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My sister has had DM1 for 13 years now. She had it since she was 6 and we have all had some difficult years to learn to help her, first with injections and later with the insulin pump that she still uses.  I’m her youngest sister (17)  and I must say I’m quite tired of not knowing what to do the last months to help her. About 8 months ago she started not really recognizing anymore when she had a hypoglycemia. The annoying thing is she is getting more violent, and when we tell to her that she should test her BG she gets even more angry. Last week she had hypoglycemia and shouted like crazy to our mum, I had to hold her firmly and I almost put a carbo tablet in her mouth.  I want to help her with this hypo unaware before living with her becomes really a nightmare! Any ideas?

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That’s a difficult situation. Hypo unaware is a scaring thing for a girl from 19y old like your sister. The first thing is finding the right moment to talk to her, you must find a moment when you are relaxed together and then raise the subject. The most important thing to avoid this violent behavior is avoiding the hypoglycemia, she has to test her BG more frequently. She has to understand that though is not nice for friends and family the aggressive behavior is a symptom of hypoglycemia which actually can help her to be aware of it. When she’s aggressive and cannot calm down she should really test her BG. Another idea is to discuss with her to start using CGM continuous glucose monitoring, which is a sensor that will measure her BG 24 h/day and give her a sign when the levels are low. This helps a lot to avoid this kind of situation you have mentioned! Good luck!

 

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Its not uncommon for people with long term diabetes to become unaware of when they are becoming hypoglycaemic, the symptoms can become more subtle as time goes on. experts think that hypoglycaemic unawareness may be due to nerve damage which reduces adrenalin release. the release of adrenalin acts as a warning system, giving warning to the diabetes sufferer by causing the body to feel shaky and sweaty etc. Your sister will be unaware that she is becoming hypoglycaemic as these warning signs are no longer present. Your sister needs lots of support with controlling her blood sugar. She needs to take responsibility for regularly testing her blood so that she can get on top of this situation. You need to talk to your sister about how this is affecting you and the rest of the family, but let her know that she is well supported by you all.
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