and did try to eat healthily but had a sweet tooth all her life.

What a condescending post. PIP is paid because being a disabled person costs more to live.

The NHS would probably save loads if women stopped having babies, or at least stopped having them in hospital. You could just close all the maternity units and let women take some responsibility for their own pregnancy and labour. Sack all the midwifes and health visitors.

As a type 2 diabetic (in remission now), I will say that berating her will lead her to feel bad about herself and may lead her to comfort eat further. Even if said kindly or with the best of intentions.

Your mum probably doesn’t produce the same amount of the naturally occurring glp1 hormone that you do, so she will have cravings and less be satisfied with the food she does consume. It’s more than just willpower. That’s why glp1 medications exist - they aren’t cheating, just levelling the playing field. They don’t have to be about weight loss.

edited just to add, that it’s not always caused by diet either, in some cases it can be hereditary

Naughty but nicely, after the cream cake.

Type 1 or type 2? Because if he is T1 and on insulin, he can eat what he wants to eat.

Too much sugar with Type 1 diabetes, long term can cause kidney disease and nerve damage to your hands and feet.Sugar, which I too love,is like an addiction.People with type 1 actually can't process sugar,so need insulin injections to do that for them.I don't understand how someone can think they can eat as much sugar as they want just because they are taking medication.
It's an individual choice though, I guess.

No.

As I said above, I have Type 1.

BLOOD SUGAR that is too high long term can cause the issues you describe. Eating SUGAR, per se, does not.

A fairly simplified version of what happens, but:

All the food you eat is broken down within the body into glucose which is used as fuel. Different types of food take different amounts of time to be broken down into glucose. Simple sugars, such as glucose, sucrose and the like are broken down more quickly. More complex carbohydrates take longer, and protein and fats take longer still, but are still ultimately broken down into glucose.
This glucose is transported in the bloodstream around the body to be carried into cells to be used as fuel.
Insulin can be thought of as a 'key' which allows that glucose to get into the cells. Without insulin, the glucose can not get in, the cells are starved of energy, and glucose builds up increasingly in the bloodstream (i.e. the blood sugar becomes too high), with the body doing its utmost to get rid of the excess via urine.

The pancreas of a type 1 diabetic produces no insulin at all. Therefore, in order to get energy into the cells FROM ANY FOOD SOURCE, insulin is needed.
It is actually easiest to dose the correct insulin amount and control blood sugar when eating something which is high in sucrose, because it is broken down so quickly. By contrast, a meal containing large amounts of protein, fat and just some carbohydrates is much harder to get right, as the rate of the foods being broken down into glucose is slow and often unpredictable. Food is still being broken down, but the insulin to cover the meal has already been 'used up'.

Without any insulin, even eating NOTHING AT ALL, the blood sugar of someone with Type 1 will skyrocket. Death will occur within a matter of days even if one were to eat nothing. This is of course what happened to Type 1s before insulin was discovered/manufactured.

In addition, people whose bodies work normally are usually unaware that their pancreas is CONSTANTLY pumping out a smaller or larger amount of insulin. For example, when one wakes up in the morning, the liver (which is one place where the body stores glucose) dumps a load of glucose into the bloodstream to provide energy to start the day.
For a Type 1, without insulin, this will of course raise blood sugar. So you need to have some insulin active in your body at all times, whether by injecting slow-acting 'background' insulin as well as fast-acting insulin to cover the meals you eat, or by using an insulin pump which gives a tiny amount of insulin every couple of minutes (so-called 'basal'), as well as a larger amount (so-called 'bolus') for when you eat something. The correct amounts of all this insulin varies from person to person, is usually different at different times of day, and is pretty difficult to get perfectly right.

So, to summarise, if you have Type 1, you need insulin, even when you are not eating. When you do eat, you need more insulin. You have to figure out how much insulin you need in accordance with what you are eating, which means you are trying to do manually something that other people's bodies do automatically, and it is hard to get it right.

However, SUGAR is not off-limits.

I'm going to finish by quoting myself from upthread:

'As someone who has been, against my will, been given all sorts of - usually wrong - dietary advice or judgement from family, friends and strangers for YEARS now...'

... would you please just stop it.

And that goes for judging people with Type 2 as well.

Well it’s her life. As long as she doesn’t expect you to take care of her in a decade’s time when she’s having her leg ulcers treated or dealing with blindness and kidney problems…

Replacing one meal with a slice of cake isn't the end of the world. Maybe with the hot chocolate you could encourage her to use sweeteners. But it's got milk in it which is good for your bones.

I mean if she literally eats that every single day and no normal food then she's clearly got an eating disorder. Which isn't that easy to just tell someone to change or stop.

My mum is diabetic and doesn't need medication but she still eats a couple of biscuits or a slice or cake every day. Alongside reasonable balanced wholesome meals. I would never bother moaning at her. Food gives people pleasure. At 86 she should be enjoying things as much as she can while there is still time!

Those with Type 1 ( or treated as type 1 )can
I don't think those with type 2 can though.

Don’t be ridiculous.
Every single one of us make ‘choices’ that might impact on other people and society. Drinking, smoking, sports, having children, eating certain foods, driving a car etc etc etc.
Each of us (if we have capacity to make those choices) also has a legal right as a human being to make our own decisions, even if those decisions are unwise. It’s a key part of safeguarding.
It might be selfish, but it sounds like she understands the implications and it’s absolutely ‘her choice’ to eat rubbish and put her health at serious risk.
It’s sometimes not as simple as a cause and effect either; sometimes quality of a life is a bigger consideration, depending on the situation.
Nobody can be ‘forced’ to be a carer.