OTHER ILLNESSES

I have just been in hospital with anaphylactic shock from a bee sting. I have diabetes controlled with tablets and wondered if this had anything to do with the severity of my reaction?

There is no connection between diabetes and allergy to bees.

My husband is on tablets for diabetes and normally has good control. He is prone to chest infections and these seem to upset his blood sugars. What should he do?

This can be a really difficult problem. Of course if your husband is ill enough to need hospital admission, he should be given insulin while his sugars are running high. At home, this is not as simple because there is no way of knowing what dose of insulin he may require, and an inadequate dose of insulin may even make matters worse. In a perfect world he would have insulin for the duration of his illness but in reality it is acceptable for him to run high sugars for a day or so, in the expectation that they will soon settle down spontaneously. In a longer-lasting illness, he will need insulin if the sugars are consistently high and there will be time to adjust the insulin dose in response to the blood glucose measurements.

Chest infections and asthma are often treated with steroids, which can cause a major rise in the blood glucose.

Since I was told I have Type 2 diabetes, I have been very depressed. Is there any link between depression and diabetes?

People vary greatly in their response to learning that they have diabetes; some are able to adjust to their new condition easily, while others find it hard to accept. We wonder what input you have received from your doctor or nurse to help you cope with this unpleasant news. We often hear of people who are told they have diabetes in a matter-of-fact way, and then see the practice nurse who gives them basic information about diabetes, sometimes backed up with some reading material. However, they leave the session feeling that their own fears and concerns have not been addressed. Such people often become angry and get the impression they have been responsible for their own diabetes. These negative emotions often cause depression and a belief that they can do nothing to improve the situation.

We support the DESMOND approach where a group of people recently diagnosed with diabetes meet with an educator who is trained to listen as well as to teach. In the opening session, people are invited to tell their own story and this leads to a feeling of solidarity within the group. After learning basic facts about food and diabetes, including the effect this may have on their future health, members of the group are encouraged to set their own goals for improving their health. When first diagnosed with diabetes, it is often difficult to work out whether the condition is serious or trivial. The DESMOND process helps people get diabetes into perspective and allows them to make informed lifestyle choices regarding food and exercise. It also provides the reassurance of meeting other people with diabetes, who are living through the same difficult experience. Other centres have developed education programmes along similar lines to DESMOND.