Support for spouse with type II diabetes
July 14, 2009 8:16 AM   Subscribe

It looks like my husband probably has type II diabetes, and I am at a loss.

So my husband just got back lab results from his first doctor's visit in over a decade, and they are notable for a fasting blood glucose of 130, as well as elevated triglycerides and LDL. He is scheduled for a follow-up visit in a couple of weeks, at which time I imagine they will do a second fasting blood glucose to confirm the diagnosis. I know that no one here is his doctor, and I am not looking for medical advice. I am, however, looking for support. His father died at age 50 or so from end-stage renal failure due to diabetes, but not before losing his legs. My husband is very resistant to taking care of himself in general (although he did just quit smoking, so yay!), and I worry that he will not use this situation as incentive to eat better and exercise, but will instead just become fatalistic and continue his same habits. So do any people with diabetes (or spouses thereof) have any words of wisdom for either him or me? Or awesome recipes for a man who LOVES sweets and HATES artificial sweeteners? Anything that someone newly-diagnosed might find helpful would be great...the more optimistic the better. I am trying not to feel like he is inevitably going to go blind, lose his feet, and die at a young age, but it's hard. I need to have positive things to offer to him though, so please bring them on!
posted by feathermeat to Health & Fitness (19 answers total) 9 users marked this as a favorite
He will not go blind, lose his feet or die young.
He will however likely have to change a few key lifestyle things; diet, excercise, smoking.
You and he can make these changes together, hold eachother accountable to these changes and be eachother's cheerleaders. It will work because it has to work. Old dogs can learn new tricks (the trick is support!)
posted by BrodieShadeTree at 8:26 AM on July 14, 2009

I'm afraid I can't give much diabetes advice (I'm sure you've already done at least a cursory googling, but keep looking; there's a lot of info/support groups/etc. online), but as a former smoker, I feel compelled to point out that the stress of this is exactly the kind of thing that can cause a former smoker--especially a recent one--to take up smoking again. Smoking can be especially problematic for diabetics, so don't forget to keep supporting his quitting smoking in the rush to learn all about diabetes.

Good luck!
posted by willpie at 8:27 AM on July 14, 2009

Hey, I'm Type II. The book, The First Year Type 2 Diabetes: An Essential Guide for the Newly Diagnosed, helped a lot with understanding.

How is your insurance? Things can get expensive, so be prepared for that. Look around at look hospitals and see if they have a diabetes program, which can help educate and/or defray costs. Definitely look around for any groups that teach nutrition or health for diabetics, education is extremely important.

Ya'll are the first part of long and deep information curve. It can be overwhelming at times, that's ok, go slow when you need to. Changes will need to be made, going slow helps. For instance, try to figure out healthy breakfasts, then move to lunch, snacks, dinner etc. It doesn't have to be in that order, but I found working in small doses like that helped to get a handle on things.

I view diabetes as a "good" disease in the sense that I have control over it and the "cure" is to eat well and exercise, and take a few drugs. It's in my control and I'm making a choice to stay healthy.

I'm busy at the moment so this is all rushed, shoot me an email or MefiMail if you like.
posted by Brandon Blatcher at 8:27 AM on July 14, 2009 [2 favorites]

First off, I would ask the doctor or your local hospital if they have any counselors or support groups for type II diabetics. Properly managed, it's a disease that can be controlled and patients go on to lead a long and healthy lives- it's certainly not a death or disability sentence! Perhaps with some sort of positive support network, your husband will be more likely to go adopt a healthier lifestyle. Just a couple of simple changes- no sodas, no candy bars, and a daily 30 minute walk- can be very beneficial.

To get started, Diabetic Cooking has lots of tasty, healthty, and easy-to-prepare recipes. I've made several of these, even though I'm not diabetic.
posted by emd3737 at 8:29 AM on July 14, 2009

My dad has adult diabetes, and while he's taken some initiative to get it under control, he hasn't made the comprehensive lifestyle and diet overhaul that a disease of this seriousness really demands. This is despite my expressions of concern, which have ranged from the gentle and compassionate to the admonishing. What I've learned from this is that is very hard to change your habits once you're past a certain age. I've also had to realize that the prospect of something as terrible as losing your legs or your sight can prompt denial rather than proactive change. This has helped me reduce my level of frustration with my dad, and communicate with him in a more productive way regarding his illness and caring for himself.

One of the big challenges here, as you say, is making a comprehensive and long-term change to your husband's diet. I think the best approach, based on my own experiences with my dad, are progressive changes rather than draconian or immediately restrictive ones. I'm not sure how responsibilities for shopping and food preparation work in your household, but sitting down together and creating a "transitional" dietary plan will help him get used to not always eating a carbohydrate with his meals, and help him lose his taste for sugary sweets and desserts. Since you probably eat together, making this part of a lifestyle change for the both of you will help make your home a supportive framework for maintaining healthy choices. Meeting with a professional dietician who specializes in diabetes management can also help with this, and take some of the pressure off of you to come up with all of the solutions.

As for maintaining communication about these issues, I've found that what I'll call scare tactics -- like reminding him of the devastation consequences of poorly managed diabetes, or criticizing him for lapses -- may make him shut down and not want to talk about it. Rather, expressing your love for your husband and your desire to spend many more happy and healthy years together may make him more receptive to being honest about acknowledging and confronting behavioral challenges. I'm sure you have many anxieties about your husband's illness, and having someone to express your true, unvarnished, scary feelings to -- whether it's a therapist or a trusted friend -- may help you express your thoughts and reflections to your husband in a manner that's more constructive.

I should also add that I think the fact that he quit smoking is a great sign and speaks volumes for his willpower and commitment to his health.

I hope this helps. Good luck.
posted by foxy_hedgehog at 8:33 AM on July 14, 2009 [1 favorite]

Best advice I ever received about living healthily (and I definitely needed it at the time):

It's not about adding a few years to the end of your life, it's about making the best of your ongoing here and now, not being in constant pain, or discomfort, or fear even.

Good luck.
posted by philip-random at 8:38 AM on July 14, 2009 [2 favorites]

My husband was diagnosed at 29 with Type II. His father also had it (but died of lung cancer at 70), his mother is borderline. So it was not a surprise to get it but he was unhappy to get it so young. It took him a while to accept it. Allow him time to come to terms with the news he has a lifelong disease.

For him, he did not make a radical, sudden change to be healthy, but over the past 9 years since diagnosis he has made many, many gradual changes and lost over 20 kilograms. I'm proud of him.

I have never nagged him, or stopped him buying something. The only thing he changed on day 1 was to switch from Coke to Diet Coke. My husband will eat the occasional sweet, but these days it is likely to be a high quality, small thing, instead of some cheap sugar snack. I decided to stop buying sweets of any kind for myself so it is not in the house.

Recipes - it takes time to lose the taste for sugar. But my husband used to drink a ton of Coke and now even a sip he cannot stand, too sweet. I would suggest not trying to replace all sweet foods with an artificial version. Try other foods, like a small cheese board or a piece of fruit.
posted by wingless_angel at 8:41 AM on July 14, 2009

Mendosa is a good reference site and so is this Australian site.
posted by TorontoSandy at 8:42 AM on July 14, 2009

Start here.

As someone who had to give up sweets for this exact reason, I can tell you there's hope - if he can get through say, a week, without sweets or starches, the cravings will go away. The first few days are hell, then suddenly it gets better. I was an absolute sugar fiend, but I have not consumed the stuff since January 2003, and haven't had a craving for it at all.
posted by chez shoes at 8:44 AM on July 14, 2009

The other thing is that the physical craving for sweets is exacerbated by diabetes--your body knows that something's out of whack, so it sends a NEED MORE SUGAR message to your appestat.

If you remind your husband that after he's stabilized his blood sugar for a while, he will (most likely) no longer crave sweets the way he does now, that might help.
posted by Sidhedevil at 8:48 AM on July 14, 2009

I was in precisely your same situation (except that my husband had quit smoking several years ago) just a few months ago. He also was not attuned to taking good care of himself -- he would binge on sweet or starchy foods, skip meals, didn't exercise, etc.

After receiving the firm diagnosis, it took us several days to come to grips, both separately and together, with the implications of it for him, his health, and our lives together. Largely, we both had to get beyond the guilt feelings, that somehow he had done this to himself. We were able to see the diabetes as the inevitable product of genetics (like your husband, there's a strong family history of metabolic difficulties) and that the work he had already done in improving his diet and self-care probably delayed, rather than brought on, the diagnosis.

He now describes the diagnosis as having been a "wake up call" that provided the necessary motivation for him to do the things he had always wanted to -- and felt he should -- do. Fast forward to today, and he's doing well. After a fasting glucose level of 154 and an A1C of 7.3 at the time of diagnosis, his A1C dropped to 6.1 after only three months.

The biggest key for him, I believe, was consistency: eating frequently without binging and exercising regularly (and don't think it didn't help when I admired the muscle definition he gained!).

Initial meetings with the diabetic educator and nutritionist were also very important. They helped him set reasonable goals for diet and exercise. It took two visits with the nutritionist for us to finally comprehend that carbs are not the bad guys -- they are, instead, fuel for the body and should be eaten at every meal -- but the amount needs to be consistent from day to day as well as balanced with fats and protein.

Best of luck to you both. You are welcome to MeMail me for further information.
posted by DrGail at 8:52 AM on July 14, 2009 [1 favorite]

I am a border line case and my doctor recommended two things which have kept me off insulin for about four years now...

Fish Oil supplements--I take 4 a day--reduces triglycerides ...and walking!!! 30 minutes in the morning and 30 minutes at night...

As for sweets, ice cream is one of the best choices. minimum impact on blood sugar. Not the ones loaded with cookie dough or caramel (burnt sugar) but plain chocolate and vanilla.

Avoid white food..switch to brown rice and whole wheat bread--no potatoes, these are easy ways to ease him into the dietary changes necessary.

Get used to eating small meals at intervals --And don't forget a diabetics best friend--peanut butter on whole wheat bread, with a little jam. Half a sandwich takes the edge off.
posted by AuntieRuth at 10:29 AM on July 14, 2009

I was recently diagnosed with a chronic disease that, while not type II diabetes, requires serious diet modification to help delay/avoid future disability. Not being able to veg out with snack food and desserts anymore is incredibly hard for me, but my boyfriend has jumped in and made things so much easier. Perhaps you could take a few tips from him:

First, he vowed to change his own diet to match my dietary limitations, and he has been following through like a champ. I wouldn't fault him for getting burgers or ice cream on his lunch break at work, but if he's doing those things, he doesn't tell me. It's a lot easier to not miss the things I can't have, when nobody's eating them right in front of me. And to tell the truth, we both know these restrictions will be good for him too, even though he isn't affected by the same condition I have. We could all stand to be more careful about the dietary things that affect health, whether it's simple carbs or saturated fat or sodium or fiber or whatever. He is constantly emphasizing how much better he feels eating this healthy food, and how good it will be for his health, so I don't end up feeling guilty about him changing his eating habits for me.

Second, he started searching online for good recipes that meet my restrictions, and has been excitedly emailing and telling me about them. Not so much in terms of "Look how low in [fat/sugar/whatever] this recipe is!" but rather "Doesn't this sound delicious?!? Let's make this tomorrow for dinner," and it just so happens to match what I'm allowed to eat. Cooking together or for each other has been something we enjoyed for a long time, but now I feel like there's an even greater element of loving each other involved because we're looking out for each other's health.

Third is that he is really good about staying positive about these changes. He is great at steering our food-related conversations away from me moaning about what I can't have, and toward ideas of how healthy and delicious the foods we're eating really are. Certainly there are a lot of former-favorite foods that I'm not eating anymore, but there are still a TON of really delicious things to eat that match my plan. As long as I focus on the opportunities instead of the losses, I actually feel pretty good about this new way of eating. And if I slip up, he doesn't launch into criticisms about what it's going to do to my health, or how if I really loved him I would be more careful. He jokes, he cajoles, he gently convinces me to stop eating the M&Ms, and then distracts me with something like a movie or a walk or... you know, something more fun.

One thing I will recommend from my perspective is to look for foods that are naturally in line with what your husband is allowed to eat, rather than trying to find substitutes that are doomed to disappoint. Artificial sweeteners, "low sugar" whatevers... They have their place, and can be good when he just really can't stand the thought of never eating cake (or whatever it is), but if you focus your foods around trying to pretend you're eating the things you miss, you will be constantly disappointed. Instead of piling the plate up with some crazy low-carb fake mashed potatoes or something, learn to be excited about lean meats, fish, vegetables, etc. that won't mess with his blood sugar.

Good luck! Whether he says it or not, your support through this is really important and meaningful. You can do this together.
posted by Inconceivable! at 11:01 AM on July 14, 2009

My dad's side of the family is riddled with type 2 diabetes, so I've witnessed what my dad and his relatives went through. If he's good about taking his insulin and whatever medication they put him on, and if he makes some effort to get whatever exercise they deem appropriate, and he controls his diet, it seriously isn't that bad.

I can't speak for everyone, but personally I have never seen someone who has done all those things and lost their legs or went blind or anything even close to that. My relatives really half-assed their diets and exercise, even, and they haven't had to worry about amputations or blindness. (Which is not to say they might not have these problems when they're older, so don't let your husband half-ass anything. However, my uncle is in his 60s, and my grandmother died in her 80s, without those problems.)

And again, personally, from what I've seen and heard, the people that have those problems just don't make much of an effort to control their diabetes. My dad would tell me stories of people at the hospital that he'd talked to along those lines. Also, you're supposed to keep a log of your blood sugar every time you take it, but for some reason, tons of diabetics don't do this. My dad would always bring his log to the doctor's office and they were always floored that he'd really done it.

So don't freak out. If it makes you feel any better, while I certainly wouldn't want to get diabetes and I take all the appropriate precautions to prevent it, after having seen what I've seen I wouldn't panic if I got it.

As for sweets, look up recipes with Splenda. If you make him some baked good with it and didn't tell him there was an artificial sweetener in it, I'd be surprised if he noticed. I can taste an aftertaste with Splenda, but honestly, only if I know it's there.
posted by Nattie at 11:10 AM on July 14, 2009

This is not diet or exercise suggestions. This is just addressing the positive outlook concerns you have.

My Oma is in her 80's. She still lives in her own home (with my grandfather), and despite arthritic pain in her knees and high blood pressure concerns, she's pretty healthy. She wears glasses, sure, and probably needs her hearing checked again. But she's not blind, she didn't lose her legs, or suffer any other problems...and she's had diabetes since she was in her 40's. She gives herself insulin injections every day, and takes god knows how many pills, and is generally pretty good with her diet (now, of course, the problem is eating enough, as she has the low appetite typical of seniors). But she still eats fruit, she has the occasional danish or waffle with fruit syrup, she likes her daily cookie or licorice treat, and so on. She's kept her sweet tooth in check for this long by indulging it - but in tastes, not whole pieces of things.

My main point, though, is that she's in her 80's, has lived with diabetes for going on 40 years, and she's still going strong. This is something that, if managed, doesn't have to ruin your life or shorten it in any way. My mom, now in her 50's, was recently diagnosed with diabetes too, and while she's had to make some adjustments we all took it in stride. I'm pretty sure now that I'll get the diagnosis at some point - it seems to be running in the family. But it doesn't worry me like it might some others, because I know that if my Oma can handle it for this long, I can handle it too.

This is not a death sentance. If its managed, you can live a long healthy life like anyone else. So why not ?
posted by sandraregina at 11:33 AM on July 14, 2009

I've been diagnosed recently with the same, and although I'm struggling with the lifestyle changes, I know both that it's controllable (at least at this stage) and what can happen if I don't (both of my grandfathers had it). Nthing with MULTO MAXIMO EMPHASIS the blood-sugar monitoring; it's easy and fast. He may never have to inject a single drop of insulin, or suffer the aforementioned horrific side effects, if he takes his meds and stays on top of things.
posted by Halloween Jack at 12:34 PM on July 14, 2009

He may never have to inject a single drop of insulin

Maybe, maybe not. Remember, diabetes is a degenerative disease. The cells that control insulin, the beta cells in the Islets of Langherhans, are finite in number and are slowly dying out as they struggle to keep up with the out of whack body chemistry of diabetics. If you live long enough as a diabetic, you'll probably have to go on insulin.

Depending on how well a person takes care of themselves probably determines when they have to go on the insulin.
posted by Brandon Blatcher at 1:23 PM on July 14, 2009

Response by poster: Thank you to everyone...I'd love to mark every answer as "best"! I am feeling a lot more positive and hubby seems to be game for some lifestyle changes, so maybe this isn't as dire as I thought :).
posted by feathermeat at 6:07 AM on July 15, 2009

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