A brittle diabetic is a type 1 diabetic (insulin dependent) who can do everything exactly right -- take his blood sugar, inject exactly the right amount of insulin given his current blood sugar and what he plans to eat, eat what he had planned -- and then, occasionally, for no obvious reason and therefore not at predictable times, his pancreas will suddenly start working and produce its own insulin. At this point he has too much insulin and goes into hypoglycemia. Depending on the amount of excess insulin in his bloodstream it can be instantly fatal. If he's driving when it happens it can be fatal for someone else. It's called insulin shock, and you're the only other person I know (except Roger) who has actually witnessed it.I know. One of my uncles is what's known as a "brittle diabetic" (still not entirely sure what that means), but one summer, during a reunion, he got to feeling exceptionally sick. Here's how everyone figured out that he was going hypoglycemic--I (and I was about eight at the time) saw him curled up in a chair and--before anyone could stop me--gave him a piece of candy. (Because, to an eight year-old, candy fixes everything.) Five minutes later he was fine. I've kept candy in my purse ever since.
No, that's more likely with hypoglycemia. Before I found out I was sensitive to milk, but after I'd been diagnosed with diabetes, I was having trouble adjusting to the metformin. One of the reasons they prescribe metformin is that it's supposed to be impossible for it cause hypoglycemia, so they can just tell patients to take a certain dose at a certain time every day with food, and then not to worry. In reality, between 1% and 5% of healthy volunteers in a double blind study reported hypoglycemia as a side effect. I fall into the 1 - 5% category. I was also having a lot of trouble with nausea on metformin, until my body adjusted to it. So one morning I woke up with severe nausea and rushed to the kitchen for some milk to calm the nausea. It helped, but then I began to feel guilty, because milk has enough lactose (a sugar) that it always raised my blood glucose level. I immediately took my blood sugar, and it was 20! So, in the first place, extreme hunger does nauseate me, so that could be the reason metformin caused nausea, in the second place, I'm lucky I wasn't in insulin shock at that level, and in the third place I'm incredibly proud of the fact that I was actually able to control the trembling enough to take my blood sugar when it was that low.
Diabetes has a nasty learning curve.
Margret
When I was first married Roger's best friend was a man named Joe Henry (he used both his first and middle names, apparently because it's customary in New Orleans, where he came from). He lived just down the street from us and was an extremely good friend to us, and he was a brittle diabetic. He was also a shade tree mechanic who kept our vehicles working when we couldn't afford to take them in to the shop. One day he'd been working on our van and I was with him on a test drive. We had pulled over for some reason (thank goodness) when he suddenly began talking strangely. Every sentence made perfect sense, in and of itself, but not one of them followed logically from the previous sentence. I asked him to wait for me and went to the closest pay phone (yes, that long ago) and called Roger, because he'd known Joe Henry longer than I had. When I described the symptoms to Roger he immediately identified it as insulin shock (he'd seen it in Joe Henry as well) and told me to get some sugar into him. There was a little fast food place (not even a drive through) across the street, with a line of people that extended out the front door, because it was lunch time. I crossed the street and barged to the front of the line, explaining that it was an emergency. I said that I had a friend in insulin shock and I needed a soft drink with lots of sugar and no ice, as quickly as possible, and tried to hand the clerk more than enough money to pay for it. He refused to take my money, gave me a coke with no ice, and I got it back to Joe Henry as quickly as possible and told him to drink it. He obeyed, and as soon as he began making sense again I told him what had happened and went back to the fast food place to announce that all was well (tumultuous applause) and try again to pay. They turned my money down, again!
Joe Henry eventually died of a heart attack, as most brittle diabetics do if they live long enough. That kind of huge blood sugar swing is extremely hard on the heart. I wish we'd had the money to give him a proper New Orleans jazz funeral.
I wonder whether it's time to forget subtlety and ask him outright? Sometimes that's the only way to get subconscious decisions out into the open where it's possible to actually look at them logically. You know him and I don't; it's a judgement call and you're the only one who can make it.I'm afraid that may be the case. I've been trying to subtly suggest he should at least consult a physical therapist, but subtlety isn't my strong suit.
Has he ever actually talked to a physical therapist? The good ones are also good listeners. They believe the patient when he says it hurts. That doesn't mean they don't push him to do a little bit more, but that's the way any kind of exercise works.
It sounds to me as if he's decided that he'd rather be paralyzed than actually try to help himself, I'm sorry to say. I hope I'm wrong.
Margret
Margret
Last edited: