Orinase (Tolbutamide)
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DIABETES AND FAMILY: DIABETIC PARENTS
The diabetic mother
Being a mother and a housewife is as hard a job as any. Unlike most, it never stops. By the end of the day you may be worn out and still have to get up several times in the night to see to the children. During the time that you are looking after your family you may feel that your health takes second place to their needs.
Daisy is forty years old now and has brought up three children. Her husband works as a long-distance driver and is rarely at home. Daisy became diabetic when she was thirty-two years old. She was very overweight and so was given a weight-reducing diabetic diet. Her weight fell a little, but her blood glucose levels rose and so she was started on glibenclamide pills. Over the years her glucose balance was never very good and when she was thirty-seven she was admitted to the hospital with abscesses and a very high blood glucose level. She was started on insulin.
Over the next few years Daisy had recurrent infections and several hospital admissions. Her weight went up and up and her average blood glucose level, measured in the clinic because she said she had no time to check it at home, was 17 mmol/1 (306 mg/dl). She got more and more depressed. During this time she gradually told us what was going on at home. One of her daughters was mentally ill and in and out of psychiatric institutions. Her son was working but came home for all his meals. Her other daughter had started a feud with her grandmother, who also lived in the house, and the two of them were always bickering. The grandmother was not very well and needed a great deal of attention. Every Friday, Daisy had been going over to her sister’s house to help with her cleaning, because her sister also had diabetes and couldn’t cope; yet her sister had diet-treated diabetes and a fit husband.
It became apparent that Daisy was bearing all the family’s burdens on her shoulders. She was neglecting herself and her diabetes completely, because she was so swamped by family chores. We suggested to Daisy that the time had come for her to think of herself and that she should ask her family to help her, not the other way around. Daisy was not too keen on this idea, but after her seventh hospital admission, she agreed to tackle her family. Since then she has lost forty pounds, she is measuring her own blood glucose levels, which are approximately 10 mmol/1 (180 mg/dl) and sometimes lower, and the grandmother has gone to live with Daisy’s diabetic sister, who now does her own cleaning- helped by her husband. Daisy’s son is eating his lunch at work and her daughter is helping with the housework now that she has no one to argue with.
Obviously there are still problems, but at last Daisy’s family has realized how ill she had become and has done something to help her.
Daisy’s story is an extreme example, but I see many diabetic mothers in the clinic who are putting off coping with their diabetes ‘until the family are grown up’. It may be too late then. Persistently high blood glucose levels may have done irreparable damage. Besides, you are not much use to your family if you make yourself ill. Looking after your diabetes does not take very much time when you get into a routine. The insulin and food pattern a housewife and mother needs is one for the person who has a variable work pattern.
One of the difficulties for diabetic mothers is that they usually do the cooking and worry that the family will not like the diabetic diet. Most of the foods that are good for diabetics are those that any healthy family should eat. ‘But my husband likes French fries and sweet desserts’. Well, provide them occasionally. You do not have to eat them, although it is obviously a great temptation if you like them. One of my diabetic patients was a wonderful Viennese pastry chef and it used to break his heart not to be able to taste his creations.
The diabetic father
As a diabetic father you may be the wage earner and so be particularly concerned about the effect your diabetes may have on your earning power. Provided you keep your diabetes under control, it should not interfere with your ability to do your job. It is equally important for you as for your partner to consider the implications of having a family and you should consider carefully the points. The physical implications are less crucial for the diabetic father. From the baby’s point of view you need have no worries about your diabetic control at the time of conception. High glucose levels do not seem to upset the sperm.
*71/102/5*
