The first time Bill Charles really understood the challenges for people like his wife, Tannis, who lives with type 1 diabetes, was more than 25 years ago when the couple travelled to England. “We were both exhausted when we got there and had a nap. I woke up to Tannis being in a state of confusion. She was sweating and disoriented, and I didn’t have a clue as to what to do. I didn’t know if she needed insulin or something sweet to eat. I gave her a Kit Kat bar and it turned out to be the right choice. Then I called emergency services. Afterwards, we had a discussion about what I should do if it happened again.”
It did happen again. And again. And each time Bill has been able to help Tannis get through a hypoglycemic event, also known as a low. “I know that as long as I give her a couple of dextrose tablets, within 20 minutes her brain function will return and things will be okay.” He adds,
Some people who have diabetes don’t want their spouse or family member involved and don’t do a good job of keeping them informed about the challenges they are facing. It’s important to have good communication.
Before she started using the newer insulins (which provide better control), Tannis had nighttime hypoglycemia unawareness, meaning she could not tell when her blood sugar was low. “Bill has saved my life repeatedly,” says Tannis, who was diagnosed at the age of 10. “He’s aware of what to do when I experience hypoglycemia [low blood sugar] in the middle of the night.”
One hard lesson Tannis has learned is never to ignore the signs of low blood sugar. She was in a hurry one day at the grocery store, and ignored the warning signs as she packed her bags into her car. An alert staff person noticed that she was acting disoriented and called an ambulance. Bill arrived before then, helped treat her hypoglycemia, thanked the staffer and took Tannis home. “I have not postponed treatment since that incident,” she says, adding,
It’s important to be open with the people in your life and to let your spouse know how you are managing. I keep Bill informed and he’ll often set a timer on his phone to remind me to check my blood sugar.
There is no doubt that Bill’s support has helped Tannis live well with the disease. And, he says, “diabetes has actually made our marriage stronger.”
The couple, who live in Winnipeg and have two grown children, made a presentation on diabetes and the family at the 2019 Diabetes Canada/CSEM Professional Conference last fall. They were joined by Tiffany Shepherd, a clinical health psychologist at Halifax’s Mumford Professional Centre (part of the Nova Scotia Health Authority), and by Diana Sherifali, an associate professor in the School of Nursing at McMaster University and a clinical nurse specialist in the Diabetes Care and Research Program at Hamilton Health Sciences. Here is some advice from the quartet for how families can best help a loved one with diabetes.
1 Understand the challenges of your family member with diabetes “With diabetes there are blood sugar numbers that people are told need to be achieved, and when this doesn’t happen people can feel like a failure,” says Shepherd, who adds,
Many of us would struggle with the amount of time and effort it takes to manage diabetes 24/7. There are no breaks or holidays.
2 Recognize that it is normal to worry Family members may have many different fears, including what to do in the case of a low and possible future complications. “The burden of diabetes can weigh heavily on families, and can also include worries about the financial burden and the general emotional roller coaster of living with a chronic condition,” says Sherifali.
3 Get educated “There is a lot of education required to understand diabetes and there’s a big workload involved in managing it,” says Shepherd. “It’s a steep learning curve and family members are faced with that same learning curve.” Going with a family member on visits to healthcare providers and/or enrolling in a diabetes education class can connect family members and help them feel better prepared for challenges.
4 Use technology as a resource Tannis began using a flash glucose monitoring system as soon as it became available in Canada in the fall of 2018. It provides immediate blood sugar readings with a scan of a hand-held reader or smartphone against a sensor that is worn on the back of the upper arm for up to 14 days. Tannis has set Bill up to receive the sensor readings, so he can see the result no matter how far apart they are. “One of our coping strategies is that if I do a scan and get a low, I will send Bill a text to tell him that I’m sitting down for a glass of juice or that I’m not driving. And I also let him know that I will send him another scan in half an hour.” Bill also once used the “Find My iPhone” app to track Tannis’s location when she became disoriented while out doing errands.
5 Support each other in creating and maintaining healthy habits “Diabetes presents opportunities for families to come together. The important point is for family members to understand what is supportive to the individual living with diabetes,” says Sherifali, adding, “It helps if everyone is on the same page.” For Bill and Tannis, that means a healthy diet. “The way we eat—lots of high-fibre foods, grains, veggies, and fruit—is beneficial for our family,” says Bill. Shared activities also help them maintain a strong relationship and good health. They travel to Europe regularly and work as a team in the kitchen. “Bill does most of the cooking, and I do the baking,” says Tannis.
6 Be a role model Eating right, getting enough exercise, and taking medications as prescribed can be a struggle for anyone, not just people with diabetes. “It’s hard for all of us to get out of bed to exercise when it’s cold and rainy and to turn down pleasurable foods,” says Shepherd. “If someone in the family has diabetes and needs to change their behaviour around their health, family members can also consider how they themselves are managing their own health.”
7 Check in, but do not nag While it may be tempting to monitor and take on the responsibility for another adult’s management of diabetes, it is best to resist this instinct. Sherifali says,
Family members may think that ‘reminding’ is helping, but it can easily become annoying very quickly. Healthcare professionals can be a source of support to help mediate and facilitate communication.
Shepherd adds that some of her patients with diabetes have agreements to check in with family members on a regular basis so they will not worry as much. For example, students in university may agree to send a couple of text messages a week to their parents to let them know how they are.
8 Find your own coping supports This can include physical activity, satisfying hobbies, and support groups when needed, says Sherifali. Visit Information and Support to find out what is available.
9 Talk often and openly “From the time my children were young I would explain to them what was happening to me, and now I’m doing the same thing with my grandchildren,” says Tannis.
10 Offer unconditional love and support “People with diabetes are generally doing the best they can and want to feel accepted even if their management isn’t perfect,” says Shepherd. “Let them know you love them and are there to support them, and to remember that they aren’t their disease.”
Looking for another way to support your loved ones who live with diabetes? Urge your provincial government to provide coverage for Flash and CGM devices and give many people with diabetes the opportunity to live safer, longer lives. Send a letter to your government representatives today.
Did you know?
2021 marks the 100th anniversary of the discovery of insulin. Today, more Canadians have diabetes than ever before. Diabetes or prediabetes affects 1 in 3 Canadians. One in 2 young adults will develop diabetes in their remaining lifetime. We can’t wait another 100 years to End Diabetes. #LetsEndDiabetes Visit 100 Years of Insulin to learn more, including how you can support those living with or at risk for the disease.
(This article appeared in Diabetes Dialogue, Spring 2020)
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