Awful Drs appt today.

Hi folkes,

I haven't been on here much in the last couple of weeks. I have been feeling poorly and having hypos at least 1 a day. ( Even when slept on the sofa all afternoon one day.) Getting to grips with carb counting. I havent spoken to a DSN in years but have an appt the week after next with the dietician re carb counting and a follow up with a DSN a while after. I have been reducing my insulin yet continuing to have hypos.

The reason for my GP visit was that I wanted to make sure nothing else was interfering with my BS as I have been reducing my insulin for weeks and still having hypos. I am on 150mcgms of thyroxine for an underactive thyroid ( previously overactive, given radio iodine treatment, consequently then going underactive and give thyoid replacemant pills ) I have lost 1 1/2 stone in about 9 mnths and am still on the same dosage of thyroxine. I have also been having some hormonal problems, headaches, very tired on waking. Palpatations sometimes ( I have previosly posted the details on another post ) Catzlady gave me a rundown of lots of possibilities.

My friend has recently found out she has cancer ( seem to be surrounded by it at thye moment ) and said it is important to rule out all reasons. Which I totaly respect and agree with. ( not that I think that I have cancer. )

I do however want to feel well and have energy.

My Gp immediately shot me down re the hormonal probs and said If you are having regular monthlys then he wouldnt even discuss it furthur. ( Not even to reassure me. I have been having times when i just go blank, Loosing things forgetting ,doing silly things. A little scary at times. ) He said my thyroid was checked in january and was fine. ( He eventualy agreed that having lost 1 1/2 stone I may now be on too high a dose. )

He was really dismissive!!!

The worst part was when i tried to explian the concerns with my readings ( taken with me ) and proceeded to tell me how I was doing it all wrong ( I had told him I was carb counting!! ) He said that I should titrate my insulin on my bs readings not carbs, when I tried to question this he became a little flustered but would not budge. I was feeeling quite intimidated at this point and was made to feel stupid!!! I now know I should have asked HOW!!!

When i got home I phoned the hospital and managed to get hold of a Diabetes nurse who after simply asking questions over the phone, reassured me that I was doing the carb counting / dose adjustment correctly and when I told her that I was still having hypos she agreed that I need to reduce my levemir again. She arranged for me to pick up a demi pen ( for 1/2 doses) and sent me some info about a pump.

Lesson learnt dont trust a GP re Diabetes. ( However I really went to rule out other concerns. Which weren't even properly discussed )

I left the GPs feeling a waste of time and stupid!

I have read other members with bad GP/ practice nurse experiences but until you recieve it you dont fully appreciate how bad it is!

Hope to get sugars sorted and hope that I feel better soon as the last place I want to go back to is that surgery!

Lucy. :evil:

Hi Guys and Gals and thanks!

claymic said:

its aweful..these are people who are meant to help us...i hated going to hospital for my diabetes checks because i was always made to feel like i am some freak stupid person who managed to got diabetes and that somehow i was inferior...

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Claymic......that is exactly how I felt! I must say though that my Hospital and my consultant have been great. I simply wanted to make sure that there wasn't some other health issue that may be having an impact, especialy as I had been feeling so poorly and still having hypos and keep reducing my insulin. Speaking to the DSN was a releif to know that I am doing the carb counting correctly.

I hate going to the Drs and avoid it until I really have to, the last time I went was 18 mnths ago yet was made to feel like it was me just managing my diabetes badly. When actually I have been trying really hard.

Fingers crosssed that reducing my basal again will help to sort things out!

Thanks again folkes

robert72 said:

Hi Lucy

Sorry to read about your troubles with the GP and that you haven't been feeling well. Been having too many lows lately, so know how exhausting it is. Hope you get your BGs back on track soon.

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Hi Robert,

Sorry to hear that you are having problems too!

Do you know why you are having so many lows and are you having to keep reducing? Just wondered if there may be a link or something else for me to consider?

Yes It is exhausting

Thanks Robert your GP sounds ace, wish I could lend him too.
Hope that you get it sorted anyway.

You take care and let us know how you get on.

Lucy.

iHs said:

noblehead said:

Shop,

How your GP can say carb counting isn't important is staggering, I would ask your DSN if you can be seen in the hospital clinic where you can mention your concerns to the consultant.

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Hi Shop

To a certain degree I can see where your GP is coming from as he thinks that using an insulin to carb ratio to work out the correct dose of bolus insulin for what you are eating is a complicated way of achieving good control and all you should be doing is altering the amount of bolus insulin according to what your bg levels are 4 times a day. Unfortunately, due to the nature that bolus insulin takes (lowers bg levels fast) unless you also test mid morning and mid afternoon and possibly eat some carb, your bg levels could well drop about 30-45mins before you eat your lunch or eve meal. So testing bg levels frequently is key to success with bolus/basal and using trial and error.

Have you looked at BDEC online yet and started off using a carb ratio 1:10 and then adjusting the ratio according to what your bg levels are 2-2.5hrs later? It's not uncommon for people to need more insulin to cover breakfast - 1.5:10 or even 2.0:10 so that their bg levels stay within good guidelines (look at NICE). When people start to need somewhere inbetween it gets easier to adjust the carb in the ratio instead of the insulin.

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Hi Noblehead,

I dont think he even knew what carb counting was. I will have to speak to my DSN and ask to raise my concerns with my consultant if it continues. I dropped my levemir again last night to 16 so will have to wait for the effect. She mentioned my activity and over the last 2 weeks it has been zero ( even my hubby picking my son up from school. )

I also noticed yesterday that I have stared with muscle wastage on my legs again. ( I had this with hyperthyroid and pre type 1 diagnosis but with diabetes it was because of high sugars not low, which is what I am having at the moment )............I am Baffled.
Although the muscle wastage could be down to inactivity, although thats alot in 2 weeks I have not been bedbound. )

iHs.............The BDEC is the carb counting course that I have been following and have worked my ratios out to be 1:1 breakfast, 1:2 lunch and 1:2 Tea. I even reduced my ratio at lunch to 1:1 to see if that needed changing and got a very high reading! I went through all of this with my DSN and she said that what I have been doing is correct.

What confused me about what the Dr said was he said I should base my lunchtime dose on what my lunchtime BS reading was. I thought that my lunchtime reading was a result of how successful my insulin dose for my breakfast had been. That really threw me!

Thanks guys for all of the advise and support.

Lucy. xxx

mep73 said:

((((hugs))))) Shop It's not fun dealing with docs that frustrated the hell out of you. Fortunately I do have a very supportive GP and he is upfront in telling me he is not a diabetes expert, or any other expert for that matter. My frustrations have been with specialists. Although my GP does get concerned when he hears I'm having numerous hypos. He reckons it's not good for your brain. I also lowered my basal a few weeks ago... but it's pretty much hit and miss. I'm still having hypos at night at least about 3 times per week if not more. I had one this morning I know.... hate waking up and feeling that hypo hangover. I went out for lunch with friends and decided to enjoy myself (haven't done that much lately)... thing is I got carried away with talking and didn't realise how much I'd eaten... my BGLs went through the roof. argghhh! I don't usually go too high... but when I do it freaks me out. But on saying that doing anything is tiring for me... I'm still getting investigated too. My iron is too low also... was going to ask you... have you had that checked?

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Hi Mep,

Sounds like youve been having a rough time too. Luckily I am not having hypos at night. I havent been out with friends yet probably need to, I have been so anxious to get my carb counting sorted and then when started to feel poorly didn't feel like going out. What is frustrating for me is that I wanted to do the carb counting to improve my BG control have more flexibility and live life without feeling held to ransom by my diabetes. I have soo many things that I want to do/ need doing and was looking forward.

Good point about the iron. Maybe that does need looking at.

Hope you get you get sorted and hope you find more energy too.

Sending thanks and hugs ((X))

Lucy.

Hi iHs

Sorry I meant to have typed 1:1.5 at lunch time not 1:2. Typing error. Also what you are saying is I should have say 3 glucose tabs then just have meal and do carb counting as per usual.

I thought that if my ratios, basal and bolus calculations were right I should'nt be having the lows just before meals. I will try the deducting the 10gms from my carb count if things dont improve. So far today readings OK

6.1 before bed ( had 1 rich tea biscuit so not to have a hypo in the night!)
4.5 on waking
6.7 before lunch.

Will see what happens this afternoon.

I did reduce my basal again last night to 16 so will see what happens in next few days.

Thanks for the advice

Lucy.