Conversation with the daughter of a 85 year old diabetic

Blood sugar test over white background

Interview with Ms. Susan Wong

On her Mum’s diabetic condition, the challenges and how she manages it daily. 

Mother’s age: 85

Location: Shah Alam

a medical doctor or property wester attaches to a patient's blood sugar

Ms. Susan Wong was still young when her mother, Mrs. Wong, was found to have Type 2 diabetes. Ms. Wong said that after the diagnosis, her mother began to live a more disciplined lifestyle. She took her medicines and went out daily for a walk.

But she began encountering problems with mobility later on. As Mrs. Wong grew older, she became less active and it seemed as though her medicines were becoming less effective. But Ms. Wong said the problem might not be due to her mother’s medicines but her increasing inactivity brought about by her advancing age, which made it difficult to maintain a healthy blood glucose level.

Last year, there was an incident where Mrs. Wong felt particularly dizzy. Ms. Wong at work at the time. Mrs. Wong called her daughter up but she could not come home sooner, so Ms. Wong’s nephew picked Mrs. Wong up and took her to the hospital. The doctor found that Mrs. Wong’s glucose level was 30 mmol/L, which was so high. An insulin shot was immediately administered. This was when it was found out that Mrs. Wong’s diabetes had become Type 1, which is different from Type 2 in that with Type 1 diabetes, the body cannot release enough insulin to regulate glucose. With Type 2 diabetes, there is insulin but the body cannot properly react to it.

Below is our conversation with Ms. Wong about her mother’s diabetes:

HomeGP: How has Mrs. Wong’s diabetes affected the people around her?

Ms. Wong: Diabetes hits people of all age, sometimes when they are younger and sometimes when they are older. Someone who is older cannot administer the insulin jab with the same efficiency as the younger ones, who are more independent.

Mama’s diabetes affected everyone in the household, even my daughter who was still in primary school. Someone who is on insulin at her age is not independent enough to administer the insulin injections herself. It was different when her diabetes was Type 2, when she could take medicines herself. Now that she’s dependent on insulin, someone has to always be there to make sure she is all right. We’re afraid to leave her alone.

Diabetes affects the flexibility of our time because have to we manage it around Mama’s injection schedule. When we go out for the day, someone must be home to look after her. If we go out together and we did not remember to bring her insulin with us, we need to come back in time to have it administered on her.

We always need to be on the lookout for hyperglycemia and hypoglycemia, which are states where there is an excess and deficiency of blood sugar, respectively. Sometimes she’s not sure herself or she won’t tell us.

HomeGP: How do you deal with such situations? Can you describe one such instance?

Ms. Wong:  Mama is very obedient when it comes to her doctor’s orders. The doctor instructed that once she has her insulin injection, she has to wait 30 minutes before having her meal. We went out for dinner once and were late to inject her insulin. We insisted that she could have her meal after 10 minutes but she wanted to wait following the doctor’s instructions. As she waited out the half hour according to the doctor’s instructions, her blood sugar went down too low and started feeling dizzy. But her stubbornness persisted and she refused to eat until the 30 minutes was up. When the 30 minutes was up, she had her meal and immediately felt better.

Type 1 diabetics themselves, while observing general guidelines, must be alert, and so must the people around them in order to prevent this from happening. Mama has her meals on schedule but still needs someone to check up on her to ensure that she eats the right food at the right interval because of her old age. She can sometimes be forgetful, lose track of time or is too strict following doctor’s guidelines, so she does not relate being dizzy to her glucose level.

HomeGP: Does her Type 1 diabetes affect travel plans?

Ms. Wong: It doesn’t incapacitate us in any manner. She can still can go on holidays. The insulin that we use is disposable; one tube can stay outside the fridge for one week. So it doesn’t interfere with traveling as long as there’s a refrigerator to keep them chilled.

We just need to look out and keep her sugar level under control and that she takes her insulin when necessary.

HomeGP: How often are the checkups and what were the doctor’s instructions?

Ms. Wong: She has her checkup every 3 months. Initially after finding out she has type 1 diabetes, the doctor gave a booklet in which to record all the food she consumes as well as her blood sugar level everyday. We had to test her blood three times daily, in the morning to get the fasting blood test, then before lunch, and finally, two hours after lunch as the sugar level peaks at that time after consuming a meal.

After a couple of weeks, when her condition became under control, we began testing her blood once or twice a week and recorded it in the booklet.

Now, after a year, we test her blood on a weekly basis and do it in the morning.

HomeGP: Any advice you can give regarding diabetes?

Ms. Wong: We all know the advice but sometimes we don’t know how to follow this ourselves. It’s basically having a well-balanced diet and doing lots of exercise. A friend of mine was diagnosed with Type 1 diabetes four years ago but does not have it anymore. His glucose level went above above 20 mmol/L. He immediately went under insulin medication for one week as prescribed by the doctor. Motivated by fear of this lifelong disease, he changed his lifestyle immediately and cut out all sweet foods and drinks as well as fried foods and began exercising daily — cycling, jogging, hiking, you name it. He wakes up at 5:30 a.m. everyday. When he went for his next checkup several months later, his blood sugar level was back to normal.

There’s also a possibility that the reason he became healthy again was that he had recently retired when he found out that he had Type 1 diabetes. Perhaps his stress was reduced. But it may just be a coincidence. It could be because of the change in his lifestyle that he does not have diabetes anymore or perhaps a combination of these things.

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