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Something's really bugging me

C

C1a1r319

Well-Known Member
Messages
87
Location
Stevenage, hertfordshire
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
ketoacidosis
I went to my nurse on Thursday to discuss my basal testing results and we had a bit of an argument about the way you do it.

It was a night basal test
My numbers were:

18:00: 14.5ate food corrected bolused
Waited 4 hours for bolus to be out of my system.

22:00: 7.1
Start over night testing
00:00: 6.8
02:00: 7.2
04:00: 7.5
06:00: 7.6
08:00: 7.1

She said that you would abandon the test because at dinner I was 14.5 above range, but I thought the test results you consider were 4 hours after my last bolus.

Also, I did a few before and I made adjustments because they were running high but a consistent high. Again she said I needed more basal, but I thought the purpose of a basal test is to see that your number doesn't move more then 2.0(either up or down) from the number you start the test on. Which it didn't. I was 11.1 and it stayed within 0.5. On one basal test I went from 8.0 to 4.0 and she said that basal is right because I was in range. She didn't seem to understand that if I was at 7.0 at the begining I would have gone to 3.0... She just said that's fine.
So angry.

Then the next moan she had was the amount of times I tested. She said you don't need to test this many times. Be trusting in your pump. I tested that many times to get an idea of when my BG do start to change and then get an idea of when to adjust my Basals(1-2hours before the BG start rising or falling)

Did I do any of this wrong?
She argued and argued until I just agreed to disagree.
 
everything you done was right and your knowledge of the basal test seems really good...........

your on a pump, which can deliver different basals every hour, half hour even, so testing every 2 hours is ideal, so well done.......

you were 6.8 at the start of the test, the 14.5 at dinner has nothing to do with your basal test overnight.........if you corrected it and you didn't make it down to target levels you could still do the test, you would just be doing it at higher levels......

myself and I am sure you and every other pump user trusts their pump completely, but the technology is there to allow us to fine tune our doses, so testing a lot comes with the pump package......all pumpers know this, as do the competent, trained pump nurses.......

is your nurse trained.....?
 
novorapidboi26 said:
everything you done was right and your knowledge of the basal test seems really good...........

your on a pump, which can deliver different basals every hour, half hour even, so testing every 2 hours is ideal, so well done.......

you were 6.8 at the start of the test, the 14.5 at dinner has nothing to do with your basal test overnight.........if you corrected it and you didn't make it down to target levels you could still do the test, you would just be doing it at higher levels......

myself and I am sure you and every other pump user trusts their pump completely, but the technology is there to allow us to fine tune our doses, so testing a lot comes with the pump package......all pumpers know this, as do the competent, trained pump nurses.......

is your nurse trained.....?
Click to expand...
Yes, she is meant to be a pump nurse. I only ever get to see her because she is the only one trained in the pump at my local hospital. Every time I see anyone else they then take me to her and say laura is your nurse. Every time I see her we argue about the way it's done until I just give up and just act like I'm too thick to understand because I can't be bothered anymore. She is really stupid. I don't mean to sound bitchy, but she is a bit not all there.
 
You did everything right!

About increasing the basal - my nurse has the same issue. With. "her" dose I was going to bed with bg at 7 and waking up with 4 and she thought this is good! Obviously whenever I went to sleep lower that 7 I went hypo at night. Her advice was "dont go to bed below 7" 0_0

It seems the knowledge of many nurses is very sketchy unfortunately :(
 
Take a look at a presentation from Gary Schneiner (from minute 42). He talks about the purpose of basal. Understanding this seems to be a problem for most nurses...

 
PaulinaB said:
Take a look at a presentation from Gary Schneiner (from minute 42). He talks about the purpose of basal. Understanding this seems to be a problem for most nurses...

Click to expand...
it really really annoys me. I can't seem to explain it in a way she understands. That or she refuses to listen to what I say because she thinks she is right because she is the diabetic nurse afterall. Lol.i don't think I should have to explain it personally. She should know. I have done dafne and that's how they told me to do it. I have also read pumping insulin and think like a pancreas and from the infprmation that is how I interpreted it.
Thanks I will have a watch of that video. Maybe I should show it to my nurse... Oh and she is on annual leave from today ... AGAIN!! She is always off on holiday.
We just do not get on.
 
Hi. I'm sure you are right. Not all DNs know much about diabetes because their training can be very poor and narrow. It's why I would never trust a hospital to do any sliding scale insulin stuff with me. Many posters have gone hypo whilst on sliding scale because the nurses hadn't a clue. Sad. All you can do is find another DN (not easy) or try to do what you know is right and actually works for you and not let her know too much if that's possible?
 
The perfect basal, those readings look fantastic to me, starting on and finishing on the same blood glucose reading with only a -0.3/+0.5 swing is what dreams are made of :)

You seem to know what your doing so don't worry.
 
noblehead said:
The perfect basal, those readings look fantastic to me, starting on and finishing on the same blood glucose reading with only a -0.3/+0.5 swing is what dreams are made of :)

You seem to know what your doing so don't worry.
Click to expand...
She said it wasn't accurate because of what I started on... I argued that it was accurate. Gave up. She doesn't know any of the principles of the basal test.
 
She probably thinking (wrongly) you started on the 14. Something, but by starting 4 hours later on a 7. Something is ideal.

Sent from the Diabetes Forum App
 
C1a1r319 said:
She said it wasn't accurate because of what I started on... I argued that it was accurate. Gave up. She doesn't know any of the principles of the basal test.
Click to expand...

Well Gary Scheiner says if your basal stays within 1.7mmol your basal dose is OK, yours was exceptionally good so don't beat yourself up. When your finished with your book Think like a Pancreas pass it over to your DSN ;)
 
noblehead said:
Well Gary Scheiner says if your basal stays within 1.7mmol your basal dose is OK, yours was exceptionally good so don't beat yourself up. When your finished with your book Think like a Pancreas pass it over to your DSN ;)
Click to expand...
Haha! I think I will.
I don't think she misread it because we have had countless arguments about it all before and it's the whole principle of insulin she doesn't understand. I don't know how she became a diabetic nurse.
 
Last edited by a moderator:
If she is handing out dodgy advice to you, she will be doing it to others too - some of whom won't argue, or know better, and who could get into real trouble.

I should complain.
Explain that she is going against advice from (list your sources), light the blue touch paper, and stand back...
 
I
Brunneria said:
If she is handing out dodgy advice to you, she will be doing it to others too - some of whom won't argue, or know better, and who could get into real trouble.

I should complain.
Explain that she is going against advice from (list your sources), light the blue touch paper, and stand back...
Click to expand...
i am going to say to my consultant that she doesn't know the procedure for testing Basals. I was saying to my mum that if she is telling me this faulty information (completely faulty, every aspect of the basal testing she ha got wrong) what is she doing to others.
She won't listen because she thinks she is right and because she is trained she knows better, but this is preventing her from learning the right way to do it...
 
My pleb reading is it doesn't matter what you were as long as you haven't had insulin for 4 hrs and your start BG is ok and you call off the test if you go high or low.. Adjust and try again another day
 
C1a1r319 said:
Haha! I think I will.
I don't think she misread it because we have had countless arguments about it all before and it's the whole principle of insulin she doesn't understand. I don't know how she became a diabetic nurse.
Click to expand...


Get her to enrol on the next available DAFNE course :D
 
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