High Blood Sugar reading but not yet diabetes

I wonder how I should deal with this in regard to my 82 year old husband? His last blood test came back as abnormal re pre diabetes and he was referred to a program. We had the initial call on Wednesday. Basically he has a phone consultation with an advisor, then will go on to group sessions by phone weekly at the same time, and have to key in a code - it is by phone not Zoom.

He is very deaf, and medically non compliant so heavens knows how he is going to cope with this. The girl who phoned to make the initial appointment ran through the topics going to be covered but I honestly think expecting an 82 year old to exercise is not really feasible. I also know very well what husband SHOULD eat but have for years struggled with this and it was sort of decided with the dietician when his weight went down, to let him eat chocolate if that was what he wanted to eat.

That said, I could NOT inject him if he became diabetic so it is in my interests for him to proceed with this but frankly I just do not see how he will be able to particiate.

Have any others had any experience of these sessions? I think there are going to be 12 of them. I am trying to stand back because whilst I keep propping husband up, I will not get any help or further investigations re the potential dementia. I really do not know if I should help out on the initial consultation or just let husband stumble along - the lady did say she had changed things so I could talk for him in the group sessions but frankly I think this is pretty pointless.

Helena, if they can’t arrange things so that your husband can and will do it on his own, then that is something they need to sort out, not you!

I started that NHS course for pre diabetes but it was cancelled when Covid struck.
Whilst you wait for a suitable solution to a course you can start controlling
blood sugar levels on your own.
It’s just a case of having a good diet, watch too much carbohydrates these turn to sugar
Snacking between meals is to be discouraged too.

Plenty info on the net. Here’s a starter for you…

I keep a check on my blood sugar level with a tester I bought…(search the net for these)

Thanks BB and Albert - I will look for a blood sugar tester. Only issue is my husband is non medically compliant so getting him to eat a healthy diet is frankly something I gave up on when his weight went down to 8st 7. The Dietician was very good and basically felt it was getting him to take in calories to stop the weight loss. So frankly, whilst I know what he SHOULD eat getting him to eat properly is not a viable option. He has agreed to stop having sugar in his coffee and go back to canderel which is a start .

I think expecting a deaf 82 year old to participate in the course by telephone is not really a viable option. I will ask him to check out the internet but not sure he could easily absorb or remember what he reads.

I shall see how the initial consultation by phone goes - only issue is if he struggles or the person has an accent, he just gives the phone to me saying I am his wife and carer.


I think the practitioner running the course needs to deal with your husband - hopefully they will realise his deafness is a barrier and come up with an alternative solution.
Though as you say, it’s unlikely he’ll comply with the advice …

Are his Fortisips suitable for someone who is pre-diabetic? He might need an alternative prescribing.


Unfortunately, this sort of attitude is typical within the NHS and Social Services.
Tell someone what to do and then move on.

This sounds ridiculous to me. My brother - he was 82 when he died - had diabetes, not just pre-diabetes, from his mid-seventies. It was impossible to enforce sensible eating so we didn’t, and I didn’t test blood sugar regularly either. He did have Metformin tablets, with various other medications, I think. I once had pre-diabetes and did a lot of blood testing on myself, but this only works if you are doing something to control blood sugar, which for me was avoiding carbs, not just sugar. I no longer have pre-diabetes anyway. You say you are just getting your husband to eat something, and that’s my experience - you probably have no hope of introducing a healthy diet.

I am not an expert but from my experience there is no point doing blood tests in the circumstances of your husband, as I have read about him in the forum (I am a former carer). He sounds just as difficult as my brother, perhaps in a different way. I am sure it is a good idea with the Canderel, but what else can you do? In theory you could test blood sugar seven times a day, before and after meals, which would be dreadful for you. I don’t think injecting insulin is going to happen if he does not yet even have diabetes.

Certainly you could try testing the blood, just so you know about it. I think these pre-diabetes courses are in any case most use for the diabetic him-or herself if they are interested in avoiding diabetes.

Thanks Greta your reply means a lot. I shall try and stand back during the phone consultation, in the home that the group leader realises that it is not a viable option for my husband to join a telephone group course. I shall also try and find out what his reading actually is and how close to ‘normal’ from his Surgery if I can.

TBH I think it is up to the Surgery to pick up if the Fortisps are suitable but it would be a nightmare without them on prescription frankly. He has 2 a day but I do buy extra because if he is not feeling good, they are a great back up and he will have 4 if he does not want to eat anything else. His weight is between 9st and 9st 7 now but it did go down to 8st/8st 7. The GP is relatively happy as long as it stays above 8st 7.

I cannot help but feel this is more of a ‘tick box’ exercise rather than a genuine effort to help!


Yes, this box-ticking seems to remove the brain. (I had to get up early to clear up after the cat was sick - I only have one!). Certainly when I was in Germany there was a development that people in doctors’ offices were increasingly being trained to run things like courses for pre-diabetics, but they had no wider understanding beyond their script, so you got reasonably educated people being given these courses who had read the subject up and knew more about it than the trainers.

We had similar unreasonable wishes from the continence nurse. It was wonderful to actually locate her, which social services and the GP could not manage, but accidentally I found a neighbour had worked there once and so we got help. But not all her suggestions worked. One thing she wanted us to do was measure how much liquid my brother drank and how much he peed. We had a chart to fill in, I think. But with four double-handed carer visits a day and difficulty getting the carers to follow the medication chart and dosette box, this would never have worked. In fact I don’t even think I could have done it myself. But the nurse didn’t really understand why it wouldn’t work. These people get trained to carry some procedure out and seem blinkered about the world it has to take place in.

Another memory: two paramedics came to take my brother for a hospital visit. One of them was very officious and somehow persuaded me to get out the blood testing kit. I had used it once but didn’t manage well. He insisted on a new needle but I couldn’t reach the sharps bin for the old one, so the paramedic pricked his own finger. His colleague obviously couldn’t stand him and was enjoying this pantomime. The first paramedic then insisted on my brother having a test for HIV at hospital. I remember about 1.00 am a doctor turned up in the hospital cubicle and took some blood. He was relieved that my brother had been put on aspirin because of problems with more specific blood-thinners. My brother told the doctor that everyone in our borough had been put on aspirin - we didn’t discuss this any further though. A good twelve hours out of my life. You carers are doing a great job!

Btw my brother ate sweet stuff to the end.

Hi Helena. First things first. You have the absolute right to refuse to inject your husband. They’ll probably start him on tablets anyway, but the moment they talk about injections you can tell them that you are not doing it and they can make arrangements for him to have his injections administered by the NHS. In my old job I helped a couple of carers who were being bullied into giving injections. The key phrasing is that “the NHS has the duty of care, I do not.” All current carer legislation supports this. You can choose what care you will give, what you can or cannot give. End of. No one can force you.

That said, your husband is 82. There’s little chance of him changing his ways or complying with new diets and as long as he has mental capacity, they can’t force him, or you, to medicate him or change his diet. His choice. Mental capacity means you have the ability to make decisions, even if those decisions are considered “wrong” by others.

And frankly I don’t see how much extra life expectancy he’d get if he did comply at that age, even assuming there was nothing else wrong with him. It may sound harsh written that way, and if you feel that way I apologise, but I believe there’s a point where no matter what you do, it’s not going to make a lot of difference, so do what you feel comfortable with.

But absolutely don’t let anyone tell you what you should do. You need to be comfortable with your decisions too.

Thanks Charles - you are a total diamond, and I am not offended. But you are right, no one can make me do injections and in nairness, I do not know how high his blood sugar is over ‘normal’ but I will try to find out. Yes he does have ‘mental capacity’ although a couple of the nicer District Nurses asked the GP to do a test. Counting back from 100 in 7’s and knowing the date is something my husband managed. That said, there was considerable brain atrophy prior to the heamatoma back in 2013 so I have my doubts. But of course, mental capacity is ‘fluid’ and most days he would run rings round professionals, even mental health professionals. One of his Consultants told me this back in 2013.

It all comes down to ‘quality of life’ and trying to make a difficult awkward 82 year old change his diet is not a viable option for me and probably not for the professionals but I will ‘bow out’ and just see what happens when he has the pre course assessment.

You’re very welcome, Helen.

But be careful. Mental Capacity is about making decisions and has nothing to do with the test you mentioned - that’s a dementia test, and it’s only to test memory function.

Mental Capacity is about taking in the facts needed to make a decision, remembering the facts for long enough to make a decision, going through the process of weighing up the pros and cons using the available facts (the informed part of an informed decision), and finally communicating that decision. Those are the four stages and someone with dementia - for example - might well be able to do all that, as long as their memory is not too badly affected. That might depend on the time of day: my Mum was always worst just after waking up. Nowadays, she’s about as bad all the time and no longer has capacity for most things.

Anyway, don’t let them fool you into thinking they’ve tested his mental capacity.

Charles that is interesting. It was the District Nurses who asked GP to check husband understood what the outcome could be with regard to his continuing non medical compliance. We got the Senior GP who said we both sounded sensible and it was not his job to get my husband to sleep in a bed. (he sleeps on a chair that extends although the DN have offered a hospital bed) I was quite prepared to go along with this but husband was very against - he is a terrible hoarder and the front room is full of old videos/dvd/tv/printers. I did offer to sort out a skip and help as at 7st, I am not able to lift heavy things, but he said he would call the police if we disposed of his things, and have us arrested plus I could clear it out when he was dead. I would point out my husband and I are at different Surgeries as my GP thought husband confused and husband immediately left Surgery and threatened to sue back in 2013. He has pressure sores and the hospital bed would probably help. I think the DN were just covering themselves as they discharged him soon afterwards although I had been told given his age, and how frail his skin was, they would not do this but would reduce visits as there had been improvements. I was left to do the dressings 5x a week as they only came 2x a week and he had a bath every day. This was against hte nurses advice BUT he has a damaged bowel and this is probably due the years when he would NOT take the lactulose as prescribed and in fairness, his GP was very good explaining how it worked . So I do think the incontinence is self inflicted to a degree, but have bee told by the Consultant that we have to learn to live with it, In fairness, he does now get 4 pads a day on the NHS but I had to wait a whole year. The Senior GP understood why the incontinence made a bath necessary, even though it disturbed the skin healing.

The District Nurses have discharged him and he is now under the care of the GP. I have been told to use Cavalon sticks but have been given no dressings. I did get him to the Surgery before Xmas but the Healthcare Assistant felt the main sore was not infected and just told me to keep it clean and monitor. It does bleed - partially due to him being on blood thinners and the skin on the other buttock MAY be breaking down so monitoring carefully. I have no medical training only what I have picked up from the nurses but I was taught as ‘dress wound if it bleeds’ but this is against what the Surgery told me so just taking photographs every few days so I can see if it is getting dramatically worse. He has been told endless times to move around more but he wont.

I do feel the NHS are punishing me for HIS medical non compliance. Sorry for the rant but at times I feel very out of my depth. Does not help being at seperate Surgeries although I think his GP is good and has done her best for him. I WILL NOT challenge him for my own mental and physical safety as he is still considerably heavier than me, but I do try my best to keep him clean, medicated and fed. I am sure others must be in similar situations. I think he would run rings round most mental health professionals most days…and I cannot prove most of what I have posted here - his word against mine he keeps telling me. But balance of probability is now coming into play…

Right, well that’s good. The GP clearly didn’t see there was anything wrong with the decision making! The Senior GP’s comments about (paraphrasing here) not forcing a decision on your husband is precisely the issue about “right” and “wrong” decisions. We’re allowed to make mistakes. It’s when we don’t understand why it might be a mistake that the problems start.

Anyway, I hope you feel able to take the next steps the way you want to!

TBH I think I have let nature takes its course,