How do I (27F) stop feeling guilty for leaving my fiancé (42M) because he’s on a downward health spiral?

In a quiet apartment, the hum of an ambulance siren became a grim soundtrack for a 27-year-old woman’s life. For two years, she stood by her 42-year-old fiancé, a type 1 diabetic, as he battled foot infections and diabetic ketoacidosis, rushing him to hospitals while juggling work and home. Her heart sank each time he ignored his doctors’ pleas, choosing neglect over care.

Now, she’s made the wrenching choice to leave, haunted by guilt yet driven by the need to protect her own future. This story unfolds like a bittersweet melody, weaving devotion, heartbreak, and the courage to step away from a loved one’s self-destruction. It’s a tale of boundaries drawn in the sand, where love clashes with the limits of endurance, leaving readers to ponder the cost of staying versus the freedom of letting go.

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‘How do I (27F) stop feeling guilty for leaving my fiancé (42M) because he’s on a downward health spiral?’

I (27F) am leaving my partner of two years (42M). He is a type one diabetic who has had many complications due to the disease. Despite experiencing these complications, his motivation to improve his management is still extremely low. He had a cgm and pump. He chose to stop using them.

His excuse was that he switched health insurance providers and that he needed his new doctor to write a script to continue getting his supplies…it’s been a year. I think he’s had plenty of time to find a new endo to rewrite a script for his dexcom and pump. It still hasn’t happened.

During our time together, he has been in and out of the hospital with foot infections and DKAs. I’ve rushed out of work and called ambulances countless times. Every single time, he is told that he needs to be more careful. Every single time, we come up with a plan for me to help him improve his management.

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I’ve offered to send him reminders to check his sugar and insulin, and at one point I kept his pills in a box so I could give them to him at the designated times. Even when we verbally agreed to one of our plans for me to support his management, he would only follow the plan for a few days before getting defensive and secretive about his sugar levels.

I also stepped up as the primary bread maker during this time, as he was frequently out of work. In addition to helping him with his medication management, I was also in charge of most household chores that he was physically unable to do. He had a decent stretch for several months where he was working and doing relatively okay with his health.

I was very proud of him, but I made it clear that I would not do the hospital merry go round again. There were times when I was calling ambulances multiple times in the span of a week, while still keeping up with work and running our household. I reminded him of this and set my bottom line. He expressed understanding.

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Well, the merry go round started again. There have been two episodes of DKA in the span of three weeks. Both times, he admitted to going days at a time without checking his blood sugar or taking any insulin. He also admitted to lying to me when he told me his sugar was fine whenever I asked.

He knows exactly what is going to happen if he keeps doing this, and at this point, I believe there’s more of a mental health component. He was prescribed antidepressants and referred to therapy last time he was in the hospital. He didn’t take the pills and didn’t go to the therapy appointment.

He hasn’t taken any of his pills for blood pressure, cholesterol, and anticoagulants in at least several weeks. He says that he is taking them, but when I look at the pill bottles and they’re still full from when they were picked up from the pharmacy, I know he’s lying.

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His friends and family probably think that I’m evil. I think they might be right, because I’m kicking a poor man while he’s down, but I’ve tried so hard to get him better and support him. I feel like an evil ableist piece of crap. My guilt is eating me alive. How do I allow myself to accept that I did this to protect myself and him?

Watching a loved one spiral can feel like clutching a fraying lifeline. The woman’s decision to leave her fiancé, whose untreated diabetes and mental health issues led to repeated crises, reflects a painful but necessary boundary. She poured herself into supporting him—managing pills, calling ambulances, and shouldering their home—yet his refusal to act left her drained. His lies about taking medication and skipping therapy suggest a deeper struggle, possibly depression, clashing with her need for stability.

Dr. Gabor Maté, a renowned expert on addiction and self-destructive behavior, observes, “When people are suffering, they can become stuck in patterns that harm themselves and those around them”. Here, the fiancé’s neglect mirrors an addiction to self-destruction, as noted by Reddit users. The woman’s efforts enabled him, unintentionally softening the consequences of his choices. A 2022 study in the Journal of Behavioral Medicine found that 40% of chronically ill patients with untreated mental health issues exhibit non-compliance, straining caregivers.

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Her guilt stems from societal expectations to “stand by your partner,” especially in illness. Yet, her fiancé’s refusal to engage—ignoring therapy and prescriptions—shifts the dynamic. She isn’t abandoning him; she’s preserving her mental and physical health. This reflects a broader issue: caregivers often sacrifice their well-being, with 59% reporting burnout, per a 2023 AARP report.

She should continue leaning on her Codependents Anonymous support, reinforcing that she’s not responsible for his choices. Journaling her feelings can help process guilt, while therapy could strengthen her resolve. Practical steps, like maintaining her new apartment and support network, ensure safety. Her exit may even be a wake-up call for him, though change must come from within. This story underscores the power of choosing oneself when love alone isn’t enough.

Take a look at the comments from fellow users:

Reddit users didn’t mince words, offering a raw blend of empathy and tough truths. Many saw the fiancé’s neglect as a slow-motion tragedy, urging the woman to prioritize her future over his self-destruction. Some framed his behavior as an addiction to self-harm, comparing it to alcoholism, while others praised her courage, emphasizing that she’s not his caretaker.

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batikfins − You’re too young to be looking after your aging parents, let alone your aging boyfriend. This guy isn’t going to change. Don’t waste your youth being a grown man’s mummy.

TaborToss − OP, you know where this is going. He is going to end up in an early grave. Whether you stay or go is not going to change the outcome. The only thing you accomplish by staying is delaying the inevitable. He is an adult, he needs to take responsibility for his own health.

He is clearly unwilling to do that. There is certainly a mental health component, but again you can’t force him to medicate or seek help. If you leave him, be direct about why. Tell him “I am leaving you. Despite all of my efforts and all of your broken agreements and promises, your behavior hasn’t changed.

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I am not going to marry you just to watch you continue to n**lect your health and end up a widow. Please get help, take care of yourself, and take action to improve your health while you are still young.”

Choice-Lecture-8437 − Your post was a hard read, u/trashcan0519. I am so sorry you have been through this and are now in this situation. You have done exactly the right thing, but anyone in your position is likely to feel guilty, and here's why.

Your situation is really not different from someone needing to detach from an addict or a**oholic who is dragging everyone down with them because that person refuses to do anything to help themselves. Your fiancé is addicted to self-destruction. He loves hating himself more than he loves anything else.

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This may seem an odd place to bring this up, but currently on *Netflix* there is a show called *Baby Reindeer*, and the main character comes to this exact realization: he is addicted to self-hate and self-destruction more than anything else. Viewed through the lens of addiction, it makes perfect sense.

Nothing else matters, and the addict will sacrifice all to perpetuate the addiction. Meanwhile, because you love him and care deeply for him, you want to help him. But when you help, it doesn't seem to really work, because he's not helping himself. He's not even helping you to help him.

You're watching this person you love act irrationally. Inside, it breaks you. I am a recovering a**oholic and addict, and this is exactly what it looks like when someone doesn't want to get clean. Does it matter that it's not drugs and alcohol? No. What difference does it make? Your fiancé is on a path that is not going to end well.

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Something about that works for him, at least right now. I will tell you the exact same thing I tell friends and family members of alcoholics and addicts who can't seem to get sober. We may not be able to save them, but we can certainly stop protecting them from real consequences.

Someone much wiser than me in AA once advised, 'If I can't help someone get sober, I can certainly help them hit bottom faster.' At the time, I was newly sober myself and trying to rescue everyone that walked through the doors of AA and failing miserably.

My mistake was trying to make everything easier, softening the blows, candy-coating the hard stuff. I was crazy really. None of that worked for me. What worked for me was facing reality: all friends and family outside of AA had completely cut me off. Solid no contact.

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I had committed multiple felonies and was on my way to prison. I was also homeless and living out of my car, which I was hiding to keep it from being repossessed. Only when I had no more b**lshit cards to play or no one to do anything else for me, only then did I do something different.

Your fiancé, sadly, is probably going to have to be slammed into his own bottom, alone, and feel it hard, before he does anything different. Based on everything you have reported, there is no chance he will change otherwise. If he is going to change, leaving him to experience that awful consequence is the only thing you can do.

And this is the important part you need to understand:. **Leaving him as you have done is actually the most loving thing you can do.** Yes, there will be people who will disagree with that. They don't understand addiction and self-destruction. Hopefully, they will not step in and try and rescue him either.

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There is an expression I learned in Al-Anon, which is the companion group to Alcoholics Anonymous: Detach with love. That is what you are doing, and if you can really understand that, it may relieve some of your guilt. I don't know if it will relieve all of it, not because you are guilty.

I want to be clear: you are NOT guilty of doing anything wrong. If anything, what you are doing is the one thing that will save his life. But you may continue to feel badly because he is likely to suffer for some time before he gets better. *(Cont'd below...)*

Aussiealterego − He has deliberately neglected his own health, expecting you to pick up the slack. He can’t be bothered looking after himself, and LIES to you about his maintenance.. All the health plans you mention are about YOU putting in more effort to manage him.

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He is not a child. All you are doing is enabling him, at the expense of your own physical and mental health. Stop setting yourself on fire to keep him warm. He is a grown adult. You are not responsible for him.

trashcan0519 − UPDATE: Thank you all for your kind words. I knew I was going to get some snark for being in an age gap relationship, and I’m actually appreciative of that because it helps me see the situation for what it actually is.

I stupidly got us into a bigger apartment during one of his stretches when he was working and doing well. I had hope that he was back on track, so moving into a better apartment would be a motivating factor to keep it up. Spoiler alert: it wasn’t.

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I explained everything to my landlord. She’s allowed me to break the lease without any penalties and move into one of her smaller apartments on my own. I had been staying at my parents since the first DKA this month. I didn’t feel safe going home every day wondering if I would find a dead body in the living room.

My now ex is still on the lease at the apartment. He is still in the hospital, so he has not started moving his belongings out. I’ll have all of my belongings out by tomorrow. Because it’s another apartment leased by our current landlord, he may figure out where I live. I’m personally not afraid of retaliation.

1) he doesn’t do confrontation. Any time I’ve expressed my frustration with him, he just stares blankly into space. 2) he’s not physically able to threaten my safety. 3) my neighbors, friends, and family are all aware. I can have an army at my apartment in seconds if I need it.

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I have close to one year of recovery in Codependents Anonymous. I have a sponsor and a good support network in the program. Really, I know what the answer is to my question. I can’t feel guilty. He is choosing this path to self destruction.

I have a life of travel, career growth, and family ahead of me, but only if I exit this situation. I’ll be a young widow if I stay. Maybe I feel foolish for staying as long as I did, getting this new apartment for us, etc., but not guilty.

Hup110516 − I say this as a type 1 diabetic. Good for you and get the hell out of there.

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wurldeater − what about a unemployed 40 year old with constant foot infections made you say yes to the dress? when you considered that you could be with someone your age who works for themselves as much as you do why did you decide this was better? i think you’ve been guilting yourself for longer than just a few months… it’s time to snap out of it

fishmom5 − You are not ableist. (I’m disabled™️, including the mental health conditions that often go with that.) He HAS to want to get better to do it. Otherwise he’s just putting you through hell, and for what?

There is a difference between staying and being patient for someone with chronic illness, even as a caregiver, and staying to watch someone harm themselves.. Don’t get dragged down with him.

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georgethezebra − I am disabled with a fairly intense medical routine of IV's at home, feeding tubes, injections etc. Yes, some days I can't be bothered and don't want to do it all. But I do it anyway because that's what it takes to keep me alive and functioning.

Your partner doesn't even seem to realise the effect his negligence is having on you, he is so self absorbed that he can't see that he's putting you through hell. I think you're right there is an element of depression going on, self n**lect is a common symptom, but he doesn't want to help himself and you can't force that.

But he can't be bothered to consider how this is all affecting you. Honestly, I would leave too. You can't do much more, if he doesn't want to get better he won't. He needs intensive help for his mental health and physical health before he dies prematurely. You don't have to torture yourself watching him die slowly, you can leave.

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Due-Parsley953 − I am a type one diabetic, there is no way I would ever do anything close to what your ex is doing, it's like a slow and painful suicide attempt! I'll be 45 soon and every Saturday I will go for a 12-16 mile walk

I try to do whatever I can to remain in as decent health as possible. Don't feel guilty, he's his own worst enemy, you did all you can but you have a life to live and I hope it gets better for you ASAP 🙂

This woman’s journey—from ambulance dashes to breaking a lease—captures the gut-wrenching choice to leave a loved one who won’t save himself. Her guilt is real, but her courage to choose a life of travel, growth, and family shines brighter.

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It’s a stark reminder that love can’t always fix what’s broken when someone refuses help. Her story invites reflection on where we draw lines between duty and self-preservation. Readers, share your experiences of balancing love and letting go—let’s spark a conversation about finding peace amid tough choices.

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