Help me persuade my friend to get tested for diabetes

[Skald the Rhymer]

Fairly simple question.

The friend in question is actually the department secretary. She has had to go to the optometrist twice in the past two months because of changes in her vision; she is constantly having to get up to go to the bathroom; she is always thirsty; she is always tired; and she's lost about 5-10 pounds in the past month or so though she is not on a diet. Nonetheless she is nervous about getting tested. I've already told her my own horror story, but I could use another--or a persuasive argument.

Thanks.

[SomeUserName]

Some people are afraid of doctors and tests.

Have her take a home test or if you are diabetic then test her blood on your monitor and see what the reading is.

That is how an old friend of mine found out he had it. Another friend tested his blood and it was off the charts. It got his ass to a doctor.

[Athena]

Find out what her fears are and address them. Stress that diabetes is not a death sentence and that there are a variety of ways to control it.

I also agree with SomeUserName's idea to test her with your glucose monitor. Of course, if she wants to keep her head in the sand, a positive reading could to more harm than good.

[MsWhatsit]

Worst-case scenario if she gets tested: It turns out she's diabetic. She has to eat a healthier diet and get more exercise. Possibly she may have to try an oral medication. She will have to check her blood sugar daily. She will probably lose weight and feel healthier.

Worst-case scenario if she doesn't get tested: She loses her vision, her feet, and possibly goes into kidney failure. (I did say this was a worst-case scenario.)

"It's better to know than not know" really worked for me but I know that a lot of people don't really think that way when it comes to medical tests. Good luck, Skald.

[Jane Elliot]

My stepfather's family is rife with diabetes. My aunt lost her vision, legs and kidneys before she died.

You could go the route that we went with my sisters. Ask her if she has a living will, a regular will, and who she wants to give the eulogy at her funeral. Tell her you're serious.

[panache45]

Diabetes is a totally treatable disease . . . but you have to get tested and begin whatever treatment your doctor prescribes. And you have to become educated about it. But being diabetic and not getting treated for it . . . that's suicide.

[Skald the Rhymer]

Originally Posted by panache45

Diabetes is a totally treatable disease . . . but you have to get tested and begin whatever treatment your doctor prescribes. And you have to become educated about it. But being diabetic and not getting treated for it . . . that's suicide.

I already told her the story of my diagnosis, which includes weeks of denial in the face of obviousness followed by a collapse in the doctor's office and a couple days of unconsciousness. I'm almost ready to wash my hands of it.

[Ferret Herder]

Twice in two months to the optometrist for vision changes? That is not freaking normal. Frankly, any optometrist worth his salt is probably already saying "you need to see an ophthalmologist" - do you know if she went to the same optometrist both times, or to another office?

The chance of diabetic retinopathy is not something to screw around with. Though treatments can be highly successful if started early enough - and the diabetes is well-controlled - there is no cure, and some vision may never get back to totally normal depending on what's going on in the eyes and how long it's left to get out of hand.

[Skald the Rhymer]

Originally Posted by Ferret Herder

Twice in two months to the optometrist for vision changes? That is not freaking normal. Frankly, any optometrist worth his salt is probably already saying "you need to see an ophthalmologist" - do you know if she went to the same optometrist both times, or to another office?

I think she had to have gone to one of those mall places where the optometrist is affiliated with an eyeglass place and they grind new lenses in an hour, as she came back with new specs both times. The twice in two months thing got my attention because it's exactly what happened to me before I collapsed in the GP's office with a blood sugar of 700 quadrillion. She mentioned to me that her optometrist also wants her to see her GP, but she's too scared; she also declined to let me take her blood sugar this morning (after promising to do so last night), as she had a bagel right before coming to the office.

And that's where I got off the take-care-of-everybody train.

[Simplicio]

Just man up and taste her urine.

[KneadToKnow]

It would be easier if she were a guy. Explain to a guy that diabetes can cause his dick to stop working, and most will hop to it.

[Yllaria]

I'm surprised the optometrist didn't say the word diabetes straight out. My guy is very up front about saying that he's looking for diabetes-related degeneration.

If the optometrist said get thee to your doctor and she didn't do it, there's probably not much hope of anyone else getting her there. You could ask her if her feet are tingling yet. That's usually the first symptom.

Sucks to be around.

[UncleMoose]

And if she's Type 1, then there's a very real chance of going into diabetic ketoacidosis and dying. Skald, your "couple days of unconciousness" - if that was caused by DKA from high blood glucose levels, you're lucky. That can caused fatal brain swelling.

Seriously - tell her if her breath starts smelling of fruit and alcohol, you're going to call 911 for her. That's a sign of ketones in the bloodstream.

[PatriotGrrrl]

Is she afraid of needles? Maybe it would help if you could demonstrate on yourself that the testing doesn't really hurt, and convince her that the doctor would try giving her oral meds rather than insulin shots?

[Skald the Rhymer]

Originally Posted by UncleMoose

And if she's Type 1, then there's a very real chance of going into diabetic ketoacidosis and dying. Skald, your "couple days of unconciousness" - if that was caused by DKA from high blood glucose levels, you're lucky. That can caused fatal brain swelling.

I realize how lucky I am to be alive. If things had gone only a little differently that day -- if I had ignored my optometrist and gone home rather than to the GP, or if I hadn't been able to get an appointment that day, or if I'd gotten a later appointment and gone home first-- I'd have been alone in my apartment when I passed out. It was a Friday afternoon, and no one would have thought anything in particular about not seeing me until, at a minimum, Sunday morning; and I doubt anyone would have DONE anything until Tuesday or Wednesday. The Dope would then have been spared years of my bad jokes about conquering the Earth on account of me being dead.

Seriously - tell her if her breath starts smelling of fruit and alcohol, you're going to call 911 for her. That's a sign of ketones in the bloodstream.

I know that too. I'll call 911 in that event, but otherwise I'm letting it go. I told the secretary my horror story after one of my subordinates told me her concerns about her; she said she was afraid of doctors, afraid of needles, afraid of knowing. We demonstrated how trivial the pain of a needle stick is (this is a white girl with a very ruddy complexion, which equals good circulation, which equals the lowest setting on the lancing device, which equals practically no pain) and she still doesn't want to take the trivial steps. So I decided to not give a damn beyond the minimum. If she passes out or smells ketoacidotic, I'll call 911. Beyond that, I'm shrugging and calling it a shame.

[SomeUserName]

Can you buy her a home test and leave it wrapped in her office or cube with a note that says "Please use this, I don't want you to DIE!"

I mean really. I hate doctors and dread tests but if I had the symptoms and someone was clearly offering to help and was sharing their fears because it happened to them I might wake up and make an appointment or at the VERY least let them test me with their tester.

[Anne Neville]

Originally Posted by PatriotGrrrl

convince her that the doctor would try giving her oral meds rather than insulin shots?

As a fellow needle-phobe, I second telling her this.

[Ferret Herder]

Originally Posted by Anne Neville

As a fellow needle-phobe, I second telling her this.

She'll still need to test her own blood glucose level, frequently. You can't see the needle, but it's there.

[Yllaria]

The doctor is still going to want a blood test that requires a regular needle for diagnosis. The little lancet stick it for daily self-monitoring. The regular test is done quarterly the first year to confirm the accuracy of the self-monitoring.

So, yes, tell her that she's most likely to be put on oral meds, but don't tell her that there will be no needles.

[Anne Neville]

Originally Posted by Ferret Herder

She'll still need to test her own blood glucose level, frequently. You can't see the needle, but it's there.

That might be enough for some needle-phobes. I can get shots or get blood drawn if I don't look. I usually hurt my neck, shoulders, or back trying to turn away from the side where it's being done (I turn my head as far as physically possible and generally try to turn it further).

I usually cry, shake, or both at some point during the process. I loathe it. But I can do it. Phobias are a funny thing, and are often oddly specific in a way that doesn't really make sense (they are, after all, by definition, irrational fears).

[Athena]

From personal experience, I would stress that most diabetics control it with oral drugs, diet, and exercise.... emphasis on the oral drugs if she's adverse to diet/exercise. When I was first diagnosed, I had no idea there were pills that helped, and it was really encouraging when my doc told me he thought that a few pills would be all I needed.

Of course, as it turns out I'm Type 1, and it's shots & insulin all the way for me. But had I heard that the first day of diagnosis, it would have been a horrible shock. As it was, I spent the first month in a deep fear of insulin. Little would I have known that a few weeks later, after doing tons of research & talking to people, I'd be asking for the insulin over the oral drugs. Life is funny sometimes.

And, for the record, I'm the biggest needlephobe in the world. I still can't stand to have blood drawn or get a "real" shot. Insulin needles are tiny - less than 1/4" long - and really just go right under your skin. No big deal. Especially after a few weeks of 6 or 8 daily shots

[gigi]

Originally Posted by Skald the Rhymer

The Dope would then have been spared years of my bad jokes about conquering the Earth on account of me being dead.

To be fair, you'd be undead and (de)composing zombie threads.

Glad you're still here in your current manifestation though.

[Skald the Rhymer]

Originally Posted by Anne Neville

That might be enough for some needle-phobes. I can get shots or get blood drawn if I don't look. I usually hurt my neck, shoulders, or back trying to turn away from the side where it's being done (I turn my head as far as physically possible and generally try to turn it further).

I usually cry, shake, or both at some point during the process. I loathe it. But I can do it. Phobias are a funny thing, and are often oddly specific in a way that doesn't really make sense (they are, after all, by definition, irrational fears).

I understand irrational fears; I used to have one for dogs, many months of therapy ago. But given that she's already seen that the blood glucose needle prick is painless, I'm going to say her real issue is denial and/or fear of doctors.

[jeepus]

The worst thing that my hub puts up with regarding Diabetes is the Neuropathy foot pain. He was probably undiagnosed for seven years or so. He gets crawling electric shocks in his feet, like electrified bees biting you. There seems to be no rhyme or reason to it, some days are better, some days are worse. The docs tell him the pain will go away when he has his feet amputated. I wonder if he'd still have "ghost pain" like people sometimes do who have lost a limb. He's in no hurry to lose his feet, but the pain is just never ending and totally unpredictable. She really doesn't want nerve damage in her feet.

[TV time]

Tell her if she gets the test she gets a free meal and soft drink at McDonalds.

Sure it's a lie. But she'll forgive you.

[UncleMoose]

Originally Posted by jeepus

The worst thing that my hub puts up with regarding Diabetes is the Neuropathy foot pain. He was probably undiagnosed for seven years or so. He gets crawling electric shocks in his feet, like electrified bees biting you. There seems to be no rhyme or reason to it, some days are better, some days are worse. The docs tell him the pain will go away when he has his feet amputated. I wonder if he'd still have "ghost pain" like people sometimes do who have lost a limb. He's in no hurry to lose his feet, but the pain is just never ending and totally unpredictable. She really doesn't want nerve damage in her feet.

Hope I'm not being intrusive, but if you're in the Boston area I just got a notification of a clinical trial for neuropathy here
http://www.centerwatch.com/clinical-...StudyID=153262
that might be of interest.

For anyone else that might find it useful in general - centerwatch.com is a clearing house for listings of upcoming clinical trials. You can sign up to get e-mails when a trial in your area and for a disease of interest is recruiting.

[Mirror Image egamI rorriM]

"The pain will go away when his feet are amputated?" Don't a lot of people get phantom limb pain after amputation?

[Zany Zeolite Zipper]

Speaking hypothetically as a person who was expected to develop the disease, and who was supposed to have been tested for it every year for the last five, what is the risk of a modern diabetes diagnosis on an active lifestyle?

I mean active in the running, jumping, and pillaging Paris sense of the term, not in the "takes water-cize three times a week" sense of the term.

Can healthy people ever taste alcohol on their breath, or is that an undeniable warning sign?

[Athena]

Originally Posted by Zany Zeolite Zipper

Speaking hypothetically as a person who was expected to develop the disease, and who was supposed to have been tested for it every year for the last five, what is the risk of a modern diabetes diagnosis on an active lifestyle?

I mean active in the running, jumping, and pillaging Paris sense of the term, not in the "takes water-cize three times a week" sense of the term.

Can healthy people ever taste alcohol on their breath, or is that an undeniable warning sign?

Not sure what you mean about tasting alcohol on your breath. Sometimes diabetics breath can smell sweet, but I've never heard of an alcohol taste.

And as far as the rest of your question... I have very little family history of diabetes (one cousin, that's it), spent last summer riding my mountain bike anywhere from 4 to 6 hours a week, I run, I hike, I eat healthy, am not overweight blah blah blah all of that. Didn't stop me from being diagnosed as diabetic last November. So it happens.

But truthfully, it's pretty rare, from what I can tell. I was just lucky

[Hari Seldon]

Just to mention that even a positive diagnosis doesn't necessarily mean daily blood sugar monitoring. I was diagnosed with a reading of 8.1 mmoles/per litre (multiply by 18 to get the US readings in mg/deciliter), which is not large. I was put on metformin twice a day and a month later was down to 5.8, which is normal (well high normal). In my most recent physical I was 5.7, with an A1C of 5.9% (I think that is also high normal). The A1C measures the percentage of blood hemoglobin that is glycosolated (combined with glucose) and is like a 3 month running average. Under these conditions, my doctor feels that daily monitoring is unnecessary.

Incidentally, I also suffer from neuropathy in the feet. The front half of each foot tingles, but they are not otherwise affected. In fact, I feel it only when I wiggle my toes. I have a strong pulse in the ankle. Suddenly about 7 or 8 years ago (before my blood sugar went above normal), I developed strabismus (double vision). My ophthalmologist speculated that could also be neuropathy. So I have prisms in my glasses, which corrects it.

[jeepus]

THanks UncleMoose, we're no where near Boston, but I'll forward him the link to centerwatch. He has done clinical trials in past with no relief. I don't know if he's up for doing another one, but I'll give him the info and let him decide.

He may have more damage than you, Hari Seldon, because sometimes he shouts when the pain hits him. He took time off from work, left town and stayed a week in Winnipeg recently, and found that his pain was gone for that week. I don't know if that's because he was not working, thus less stress, or that he was at a lower altitide. We're in Denver, so 5,000 feet or so.

[clayton_e]

My sister was recently diagnosed and I was recommended (by her doctor through her) to go for a genetic test (done locally at the hospital I work at and sent to him) as part of some big case study.

I havn't done it yet, though I should.

Apparently I have some risk factors.. Family history I had no idea about before two months ago, that might have an impact on me.

Apparently the genetic test is so accurate they could tell me close to what month I'd be affected.. even if it was years off.

I have a few "symptoms" (I put that in quotes because they're so vague..)

- Bad vision (but I've always been nearsighted, had surgery for an unrelated issue and turned out to be nearsighted after.. who knows)
- Occasional foot numbness (though this just might be caused by any number of things.. and its not whole foot.. often its just from being in one position for a while with pressure. Not "foot asleep" numb.. just odd sensation)
- Somewhat tired here and there. But that might be a mix of insomnia and working late.

In any case, I'm getting tested for it shortly.



My mom actually said "Hey, Clay, if you don't feel comfortable getting tested its ok.. if you're scared.."

My response was "Why would I not want to get tested? If its so it is so.. and I'll just have to deal with it. If anything, knowing will be a good head start on dealing with it.. While not knowing will only put me behind."

So.. crossing fingers.. looking at the odds and being generally happy with them.. Going in next week and not really thinking much about it. Meh, if its so its so and I'll deal with it. Why scare myself over something that is treatable.


In any case it was a major factor in my attempt to quit smoking.. Which in a little over a month had a couple false starts but now is well over a week without a smoke and on top of that not even a desire. Smoking can't help diabetes.. or life in general.

[cornflakes]

I don't have any good suggestons, but I'm in the same boat as you with my brother and I wish you luck.