October 26, 2015

Unmanaged Diabetes Equals Complications

Barry called yesterday and said he had an acquaintance with a problem. He said Allen was on the way and asked for my help also. When I arrived, Barry said that a blood glucose meter reading he had given the person said “High.” I suggested that he be taken to the hospital and the person said “No Way.”

I asked what type of diabetes he had and he said type 1. I asked when he had last taken insulin and he said he was out and had not taken a shot since the morning before. At that point I said he needed to go to the hospital as he could develop diabetic ketoacidosis and without emergency treatment he could die. What he said next shocked all three of us. He said that is the plan.

We looked at each other and I said he was going to the hospital whether he wanted to or not. When he refused, Allen called 911 and the ambulance and police were there very fast. Thank goodness for the police as he was very combative. Allen explained what was happening and when they had him restrained, he started convulsing. He was loaded into the ambulance and Allen was asked to go with the ambulance.

Barry and I followed shortly after we made sure that the police has secured his home. When we arrived at the hospital, Allen said that they had treated him and he was stable, but they were monitoring him and put him under a suicide watch. Allen said he would be transferred to another hospital that could give him the counseling necessary and make sure he had the medications needed. Then the Doctor came to talk with us. We confirmed that he had refused to come to the hospital and had not taken insulin for over 24 hours. The doctor asked us several more questions and Barry gave him what family information he knew and the doctor thanked us for calling 911.

When one sister arrived, she asked which one of us had called 911 and Allen received a big hug. She briefly said that he was having vision and kidney problems and may need a kidney transplant, but until he was evaluated, she would not know for sure. She did think that could be the reason he was avoiding taking his insulin and beyond that the family was aware that he was not taking care of himself. She stated that they had been working with him, but he was rejecting help and would not tell them what his blood glucose readings were or where his medications were located.

She asked Barry and Allen to stay until after she had talked further with the doctor and then accompany her to his house and do a search for anything that might be found. She thanked me and I left. Later that afternoon, Barry called and said they had found his medications, but it looked like he had not taken them since filling the prescriptions. They found one vial of unused insulin still within the expiration date, but no others. They had even looked through the waste baskets. They found several unpaid bills and other information that the family will need to take care of and a few other problems they will need to investigate.

Barry concluded that she had contacted the rest of the family and they were at the hospital or would be during visiting hours until he was transferred, probably the next morning.

This is scary what can happen when a person is not wanting to take care of him/her self. This is an extreme example of a patient caused complication.

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