WuTwo
Well-Known Member
- Messages
- 1,867
- Type of diabetes
- Type 1
- Treatment type
- Insulin
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People whose attitude says "Me, my opinion, my desire is greater and more important than anyone else"
And to whom the principle of ahimsa is a closed book that they refuse to open because it would make life more difficult for them.
For the past 5 years my HbA1c has never been above 6.3 (sorry, still using old money) and have been told that that my diabetes control via insulin pen was excellent. Now, having changed medical practice, I am told that my HbA1c is too low and that I am hypo-unaware! Looking back over the last 5 years, on average I have a low blood sugar, I.e below 4.0, once per month, and an incidence of a reading below 3 of about once every 4 months and these are usually as a result of activity. I am aware of hypos because it physically manifests itself with the usual symptoms, but these symptoms only appear when sugar falls to about 3.7 - so I am NOT hypo-unaware. I adjust my insulin (Mixtard 30) dose based on my glucose reading and am now told that this is wrong too! I am told that I MUST stick to a fixed dose irrespective of glucose reading. This seems wrong to me, and basically makes me ask the question 'why bother doing a glucose test 'cos you ignore the result anyway!' What do others think?
The reason they say you shouldn't adjust a mixed insulin is because you're not just chopping and changing your bolus insulin, you're pushing extra basal in as well (or not having enough at some times). As far as possible they like you to maintain steady levels of basal simply because as a long acting insulin, you get long lasting effects - depending on the mix the basal could last 10 hours in the system. Too much basal and you will run low for hours which might sound like a good thing but there is a difference in function between the two insulins. The basal is to maintain brain and body function efficiently; it's your background insulin and can't be used to achieve carb control. That is the job of the bolus insulin. What you're trying to do is dose adjust as if you were on MDI.
Your best best might be to ask if you can change to MDI, and then you could carb count and dose adjust without affecting your basal insulin.
I'll tag @kitedoc who can probably explain better than I ever could!