Recently one of the nurses I work with caught her patient lying. It seemed so ridiculous as to why she would do it. It made no sense to her care, and she had no idea that we had caught her in her deceit.
Sometimes patients who are diabetics hate testing their blood sugars. I can't blame them as I don't think I would particularly enjoy it myself. But, to keep themselves healthy they are required to check it multiple times a day. When a patient is admitted to the hospital they put away their own testing equipment and the nurses will use the hospitals equipment to do it for them. Sometimes a patient will prefer their own equipment and to check it themselves, so we are happy to let the patients do that. The nurse will simply ask the patient to report their blood sugar at the appropriate times. Patients will often have better control of their blood sugars when managing it themselves in the hospital because they know what works for them.
For this patient we were sending off a chem panel everyday which included her glucose level. She didn't know that we were checking her glucose when we drew her blood every day as it was done in the laboratory. Well, after a couple of days it became clear that she was lying when reporting her blood sugars to us. The lab would show us a value >250, and she would say it was 90. No, it wasn't a glucometer problem, she was choosing to lie. When reporting her own numbers as normal she wasn't receiving the insulin that would correct the hyperglycemia.
I have no idea why a patient would want to lie about their blood sugar, especially since it can have immediate harmful effects and long term can do serious harm to the body.
Monday, December 10, 2007
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8 comments:
I have had diabetes for 35 years; got it when I was 15. Now that I am almost 50, I have come to some conclusions about diabetes. Diabetes self-care has always had moral issues related to it. Have you ever heard of someone referred to as a "Good breast cancer patient", a "good migraine sufferer", or a "good RA sufferer"? The only labels like these are for us pateints with diabets; "good diabeteic" or "bad diabeteic"
My theory is that the first main physician for people with diabetes was Elliott P. Joslin; son of a New England Methodist Minister.
I have found that when someone lies (including myself) it is because of fear. What this diabetic patient is afraid of, I can't say. But if she told us why she is lying, it would be because she was not afraid of us anymore.
I don't think this patient is fearful and that is why she is lying about her blood sugar. I think she is avoiding treating her disease at all because she doesn't want to.
Many people with chronic illness go through bouts of not wanting to do it anymore, if wanting to get back to a "normal" life. It's a constant battle for chronic illness patients to be 100% compliant with treatment.
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I have read that some younger women with diabetes do not take their insulin because doing so makes them gain weight. Some of these people end up dying from complications of untreated diabetes. I don't remember where I read this. This may be why your patient was telling you the wrong bs level. She didn't want to gain weight from insulin administration.
It's just speculation, but she could be in denial or just not want to deal with it. It could also be that she feels better with a higher blood sugar. I know I've had patients who've stated that.
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