Living alone and danger of insulin shock

[WanderWoman]

I have a close friend who is Type 1 and who lives alone.  On three different occasions over the years I have called him and altho he was able to answer the phone, it was clear immediately that he was far enough into low blood sugar crisis that he was no longer able to think clearly enough to take appropriate action.  I had to "rescue" him each time. We have established a custom of his calling me every morning soon after he wakes up, which seems to be his time of greatest risk, and I can usually tell immediately if he is OK or not.  



However, I have encouraged him to find a resource other than me for a daily morning check on his welfare.  He claims he has looked into it and has not been able to figure out anything -- but I don't like being 100% responsible for his safety.



Is anyone reading this a Type 1 living alone?  How do you deal with this risk?  Have you found resources where, for example, a network of Type 1s living alone call each other to check on welfare?  Or are there medical support services that do this?  Or ????

[JDRF-Team-dm]

Dear WanderWoman,



Thank you for reaching out to the Juvenile Diabetes Research Foundation. While I am a volunteer, I am not a physician and am not able to give you medical advice.



I admire the great support that you are giving to your friend. This is a heavy responsibility for one person to take on however. Many people with type 1 live alone and in some cases it can indeed be a difficult situation.



It sounds as if he either needs to adjust his insulin and carb intake to avoid these early morning low blood sugars. This should be done through his doctor. Another idea would be for him to also work with a diabetes educator that can help him in counting carbs and what to eat. On the other hand if he is having problems feeling the lows coming on, this is a more serious problem and again he needs to work with his doctor.



I, personally, am not aware of a network of type 1's that call each other in the morning, but it is a great idea. There may be other comments to follow regarding this with information on a network. There are also many different medical alarm companies where people have a tiny button that can be worn around the neck and when they push it the company sends medical help. You may also want to check with your local fire department. For instance in Seattle there is a program like this through Medic One and Harborview Hospital.



As I said earlier, please look for additional comments from others with more ideas on this. I wish you and your friend the best of luck and I hope you can come up with a reasonable solution to this problem.



dm

[nurse12hr]

While I admire you for taking on this responsibility, sooner or later, there may come a time when you are not available.  I think you need to sit down with your friend and have a frank discussion about his DM management plans.



There is a fine line between helping and taking on too much responsibilty for someone else.  By continuing to call and "check" on him, he does not need to own responsibility for managing his own care.  Also...maybe I am overstepping...but is there some possibility of a romantic relationship here, maybe only in his own mind?  Subtly guilting you into calling every day is an extremely powerful way of keeping you very involved.



What would happen if you overslept?  Had a sudden family emergency of your own?  Went out of town unexpectedly?  Bring these scenarios up to him gently, and tell him you are not abandoning him, but want him to become more responsible for his own care and well being.



My advice is to talk to him about some of these points.  There will come a time I suspect, when you may have to say "no more" and stop calling every day.  Be sure you have the inner strength YOURSELF to do this.  And what a wonderful friend you have been to this person.  THAT doesn't have to stop!

[JDRF Team SGG]

For years, I, too, was a diabetic who was at risk for night-time lows. It didn't happen often, but when it DID, it was frightening, and I feared that it could be life-threatening. I finally talked an endocrinologist into letting me change to a new method of taking my insulin, and I feel that it is one that can be almost fool-proof in preventing the night lows. I am speaking of taking Lantus insulin, which is advertised as a 24-hour insulin, but certainly doesn't just cut off after 24 hours to the minute. In reality, it sort of peters out at some point between 20-24 hours for most people. This endocrinologist has me taking it in the morning so that it is petering out while I sleep. The rationale is to keep any insulin from peaking while sleeping, and since I have been doing this, there have been no dangerous lows while I sleep at all. If left alone, the insulin would just continue to wear off, and even if I did have a low while sleeping, my glucose levels would rise at some point in the morning. I would suggest that your friend talk to his doctor about this as a possibility for preventing night lows, which have to be terrifying to him as well as to you. I am NOT a doctor, but am only speaking from my personal experience, but feel that this is a good solution and one that is worth him checking out with his physician.

[Tom_Bomb]

As a Christian diabetic, I am horrified that anyone would consider doing an short, inexpensive daily check on someone living alone to be a burden.  I would ask, which is the greater burden: the checker's selfishness or the diabetic's condition?  

In my youth, it was common for healthy neighbors to check on healthy neighbors just to chat.  Think of the old "I Love Lucy " series.  Lucy and Ethel seemed to make contact every day.  My mother was the same way with her friends.  My, how things have changed.

Does the selfish person think because their condition is currently common, that makes it right?  Does the selfish person ever consider how wars of conquest--the ultimate act of personal selfishness--bring uncounted burdens to others?

If someone came to me with that attitude, I would say, "Forget it.  You're not a friend.  Leave me alone and go your way to hell with the other selfish pigs.  Clearly, you are too naive or too lazy to lay up a treasure in heaven.  And there is no such thing as false guilt.  If you feel guilty, it's because you are guilty.  Guilt within a person is always the clearest voice of God."  St. Paul said that he who doubts and eats is damned if he eats.  To get to heaven, we have perfectly clear consciences.

The issue involves more than diabetics. I have known more than one person, three in fact, who died alone in their homes.  And these were not elderly people.

Romantic intentions? Not everyone wants to be alone and unloved.  Not all those who want a friend want sex.  The problems come with the conditions we set.  And daily checking on a diabetic or some other vulnerable person is not unreasonable.

[triskit82]

This shouldn't  be happening on a regular basis. He obviously needs work with his Dr and make some changes to his treatment plan.