Search
Search titles only
By:
Search titles only
By:
Home
Forums
New posts
Search forums
What's new
New posts
New profile posts
Latest activity
Members
Current visitors
New profile posts
Search profile posts
Log in
Register
Search
Search titles only
By:
Search titles only
By:
New posts
Search forums
Menu
Install the app
Install
Reply to Thread
Guest, we'd love to know what you think about the forum! Take the
Diabetes Forum Survey 2024 »
Home
Forums
Diabetes Discussion
Type 1 Diabetes
Anybody? Please help!
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Message
<blockquote data-quote="kitedoc" data-source="post: 1969461" data-attributes="member: 468714"><p>Hi [USER=499301]@Frenchfancyxoxo[/USER], You are sending a clear SOS ! we hear !!! As a T1D myself, but not as professional advice or opinion (which professional opinion I know you really need in the extra competent variety):</p><p>There have been two cases reported and others suggested by forums that <em>Novorapid injection</em> (and <em>on the forums other short-acting insulins</em>) can cause severe pain due to the insulin causing a <em>sudden drop in potassium in the blood</em>. </p><p>In the report <a href="http://www.nbci.nil.nih/gov/pmc/articles/PMC5622161" target="_blank">http://www.nbci.nil.nih/gov/pmc/articles/PMC5622161</a> they measured potassium, magnesium and calcium in the blood just before, and 30 minutes, after the patient took an injection of novorapid under the skin (subcutaneously). The person developed severe muscle aches. Only the potassium level dropped.</p><p>If this patient took a potassium-rich supplement (over the counter from chemist), before injection the pain did not happen or was much less. Only 2 reported cases of this , so rare. And both had a degree of neuropathy but in your case although the nerve conduction studies are used to diagnose diabetic neuropathy there is not always agreement, yes or no to neuropathy, even by experts reporting of the nerve conduction studies. (from my reading).</p><p>Now could this potassium drop also apply to long-acting insulin? No reports of it but then have you or anyone been measured for it and could the drop happen perhaps later with the long-acting insulin ? <em>A question for your doctors *</em></p><p>With some forms of neuropathy (and again the question of whether the nerve conduction study rules out neuropathy for you) there can be an inflammation of the nerve when previously poorly controlled diabetes is brought back quickly under control. </p><p>The nerve trouble seems to flare when the change is sudden compared to when the change is more gradual. It comes under the heading of <em>'insulin neuritis'</em>. I guess they might need to <em>take a small sample of your skin </em>to work this out (by looking at some of the nerves in your skin under the microscope)).<em> A question for the docs. **</em></p><p>As regards your<em> fevers</em>: </p><p>Are your leg pain and the fevers related? : I cannot even begin to guess but when the cause of your fevers is worked out then a connection, if any, is likely to appear. </p><p>If the following repeats things you have already been asked or tested for I apologise. I am just trying to think about everything.</p><p>It seems unlikely that you would not have had your urine tested for infection. And the 'throw away 'line you mentioned from the doctor deserves a report against him/her. But i assume that each time when you have been admitted to hospital that, after some tests, you were likely put on antibiotics even though a cause for fever was not identified before or after.</p><p>Doctors I have noticed are knowledgeable about the area, country they live in as regards usual medical conditions but not so much about other countries, so UK in the temperate zone compared to say, Africa and Asia, where tropical disease usually not seen in UK happens and where doctors there are much more familiar with tropical medicine and how to test for those conditions..</p><p>So<em> from my reading-up:</em></p><p><em>#If you have travelled to other countries it is important to let your doctors know (especially if if they have not thought to ask you)</em>. accomodation (cities, countryside), exposure to animals there, food eaten, any illness whilst there or after returning home</p><p><em>#All medications, legal and any illegal , which you have taken or think you might have been exposed to is important for your doctors to know.</em></p><p><em># Occupations and pastimes: e.g. exposure to caged birds, to bats, particular insects, to animals, metals, abattoir work, cattle work including calving, same for sheep, goats and the like; fishery work etc.</em></p><p>Sometimes a test result comes back showing that there is a low, medium or high level of inflammation in the body but not what the cause or location of the inflammation is.</p><p><em>Some doctors</em> might report these initial results were not helpful. And then that further tests looking for a cause were 'negative' or not showing a particular cause.</p><p><em>Others</em> might say that the initial tests confirm that there is inflammation but not what or where it is. And that tests to chase after a cause so far have not found the causes they were looking for. They would need to consider what other, perhaps more rare causes, to test for. </p><p>From the two different ways of being answered you can see how much or little your impression of hope in finding an answer can depend.</p><p>Further there are specialists in infectious disease who also know about tropical disease, but who will not know as much about other inflammatory (non-infective) causes of fever etc, the latter is part of another speciality</p><p>These days it is rare to find the all rounder physician, the diagnostician, who has sufficient grasp of all areas of medicine to be able to piece together the cause or causes - the Dr House, without all the quirks and other problems!!</p><p>I have confidence that matter will eventually be sorted.</p><p>But you need help now. </p><p># Can your GP arrange some form of<em> disability pension or sickness payment </em>to help you whilst you cannot work? And some way to help <em>give your children some care whilst you rest.</em></p><p><em>#There is a law that patients are to be treated appropriately for their pain.</em> Yes, it is easier when the cause it known but pending that your GP and any specialist involved have a duty to provide you with some form of pain relief to allow some respite, ability to rest and sleep etc. Often the pain can be characterised enough to know what type of medication may be most suitable to try.</p><p>Sometimes the symptom, pain, has to be treated before the cause is found. Just as an example, palliative care doctors are quite skilled at this. Whilst you are in no way in need of palliative care itself, the expertise from that area to manage undiagnosed pain is often very useful. So: </p><p>1) ? may be tests for potassium level based on the info above *</p><p>2) Query for the diabetes and neurology specialists about 'insulin neuritis'.. and if there is anything to do about your diabetes management **</p><p>3) can your GP 'chat up' the local Palliative Care Specialist about pain relief for you.?</p><p>4) Failing that, the next cab off the rank is GP to 'chat up' the Pain specialists.</p><p><em>Ask about use of a substance called PEA, </em>which is made in Holland, I think. it is reported to be useful for nerve and other pain.</p><p>A drug called<em> ketamine </em>is used in pain medicine and palliative care for temporary relief of nerve and other pain. </p><p>(and experimentally for depression but that is another story).</p><p>5) pain management also involves psychologists and psychiatrists, NOT anything about it all being in your head, but that pain affects us mentally and help in that area can add to the effectiveness of other measures.</p><p>I too apologise for the long post ! If I think of other things I shall post them.</p><p>Sincere Best Wishes with you in obtaining pain relief, with your situation improving and causes and remedies being found.</p><p><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /></p></blockquote><p></p>
[QUOTE="kitedoc, post: 1969461, member: 468714"] Hi [USER=499301]@Frenchfancyxoxo[/USER], You are sending a clear SOS ! we hear !!! As a T1D myself, but not as professional advice or opinion (which professional opinion I know you really need in the extra competent variety): There have been two cases reported and others suggested by forums that [I]Novorapid injection[/I] (and [I]on the forums other short-acting insulins[/I]) can cause severe pain due to the insulin causing a [I]sudden drop in potassium in the blood[/I]. In the report [URL]http://www.nbci.nil.nih/gov/pmc/articles/PMC5622161[/URL] they measured potassium, magnesium and calcium in the blood just before, and 30 minutes, after the patient took an injection of novorapid under the skin (subcutaneously). The person developed severe muscle aches. Only the potassium level dropped. If this patient took a potassium-rich supplement (over the counter from chemist), before injection the pain did not happen or was much less. Only 2 reported cases of this , so rare. And both had a degree of neuropathy but in your case although the nerve conduction studies are used to diagnose diabetic neuropathy there is not always agreement, yes or no to neuropathy, even by experts reporting of the nerve conduction studies. (from my reading). Now could this potassium drop also apply to long-acting insulin? No reports of it but then have you or anyone been measured for it and could the drop happen perhaps later with the long-acting insulin ? [I]A question for your doctors *[/I] With some forms of neuropathy (and again the question of whether the nerve conduction study rules out neuropathy for you) there can be an inflammation of the nerve when previously poorly controlled diabetes is brought back quickly under control. The nerve trouble seems to flare when the change is sudden compared to when the change is more gradual. It comes under the heading of [I]'insulin neuritis'[/I]. I guess they might need to [I]take a small sample of your skin [/I]to work this out (by looking at some of the nerves in your skin under the microscope)).[I] A question for the docs. **[/I] As regards your[I] fevers[/I]: Are your leg pain and the fevers related? : I cannot even begin to guess but when the cause of your fevers is worked out then a connection, if any, is likely to appear. If the following repeats things you have already been asked or tested for I apologise. I am just trying to think about everything. It seems unlikely that you would not have had your urine tested for infection. And the 'throw away 'line you mentioned from the doctor deserves a report against him/her. But i assume that each time when you have been admitted to hospital that, after some tests, you were likely put on antibiotics even though a cause for fever was not identified before or after. Doctors I have noticed are knowledgeable about the area, country they live in as regards usual medical conditions but not so much about other countries, so UK in the temperate zone compared to say, Africa and Asia, where tropical disease usually not seen in UK happens and where doctors there are much more familiar with tropical medicine and how to test for those conditions.. So[I] from my reading-up: #If you have travelled to other countries it is important to let your doctors know (especially if if they have not thought to ask you)[/I]. accomodation (cities, countryside), exposure to animals there, food eaten, any illness whilst there or after returning home [I]#All medications, legal and any illegal , which you have taken or think you might have been exposed to is important for your doctors to know. # Occupations and pastimes: e.g. exposure to caged birds, to bats, particular insects, to animals, metals, abattoir work, cattle work including calving, same for sheep, goats and the like; fishery work etc.[/I] Sometimes a test result comes back showing that there is a low, medium or high level of inflammation in the body but not what the cause or location of the inflammation is. [I]Some doctors[/I] might report these initial results were not helpful. And then that further tests looking for a cause were 'negative' or not showing a particular cause. [I]Others[/I] might say that the initial tests confirm that there is inflammation but not what or where it is. And that tests to chase after a cause so far have not found the causes they were looking for. They would need to consider what other, perhaps more rare causes, to test for. From the two different ways of being answered you can see how much or little your impression of hope in finding an answer can depend. Further there are specialists in infectious disease who also know about tropical disease, but who will not know as much about other inflammatory (non-infective) causes of fever etc, the latter is part of another speciality These days it is rare to find the all rounder physician, the diagnostician, who has sufficient grasp of all areas of medicine to be able to piece together the cause or causes - the Dr House, without all the quirks and other problems!! I have confidence that matter will eventually be sorted. But you need help now. # Can your GP arrange some form of[I] disability pension or sickness payment [/I]to help you whilst you cannot work? And some way to help [I]give your children some care whilst you rest. #There is a law that patients are to be treated appropriately for their pain.[/I] Yes, it is easier when the cause it known but pending that your GP and any specialist involved have a duty to provide you with some form of pain relief to allow some respite, ability to rest and sleep etc. Often the pain can be characterised enough to know what type of medication may be most suitable to try. Sometimes the symptom, pain, has to be treated before the cause is found. Just as an example, palliative care doctors are quite skilled at this. Whilst you are in no way in need of palliative care itself, the expertise from that area to manage undiagnosed pain is often very useful. So: 1) ? may be tests for potassium level based on the info above * 2) Query for the diabetes and neurology specialists about 'insulin neuritis'.. and if there is anything to do about your diabetes management ** 3) can your GP 'chat up' the local Palliative Care Specialist about pain relief for you.? 4) Failing that, the next cab off the rank is GP to 'chat up' the Pain specialists. [I]Ask about use of a substance called PEA, [/I]which is made in Holland, I think. it is reported to be useful for nerve and other pain. A drug called[I] ketamine [/I]is used in pain medicine and palliative care for temporary relief of nerve and other pain. (and experimentally for depression but that is another story). 5) pain management also involves psychologists and psychiatrists, NOT anything about it all being in your head, but that pain affects us mentally and help in that area can add to the effectiveness of other measures. I too apologise for the long post ! If I think of other things I shall post them. Sincere Best Wishes with you in obtaining pain relief, with your situation improving and causes and remedies being found. :):):) [/QUOTE]
Verification
Post Reply
Home
Forums
Diabetes Discussion
Type 1 Diabetes
Anybody? Please help!
Top
Bottom
Find support, ask questions and share your experiences. Ad free.
Join the community »
This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies.
Accept
Learn More.…