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Awful Drs appt today.

S

shop

Well-Known Member
Messages
665
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

sorry to hear of your bad time at your G.P's the thing is alot of G.P's these days are not much good all they seen to do is look everthing up in there little medical bible. Do you have a diabetic consultant he/she would be alot more helpful, I had a G.P once who had ago at me for having loads of hypos as if i can help it i have lost all my awareness, i ended up putting a complaint in about him and changed my G.P.

tracey167
 
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.
 
Just wanted to say I'm thinking of you and hope you finally get some answers from somebody who can give you the time and care you should be given! Take care x
 
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...
 
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...
Click to expand...

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.
Click to expand...

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 :(
 
shop said:
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.
Click to expand...

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 :(
Click to expand...
My insulin seemed to be losing power a couple of weeks back, so I had to crank it up. Whatever caused that seems to have passed so I am lowering doses again. It's the basal that always takes time to adjust. I actually went to see my GP about it on Tuesday and he's doing some tests to see if I had any infections. My GP is awesome btw, even with diabetes - wish I could lend him to you ;)

Take care

Robert
 
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.
 
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.
 
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.
Click to expand...

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.
 
((((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?
 
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.
Click to expand...

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.
Click to expand...


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
 
Disgraceful!
Do you have an NHS drop-in centre near you? You might get better treatment there.
Hana
 
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?
Click to expand...

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.
 
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!

Lucy. xxxshop



Lucy

If using a ratio of 1:20g carb at lunchtime is causing you to have a high bg level 2-3hrs later but 1:10g carb ratio is causing you to go low have you tried to use a ratio of 1:15g carb?

Also if your bg levels are towards being on the low side before you eat a meal are you eating some glucose to lift you up towards your target and then using your insulin to carb ratio? Another way is to deduct 10g carb from your carb count, so if your bg levels are lower than what they should be instead of calculating a ratio to eat 30g carb (example) only calculate for 20g carb. To correct a high bg level use the 100 rule but only do this when 4hrs have passed and allow the bolus insulin to finish its action.
 
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.
 
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