My friend is in trouble. Any diabetic nurse educators out there?

stidget99 · Jul 1, 2005

Here you have an intelligent woman who knows the consequences of being non-compliant. Seems to me that she has made her decision and nothing you do will convince her to follow the prescribed diet. I know it's difficult but you have no choice but to sit by and watch her deteriorate. It's sort of like a COPD'er or a lung cancer pt who continues to smoke. What can you do????

grannynurse FNP student · Jul 1, 2005

I am looking for a diabetic educator or anyone else familiar in the care of diabetus. I have a very close friend of 58 who has tyoe 2 diabetus. She has had it for many years. She is overweight, and she has already had heart bypass surgery. She simply cannot stop eating sugar. She says it relieves her stress, and she can't stop. Now her sugar has reached 300. The diabetic nurse educator told her that her dr. wants her on Byetta, and if she continues to eat sugar, she will have to take insulin. These are my questions.
1. What do I tell a person who says she can't stop eating sugar when she is a diabetic and knows the consequences. I am talking about an educated person who has already had open heart surgery due to her diabetus. She is going to a nutritionist. She doesn't listen to the nutritionist.
2. She is afraid to take Byetta. She says that she is afraid to inject herself with something that she says looks like a pen. Can anyone describe how this is injected. I told her I would help her, but I am not working, and I am not familiar with this.
3. Can anyone tell me some positive things about this medication that I can tell her so that she will take it.
I honestly feel like she can't control her eating, and she has just given up. If anyone can offer me any advice, I would appreciate it. She tells me that it is an addiction ,and she just can't stop herself from eating particularly sugar! I am really worried about her.

As an insulin dependent diabetic and a formerly overweight individual, there is little you can do. You certainly should not sit in judgement of her or talk to her about her failure to control her blood sugar. Until she wants to take control, there will be a great deal of resistence. I took conrol after my health began to deteriorate. She will have to reach that point. Her diet is an addiction or at the very least a form of addiction. She needs to hit bottom. :crying2:

Grannynurse :balloons:

icuwant2rn · Mar 19, 2006

I feel you. My ex- brother-in-law is a diabetic who refuses to change his eating habits. He is already on oral insulin, but refuses to take responsibility for changing his lifestyle. I am in the process of writing a report on type 2 and intend to give him a copy of it along with the number of a good nutritonist. After that, it is up to him. You can only help those that want help.

SuesquatchRN, BSN, RN · Mar 19, 2006

One of the things I really, really have to work at is not being judgmental about non-compliant diabetics.

Granny's post helps. I certainly understand addiction, as I avoid alcohol and nicotine as if they were, well, addictive substances to which I'm addicted. It's very hard for me to see sugar as being the same thing, but then, how the heck else do you explain the denial of someone 600 pounds who is insisting that they don't eat too much?

You can't make a person who doesn't want to change change. When I was smoking people would say the most idiotic things to me. "Do you know that's bad for you?" I'd answer, "No XXXX? Well, thank you. I'm going to throw these away right now because I had no idea. I've been on Mars for the last 25 years."

Let her alone.

grannynurse FNP student · Mar 19, 2006

One of the things I really, really have to work at is not being judgmental about non-compliant diabetics.
Granny's post helps. I certainly understand addiction, as I avoid alcohol and nicotine as if they were, well, addictive substances to which I'm addicted. It's very hard for me to see sugar as being the same thing, but then, how the heck else do you explain the denial of someone 600 pounds who is insisting that they don't eat too much?
You can't make a person who doesn't want to change change. When I was smoking people would say the most idiotic things to me. "Do you know that's bad for you?" I'd answer, "No XXXX? Well, thank you. I'm going to throw these away right now because I had no idea. I've been on Mars for the last 25 years."
Let her alone.

There are many reasons for an individual to be non-compliant in the treatment of a chronic disease. One of the reasons that a good many do not comply is because of the lack of their involvement in the planning and treatment of their disease. They are handed a scrip, a diet, told to exercise more and prehaps a referral to a nurse educator. And they are told all the bad things that will happen to them if they fail to take charge. It all sounds so simple doesn't it.

Grannynurse:balloons:

Long Term Care Columnist / Guide · Mar 19, 2006

As the saying goes: You can lead a horse to water, but you can't make him drink.

Your friend undoubtedly knows the consequences of continuing to eat as she does. (Knowing and doing are two different things, however.) I can tell you from personal experience that food addiction is THE hardest addiction to overcome because while one can stop drinking, smoking, doing drugs etc., we can NOT stop eating! And sugar is everywhere........even in things like low-fat salad dressings, breads, rice, and other so-called 'healthy' foods. It's not just candy and cake that get the diabetic into trouble---all refined/processed foods contain simple carbohydrates, which drive blood sugar up almost as efficiently as a Snickers bar.

Yes, I agree that education is valuable, and your friend may very well benefit from it. But pressuring her to change, no matter how well-intended, is guaranteed only to drive her to the refrigerator. Just let her know that you care for her unconditionally, and will support her no matter what.

BTW, I loathe the term 'noncompliant'........it implies a judgmentalism that has no place in nursing practice.

Just my 2 cents worth.

Nurse Ratched, RN · Mar 19, 2006

The original post is 8 months past - I wonder how the person is doing?

krisssy · Apr 6, 2006

The original post is 8 months past - I wonder how the person is doing?

Oh thank you so much for asking. My friend decided to take the Byetta. It has helped in that she feels better when she awakens in the morning. But, it has not helped with her diet problems at all. She told me she has no desire for meals-only snacks. She has an appt. with another nutritionist, but she has tried that route before, and it never worked. This is just like an addiction to drugs. She knows she is hurting herself, but she can't stop. I am reading a very interesting article called the Trantheoretical Model of Health Behavior Change. It is written by James O. Prochaska and Wayne f. Velicer. I will get back to you when I finish reading this article, but so far it seems like a new idea for changing addicting habits that are bad for one's health. One of the main issues is that there are steps to change, and if you try a certain process before the patient is ready, it won't work. I will get back to you about it. If you are interested in reading the article, it was in the American Journal of Health Promotion 1997-volume 12 (1)38-48. I am pretty sure that I read that it was revised after the first printing.

Krisssy

krisssy · Apr 6, 2006

As the saying goes: You can lead a horse to water, but you can't make him drink.
Your friend undoubtedly knows the consequences of continuing to eat as she does. (Knowing and doing are two different things, however.) I can tell you from personal experience that food addiction is THE hardest addiction to overcome because while one can stop drinking, smoking, doing drugs etc., we can NOT stop eating! And sugar is everywhere........even in things like low-fat salad dressings, breads, rice, and other so-called 'healthy' foods. It's not just candy and cake that get the diabetic into trouble---all refined/processed foods contain simple carbohydrates, which drive blood sugar up almost as efficiently as a Snickers bar.
Yes, I agree that education is valuable, and your friend may very well benefit from it. But pressuring her to change, no matter how well-intended, is guaranteed only to drive her to the refrigerator. Just let her know that you care for her unconditionally, and will support her no matter what.
BTW, I loathe the term 'noncompliant'........it implies a judgmentalism that has no place in nursing practice.
Just my 2 cents worth.

The article that I just described says the same thing about words like non compliant. I will get back to you about what they said exactly later.

Krisssy