Diabetic DP - how can I help him?

[SpikeLeesLeftKnee]

DP is diabetic, diagnosed 2.5 years ago. He isn’t dealing with it at all well. He is young for type 2 with no family history and despite being slightly overweight for a few years, no risk factors.
He went on an intense diet six months after being diagnosed and lost 12kg (making him v close to being underweight). His numbers improved to pre diabetic levels and the diabetes team were really pleased with what he had done.
Since being diagnosed he has changed- his mood is up and down but mostly down. He hasn’t come to terms with being diabetic and is consumed by it. He is so stressed that he is going to die. He does not want to be on any medication.

Recently his numbers have been sky high. He eventually went to see the nurse at our gp who prescribed metformin but it isnt having any effect on his numbers.

He is in such a bad place and I’m worried; about his numbers and the immediacy of him needing it addressed and also his low mood. He says he wants to die frequently but also says that he is terrified of dying from all the complications of diabetes. He says he wishes he could turn back the clock and make himself not diabetic. He’s starving himself and then when he does eat gets angry at himself saying his numbers are high because he’s eaten something. It can’t go on like this.

I’m really struggling with how to help him. I’m struggling because he won’t get help and I’m honestly scared about how high his numbers are and whether I should be forcing him to go to the hospital. I don’t even know that he would comply.

He has been in a really bad place today. We went out for a walk and I listened to him and I spoke with him about what we could do to address things. I spoke to him about addressing his low mood and about his numbers. It hasn’t helped. I think I’m making things worse. I feel like I’ve been walking on eggshells since his diagnosis.

How can I listen better. What can I do to help him? I feel so lost for him, and I’m worried.

My brain feels like it has a million tabs open at the moment i’m worried I’m just not doing the best job at helping him. We have a three year old who doesn’t sleep, exhausting full time jobs and a lot of family stuff going on including my sister being recently diagnosed with MS, my Dad undergoing cancer treatment and my Mum who is showing signs of dementia.

I sound so cold but I just want to scream into a pillow.

Are the drs sure he is type 2 and not type 1? Especially considering he is younger and not so overweight? Type 1 isn't just diagnosed in children?

He needs a C-peptide test to be sure. But if he is type 1 (or even if not) he may need insulin. It's really not that bad. You do learn to just cope as there is no alternative. I've been type 1 30 years and I have ups and downs with my control. Some drs are much much better than others about understanding that most diabetics don't flow the rules (as in, their sugars don't follow the rules, not just the person breaking the diet rules 😂).

Plus he may find social media groups helpful? To be able to talk to people in a similar situation. I've got a small group of type 1 women I'm friends with (we met 'online' as pregnant diabetics over a decade ago) and we sound off to each other regularly and usually meet up once a year.

Agree with User . I think he needs to go back to his team and ask for help/confirmation of the diagnosis - he could well be Type 1 particularly with the weight loss.

Even if he is type 2 there is no shame in being on insulin. I had gestational diabetes and obeyed the diet rules to the letter but I still ended up on insulin. It can make things a lot easier and isn't a sign of failure. Does he have clinic appointments? Can he ask for psychological support? Diabetes can trigger eating disorders in people who are vulnerable to them so he does need support if that's a risk.

Sorry - meant to say OP you sound like you have way too much on your plate at the moment. Don't beat yourself up. Yes, you want to be supportive but equally, he needs to step up and get help. So sorry you are both going through this.

Does he have any other health issues, there is another form of diabetes called 3c Diabetis mellitus (sp?), it is related to and often diagnosed as type 2 but type 2 treatments do not help improve.
It might be worth going and getting another opinion,

Have a look at LADA aka type 1.5 diabetes and speak to the GP about it for further tests www.diabetes.org.uk/diabetes-the-basics/other-types-of-diabetes/latent-autoimmune-diabetes

Hi Op, what are his blood sugar readings? It’s great that he’s lost weight but the reality is that starving himself then eating will cause huge spikes in his blood sugars which can cause problems. Does he get thirsty and pass more urine? Depression following on from a chronic lifelong diagnosis is not uncommon as it puts our mortality into sharp focus.
It sounds as if your DH needs proper education and some guidance and advice from his diabetic consultant. Most hospitals have a few Diabetic nurse specialists who are well placed to provide ongoing support and education, may be worth contacting them. If this isn’t possible his GP can help.
It is definitely a priority getting proper screening done to ascertain exactly what type of diabetes he has - can be done by blood profiling and I would also recommend a hba1c test to see how stable/unstable his blood sugars have been over the last 8 weeks. It’s rare to have the 1.5 or 3c type mentioned above but worth exploring.
It’s confusing because there are a lot of “diets” that claim to cure diabetes and some do have good results for patients but they’re not suitable for all and we only tend to read about the success stories.

You sound like you have a lot going on OP and I hope you’re DH gets this under control soon.

I developed type 1 when pregnant with my first st 41. I've had a few scary moments but 95% of life is normal- I had another baby and both are now in their teens. The only thing I'm cautious about is going away without another adult. I worry about going abroad with my kids (not so much now they are older). But other than that: i work, I exercise, I eat pretty much what I want (though not as much as i'd like - but that's true diabetes or not). He needs to get some sort of counseling.

Have a look at that Dr. Mosley book. What does he eat? He CAN eat a lot of fat and protein. Would that cheer him up? He needs to go low carb. I had gestational diabetes. My numbers were perfect. I just kept carbs to a minimum and walked for 30 mins a day. I had high fasting levels in the morning, so used to eat greek yoghurt and lump of cheese before bed. Meat, tofu/seitan/quorn, full fat dairy, berries, avocado, nuts, eggs, fish... veggies (if they grow above the ground), a small portion of pulse every now and again. Avoid flour, potatoes, sugar (including must fruit).Don't be afraid of fat.

Can I suggest he joins a forum on diabetes.co.uk? I was diagnosed type2 but I was really upset when it happened but I have found the forums really useful there. The type 2 forums give good advice re low carb but he will find other people who have had similar and can advise. Hope things get easier for him (and you!)

I found greeting a meter and testing really helpful so I can see blood glucose levels really useful even though I paid for this myself ...

How high are his readings. Starving himself and not taking his meds is the worse thing he can do. Like pp say he needs testing.

Thank you everyone for the responses- apologies I didn’t respond until now.

Things for DP have not been great since I posted, he has continued to lose even more weight and his numbers have been dangerously high.
It culminated in me calling nhs 111 last Sunday morning after his blood glucose reading was so high it wouldn’t register on the meter (>33). He spoke with them on the phone and they called back twice more throughout the day to check his numbers were coming down. They came down to 17 at their lowest. They were able to give him the results of his hb1ac test over the phone that had been done in early Jan and that was 11- not great but better than we had expected. They said they would get the GP to call him on Monday which didn’t happen.

He managed to get through to the GP receptionist on Thursday (after trying all of tues and weds) who apologised and said that they had missed the note from 111 to call him. The first appt to speak to the GP is Monday coming. There just doesn’t seem to be any urgency there.

DP looks and feels dreadful- he is skeletal, his vision is blurry and he cannot sleep properly. His muscles are constantly aching. His numbers are constantly hovering around 13-low 20s.

He urgently needs a referral back into the diabetes team (they discharged him from it about 1.5\2 years ago after he managed to get his numbers in check with diet and metformin) but this can’t go on. I’m terrified and feeling so frustrated by the lack of care/urgency from the GP.

They need to get him onto insulin ASAP. Sorry you’re going through this. Did they check his other bloods?

The most important thing is to get whatever medication he needs in the short term to control these blood sugars.

His condition may have changed to diabetes 1.5. It's hard to say over the internet.

Does he check his bloods several times a day? It's a concrete way of knowing how effective the meds and diet he's using are.

In the immediate future, until he can be seen and properly assessed, he needs to reduce all carbs. Not zero carb but very low carbs. Try to get it between 20-30 a day. Carbs to come from above ground vegetable and salad for now. Eat all proteins alongside the low carb and enjoy fats.

This will buy him time and start bringing glucose levels down.

It's sounding like he needs some insulin alongside the metformin. Aloe Vera juice as a stop gap can boost insulin production and can help.

I think his main focus should be getting reassessed. Important to test several times a day and take this data with him when he is seen.

He can do this. It can be terrifying when what you are doing doesn't appear to be keeping you safe.

I agree with other posters about joining online support groups. They are a cheery lot with lots of experience and support.

He requested a full blood panel in jan and had that done. Nhs111 were able to give the hba1c over the phone last Saturday but don’t know what the rest of the results showed.
When he managed to get through to the GP reception on Thursday they said that the dr is only phoning patients about blood results if they are urgent. Next available appt is Monday coming.
I’ve just seen on another thread that the hba1c being 11 is really not that great at all (I naively thought it meant an average of 11 like the results you would get from the blood monitor but that 11 on an hba1c actually translates to 17 on the blood monitor, as an average over 3 months)
We called the diabetes team at the hospital to see if we could get him ‘back on the books’ so to speak but (understandably) they will only do that with a referral from the GP.
Sorry if I’m not making much sense.
Feeling increasingly worried and frustrated by the lack of urgency from the GP and concerned that I’m under reacting and not doing enough to address/sort it. It doesn’t feel right.

Thank you @purplebagladylovesgin (I hope I’ve done that link properly?)
I will have a look at aloe Vera juice in the interim. We have been mostly low carbing since early Jan, and are well versed in it from when DP went on the low carb diet for a significant period after he was first diagnosed. It hasn’t had any affect on his numbers sadly which is all the more reason why I think it needs urgently addressed; whatever is going on with his diabetes, it isn’t being impacted by lifestyle, diet and metformin and needs further investigation. Just feel like we are hitting a brick wall trying to get to that point.

I'm going to give you some screen shots that might help...

These help explain how your daily blood glucose translates into your HbA1c test results.

Take him to a&e op. His symptoms sound worrying and I don't think he should wait for the GP to organise a referral.

Another thing I didn't realise until last year is that metformin doubles the positive affects of exercise. We often do a brisk 10 min walk and this is enough to bring levels down by a point.
I know that probably isn't enough right now but it could get things going in the right direction.

It is sounding like insulin is required. I hope you get through swiftly on Monday.

Do you have a diabetic nurse you can talk to as well? Ours is good and will often put her head around the doctors door to update him.

Wishing you all the best.

The blurry eyes is due to high numbers. I agree with a previous poster who suggested he needs to be on insulin as any medication he has isn't working. The losing weight is a worry and if he is young like you say if they haven't discounted another type of diabetes I would press for that and ask for blood work. Hope the GP takes note. It's sad that you have to shout to be heard!

How did Mondays appointment go?

I bet he’s type 1 or 1.5. Have his ketones been checked? He could well be in DKA and need immediate hospital treatment.

Thanks for all the responses.

Monday’s call with the GP was not helpful at all.
The GP rang and spoke with DP and advised that he would not be referring to the diabetes clinic as DP not currently on Max amount if metformin (he is on 3 tablets a day, GP said he must be on four before he can be considered for a referral back to the diabetes clinic). He said that he would up DPs metformin to 4 and would review after 6 months as his numbers would not come down immediately.

I was listening on speakerphone and asked to speak to the GP at which point I asked to speak to them. I explained the weight loss, high numbers and concern particularly following the call I’d made to 111 when DPs numbers were >33.
The GP said that the notes on file said that 111 had told him to go to A&E and that no follow up from the GP was required (this did not happen, 111 called back twice last Sunday to check DPs numbers were coming down and they advised GP would follow up the next day which they did not do). Had we been told to go to A&E, we would have so someone is lying (btw I’m not trashing the nhs here, several members of my family are nhs staff and I could not praise the NHS enough for what they do but this has just frustrated me beyond belief).
After speaking to the GP at length, he advised that DP should be going to A&E at any sign of ketosis but that he would not be referring him to the nhs diabetes clinic but also admitted that the weight loss and other symptoms did make him think it was possible he did not have type 2 so they will keep a close eye on it. 🤔
We requested a private referral and have been charged £25 for the privilege. I have emailed some private clinics with enquiries for consultation (although admittedly I’m not sure what I am asking for/ what the process would be) and I am waiting to hear back.

In the interim, DPs numbers are lower than they have been (

Hi @SpikeLeesLeftKnee.

I’m no expert on diabetes but know a bit as my DF and a couple of work colleagues are diabetic (and, naturally enough they talk about it a lot).
From your posts the GP is not providing adequate care at all. Having readings that high, and blurry vision is serious. I can’t imagine it’s adequate for them to say they will just keep an eye on it over the next six months. I was also under the impression that many type twos are reversed by substantial weight loss. If your partner is type 1 you definitely don’t want that going on undiagnosed another 6 months. I would insist on a second opinion. I wish you both all the best.