Confusion and conflicting messages - again

lilibet

Well-Known Member
Messages
515
Hi again

Am becoming major pain in the pancreas to this site I fear (boom boom).

Just had conflab with SDN who has cut insulin down to 6u am and 4u pm (honeymooning, moi?). She is aware I am desperate for control but the cut is due to 4's most afternoons and a lovely hypo today at the same time. However the cut at night time is because I am going to bed in the 5's at times (though not always) and she says that for a newly diagnosed the control is 'too tight' :?:

When I queried this reasoning she said gold standard pre bed was around 7. preferably 8 and otherwise as long as bg was not over 10 that this would be fine for now. When I queried how long they would keep me at non diabetic levels of bg I was advised that I was not to worry about this as when honeymoon period ended my requirments would go up.

Is it just me?
Is she right that newbies are preferred not to have readings like this already? I am only staring to try as I mean to go on (lectured again for not eating gigantic plates of pasta if I want). She says she knows I want tight control but it is too soon to be at this level. Am frustrated and feel quite despondent now. Am glad insulin is cut but not to expense of high bg.
BTW they havent all been at 4-7, some are still over this (almost 50/50 over test period of 9 days).

I also queried post prandial as when driving they are not within range sometimes hours after eating. I asked when we would start to look at this. Was told no to worry about that for now.

Not to worry! I know what the research says.

Sorry for the moan people. Am fed up working really hard and trying to be positive in lieu of some notion that things will work out eventually, maybe, whenever. :?

Lx
 

hanadr

Expert
Messages
8,157
Dislikes
soaps on telly and people talking about the characters as if they were real.
Ask her if she were diabetic if she wouldn't want to have tight control as quickly as possible. Why wait?
Certainly don't eat platefuls of pasta.unless it's the low carb stuff I've been reading about, which is sold in a healthfood shop about 15 miles away in another town, but might be worth my diesel money.
 

fergus

Well-Known Member
Messages
1,439
Type of diabetes
Type 1
I always thought that abnormal blood sugars were an unfortunate consequence of poor control? It seems these days as if some health professionals see it as a duty for diabetics to have raised bs levels. Jeezo, it makes me despair sometimes.
I think you're absolutely right to be sceptical, lilibet. No healthy non-diabetic would ever go to bed with a bs at 7 or 8, so why should we? Those are not healthy numbers full stop.
Too early for tight control? What, do they want you to develop complications first?

All the best,

fergus
 

caitycakes

Well-Known Member
Messages
110
At the clinic I attend, they tell you to adjust your own insulin and to phone them if you have any questions or worries. I felt quite deprived at first because I was so scared and felt that a bit of hand holding was in order, but they were right. The only way to do it is by yourself. They don't know what your lifestyle requirements are, or whether you like to eat more at the begining of the day or at the end. I was started on 10 and 10 and made all the adjustments myself. Now take 2 am and 7 pm (I like a bigger meal at the end of the day) and eat much less during the day. This is what suits me best. At first I felt I was feeding the insulin, but not any more. With a few adjustments it is definitely serving me instead of the other way round.

caitycakesX
 

lilibet

Well-Known Member
Messages
515
Well

As suspected would happen, BS back in double figures before bed for the first time in two+ weeks and higher this morning.
Am actually livid now but have decided to give it one more day with their advice, change what I am eating at tea time and then see. I prefer my bigger meal at night too so am loathe to cut portions again (only having tablespoon starchy carbs at most) If they are higher again, I will be calling first thing tomorrow and strongly suggesting my night time dose increases to what it was.
Have new patient appt with endocrinologist in 4 weeks - god help him.
Maybe if they are lucky the lurking low mood will descend and I'll be too depressed and unwell to be feisty.

My DSN knows my wishes for my condition (ie tight control, always) and I dont understand why they dont realise that most people with diabetes psychological wellbeing is tied to their blood sugars from what I can see, and its certainly the case for me.

Thanks for the support guys

Lx :
 

fergus

Well-Known Member
Messages
1,439
Type of diabetes
Type 1
Hi lilibet,

Am I right in thinking you're on a mixed insulin with 2 injections daily? That will always make tight control a little harder than a basal bolus regime of course. In a sense you will be eating to cover the insulin, rather than injecting to cover your meals. Did they start you out on this system to allow you time to adjust to the self-injecting way of life? I'd be interested to know what the thinking is.
Basal/bolus would mean injecting more often, but you would have a lot more flexibilty over what / when / how much to eat.
You'll get on top of this!

All the best,

fergus
 

lilibet

Well-Known Member
Messages
515
Hi Fergus

Yes am on premix 2x daily. Have no idea why they started me on that. Initial regimen was sliding scale via hospital inpatient stay so dont know if the 'crisis management' aspect has influenced them. In terms of injections etc, like most people you dont really have much choice but to get on with it, if you are able.

DSN has made reference to basal/bolus and the fact that most people eventually go on to this but no timescales mentioned as such and no reference made to me. Caitycakes has made point that due to low doses at present plus honeymoon period they might be reluctant to given titrating the dose might be difficult . Or maybe they are just trying to get me stable. My worry is of course is that stability wont be forthcoming. At present am on 6 and 4 am and pm -Mixtard 30

I appreciate Rome wasnt built in a day I and probably err on the side of zealous but I would have thought that was a good thing :!: DSN clearly thinks because diagnosis only three or so weeks that I am rushing thing and things need 'time to settle'. Not to sound overly negative but as far as I was concerned, the clock started ticking as soon as I was diagnosed, and more so cause I obviously had it before diagnosis - for who knows how many weeks.

I was devastated, like most people, on diagnosis for the reasons that I knew what diabetes entailed and what the complications are. As the A and E doc (un)kindly said whilst I cried my eyes out on a trolley 'well, at least you're taking it seriously'.

Again, thanks for the support. Im sure I'll get there. I just want to get there quickly and the unfortunate thing about this condition (aside from everything else) is the fact that there are no benchmarks as to how long it should take to settle etc. Being told Im making progress is the stock phrase but doesnt cut the mustard as far as I am concerned.

L x

PS is mustard low carb :p
 

Trinkwasser

Well-Known Member
Messages
2,468
lilibet said:
Hi Fergus

Yes am on premix 2x daily. Have no idea why they started me on that.

Because it's cheaper. Next question.

Personally I'd have thought the honeymoon is just exactly the time when you'd need to maximise control and be able to tweak your doses.

You know, sometimes I seriously think they DON'T WANT people to have good control because it would be UNFAIR to the people who can't achieve it.
 

sugarless sue

Master
Messages
10,098
Dislikes
Rude people! Not being able to do the things I want to do.
My doctor was full of doom and gloom today about the inevitability of me having to go on tabs.I said ,fine when I have too,but I don't need to yet.She tried to give me aspirin,as this upsets stomach I politely declined .She tried to give me Simvastatin but I said I would just lose some more weight instead!!I explained about low carb and decreasing the amount of circulating insulin (thank you Fergus!!) I even managed to get 100 test strips but sadly only for a month!Means I can fine tune a bit more anyway.
 

Trinkwasser

Well-Known Member
Messages
2,468
sugarless sue said:
My doctor was full of doom and gloom today about the inevitability of me having to go on tabs.I said ,fine when I have too,but I don't need to yet.She tried to give me aspirin,as this upsets stomach I politely declined .She tried to give me Simvastatin but I said I would just lose some more weight instead!!I explained about low carb and decreasing the amount of circulating insulin (thank you Fergus!!) I even managed to get 100 test strips but sadly only for a month!Means I can fine tune a bit more anyway.

Mine is sensible enough to admit to being impressed but prevented by the PCT rules from doing other than proscribed. I suppose if most people follow the high carb diet and take their pills and never test they inevitably decline and end up on insulin and doctors simply haven't seen enough people doing otherwise yet to think of us other than as lucky.