Someone expert in diabetes II?

We know my mother has had diabetes for at least 15 years. Her sight is rather good, no feet problems. But she looks sick, tired and older than her real age. Honestly, she does not quite adhere to her medication and food habits, she loves drinking normal coke.
Her major problems are teeth problems (has lost some pieces) and some kidney infections.
As I said, it is a challenge for her to follow good eating habits and adherence to medication.

How can I help her to adhere to medical treatment and improve eating habits? What about the prognosis for already present problems like teeth and kidney? Of course, the doctor will have to see her. But how are your experiences in similar cases?
Thanks.

Hmmm. The key to measuring how successful she is with her diabetes rests with measuring her HgBA1C. That is the best marker of her diabetic status. Other markers are measuring her urine microalbumin, urine surgars and ketones, as well as BUN and Creatinine clearance. These are markers for kidney function.

The main areas of concern are kidneys, eyes, vasculature of her lower legs and nerves of her lower legs. These will be the things that go bad first. Without good compliance with her meds and diet, her liklihood of developing secondariy problems: blindness, non-healing foot ulcers that lead to amputations, kidney failure, etc are all increased. Her teeth issues are less from the diabetes and more simply from the amount of coke she drinks. Having such poor dentition puts her at risk for other types of infections not related to the diabetes.

What you can do... take charge of her health.... if she insists on drink coke, limit the amount she can have in a day. ensure she otherwise eats healthy. Give her her meds to take and make sure she takes them. Check her feet frequently for sores or discoloration... these are signs of poor circulation: peripheral vascular disease. And lastly, she needs to see her doctor no less than every three months for continued evaluation: labs, physical, etc. If she is not willing to do at least this much, then she is resigning herself (and her family) to a significant health care issues down the road that someone will have to step up to assist her with.

Sorry about the forboding tone... but diabetes is a VERY serious illness.

Good luck. Peace

The way I read it Frank your asking how to get your mother to do what she is supposed to do. If I am right then here is my best advice. To form a habit you have to do something for around a month. If you were to give her her meds at the right time every day for a month then maybe she would feel better and do it herself. The food thing is harder lead by example. And if you live with her it would be easier to make some of the meals for her. After she does all this for a month it will become a habit and she will see how much better she feels and hopefully stick with it. Good Luck.

its vital she takes care of her kidneys. alot of medications (especially diabetes including insulin) are excreted out of the body through the kidneys.

Honestly? Not very good. It's been my experience that unless a diabetic really wants to control herself, she will not do it very well. It takes a lot of self-discipline to eat right, exercise, have regular checkups and maintain a level blood sugar--and most diabetics fall off the wagon over and over again. It's just too tempting sometimes to eat that second piece of cake, or drink that coke.

You can ask her to make one change at a time. Nothing else--just one change. Tell her that you love her and you're concerned because she doesn't look good, and you want to help. She may be receptive. If she is, then just do ONE thing--and have her do it until the new habit is fully established. For instance, you can have her walk around the block after dinner every other day. Or drink half real coke and half diet coke for two months, then cut down the real coke again by half, and so on until she's only drinking diet coke. Or you could make lunch for her twice a week--something vegetarian and lean, instead of what she might fix for herself.

By making the changes small, one at a time, and keeping up with a good attitude, you might get her to change her habits. It won't be overnight, and it might not even be enough to stave off some of the worst effects, but it will be worth a try.

In the end, however, it is really up to her, not you or anyone else, to WANT to change and be healthier.

Also, when she slips up--and she will--don't criticize or get upset. Just smile and say something like "well, that's fine--everyone deserves a break now and then" and then go right back to the better way immediately. Keep track of her "slip ups" though--because you may need to show her that she's slipping up way more than just "occasionally" if she uses that argument sometime down the road.

It's really a tough road. We all screw up now and then (I did today! Big time!) but tomorrow I am back to my healthy diet and exercise schedule. No fail. I don't want to end up a statistic like most diabetics.

I wish you a lot of luck with your mom--you obviously care and that's a good thing. Make sure her affairs are in order and help her as much as you can. That's really all you can do.

This is really the big question, how to "motivate" diabetics to take care of themselves. Unfortunately, diabetics usually feel OK even when their control isn't very good, which doesn't help. Also, you cannot "motivate" another person, they have to find it within themselves. However, here are some things that can help:

1. Understand that we diabetics are constantly blamed for our disease, and if we put something in our mouth that has sugar in it we are chastised even though we shouldn't be. This tends to produce a rebellious reaction in many people, kind of a "I don't care what anybody tells me to do, I'm going to do what I want" way of thinking. By helping her understand that she didn't deserve to get diabetes and that it's just the breaks and something she'll have to live with, that might take the edge off. The key is to help her realize that she is in control of her disease, not her doctor, not her family, just her.

2. Help her establish some long-term goals. Diabetes can cause depression and hopelessness, to the point where we feel like no matter how hard we work at it, our blood glucose isn't always where it should be, and it's defeating at times. Help her develop some hobbies and interests that make her think towards the future.

3. Learn everything you can about diabetes. Things have changed so much just in the last 10-20 years, so make sure your information is up-to-date. Diabetics are no longer forbidden from eating sugar, it's all about carbohydrate counting and staying within a certain limit, such as 30g or 40g per meal. Sometimes just minor changes like eating only half of a sandwich instead of a whole one and adding some veggies is all that's needed to make her diet "diabetes friendly". And snacks are OK, too, again just try to encourage lower-carb and lower-fat ones. But an occasional "bad" treat is OK, just keep an eye on things.

4. Get her exercising. It naturally lowers blood glucose and increases positive hormones that give a sense of well-being.

5. Make recurring appointments with a Diabetes Educator (see her doc for a referral) and attend with her. They know way more than the docs do, and their focus is on helping you succeed, not beating you down for being a "bad diabetic". They can help her identify blood glucose patterns and make adjustments in medications or exercise to correct them. Having you with her to maybe take some notes and ask questions would be very helpful. They are a godsend and I wouldn't do without them - I see one every few months.

6. Get her switched over to Diet Coke or Coke Zero (tastes just like real Coke!) by mixing it with real Coke for a few days, and gradually increasing the percentage of diet until you're at going full strength. If you do it in baby steps, the conversion will be easier. Then she can have the freedom of drinking all she wants! More water would be good, too, especially with her teeth, but it would be a big improvement.

7. No scare tactics like mentioned above! They don't work and just cause depression!

When I was first diagnosed, I went through the denial stage, and did not watch my diet. I even quit taking my meds all together for about a year. I developed gum disease and started loosing my teeth. I looked like 3rd shift at the Waffle House. I had to have all of my teeth removed and get dentures. My doctor started to worry about my kidneys. I felt like crap, although I would not tell anyone, and did not look so hot either. The infection I had from my teeth was all through my body, and took its toll on my looks. Finally, my daughter, (who has type 1) sat me down and had a long talk with me. It was strange that I took such good care of her and her diabetes when she was growing up, but I would ignore my own disease. Slowly, I got my act together. I have gone through a great transformation since then. I feel better, look better and take care of myself. I have no problems with my kidneys. Take your mom to a few diabetic educational classes. At first I went to a few with my daughter. Three years ago, I decided to start going to them on a regular basis because there is so much diabetes in our family. Now I go once a month . I learn something new every time I go. Get her an appointment with a dietitican or nurtritionist to help her with her meals. Every diabetic should have a nutritionist that she can go to when she has trouble with food. Limiting carbs in the diet is one of the most important things for a diabetic. You, your mom and her doctor are going to have to work this all out. She is going to have to be willing to do it, or nothing will work. Her health is at stake. She could get kidney failure, heart disease, heart attack, stroke, blindness, amputation of limbs from gangrene, just to mention a few things. Take her to a old folks home and show her patients that have complications from diabetes, so she can see it for herself. Bottom line is that all the help in the world will not work if your mom is not willing to take care of herself. You will have to have the talk with her like my daughter did with me. You could get her on the South Beach diet. Many nutritionist suggest it for their diabetic patients. Skip phase 1 and start with phase 2. It is a very healthy, easy diet, and will teach about good and bad carbs. It has lists of things you can and cannot eat, and includes lots of recipes. I use it all the time. It does not require "special" foods, just the things you usually have in the house. But your mom is going to have to get some education about her disease, and classes are the best way to do it. You can ask questsions and get good answers..Good luck.