Being honest with your doctor

[PurpleSky1111]

Hi all - my first post here!,

I very carefully watch my diabetes, due to a busy job and small toddler to look after once i'm home - it does bounce around a lot from high to low.. mainly because i'll get interupted by my toddler when about to do my injection, or his terrible sleep patterns mean I dont eat very regularly which my blood sugards never agree with! ( tends to go high if I dont do insulin regularly ).

Last week, for the first time in my 28 years as a T1 I had a hypo in the evening so severe that i was unconcoius and my partner had to call out the paramedics. Yesterday my blood sugar dropped to 2.8 before I noticed it was going low.. so i'm beginning to think i'm starting to loose hypo awareness.

I really would like to be put on a pump.. I believe that style of insulin delivery would suit my busy lifestyle and help me get much better control, I already carb-count and I truely believe a busy stressful job and busy irregular homelife wiht a small child are the reasons I struggle to get very good control.

I'm worried though, If I go to my dr and ask for help with this.. if I admit that my hypo awareness is going that I may loose my license?
TO NOTE : I always check my blood before driving, and I do ( apart from the other day ) always eventually feel myself going low - i've never had a hypo related incident in the car and I do believe i'm safe.
I'm so worried though, that asking my dr for help with this apparent losing of hypo awareness may affect my ability to drive next time I have to renew my license.

Those who've had similar loss of hypo symtpoms, were things OK with the DVLA?

 

[copepod]

Unfortunately, you have now had one incidence of hypoglycaemia requiring help from paramedics [or any other person]. Two such incidents within six months would mean you would lose your licence.

 

[noblehead]

The thing is @PurpleSky1111 you still have to remember to bolus and eat even on a pump, if you forget to bolus then your bg will go high and if you bolus and don't eat then you'll go hypo.

The hospital will automatically notify your gp surgery that you've been attended to by the paramedics due to a hypo so your better being open and honest with them. Best wishes and hope you get it all sorted.

 

[PurpleSky1111]

it's not so much hat I forget, but often I'm interrupted - a pump would mean I had the insulin with me - if I'm stuck in a work meeting or pulled away by my child I just feel it'd be easier.
Also the constant insulin would stop it going high in my opinion!

I realise my dr will be notified - but I'm just wondering how everyone copes.

I drive very safely, check my blood often, I just fear I'm starting to loose my symptoms and I'm a bit scared if I admit that the. I may loose my license. I'd never drive if I was at risk of going hypo or having a hypo unaware - I just want to speak to my dr to get help before things get that bad, but I'm worried it will affect my license regardless of the care I take

 

[tim2000s]

Also the constant insulin would stop it going high in my opinion!

The basal injections you currently do will already be doing this. The pump simply applies basal in a slightly different way using fast acting insulin.

 

[PurpleSky1111]

Yep, I know it does, but I also know me and my body if i haven't done fast acting insulin in a while it seems to go up quicker even if I haven't eaten! But everyone is different and diabetes is not a perfect science.

I'm not really after a debate about whether a pump is right for me or not, if I were I'd have to put many more details about why I'm thinking this way down - everyone's body is different,

I'm just wondering how everyone gets blood sugar advice talked about and if it affects their license.

at the moment I'm wary of saying more than I have to , to my dr - not because I have poor control, it's generally the best I can get it - I just want some advice from him and I'm wondering if such thoughts make others wish to hide things from their Dr .

 

[noblehead]

Just my own opinion @PurpleSky1111, but if your not honest with your HCP's then how are they meant to help you, this is particularly so with the two main issues you have at the moment (pump & licence).

By law you must disclose your hypo unawareness to the DVLA just to keep you and everyone else safe on the roads, hypo unawareness can be reversed in some cases and your diabetes team will talk to you about how to go about this.

 

[ButtterflyLady]

I can understand you fear of losing your licence, I would be severely affected if I lost mine for some reason, so I really get that.

However, your safety and that of others in your car and on the road is paramount. I believe you when you say you are doing everything you can to prevent hypos while driving. But can you be 100% sure it is enough, knowing how complex the human body can be?

Just playing the devil's advocate here, not criticising or debating.

 

[tim2000s]

As someone else posted somewhere else:

"While you are the only one in the car, you are not the only one on the road"

In other words, if you killed someone due to an inadvertant hypo, how would you feel? Tell the HCPs.

 

[Diakat]

I also work and have a 5 year old so do understand how sometimes your injections/eating slip. And totally get the need to drive! But you have to care for yourself or won't be there for your toddler. Can you get toddler involved? My little one loves to pick the needle I use to inject - bloodthirsty! And if I say I'm low she'll tell me to eat. It all depends how old they are I guess, but they need to see you are important. No ideas re pump/dvla but health and safety are paramount.

 

[slip]

If your BGL is rising when you've skipped or delayed a meal your Basal isn't right, suggest you talk to your HCP to discuss changing it (and then probably your carb ratios too) while you're at it I suggest you talk about the bad hypo (they may pick up on something that happened around that time that you've not realised caused it and so then can be avoided in the furture)

Normally to bring back hypo awareness you'd run your BGL constantly slightly higher than normal for a bit.

I'm sure everyone here realizes when they get in a car and drive it is not just about their own safety..........

 

[PurpleSky1111]

Thanks all for the advice.
I have no intention of not talking to the dr about these issues, I was just wondering if such things have caused problems and I've now got some good advice on how to fix it a bit
@Diakat my child is not quite there yet , I'm trying to involve him now and he's becoming curious about what I do but his comprehension of it feels just a few weeks out of reach still!

 

[Diakat]

@PurpleSky1111 it's amazing (and disturbing) when they do. The first time she told me I would die if I didn't eat was horrific! Obviously her dad had been explaining things :-/ but they really do take it in their stride and she knows that after food/insulin I'll be a nicer mum. Huge hug BTW.