Diabetes advice please

[BikeRunSki]

Sorry in advance, I have a feeling that this will be long.

My mum (67) was dignosed with Type 2 Diabetes about 2 years ago. She has been on her Desmond course, but still seems to be in complete denial about her condition. She hasn't drunk alcohol for over 30 years, which must help, but she will tuck into bread, cakes and ice cream (her favorite) with abandon, sayinmg stuff like "I shouldn't be eating this...." or "I'll be good tommorow".

I have just spent a week with her ( I don't see her that often, she lives 250 miles away), during which time she had a blood sugar test, the result of which was "9" ( I don't know what units, but I am hoping that this will mean something to diabetics). When she was diagnosed it was 7, and she says it shouldn't be above 5.

She has no grasp of even the most basic chemistry, so considers a jacket potato to be as "bad" as ice cream as they are both carbohydrate. During the time we were with her she offered us pudding every meal and biscuits or cake with every cup of tea. She would eat them, even when we refused. Her partner says that this is normal.

She thinks she takes daily exercise by walking the dogs - but she has done this for many years, so it is not anything new to her body.

I am really worried for her, as she is in so much denial about what she ought to be doing, what she ought to be eating and so on. I am really worried about if she becomes insulin dependent, as she hates jabs so much that she won't carry an EpiPen despite being anaphalatically allergic to bee stings, and has been known to go to Yellow Fever areas without vaccination.

Please help me help my mum. She is quiet stubborn, so it needs to be quite stealthy!

I have type 1 which is quite different but didn't want your post to go unanswered.

It is good that your Mum has gone on the desmond course as it should have helped her understand a bit about carbohydrate counting etc.

tbh icecream is not necessarily worse than a baked potato, especially if she is active and does not have any cardiovascular problems. The fat in icecream mean the sugar is absorbed fairly slowly. A baked potato is quite high carb.

9 doesn't sound like a terrible result to me, it depends what her typical results are. It is concerning if she feels she can't keep to her targets in general. I'd be suprised if 5 was a realistic target, this is more of a non-diabetic reading. I have tight control and my targets are never 5! But I don't know enough about type 2 to be sure. She needs to talk to her diabetes team about this. It would also be interesting to know what her team think of her HbA1c level, a sort of average blood sugar.

Good that she is walking daily, more than a lot of people do. Would her partner take her dancing or ten-pin bowling? Exercise can be scary when you are diabetic. She is maybe worried about having a hypo. Again something to discuss with her team.

There should be regular meet ups for her course - something she could go to with her partner? Contact with other people who truly know how you feel really makes a difference and can help strengthen resolve. Could her partner get involved with shopping and cooking to help make tasty but appropriate choices? There are lots of diabetes cookbooks, some of which are not bad. Maybe you could get one and tell her you picked it up cheap at a book club or something?

2 years isn't long to get used to such a life-altering condition and I imagine it is quite easy for people with type 2 to have a prolonged denial phase as the onset and effects are so insidious.

If your Mum does end up using insuling she might be happier as she may have more freedom in her diet. The needles are tiny. Her HbA1c would let her clinic know if she was skipping doses and they could address that.

I'd also have alook at the desmond diabetes and diabetes uk websites.

Hope this helps a bit, hard to get it spot on as out conditions aren't the same, but hopefully enough common ground to be able to give some pointers.

As mrschigur points out, a jacket potato has an extremely high glycemic index and is actually from a "sugar hitting the bloodstream" pov probably worse than ice-cream which would have a lower GI due to protein/fat content.

My mum is type 1 for over 30 years, she's actually done really well wrt diet and exercise. Nonetheless has had cataracts removed twice, her kidneys are failing, her blood pressure is high and she's been threatened with amputation.

Perhaps your mum needs reminding of the really nasty stuff which can happen. On the other hand... it's not as if smokers don't know...

But, I am reminded of group sessions my mum used to talk about where a leader (fat fighters) type would say:

"OK, on the forbidden list are cakes, biscuits, croissants, clubs, kit-kats, mars bars, danish pastries, upside-down cake, victoria sponge."

Mum said there was always one who'd missed the point, would raise a hand and ask "Sooo... gateau is OK?"

@ gateau

I've done the type 1 version of the desmond course and it is great - loads more freedom with what you can eat. I have had 3 jaffa cakes today (as well as "normal" food) and blood sugar is spot on. I don't think I'd survive without the odd danish pastry..

LOL at Skihorse!

Thank you for your replies. I am going to get myself clued up, before working on mum. Her partner too. He gave her a pin-prick tester for Valentine's day .

hello again, I was thinking about your problem on the way in and wondering if you could kind of "challenge" her on a healthy eating/"diet" type thing by for example getting her in to low-GI via the back door? Wasn't it Anthony Worrel-Thompson who wrote a low-GI cookbook?

Also when I can be arsed motivated enough I follow a Paleo style of eating but it's not without treats. E.g., I can make my own "brownies" by mixing almond flour, coconut fat, cocoa powder, dessicated coconut, nuts and say a handful of dried (no sugar added) cranberries. OK, I'm not going to lie and say they wouldn't taste better covered in molten caramel... but they're really not bad.

Maybe you could trick her in to a 'best recipe competition'? Tell her you want to enter a competition on the internet (that should confuse her! ) for best low GI dessert but you don't have time to experiment with everything.

As far as bread goes - I have a real weakness for that but find I can enjoy sandwiches without the side effects if I eat german pumpernickel style breads if you can get them in the UK?

I am afraid to say that if your mum is still in denial then there is no point in you getting stressed about it. The Desmond course is very good and aimed at new Type 2 diabetics. Would she be interested in joining a local Diabetes group? Diabetes UK has a very good website, regular magazine with peer articles if you join. In the meantime all you can do is be supportive and lead by example.
About meds - there are lots of oral medications to help maintain a more normal blood sugar level before insulin would be considered.
There are lots of things that she can do but as I say until she comes to terms with it ....

Hello Bikerunski
I am type II diabetic for about 4 years now. Currently I take no medication whatsoever, even though I have been prescribed metformin 500mg three time a day and Glipcizade 80mg twice a day.
My sugar is soley controlled through a special diet. Just to give you an example, today my fasting blood sugar was 6.1 mmol/L. The highest it has been this month was 7.6. This is with no meds.
The diet is one that eliminates certain types of food and you can eat as much as you want of certain types. If your mum has a sweet tooth, agave nectar syrup is great. It is 25% sweeter than sugar and low GI!
Please email me and I will send you the ebook that lists this diet.
Good Luck

Hello again ladies, I am not ignioring you, but have just spent 10 days in hospital with DS (he is OK now).

SKihorse - cookery recipe challenge would never work! She is - by her own admission - a terrible cook! In the past we have pleaded with her not to cook. She is also 250 miles away.

UKhomeopth - I'll CAT you.