High blood sugar

[Guest]

Our GP has just called to tell my 83 year old husband that he should go onto medication for high blood sugar, the figure 66 was mentioned. Problem is my husband has lost all confidence in doctors and blames the GP for not recognising the sudden onset Type II diabetes as being someone requiring more investigation 3 years ago. He's had a rough few months trying to get this diagnosis confirmed and he has also lost faith in the MDT who passed him around for months. We previously used diet to reduce his blood sugar to normal but now that he has been told he has advanced pancreatic cancer and the oncologists have guided him away from chemo due to his age, heart/stoke problems etc he doesn't want any more medication. We have our first visit from a representative from the palliative care team tomorrow. I am obviously worried about him but he just keeps saying he wants the medics to leave him alone. My concern is that at the moment, apart from creon and the omeprozole he is only taking paracetamol for pain. His bowels seem fine and he is eating well, if this changes he may need help. Not knowing what to expect is really frightening me as I imagine all sorts and feel that he may refuse to co-operate with the palliative care team which will leave me alone to cope when he gets more ill. He has a large cancer in the body and tail of the pancreas and it seems to be spreading to the stomach/small bowel. Several of his veins and arteries are surrounded by the cancer and he has been told that on average people in his condition at his age and with his complicating factors live between 3 and 6 months. He doesn't seem depressed just doesn't want more drugs and trips to doctors or hospitals. He has actually been to Spanish class today and to our local market but does get very tired.

[PCUK Nurse Jeni]

Hi Marmalade,

Thanks for posting regarding your husband and his high blood sugar levels.

I am not sure what the figure of 66 means, as this would be a mightily high level, and most monitoring equipment can only measure levels up to about 35. However, 35 in itself is extremely high. So, if it is above this, then it is very high.

How is your husband feeling? you would normally expect a person with a very high blood sugar to have symptoms - I know he is already a diabetic, but you would expect to see symptoms similar to when he was first diagnosed - so passing large amounts of urine, thirsty all the time, headaches, feeling sick, blurred vision, tiredness, weight loss - these types of things. Occasionally, dehydration as well. The trouble is, without medication to bring the levels down, then he will become dehydrated and if the levels keep rising, he may become quite ill. Also, if it is not treated, he may end up with ketones in his blood & urine - this is a pretty serious condition.

So, perhaps you might be able to speak to him about the necessity of the medication - it may only be one tablet twice a day, depending. At least if he spoke to his GP about it? is there anyone at all that he trusts? A practice nurse maybe? maybe he could discuss it with the palliative care team when they visit?

I hope this helps?

Kind regards,

Jeni.

Pancreatic Cancer Specialist Nurse,

Support Team.

[Proud Wife]

Hi Marmalade

Jeni has covered the practical side and as a diabetic myself, I know if my sugars are high I can feel really poorly. Your husband has enough to cope with at the moment and as Jeni says, medication could very easily resolve the symptoms of high blood sugar. However, my husband who has PC is not the easiest of patients and I know exactly what you going through. It can be so hard for the carer sometimes, we are stuck in the middle of wanting to do whatever is best but respecting the wishes of our spouses at the same time.

I don't blame your husband at all, he's probably fed up with being prodded and poked but you of course want the best for him. I think you might find when the time comes he may be more co-operative with the palliative care team but if not, then you can always refer to the palliative team and don't forget, there will always be someone on here that's able to answer any questions that you may have.

Good luck xx

[Guest]

Thanks nurse Jeni and Proud wife. Yes he did say 66! I have printed off your answer and I will try and speak to him about it…

[Guest]

Sorry Jeni, the test was a blood test taken at about 9.15 am after my husband had eaten his breakfast I believe it was an annual HbA1c test. Although he was diagnosed with type II diabetes two years this was a completely out of the blue result which surprised the doctor as well as us. With 4 months we had the reading within normal limits by cutting out any eating between meals and only eating un processed food and sugars. I have read him your response and I am hopeful he will call the GP back tomorrow (fingers crossed). He has lost a small amount of weight, a few pounds and is peeing fairly frequently but he is 83! Other than that no symptoms and his blood pressure has been really good of late.

[Guest]

Hi Marmalade,

So sorry to read about your husband, and that the medical professionals have yet again let someone else down. I think it is more of a let down to the older generation, as they put the whole trust into them, which they rightly should, and to see that they have been let down by someone they completely trust, it is just a huge blow and I am so sorry for the way your husband must be feeling.

Does your husband have a lot of pain? My Dad had Codeine as well as paracetamol, and he was ok with that in the majority of the illness.

With regards to the palliative team calling round, could you have a word with them before they speak to your husband? Just so they don't uoset him. I think as they have done this hundreds of times, it becomes routine and they can be quite blunt regarding the future.

That aside, lovely to read he has been out and about and enjoying life. That is what it is about, quality of life, and you both should embrace that.

Really hope today goes well. I hope you get someone nice, and that your husbands restores a little bit of faith.

Leila xx

[Guest]

Hi Leila,

The hospice palliative care team people came and were good. As you say, a little it blunt but in a way I think we prefer that. Our daughter is a hospital doctor living 2 hours away from us but she has been here today and tells us that the HbA1c score is a measure of what has been happening over the last 100 days and that a few days thinking about it is not going to make much difference. It's high but not astronomic in the scheme of things. Both she and the palliative care care team have said that he doesn't have to do anything but that he may find trying something to bring the sugar down a little may help him as things progress and if one drug upsets his tummy another may not. Our daughter also suggested that she come with us to see the GP and agree the priorities for his ongoing care. We all agreed she is right to help us iron this out as he is still being called for various routine screening appointments and the GP is trying to manage risks when prescribing pain medication alongside his warfarin and other heart/anti stroke medication. We feel that we have now moved into the last months of his life and that the focus should be entirely on keeping him comfortable as opposed to preventing secondary health problems. We hope that we can all then just have the one focus and gear medication and nursing to this end. We have an appointment for next Thursday. The palliative care team have suggested we join a short course called "coping" designed for patient and carer and I think my husband is inclined to give it a try. Just want to say that it does help to be able to post on here and even a short note from others helps with the sense of awful loneliness. Thank you all, Miriam

[sandraW]

Oh Miriam,

Its awful really that it helps so much that there are others that have either gone through the same thing, or are still going though it, but it does help to know that you are not alone. You will of course be shouldering all the worry so you don't have to pass it to your daughter or your hubby but that's what we do isn't it, put on that brave face. Your daughter will be a massive help for you in getting things sorted and as you say you can then all work towards helping your husband stay as healthy as he can and have some good quality to his life. Just to let you know that you are in our "family" too now and there will always be someone there when you need to let off some steam take care sandrax x

[Guest]

Hi Miriam,

I am so pleased to read your daughter knows what she is talking about and will help you both. That will be a huge relief and weight of your minds. If she knows what needs to be done, she will fight for her Dad and make sure he is treated the way he deserves to be.

Also pleased you got on well with the palliative nurse, it is good to get someone good, when you do, hang on to them.

Like lovely Sandra said, it is awful that everyone here can understand your pain, but I agree, that is very comforting. I think people in 'real life' just don't understand and will never understand unless they have walked in our shoes.

Don't ever feel you can't post here, someone is always here and will always reply.

Leila xx

[Guest]

The meeting with the GP went well. I don't know if it was because there was another doctor there (our daughter) but there was a completely different attitude. My husband has now been taken off all his preventative medication including warfarin, ramipril, and simvastatin which means he will not need his INR checked either. They have also cancelled flags for monitoring his aortic aneurysm and other irrelevant but lucrative for the GP, tests. This leaves the way clear for him to have access to a much wider range of pain killers when the need arises and reducing his blood pressure drugs is old as blood pressure tends to drop as the patient becomes more ill. As to the panic over the blood sugar it appears the other GP (nice man but not the most switched on) overreacted as, although high it is not unusual and as his pre lunch blood sugar was 9.2 the GP and our daughter decided to monitor for now rather than medicate which pleased my husband greatly and stopped me stressing.

[Guest]

Hi Miriam,

So very pleased to read your daughter has taken control. She seems to know what she is talking about. A huge relief for you both, especially your husband, who will now be in good hands. Someone to trust and rely on.

Hope he is still going to Spanish classes.

Leila xx

[PCUK Nurse Jeni]

Great news Miriam!

And yes, undoubtedly, having another doctor there was an impetus for more detailed assessment.

That's great that some of his meds are being stopped - and that there is no need for medication for the diabetes - yes, not too high really.

Hoping things pick up even more after this now.

Kind regards,

Jeni,

Pancreatic Cancer Specialist nurse,

Support Team.