The Diabetic Partner Follies, Act 10: When Partners Clash Over Doctor’s Care

Welcome back again to the Diabetic Partner Follies, where the significant others of the PWDs (people with diabetes) are invited to vent. This week, we feature another double-diabetic household, in which one is none-to-happy with the other’s medical providers. A new kind of sticky wicket. Hopefully, you all out in the Community can offer some advice here. (And remember, if you’d like to submit a post, email me here.)

So, Amy, you haven’t heard from me for a while, here’s a question or a rant or whatever you want to call it:

We’re both type 2s, about 8 years from diagnosis, and married 3 years. What’s a person with diabetes, married to a person with diabetes, to do when one partner is unhappy with other partner’s diabetes management, and with the other partner’s doctor?

I know that there is a standard of care that is recommended for diabetes, and that in each state, any doctor may be reported to the governing authority for failing to meet the standard of care in any particular case, not just diabetes. My state board says that they may investigate issues of “Quality of care” meaning inappropriate or substandard care.

So, is letting my beloved go for years (3+ years) with an HbA1c of 8.8 or greater substandard care? Is putting him on a course of oral steroids without adjusting his medication for the known and expected increase in blood sugar levels, is that substandard care? Is prioritizing treatment of annoying or uncomfortable medical symptoms over his diabetes, which could be developing potentially life-threatening complications, is that substandard care? I sure think so.

In my case, my relationship with my physician is a partnership, pre-dating the marriage, with input from both of us. We make a plan, we work the plan for a while, we run tests and evaluate the results, and repeat, as necessary.

Since my partner does not invite me in to his medical appointments, I have no idea what their relationship is. Is my partner overruling the doctor? Has the doctor lost all hope of affecting my partner’s behavior? What is going on?

Trust is one of the bases of any good and healthy relationship. How does living in a double-diabetes household affect this? I trust my own diabetes self-management plan. I trust my own diabetes knowledge. I trust my own choices, both good and bad. But it’s harder to trust his. The blame tends to land squarely on the physician, because it’s easier to blame this outside physician than my own beloved.

I don’t want to be the diabetes police. I want to trust my beloved. It’s just hard to do when I see this as threatening our long and happy life together.

– L.R.
Portland, OR

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3 Responses

  1. vicki
    vicki December 3, 2006 at 9:26 pm | | Reply

    IMHO, a doctor who allows an A1C of 8.8 to continue IS doing the patient great harm. Even the ADA’s too-high standard is an A1C of 7, which will still allow complications to develop. And yes, putting him on steroids without adjustment of meds for the increase caused by those meds is clearly substandard also. I think you have a clear basis for complaint.

    But first, can you get your husband to read a GOOD book on diabetes care? I would suggest Gretchen Becker’s book on type 2 diabetes called

    “The First Year, Type Two Diabetes, An Essential Guide for the Newly Diagnosed”

    Your beloved may be well past his first year but it sounds like his diabetic education is sorely lacking.

    Good luck!

  2. Misty
    Misty December 4, 2006 at 1:37 pm | | Reply

    Your husband is most likely still in denial. Denial can last a long time for some people.

    Some people just are not willing to change their way of eating and think nothing will happen to them.

    His doctor may not be aggressive enough and/or has a non-compliant patient.

    Some patients are not willing to give up/reduce amount of foods they love in order to bring BS under control or exercise on regular basis.

    Your husband is the only one that can do anything about his diabetes. He can take pills until he turns to a pill but that will not solve the diabetic problem. It takes a lifestyle change in eating habits, portion control and exercise alone or along with meds to succeed.

    If your husband is in control of what he eats, portions, and exercises, then you can start blaming the doctor for not being aggressive enough.

    First of all put the blame where it needs to be, on your husband.

    You can nag and nag but it will do no good. In fact the more you nag the more rebellous a spouse will be.

    If your husband has not seen a “Diabetes Educator”, he needs to. The educator will go over the foods he likes, dislikes, explain how to count carbs, tell him how many carbs to limit his meals to, how many carbs for a snack, etc. In many cases we have to reduce number of carbs per meal an educator allows in order to keep our BS from going too high. I was allowed 42 carbs per meal but my body can only handle 32 carbs per meal (diet/exercise only control).

    The best thing you can do on on the home front is to provide good nutritional meals, enough for two servings only when possible so there is no extra for second servings. Keep the kitchen free of no-no foods which will make it less tempting.

    One thing I do is cook the meal, put extra into serving size containers and toss in the freezer for later before we eat. This eleminates second serving from being available.

    Get your husband to join you in taking a walk after meals. Don’t tell him he needs to walk, just ask him to join you while you walk.

  3. Jack Sprat
    Jack Sprat December 7, 2006 at 12:51 pm | | Reply

    There is so much information about Type II diabetes and much of it seems conflicting. Some say that diabetes can be reversed or “cured”; others say that it is a chronic condition. Usually the ones who say it is chronic are doctors (who may or may not have an agenda). I must admit, I find it suspect that the first strategy by most doctors is to recommend medication, often without giving a diet and exercise program a chance. As a result, many people with diabetes do not lose weight, exercise or change their eating habits because they think the medication is treating the disease. This makes me think the medical and pharmaceutical industry is using diabetes as a way to make money and not cure people. What is the real truth?

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