Category Archives: medication

Romance

 

Dating and Diabetes

You landed the date. Nabbed a reservation at a nice restaurant. Even wore that fancy shirt that looks great but sort of itches. You’ve thought of everything—except how to divulge your diabetes.

If you’re stressing about when to tell your date about your diabetes (or whether you should keep it a secret after all), take heart. There’s no rule book you don’t know about.

Your comfort level, your date, and a dozen other factors will influence how and when you tell. Still, there are some guidelines you can follow to determine what’s right for you. Read on for tips that’ll help you transition from “Nice to meet you” to “I have diabetes.”

Making It Work

Here is what Kelly has done to best support her health and her relationship over the past 10 months.
Be honest. Kelly has been very honest about her food, exercise, and lifestyle needs to remain healthy. When her sugar levels were a bit elevated after big meals at relatives’ homes, she and her boyfriend, Joe, adjusted accordingly, and Joe was able to speak about portion sizes with relatives. He believes that being open and honest initially about topics that affect you is key to any relationship, and diabetes is no exception.

Teach with patience and love.  Joe liked Kelly’s method of teaching him her processes for maintaining her diabetes. She kindly asked him, “Hey, do you want to learn xyz?” and engaged him in different tasks if he felt comfortable. She taught him how to set up the glucagon pen with an old one (not to worry—it was properly disposed of and not used on her). Essentially, you don’t have to teach that person everything at once. But ultimately, if this person is someone you spend a lot of time with and want to spend the rest of your life with, it is important to determine if you can handle what it takes for
a healthy future.

Patience, patience, patience. Joe cannot tell you how many times Kelly will share a reading with him, and she will ask, “Is that good?” She is the calmest person he has ever met, including when he sees her calmly explain to him how this affects her. Patience is key as your significant other gets a handle on your diabetes.

Take care of yourself. Kelly continues to go to the gym, notes her infusion set changes in her phone, and monitors her blood glucose levels. Her self-care habits are inspiring, and her example has helped Joe to lose weight. As a result, he feels healthier and more confident, and the chain reaction continues to ripple through all elements of their relationship.

Ask for help. It was very helpful when Kelly told Joe about eating habits she wanted his help to improve, such as consuming more fruits and vegetables. Her confidence in him for support has improved the relationship significantly.

Here is what has helped Joe help Kelly manage her diabetes and strengthen their relationship:

Ask questions. You get educated, your worries are eased, and it shows that you care.

Get involved. Joe exercises and encourages Kelly to exercise. They’ll go to the gym together. He eat s well and encourages Kelly to eat well. They go shopping and he’ll fill their grocery cart with foods that her nutritionist recommends. To get involved, you have to be aware of the unique needs of your significant other, so once again, ask questions to see how that person would best like you to get involved.

 Diabetes and dating means doable.

To Tell or Not to Tell

The biggest concern most people with diabetes have is that a date will stop liking them once diabetes is in the picture. Generally, most people are more concerned about that than is reasonable. Which is to say, your date probably won’t be freaking out as much as you are when you mention your diabetes.

True, there’s always a chance you’ll be dumped because of your diabetes, but that’s not likely. And if it does happen, ask yourself: Do I really want to date someone like that? You might meet a person in your life who may be turned off or freaked out about your diabetes, and that might break your heart. It’s going to be a tiny, tiny portion of all the people you’re going to see in your life.

We often project our own feelings about diabetes onto the person we’re dating. If you see diabetes as something to be ashamed of, or if you see yourself as somehow deficient simply because of your diabetes, you may expect others to treat you accordingly. The goal, then, is to work through those feelings until you accept your disease and understand that diabetes doesn’t make you less worthy of love.

In the end, whether you tell a date about your diabetes is up to you. If you’re more comfortable keeping it to yourself, that’s your choice and it’s a valid one. But keeping secret something that affects every aspect of your life may cause problems as your relationship develops. This is especially true if you have type 1 diabetes because it’s harder to hide insulin injections or a pump, and you’re more likely to need to treat lows.

If you’re in a serious relationship, your significant other should be told. To leave your significant other out of that doesn’t lead to an honest relationship. Not only will you be hiding who you really are from someone you’ll increasingly spend more time with, but the lengths you’ll have to go to in order to hide your diabetes can be tiring and cause stress.

The Timing’s Right

There’s no right or wrong time to tell someone about your diabetes, but earlier is generally better. That doesn’t mean you need to reveal it during introductions or even on your first date, but the longer you wait, the harder it will be.

If you wait very long to tell someone, you run the risk of your significant other believing you didn’t have enough trust in them to tell about your diabetes.

Plus, you might devote a great deal of time to a relationship that you wouldn’t want to pursue if your significant other isn’t supportive. Kelly from the story above said that, “My diabetes is such a big part of my life.” It used to take him about five dates to make sure she liked a man enough to talk about her type 1 diabetes. She said, “I want somebody that’s supportive. If somebody gets concerned or scared, that’s a red flag.”

How soon is too soon to tell all? That’s a matter of individual preference. It’s like talking about exes or your previous relationships. You don’t want to give too much information too soon.

 

No Big Deal

Diabetes is a part of who you are, but it’s not who you are, so there’s no need to make a huge deal about it when you decide to broach the subject with your date. Sometimes what you do on your date, such as going out to dinner, will open a window for you to discuss diabetes.

“I didn’t really plan it out, how I did it,” says Kelly. “I said, ‘Oh, by the way, I’m diabetic. I don’t know if you’ve seen me doing this. That’s me checking my blood sugar and giving insulin.’ ” Turns out, Joe, hadn’t noticed her meter or insulin pump but asked her all about his diabetes when she mentioned it.

Remember, your date doesn’t need to know the inner workings of your glucose meter or exactly how to count carbohydrates right off the bat. Simply mentioning it—that diabetes is time consuming but treatable, for instance—will get the ball rolling. Once you mention that you have diabetes, the pressure’s going to be off. Things will come up naturally.

Couple’s Diabetes

Does dating (or marrying) someone with diabetes make for smoother sailing?

One of the advantages of a diabetic couple is that, in day-to-day life, that’s a topic that comes up often.

Your diabetes management may not work for your significant other—and that can cause problems. You may exercise for an hour a day while your partner barely fits in a workout. You have to respect that and just move on. Everyone has a different philosophy.

Crucial Details

Even if you plan to share the bare minimum about your disease, there’s some basic information your significant other should know. Anyone with whom you plan to spend a great deal of time should know about hypoglycemia and its warning signs—and not just because you might get a bit cranky when low. Understanding how to treat a low and what to do in an emergency is important for partners of people with diabetes. Plangetis learned how to give glucagon by practicing with a pillow and one of Dallas’s expired kits.

Teaching a boyfriend or girlfriend how to handle a diabetes crisis isn’t just for those on insulin. That can also apply to diabetes with pills.

 

Information Overload

Think about how long you’ve had to get used to the day-to-day tasks of diabetes. Springing everything you know about diabetes on someone who may have no prior knowledge of the disease can overwhelm him or her.

The best thing to do is take the lead of the other person. If they ask questions and seem to want information, then you can give them all the information they want. If they don’t fire away with questions, it may be a sign you need to move more slowly in sharing aspects of your diabetes.

 

On the Same Page

Consider how involved you’d like your boyfriend or girlfriend to be in your diabetes management. Do you want him or her to avoid the topic completely? Are you looking for someone to push you toward your goals? There’s no right or wrong answer—it’s your diabetes so it’s your choice.

But keep in mind: Your date isn’t a mind reader. If you want the person to avoid foods you can’t eat, or if you need to be held to your exercise goals, you’ll need to spell it out. That’s what Kelly did for his boyfriend  She told him ‘Help me out. My weakness is I have a big sweet tooth.’ She said, “If he’s too intrusive, I’ll tell him.”

As two people become serious, it’s natural for diabetes to play a bigger role in the relationship. The size of that role is up to you, but many people consider their significant other a partner in their own diabetes. “I wanted him to be as supportive and as involved as possible,” Kelly says. “I treat him as if he has diabetes.” The burden is lighter now that they share it.

 

AUTHOR’S NOTE: I made Kelly and Joe up.

 

Marriage and Diabetes 

They said that the first year of marriage is often the hardest. Learning to live as a pair and work as a team when diabetes is in the picture often requires some adjustments, even for the longest-term couples. Here are some tips:

1. Unite as a Team

After planning a wedding and celebrating the big day, then coming back down to Earth, you may find that you have neglected parts of your relationship. Starting off as a married couple means investing in togetherness—even when it comes to tackling diabetes. When one partner is removed from the other’s disease management, it can get in the way of a team approach and healthy relationship.

2. Be Aware of Care

Your partner should not be left in the dark about your diabetes management. For example, Dylan Hardwood-Sanchez, 35 of Virginia, has been married to her husband, Diego, for 2 years. She was diagnosed with  type 1 diabetes as a child. She manages it properly by following a healthy diet. It’s up to the person with diabetes to educate their partner in the care of their health. If a partner is willing to attend an educational program or [a] session with a diabetes counselor, that would be a huge step forward for the couple.

 

3. Have Patience.

Vicki Palermo, late 30s, of , has been living with type 1 diabetes since she was a child. Her husband, Sam Robinson, doesn’t have diabetes, so his learning curve has been a bit steeper (the couple has been together since 2020 and married in 2030). “Life with diabetes, or a new life with a loved one with diabetes, is like learning a new language,” Robinson says. “There are lots of new terms, new tools, different meanings, and jargon to learn.” Sam read all kinds of things about diabetes, but that was only part of the story.” His cousin, Maria also had type 1 diabetes. Talking about expectations for both partners, as well as any assumptions either might have, has helped the couple navigate life together.

 

4. Set Some Rules

Katie Marceau, a book editor, said that she and her husband, TJ set ground rules for how they would manage her type 1 diabetes as a shared responsibility. When TJ thinks she’s low, he has permission to tell her to check her blood glucose, no questions asked, and Katie will comply. But they also have boundaries. There is a risk for the partner without diabetes to become the “diabetes police,” over-managing the spouse’s health—and likely frustrating both. Allow people with diabetes to make their own decisions about their diabetes management. It’s important that the person without diabetes … be flexible and understanding.

5. Safeguard Reproductive Health and Pleasure

Problems with blood glucose control can affect intimacy in the bedroom, too. Men with diabetes, especially those with poor glucose control, can develop erectile dysfunction. Women with diabetes who are trying to get pregnant should aim for excellent glucose control—an A1C as close to normal as possible—and should have their thyroid function tested before trying to conceive. Women may face urinary tract infections, experience pain during intercourse, or require additional time to become aroused. If your spouse begins to have sexual issues, don’t take them personally. There are effective treatments. Talk to your health care provider about what may work for you and your spouse. And if one doesn’t work, try another. Intimacy is a very important area of your life together. You don’t have to say farewell to it just because one or both of you have diabetes.

 

AUTHOR’S NOTE: I made those people up.

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Overmedication & Hyper-and Hypoglycemia

No matter what the reason (i.e. concerns over high glucose levels), overmedicating is extremely dangerous. The health risks are severe hypoglycemia or diabetic shock. Insulin reaction can occur anytime there is an imbalance between the insulin in your system, the amount of food you eat, or your level of physical activity. It can even happen while you are doing all you think you can do to manage your diabetes.

The symptoms of diabetic shock may seem mild at first, but they should not be ignored. If it isn’t treated quickly, hypoglycemia would cause you to faint, requiring immediate medical attention. Diabetic shock can also lead to a coma and death. It is extremely important that not only you, but your family and others around you, learn to recognize the signs of hypoglycemia and know what to do about them. It could save your life.

Do not be overly concerned over your glucose levels unless you’re getting too many lows or highs.

Sometimes it’s better to be high than low because nothing happens to you, but too many highs equals hyperglycemia if you don’t treat it properly.

Causes of Hyperglycemia:

  • If you have type 1, you may not have given yourself enough insulin.
  • If you have type 2, your body may have enough insulin, but it is not as effective as it should be.
  • You ate more than planned or exercised less than planned.
  • Illnesses
  • Stress
  • You may have experienced the dawn phenomenon the early-morning (4 a.m. to 8 a.m.) rise in blood glucose level. (a surge of hormones that the body produces daily around 4:00 a.m. to 5:00 a.m.).
  • For women—PMS, the actual menstruation period, or when the period ends
  • Sitting down for a long time
  • Long time between meals without insulin
  • Skipping insulin shots or taking diabetes pills

 

Symptoms:

  • High blood glucose
  • High levels of sugar in the urine
  • Frequent urination
  • Increased thirst or hunger
  • Dry skin or mouth
  • Blurry vision
  • Feeling sleepy

 

Check your glucose often. Ask your doctor how often you should check and what your blood glucose levels should be. Checking your blood and treating high blood glucose early will help you avoid problems associated with hyperglycemia.

Failure to treat it properly leads to a condition called ketoacidosis (diabetic coma) could occur. Ketoacidosis develops when your body doesn’t have enough insulin. Without insulin, your body can’t use glucose for fuel, so your body breaks down fats to use for energy.

  • When your body breaks down fats, waste products called ketones are produced. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Unfortunately, the body cannot release all the ketones and they build up in your blood, which can lead to ketoacidosis. Ketoacidosis is life-threatening and needs immediate treatment.

Symptoms:

  • Shortness of breath
  • Breath that smells fruity
  • Nausea and vomiting
  • Very dry mouth Talk to your doctor about how to handle this condition.

Failure to treat hyperglycemia properly also leads to long-term problems with your:

  • Heart and blood vessels
  • Eyes
  • Kidneys
  • Nerves
  • Teeth and gums
  • Skin
  • Feet

In order to prevent hyperglycemia and those long-term problems, practice good diabetes management and learn to detect hyperglycemia so you can treat it early before it gets worse.

 

Causes of hypoglycemia:

  • Becoming more physically active than usual
  • Skipping a meal
  • Not eating enough
  • Changing when or how much you normally eat
  • Taking your insulin or medication at a different time than usual
  • Taking certain medicines
  • Overmedicating
  • Drinking alcohol excessively without eating

The symptoms of hypoglycemia can be classified as mild or early, moderate, and severe. Mild symptoms include:

  • Dizziness
  • Irritability
  • Moodiness or sudden changes in behavior
  • Hunger
  • Shakiness
  • Sweating
  • Rapid heart beat

Moderate symptoms include:

  • Confusion
  • Headache
  • Poor coordination

When hypoglycemia becomes severe, symptoms include:

  • Fainting and unconsciousness
  • Seizures
  • Coma

Hypoglycemia can also occur overnight while you sleep. Symptoms include:

  • Crying out in your sleep
  • Nightmares
  • Damp pajamas or sheets resulting from perspiration
  • Waking tired, irritable, or confused

If you experience any possible signs of hypoglycemia, check your blood sugar to make sure it isn’t 70 mg or below. If it is, you should treat it quickly or seek emergency care. If you can’t check your blood sugar level for some reason, you should go ahead and treat yourself for low blood sugar if you notice symptoms or seek emergency care. If symptoms are moderate, severe, or you are unable to help yourself, seek emergency medical attention.

If your hypoglycemia is mild or moderate, the best way to raise your blood sugar level quickly is to eat or drink some form of sugar. You might take glucose tablets, which you can buy at the drug store. Or you may want to drink a half cup of fruit juice or eat five to six pieces of hard candy.

Other snacks you can use to raise your sugar level include:

  • One-half cup of regular soda — not diet
  • Cup of milk
  • 1 tablespoon of sugar
  • 1 tablespoon of honey
  • One-quarter cup raisins
  • 2 large or 6 sugar cubes dissolved in water
  • 3 glucose tablets

You can also ask your doctor or dietitian for recommendations for other snack items that can help raise your blood sugar level when you need to.

After you’ve taken a snack, wait 15 minutes and check your blood sugar level again. If it is still low, eat another snack, then wait 15 minutes and check it again. Repeat the process until your blood sugar level is in its normal target range.

If you lose consciousness, you will need immediate medical attention. It’s important that you educate the people in your family and the people you work with about diabetic shock and about what to do if it happens. Someone should call 911 or arrange to get you to an emergency room if that’s not possible. Untreated low blood sugar can become severe and cause you to pass out.

Ask your doctor to prescribe a glucagon rescue kit and then teach others how to use it. Glucagon is a natural hormone that rapidly causes the level of sugar in your blood to rise. If you are unconscious, someone injecting you with glucagon even before emergency help arrives can prevent further complications and help you recover.

In order to prevent diabetic shock or hypoglycemia:

  • Understand the medication you are using, whether it is insulin or a pill that increases the body’s production of insulin. Ask your doctor how and when to take the medication and be sure to always take the recommended dose at the recommended time. Also ask your doctor to explain when you need to make adjustments to your medicine when there is a change in your schedule or routine or when your A1C is too high. DO NOT OVERMEDICATE EVER!
  • Be sure to follow your meal plan, eating the right amount of the proper food at the right time. Don’t skip any meals or snacks, especially before going to sleep or exercising. Discuss your snacks with your dietitian. Some snacks may be better than others at certain times for preventing hypoglycemia. During periods of more intense physical activity, be sure to eat more carbohydrates.
  • Be sure to check your blood glucose level routinely according to the plan you’ve worked out with your doctor. Also check it before you begin to exercise and at regular intervals during exercise or other exertion. And check it again after you’ve finished any physical activity.
  • Discuss your use of alcohol with your doctor. Your doctor can help you understand how to drink safely so you don’t increase your risk of hypoglycemia.

Because hypoglycemia can occur quickly at any time, always be sure that you carry with you or have quick access to snacks that raise your blood sugar. Never drive a car if you have hypoglycemia or suspect it is coming on. Diabetic shock can cause you to pass out behind the wheel. If you are driving and notice symptoms, stop and check your blood sugar. If it’s low, take a snack and don’t start driving until the level is back in the normal range. Wear a medical ID bracelet or carry a card that identifies you as having diabetes. Be sure the card says what to do if you’ve become unconscious. Be sure your family members know what hypoglycemia is and what not to do — give you insulin, put their hand in your mouth, try to give you food or fluids — if you pass out.

The most important precaution is to always follow the diabetes plan you’ve worked out with your doctor. Not only will it lower your risk for hypoglycemia. It will also help prevent long-term, major complications. Adjust your diabetes plan if you have low blood sugar often.

Medical IDs: Many people with diabetes, particularly those who use insulin, should have a medical ID with them at all times. In the event of a severe hypoglycemic episode, a car accident, or other emergency, the medical ID can provide critical information about the person’s health status, such as the fact that they have diabetes, whether or not they use insulin, whether they have any allergies, etc. Emergency medical personnel are trained to look for a medical ID when they are caring for someone who can’t speak for themselves. Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record for use in an emergency.