How can I convince someone that they REALLY need to see a M.D.?
June 14, 2009 8:27 PM   Subscribe

My SO has a fairly serious medical condition, and refuses to go to the doctor. Is there any way that I can/should address this?

My SO of 3 years is in pretty good health, not overweight, non-smoker, but has known for a while that he has high blood sugar. Today I was talking to him and I noticed that I smelled what I perceive as artificial cherry smell on his breath. He had not eaten artificial or real cherry anything today.

I recognize it as a ketone smell, meaning ketoacidosis, which in my non-professional opinion would mean that he has likely gone from pre-diabetic to diabetic. He acknowledged this, and apparently has no intention of going to the doctor. I even looked up ketoacidosis, and pointed out to him that he was exhibiting several of the signs. He just rolled his eyes and politely told me to quit nagging.

Maybe I'm taking this the wrong way, but I feel like his total lack of concern for his health, and his unwillingness to go to see the doctor, translate into not really giving a crap about me or us or whatever (besides the obvious fact that he is ignoring a really big problem). It makes me feel like he doesn't value our relationship, because he doesn't seem to care if he doesn't get to spend time with me due to death or extreme illness. It's rather hurtful. He needs to see a doctor. Is there some way that I should react to this that would be more effective than nagging? Am I taking this the wrong way, and making a mountain out of a molehill?

He's not depressed, he always seems to be happy with me and our relationship, but he is one of those people that avoids seeing the doctor unless his arms blew off or something, and even then he would probably try to use duct tape to tape them back in place instead of seeking medical attention. My throwaway email is Any thoughts, insight, ideas, anecdotes, etc., would be appreciated.
posted by anonymous to Human Relations (46 answers total) 9 users marked this as a favorite
Can you call a doctor and describe the symptoms? If it is something serious, perhaps you could then pass the phone to your SO.
posted by hydrophonic at 8:34 PM on June 14, 2009

Have you shown him a list of the myriad serious side effects of prolonged ketoacidosis?

Also, you can get ketone sticks from your local pharmacy (for detecting sugar in urine) -- perhaps he would be more willing to seek treatment if he saw scientific proof that he's spilling sugar?

This is not the kind of thing where you maybe should nag him because he might feel better if he goes to the doctor. If you care for him and want him to be alive and healthy far into the future, you must get him to the doctor.
posted by telegraph at 8:36 PM on June 14, 2009

In all honesty, he's probably terrified. Give him some time to digest this information, and then tell him you feel his health and future are in danger and you simply won't rest until you know he is on is way to being well, which means doctor=step number one.

But please, please, do not make this about you. I can not imagine someone who would have limbs amputated or die rather than simply break up if he truly did not want to spend his with you. Poor guy's just been handed a big nugget to chew on, I can almost garauntee this is all about him.
posted by agentwills at 8:46 PM on June 14, 2009 [4 favorites]

It makes me feel like he doesn't value our relationship, because he doesn't seem to care if he doesn't get to spend time with me due to death or extreme illness. It's rather hurtful.

This is what you need to tell him, in depth. This is not nagging, this is sharing your feelings - and if he continues to hurt your feelings there are going to be serious repercussions for your relationship.
posted by bigmusic at 8:47 PM on June 14, 2009 [1 favorite]

If he is exhibiting signs of ketoacidosis on a regular basis, he'll eventually end up in the hospital emergency room with some serious complications. Sometimes people get so deep into denial about their health problems that they don't seek help until they get a scary wake-up call. Your SO might be one of those people, unfortunately.

Have you told him exactly what you told us about how his lack of concern for himself makes you feel? Maybe he wouldn't be so quick to consider it "nagging" if he knew how it was affecting your feelings (which, by the way, are completely legitimate).
posted by amyms at 8:49 PM on June 14, 2009

People who avoid doctors do so because they're frightened, and because they've displaced their fear of discomfort and pain onto the doctors who are supposed to heal and prevent that discomfort and pain; they associate doctors with disease and injury, which allows them to avoid facing their situation long enough to realize that doctors are the ones who can alleviate that disease and injury.

Since that association is the general basis of this avoidance of doctors, people who do this only get more closed-minded and more aloof to the severity of their situation. You say, half-jokingly I think, that if his arms were blown off, he'd try to put them back on with duct tape; I think you have a very reasonable suspicion that you're more correct in that than you want to be. But it's worse than that; if his arms were blown off, he would refuse to go to the doctor because his arms had been blown off; avoiding the doctor is his displaced way of trying to avoid the pain, and, because what he's facing right now with his impending diagnosis as a diabetic is potentially painful and even life-threatening, and at least means some discomfort and some rearranging of his life, he is trying even more forcibly than usual to avoid the doctor.

anonymous: He needs to see a doctor. Is there some way that I should react to this that would be more effective than nagging? Am I taking this the wrong way, and making a mountain out of a molehill?

Last things first: no, you're not making a mountain out of a molehill. You clearly know enough about diabetes to know this: to put it bluntly, diabetes is a potentially life-threatening condition, and he could or even will likely die as a result of it if he doesn't see a doctor.

And, yes, there is a better way to go about this than nagging. I don't know if that's really what you're doing, but it sort of sounds like it; nagging is a generally harmless way couples have of pushing each other to do the things they have to do, and, though doing it too often can be very bad for a relationship, it doesn't sound like that's the state you're in. But you're not in a position that calls for it. If he forgets to take out the trash, if he forgets to send a certain bill, if he keeps phrasing certain things in a way that really annoys you, then it's the right time to nag—by which I mean, you remind him gently but proddingly that there's something important he should take care of. This situation is nothing like a situation where that would work—he's being to stubborn, and more importantly this is a hell of a lot more important.

You should tell him you two need to talk. Make this seem as ominous as possible, because it is. And be stern. Tell him, as forcibly as you can, what you (very correctly) told us: that he's threatening to take something from you, too, in gambling his life. Say: “Honey, you're being extremely selfish. Did you ever think of what I would have to do if you died? You're my partner, and you mean a lot to me, and I don't you to screw that up just because you're afraid to see a doctor.” Tell him, “If you let it go untreated, your diabetes can cause kidney failure, blindness, loss of sexual function and inability to ever have sex again, loss of limbs, cardiovascular disorders, heart failure, and, yes, death. Don't you realize that I like having sex with you, that I like the fact that you can walk and talk and see things, and most of all, I like the fact that you're alive? And not only do I like those things; I depend on them. I know it's uncomfortable, and I know it's a big change, but we are going to go to the doctor because what you're gambling with here matters a lot to both of us.

Don't take no for an answer. Seriously. He needs to know that he could be killing himself by not seeing a doctor—and he needs to be told, not reminded or informed or remarked to or nagged, but told, in a way that catches his attention, scares him a bit, and recalls to his mind the fact that he's a valued person and his moral imperative to see a doctor has to do with how much you value him.
posted by koeselitz at 9:07 PM on June 14, 2009 [1 favorite]

In other words, please get ready, because I know this isn't going to be easy for you, either: you need to scare the living shit out of him, you need to put the fear of god into him, and you need to make him see how incredibly important this is to you.
posted by koeselitz at 9:08 PM on June 14, 2009

Read up on denial and diabetes. Sadly, denial is so very common with this disease. I have lost several family members because they so deeply denied the severity of their condition.

Understanding first that your SO is in denial out of fear and uncertainty about a lifelong disease is an important step. However, don't just accept that he is in denial. Having to bury a loved one knowing that you could have stepped in and taken away the [candy/bacon/whitebread/whatever] is a guilt that no one should have to go through, but many do.
posted by moojoose at 9:14 PM on June 14, 2009

I'm also in diabetes denial. And I'm utterly fine about that.

Why? It's not affecting my life now. Plus I've always felt a bit squeamish about taking pills and the like. Sure, the doctors are telling me I have diabetes. Is it affecting my day-to-day life? No. Aside from having to take a bunch of pills that don't seem to improve my life one bit.

Sure, I should do something about it. Tomorrow. If I remember. After all, if I don't take the pills, it doesn't make my life worse.

Quite frankly, I've read up around it. All the scary stories. and it totally does not connect to me at any level. So if your other half is like me, scaring him won't help either. Probably, nothing will until it affects my life on some level.
posted by almostwitty at 9:21 PM on June 14, 2009

For what it's worth, the fact your other half is in denial about his diabetes has no bearing on how he feels about your relationship. It's simply that it's not affecting his life on any level. So why take action over something that isn't impacting on him?
posted by almostwitty at 9:23 PM on June 14, 2009

After all, if I don't take the pills, it doesn't make my life worse.

It doesn't make your life worse now. It'll make your life end soon. Good luck with that.
posted by incessant at 9:35 PM on June 14, 2009 [9 favorites]

I hate to pile on almostwitty, but...

"So why take action over something that isn't impacting on him?"

Thing is, it is impacting him. Slowly, and without him realizing it, his blood sugar is affecting his body, and eventually that will impact him. And possibly in a very big way- losing a foot, major kidney problems, problems that will change his life (and the lives of the people in his life, like the OP) in a terrible way. Pretending the disease away doesn't make it go away.
posted by MadamM at 9:49 PM on June 14, 2009

Has he seen an image search for diabetic foot?
posted by chez shoes at 10:00 PM on June 14, 2009

You are not making a mountain out of a molehill. When I was in high school, one of my teachers who had been in denial for years about his diabetes ended up having to get most of one leg amputated. He nearly died.

I don't mean to be melodramatic, but I just had to chime in: this is not a disease you or your SO should take lightly.
posted by teraflop at 10:13 PM on June 14, 2009

I'm going to disagree with everyone else here -- it does seem like nagging to interpret his own choices about his own body as some kind of lack of care for you, or the relationship, or something. And I can see how someone might react against this by stubbornly refusing to see the doctor. Pressuring, in other words, is not going to help.
posted by paultopia at 10:15 PM on June 14, 2009

almostwitty: Quite frankly, I've read up around it. All the scary stories. and it totally does not connect to me at any level. So if your other half is like me, scaring him won't help either. Probably, nothing will until it affects my life on some level.

Friend, I urge you to go deal with this. How the hell do you even know what stage of diabetes you have?

My next-door neighbor was in the same position you are: he knew he had something like diabetes, and he did nothing about it. He was strong and healthy; he'd been in the army for years, he wasn't even 40 yet, and he figured there wasn't a damned thing diabetes could throw at him that would amount to much. He ran every day, could do two hundred pushups at a stretch, and was built like a tank.

The doctors said that the heart attack he had would have killed him if he didn't already work in a medical facility. (Yes, I know; he worked in a medical facility and yet he avoided treatment. Well, medical techs make mistakes too, unfortunately.)

Now, I'm sure you tell yourself that it'll surely get worse gradually, and that, when it starts to get worse, you'll seek treatment. The trouble is: it often (not sometimes, but often) goes straight from mild symptoms to the severity of a heart attack or a seizure. That's really the whole significance of diabetes: it destroys the body's ability to regulate its continuity of blood sugar, so everything is out of balance and your health veers erratically. The whole point of diabetes, to say it bluntly, is that it could hurt you at any time.

Please connect with this fact. It might not involve annoying treatments; it's just conscientious.
posted by koeselitz at 10:18 PM on June 14, 2009 [3 favorites]

paultopia: I'm going to disagree with everyone else here -- it does seem like nagging to interpret his own choices about his own body as some kind of lack of care for you, or the relationship, or something. And I can see how someone might react against this by stubbornly refusing to see the doctor. Pressuring, in other words, is not going to help.

Since anon can't respond, I will: using her own analogy, if his arms were blown off and he refused to see a doctor, would you think that refusal was just him responding to her nagging by being stubborn? Or would you judge as the rest of us have that, regardless of motivation, his life really takes priority over his pride?

Yes, getting your arms blown off seems a lot more serious than getting diabetes. But it's not. Diabetes can make your limbs fall off by slowing the flow of blood to them. This is really a life-threatening thing, and confronting him about it isn't ‘nagging;’ it's being a friend and a partner enough to tell somebody when they're being pigheaded and pretty much suicidal.
posted by koeselitz at 10:22 PM on June 14, 2009

"We're going to the Doctor's next Tuesday at 8 AM."

Don't nag your SO over little stuff, so you can with the big stuff like this.
posted by txvtchick at 10:39 PM on June 14, 2009 [2 favorites]

How about analogies?

Imagine that you got a test result saying that your tap water had 75% of a lethal dose of arsenic in it. The test says, the level seems to be increasing but we're not sure how fast it's increasing. Would you continue to drink that water because hey, it's not affecting you yet? Or would you take steps to change things -- dig a new well, or get a filter, or something?
posted by LobsterMitten at 10:48 PM on June 14, 2009 [1 favorite]

I think that your displacing your fears about his health into "my boyfriend doesn't love me!" is in the same psychological ballpark as his denial about possibly having a serious medical condition. Do not make this about his love for you because he can argue about that - it's not true, and it's not helpful - if he's phobic about doctors it's got nothing to do with you.
I think you can make it about you in terms of your very real anxiety. Don't insist that you're right - but tell him the absolute truth that you're scared to death and that if he sees a doctor and you're right - he can get treatment and live a healthy life. If you're wrong, then your fears will be put to rest. Either way - everybody wins - but asking him to go as a favor to you is very different from insisting that his reluctance means he's a crappy boyfriend.
posted by moxiedoll at 11:15 PM on June 14, 2009 [2 favorites]

From your perspective, your partner is facing a choice between:

a) Unnecessary disabling illness, blindness, limb amputations, kidney failure and eventually early death, bringing stress and misery to you and everyone he loves.
b) Seeing a doctor, having a few tests and remembering to take a daily regimen of pills.

From your SO's perspective, the choice is between:

a) Life continuing as normal, albeit with funny smelling breath and a nagging partner.
b) The sudden intrusion of medical science into his life. Pain, needles, horrible side effects, smug doctors disapproving of his diet and other habits, crippling medical bills, increased insurance premiums, and the stigma of being diagnosed with a disease which is so closely linked to lifestyle that many people will consider it "his fault".

He's either being unreasonably optimistic about his chances without treatment, or unreasonably pessimistic about what treatment will actually be like. You know your partner best, but if scaring him about the worst-case scenario hasn't worked, maybe you need to change tactics and try showing him that treatment for Type II diabetes that's caught early is really not that onerous? Does he realise that it won't necessarily involve finger pricks and insulin shots and and never eating sugar again? Work on that. Then drag him to the doctor regardless.
posted by embrangled at 11:37 PM on June 14, 2009 [3 favorites]

This is different for every person and every relationship, but if something like this happened in my experience, I would email/call his mother or brother or another family member (or even a very close friend) who is reasonable and has a good relationship with him — and let them know what the situation is. You might need a whole coalition of people who care about him to shove him into the doctor's office.
posted by dreamyshade at 11:48 PM on June 14, 2009 [1 favorite]

Sorry, just did some more reading and realised that ketoacidosis is more commonly associated with Type I diabetes than with Type II. My advice stands, but if you think that's what he has then his need for evaluation and treatment is even more urgent.
posted by embrangled at 11:53 PM on June 14, 2009

I watched my mother die, slowly, over 5 years, from treated diabetes. She kept her feet, but she couldn't walk on them for the last 4 years of her life, and had daily administration of creams, lotions, and air-driven massage boots to her lower limbs, to keep the associated lymphedema and infection related edema minimized. Eventually, her kidneys failed, and her eyesight worsened below the point where she could read or effectively even watch TV. She had home nursing care regularly through the last 4 years of her life, was several times admitted to hospitals for infection control and other diabetes complications, and needed my father's 100% attention and love, through that time. Despite her hopes to travel in her retirement, diabetes overwhelmed her life plan, and that of her family, and left her a bed-ridden, medically dependent invalid for much of the last 5 years of her life. In the last year of her life, she was hospitalized 7 months, and in a long term nursing home 5 months.

She died, in a hospital, with bed sores on her backside, at her hips, so deep, that the ilium of her pelvic girdle was clearly visible when her dressings were changed. She was semi-delirious from pain meds, most of the last month of her life.

On the last day of her life, she told me, for the 100th, or more time, that she was in pain, and didn't want to live anymore. She had massive infections, absolutely no quality of life, constant pain, and barely knew her family.

She died, alone, in her ICU hospital room, about 4 hours after I left her.

But it was about 4 hours later that the hospital called to tell my father she was gone, and that I got up to take him to her, that final time.

It took me 2 months to find out about that 4 hour time lag, between the time she probably actually died, and the time my father was called, and to understand that she was "checked" once in that 4 hours by the hospital nursing staff, who had administered a large dose of Xanax, "to help her sleep" and that only noticed she was dead after her vital signs monitors had been "silenced" by a non-licensed "nursing aide" who thought she was simply thrashing about too much, dislodging her monitor probes unduly, before the Xanax "kicked in."

The last 4 months of her life cost Blue Cross/Blue Sheild more than $582,300, according to the invoice copies of hospital bills I received, at my father's address, as I helped him deal with her passing. In aggregate, her hospital bills, doctor bills, and BCBS benefit statements for those 4 months represented a pile of paperwork exactly 4 feet 2 inches thick (because I've measured them).

She had the best treatment American medicine can offer for chronic diabetes, according to her doctors and the hospital of her choice, and she still died alone, in pain, and afraid.

I may never forgive myself.

But I damn sure have resolved to never put myself in position to die in an American hospital.

I salute your man's resolve, anon, and I wish him courage in his convictions, and eagle's wings to any destination beyond this world.
posted by paulsc at 12:36 AM on June 15, 2009 [4 favorites]

Go buy a glucose monitor. They're cheap, and he'll need one anyway if he turns out to diabetic. Maybe seeing his blood sugar levels will get him motivated; at least there's no denying it at that point.
posted by sero_venientibus_ossa at 3:45 AM on June 15, 2009 [1 favorite]

I recognize it as a ketone smell, meaning ketoacidosis

Not to detract from the possible extreme seriousness of this, but ketone breath does not necessarily mean ketoacidosis: It can also mean ketosis, which is what happens when the body starts using body fat instead of glucose. It happens to me whenever I don't eat enough food for a while- so you should check with your SO to see if he's eating properly.
If this isn't the result of short-term starvation, he still needs to go to a doctor.
posted by dunkadunc at 5:02 AM on June 15, 2009 [1 favorite]

He sounds like me. Working on the car I sliced my thumb open and didn't do much other than wrap it in a oil soaked rag, so I could finish what I was doing before taking care of the wound. I mean, it's just blood and these things can be disinfected and heal, right? Besides, I had the spark plugs out and wasn't near home. But I pissed my wife off quite a lot so I'm a bit quicker to clean and bandage them now.

The reason I used to stay away from the doc is because of the bureaucracy. You MAY have this thing THAT'LL KILL YOU! Do this test, find out your ok, and then move on to the next test to see if you're going to die. It gets old, and we've got better things to do. Unless, as you say, his arm is falling off. Which is significant enough, and simple enough, to require a medical visit.

So meet him half way. Just like cars need oil changes and preventive maintenance inspections, so do people. Go see a doc and you two can go have steak at his favorite restaurant afterwords, etc. Ask the doc to outline how and why they are doing what they are doing, so he can understand it. Once you've planted the preventive maintenance of the body ideal in his head he can start to think of them like mechanics and will come around eventually.

Human Body
* Inspect once a year.
* Keep hydration, vitamin, electrolyte, and food levels topped off.
* To avoid valve wear and blockages use foods low in saturated fats and triglycerides.
* Replace parts based on need and availability.
posted by jwells at 5:38 AM on June 15, 2009 [3 favorites]

Is he dieting without carbs or with very low carbs? It could just be ketosis.
posted by reishus at 5:49 AM on June 15, 2009

Perhaps you should emphasize the potential loss of sexual function. Diabetic impotence could be more important to him than kidney failure. Helpful statements like, "I hope we don't lose *this* anytime soon."
posted by Midnight Skulker at 6:10 AM on June 15, 2009

but he is one of those people that avoids seeing the doctor unless his arms blew off or something

You need to figure out why this is, otherwise everything you suggest or try will be blocked by this wall. This is the key point and the best hope for getting him to change.

You should also take steps to protect yourself emotionally from his inaction. Your post indicates you're taking this very personally and in doing so you're guaranteeing yourself a lot of future pain. Take care of yourself so you can be strong enough to help him when he needs it, because he will. This will entail a bit of emotional distance.

You should also evaluate how much of this you're willing to put up with. I'm not advocating that you dump him or leave him, simply that you steel yourself for everything that's going to be coming down the pipe if he doesn't change, because as a Type II diabetic, I can tell you that it can be pretty bad.
posted by Brandon Blatcher at 6:58 AM on June 15, 2009

Ten years ago, my mother started nagging my father to do something about the fact that he could no longer piss properly. For years, his response to that was that he was "aware that he had a prostate situation" and that he was "managing it himself".

A year ago, he had a stroke. Blood tests showed elevated levels of PSA. He still refused a proper urological exam, even though the catheter they'd fitted in the emergency department had drained three litres of urine.

A month ago, his post-stroke rehabilitation had progressed to the point where he was able to go home and spend one night in his own bed, for the first time since his stroke. Arrangements were being made to fit the bathroom with grab rails and whatnot and it looked like he was on his way home. Two days after that he was back in the emergency department with renal failure and sepsis.

A long overdue CAT scan showed a 16 by 20cm tumor where his prostate used to be, which was putting enough pressure on his ureters to prevent his kidneys draining properly. He has had to undergo a double nephrostomy, then insertion of stents into the ureters, then a third operation to undo the nephrostomies. He's currently recovering from that. In about a week he's expected to be well enough to go back to a rehab unit again. But the cancer has metastasized, there's large amounts of it in the lymph nodes in his back, and there is no longer any realistic possibility of stopping it from spreading further.

My father's prostate caused him trouble for years and he still refused to have it seen to. Now it's doing its best to kill him.

If your SO does indeed have diabetes, and he does nothing about it now and continues to do nothing about it until deteriorating vision or a drooping dick or non-healing ulcers begin to get his attention, he will have left his run too late as well. So, don't nag him any more. Make an appointment for him and take him to the doctor.
posted by flabdablet at 7:31 AM on June 15, 2009 [1 favorite]

known for a while that he has high blood sugar

I wish this question had more details. What does "for a while" mean? What do you mean by "high"? Did he use a glucometer, and did he know how to use it? Is he drinking a lot of fluids? Is he very fatigued? Is he eating a lot? Is he losing weight? These are essential details to evaluating the seriousness of the problem here, and they'll determine what the right answer to this question is.

But assuming that your SO, who you say is not overweight, has had blood sugar, say, above the 200 mg/dL level for a few months or so, then you should probably call a doctor now, on his behalf, and explain to the doctor what you know about your SO's blood glucose levels.

It seems like people here are thinking that your SO could have type 2 diabetes, which can have a somewhat gradual onset, as the body's insulin resistance increases over a period of months or years. And maybe that's right - but it's unlikely (though not impossible) for a nonoverweight person to develop that disease.

On the other hand, there is type 1 diabetes, where the body's ability to produce insulin basically just craps out. Though onset of type 1 most often occurs in children (thus the name juvenile diabetes), it can certainly happen in 20- or 30-year-olds. Now, if your SO has developed this disease, then the resistance to seeing a doctor is maybe understandable, because yeah, this will result in a lifetime of needles. I'm sorry I don't really have any special insight into overcoming that.

But I just wanted to point out that if your SO has developed type 1, then he needs help sooner rather than later, and there is no molehill here - only a mountain. Many cases of type 1 diabetes are diagnosed when the person ends up in the hospital.
posted by chinston at 7:39 AM on June 15, 2009

Sometimes it works if you don't fight a person head on. Instead, you might try asking him about his long term medical and disability insurance, life insurance, what arrangements should be made for your mutual property, living arrangements, car, etc. should he become too ill to live as you are now, drive, etc. It's not a bad thing to discuss anyway if you are responsible for each other because life is so unpredictable. Be prepared to lay out your own wishes and arrangments. Perhaps he'll get the hint when he knows you're preparing for his not being around or in a medical facility for some time. If he doesn't, then at least you have an idea of the resources available to deal with the result of his inaction.

I sure hope he mans up and goes to the doctor. My DH is almost as bad. I told him a few years ago that I love him, don't want to lose him, and how devastated the girls and I would be to lose him. He gradually got the hint and now takes a couple of pills a day for his two conditions and just might outlive me.
posted by x46 at 7:52 AM on June 15, 2009

Actually, sero_venientibus_ossa makes a great point. Grab a monitor and some sticks from the pharmacy and use the hard evidence (if it's there) to get him to see a doctor. Test yourself first so you can (lovingly) call him a wuss if he won't do it.
posted by agentwills at 7:55 AM on June 15, 2009

I take this stuff very seriously considering I'm married to a Type 1 diabetic. When you're in a relationship with an insulin-dependent diabetic, you play a crucial role in the management of the disease and treatment should be a team effort. Right now, though, you're doing your part but he isn't doing his. Were I you, I'd break up with him if he doesn't take care of his diabetes -- let him ruin his life, but don't let him ruin yours.
posted by incessant at 8:36 AM on June 15, 2009 [1 favorite]

Make an appointment for him and take him to the doctor.

Were I you, I'd break up with him if he doesn't take care of his diabetes -- let him ruin his life, but don't let him ruin yours.

Exactly. Don't over-think this, just do what you need to do, calmly and in a matter of fact manner. In every relationship both parties have some "put their foot down" areas. This should be one of them.
posted by txvtchick at 9:16 AM on June 15, 2009

Also, you can get ketone sticks from your local pharmacy (for detecting sugar in urine) -- perhaps he would be more willing to seek treatment if he saw scientific proof that he's spilling sugar?

Just needed to correct this. Ketone sticks don't detect sugar in the urine. They detect ketones.

Besides that, though...

I'm assuming he has type 2 diabetes? It's very rare for a type 2 diabetic to get DKA (Diabetic Ketoacidosis). OTOH, if he's type 1 and not on insulin it sounds like he'll be in the ER soon.

I realize I'm not actually answering your question, but I'm confused about what the situation really is.
posted by INTPLibrarian at 9:23 AM on June 15, 2009

What txvtchick first suggested is what I'd do under the circumstances: make him a doctor's appointment, let him know when it is, and show up that morning to provide moral support — and give him a ride in case he "forgets." If you're going to push him on this, you might as well do it in a way that says "I love you; relax and let me help" rather than "OMG PANIC YOU'RE GONNA DIE AND IT'S ALL YOUR FAULT."

'Course, there's probably some guys who'd respond worse to that approach. It all depends, I guess, on whether this is more about fear or more about other stuff. If you think he's doing this to prove his independence, for instance, (doubtful IMO, but he's your boyfriend and not ours, so who am I to judge?) then yeah, proceed straight to scaring the crap out of him and let him make the appointment his own damn self.
posted by nebulawindphone at 9:24 AM on June 15, 2009

@ paulsc
I'm so sorry for what you had to go through with your mother. How awful for her and for your family. My husband's aunt recently passed away from complications of extreme obesity and diabetes and had a lot of the same issues (bed sores, etc.) Unlike your mother though, she was moved to hospice for the end of her days and was treated respectfully and lovingly by the doctors and nurses who are equipped to handle such situations. They did everything possible to make sure she didn't suffer at the end. It's inexcusable that your mother didn't receive the same care.
posted by caroljean63 at 9:50 AM on June 15, 2009

One night, driving home, I saw a car in the bay, fortunately in very shallow water: diabetic coma. Driver was fine, but this could have been quite tragic, not only for the driver, but for another car, pedestrians, passengers, etc.

My dear friend and boss died before he turned 50, partly due to complications related to diabetes, and he was being treated.

It's a drag to have a chronic health condition, but diabetes can be managed. Death is crummy; losing limbs, eyesight, mobility, etc. is crummy on an ongoing basis. To the extent that crumminess can be avoided, one should at least try.
posted by theora55 at 11:32 AM on June 15, 2009

I recommend crying. It worked on me.

This is anecdotal by necessity; I don't know you or him, and I'm no relationship expert. My wife wanted me to get checked out (not for diabetes). She said just what you've said here; she viewed my unwillingness as a lack of regard for her and our son. I said what others have said here; at that point, it wasn't about her, in my mind. I was just uninterested in going, due to the inconvenience/fear/everything else.

What I think some of the responders here didn't say is that both points of view are valid, and both are wrong. I think this situation calls for a little of the sentiment summed up by that "Marriage is 60/40, and both sides have to give the 60" saying. Only when my wife started crying did I realize how much she cared, and what her nagging had really been. So if you're not so invested in the relationship, and can leave him like some here have suggested, well that might be the easier way. But you first might make sure you've made the size and scope of your feelings known.
posted by troywestfield at 2:08 PM on June 15, 2009

This is a strange set of facts.

A diagnosis of "pre-diabetes" plus knowing "for a while that he has high blood sugar" indicate Type 2 diabetes.

"Ketoacidosis" plus "not overweight" indicate Type 1 diabetes.

If it's Type 2, he ought to see a doctor and get on some kind of treatment regimen.

If it's Type 1* and he's in ketoacidosis, it's emergency room time. This is not a danger of developing long-term problems, as commenters above have suggested. This is a danger of imminent coma and death.

*Other symptoms include ravenous hunger, rapid weight loss, drinking fluids like a fish, and pissing like a racehorse.
posted by palliser at 8:13 PM on June 15, 2009 [3 favorites]

Make him read this:
posted by jenfullmoon at 9:42 PM on June 15, 2009 [1 favorite]

IANAD (doctor OR diabetic), but I trust others' opinions that this is quite serious. Let's say he were a junkie or engaged in some other type of dangerous activity like auto-erotic asphyxiation. What would you do in that scenario? Here's what I'd do: I'd make an appointment for him (rehab/shrink/doctor) and if he refused to go I'd pitch the biggest fit you ever saw, replete with yelling and tears, and then I'd pack my bags.

My husband is also impossible to get to the doctor. He's been refusing for months to go for a relatively minor problem, so I made an appointment for him. It's this afternoon, and I've sent him two reminder emails and I will be calling him shortly to make sure he's on his way. If it were as serious as the situation with your SO, I'd be driving him to the doctor myself or leaving him. Nothing else would get his attention.
posted by desjardins at 11:21 AM on June 16, 2009

Also, persistent nagging quickly becomes background noise. You need to put the equivalent of an airhorn in his ear.
posted by desjardins at 11:23 AM on June 16, 2009 [1 favorite]

If you go the "come to Jesus" heavy-duty conversation route, I would consider making a doctor's appointment now and presenting it to him as something you need him to show up for as a condition of an ongoing relationship.

The circumstances were different (depression), but I have successfully done this for a loved one who needed help and was ambivalent/resistant about dealing with it. Just removing the barrier of having to make the appointment made a difference.
posted by Lizzle at 1:35 PM on June 17, 2009 [1 favorite]

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