Diabetes advice question ...

[donnellysdogs]

Actually the worst advice I got from pump nhs staff was that I HAD to have jelly babies as hypo stoppers. These crucified my stomach, gave ms slow colonic transit and since giving them up 18 months ago my stomach has taken 12 months to recover, but my slow colonic transit has completely disappeared, my gastro consultant says there is a large increase of diabetics with stomach problems and he is dept are now going to ask diabetics if they have jelly babies or jelly.....i have now been discharged from gastro consultant and no longer have any laxido's or enemas. I only have milk and sugar or dolly mixtures as my hypo stoppers.


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[iHs]

I am not trying to bash anyone here............

I am simply saying that mixed insulin's restricted peoples lifestyles and that the insulin available today gives more flexibility...

I can't remember saying anything about the knowledge and experience of iHs........

So your on a pump..........were you given training on you how to operate it........?.....

Do you use all the functions on it......?

Hi

Everyone is entitled to their own view point but regarding twice daily insulins not giving the same flexibility as bolus/basal, is that bad? Cant say that I suffered much at all tbh as I still ate the food I wanted and more or less ate the same quantities of food using bolus/basal too. The only thing that was different for me was doing more injections and having more hypos. Carb ratios were never discussed with me at all under GP care and I only found out about DAFNE by reading on the forum about BDEC and also reading Nobleheads msgs and clicking on some of the links left by Phoenix. I then realised what DAFNE was all about and how to adjust the ratios to the desired bg levels and started testing a lot more. I only got a pump through trying to control my bg levels a bit too tightly and also because my bg levels dropped very low naturally from midnight to 3am and then started to rise up sometimes slowly but sometimes fiercly and as a result anxiety started to rub off on my OH.

Twice daily insulins were about for many many years before bolus/basal became available and we all survived and still are

 

[iHs]

I believe iHs is on a pump and from what I know of iHshas one of the best knowledges I know of mixed insulin, mdi and pumping. If it hadnt have been for iHs my pump knowledge given to me by my initial hospital would have been ****..it was only due to iHs who gave me the best guidance ever that I gained the knowledge that made me inform accuchek and Abbot Navigator that there was something wrong with their sets for Accuchek and the Strips for Navigator..
IHs gave me the knowledge to look at patterns and I realised the problems I had were not my body.
Incidentally, I was taught so well when I was admitted to Poole General Hospital in early 1980 that I have never had a carb counting course.... And I manage my food perfectly...


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That's really lovely to think that of me. You are more than welcome..... You also helped me too lol

 

[novorapidboi26]

My belief is that the basal/bolus regime is far superior to the mixed insulin regime you seem to be very fond of, even though your pumping now.......

is it bad not having flexibility, no I suppose not, but what happens if something changes, weight, health, lifestyle.......

you can adapt and adjust to life on mixed insulin's, I was on it for many years, only up until about 6 years ago actually......

but looking back it just wasn't cutting it in comparison to the basal/bolus...............I think more importantly the basal/bolus can cater for changes better, both short term and long term.......

I realize that you can see my point and that you have used the basal/bolus and can see its benefits but that your just defending the mixed insulin as your experience was good on it.....

what changes in control did you observe when going over to basal/bolus?

 

[donnellysdogs]

More hypo's!!-lol!!

I actually personally think that it all leads to actually being able to carb count.

I helped a guy with a pump a few years ago that had been on mixed insulin all his life and for 30 years he had ate the samefoods... He never changed from his breakfast and foods that he was told he could eat 30 years ago....he was never taught how to adjust or exchange count. Just stuck to the same foods.

I was shocked. He then went on to a pump.... No mdi and a week before got taught how to carb count....

I will never forget him driving back home after coming to see me on his first weekend of having a pump. He phoned me on the way back... And asked how many carbs in a big mac?!!!

It certainly changed his life for him to carb count!! Pmsl!!! I moved shortly after but always wonder how he got on...and whether he still has the same food for breakfast, lunch and dinner or whether he found carb counting gave him his life back...


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[donnellysdogs]

We are all individual.. What suits some will not suit others... But carb counting and portion control is a must.




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[novorapidboi26]

We are all individual.. What suits some will not suit others... But carb counting and portion control is a must.




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I am in total agreement with that........

Even though I was on mixed insulin, I was never told about carb exchanges etc.....

Say you wanted to have a large pasta dinner with some garlic bread, a meal you wouldn't normally have......how would you adjust for this on a mixed insulin.........? Could you adjust......?

 

[iHs]

I eventually was given a Humalog bolus pen to use as a backup to my twice daily Humalog Mix if there were the odd occasions when I had more carb than my usual amount. So you could say that I had the best of both worlds

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[novorapidboi26]

Indeed............

The only issue then would be fluctuating background requirements.......

Was it long after you were given the Humalog bolus that you were offered a standalone background insulin?

 

[iHs]

I wasn't offered bolus/bolus at all. What happened is that I read an advert in Balance mag about this wonderous once daily insulin called Lantus so thought great.... no hypos etc and I could do away with a second injection and go back to my once daily regime that I had using Lente. When a consultant told me that I would also need to do a bolus injection I nearly said well thanks but no thanks. He said that Lantus and the bolus regime was new and asked me to give it a go so I said ok. What he didnt know was that his advice on dosage was not at all correct an I went very badly hypo

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[novorapidboi26]

The advice given wasn't too good then.........

But it seems as though you were right up at the front when these new regimes were being tested out.........

 

[donnellysdogs]

With mix insulin though... If its 30 /70 for example it is still possible to work out that 10 units is effectively giving you 3 units of fast acting.

From there you can play around with food types, .. So if you were basing it on 1 unit = 10g of food you would know that would give you 30g of carb throughout the period of the mix being given.. So you could decide whether to have 3 digestives or say an apple and a pear with a pink wafer biscuit. Mixtard etc is more limiting however if you know what levels of carbs keep you even you can still play around with the types of food you have.

Saying that, it is limiting if you have say teeth out and want less food or if you are hungry and wanting more.. But again if wanting less.. Soups are good lesser food for quantity and if you want more jacket spuds are filling...

Its when you want to have a piece of xmas cake, or birthday cake or puddings or takeaways that are limiting. Thats why I see iHs view on kids having mixtards, but in this day and age kids seem to be constantly eating runbish which to me is very limiting for them. ( not that I think they should eat runnish-lol!!), but I know if I had a child going to a birthday party or going out with friends I would not want my child to feel different and have to say "i can't have that" having seen a friends child on a pump and another child at school, the pumps do allow them more flexibility to be able to join in days of halloween parties, and eat what is on the menu at school.


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[smidge]

Interesting discussion. I think basal/bolus can make a massive difference to quality of life, but only if used properly and with good solid advice. The mixed insulins did not allow for the occasional treat very well, whereas the basal/bolus can do that. However, from my recent DAFNE experience I would have to say that they are not being used to support the occasional treat but to encourage the eating of any amount of carb you like and jabbing to cover it. This is flawed in so many ways. Occasional treats are good and enhance quality of life while causing no harm if covered with the appropriate dose - eating 'normally' is bad for a diabetic because the definition of 'normal' tends to be very high in carb which effectively raises our BG, causes us to take high doses and puts us at risk of serious hypos.

Smidge

 

[Daibell]

My Diabetes expert GP gave me a scrap of A4 on diet at diagnosis which was almost devoid of info. My DN gave me the East and North Herts booklet a year later when she realised I didn't have it. As I was underweight at diagnosis I wasn't told to lose weight. The E & N Herts booklet on diet is ridiculous but almost 10 years old. It says 'no special diet' is required. It says a healthy diet should be Low sugar, low fat, High in fibre and starchy carbs and low salt. It goes on about low fat, low salt and having lots of carbs in succeeding text. For someone who is actually T1.5 this advice for me was really stupid; thank you NHS for trying to make my diabetes worse.

 

[Daibell]

I know its not people bashing. But basal bolus regime has to jave carbcounting with it, and nowadays people just have to wait and wait, desppite the GP's now having targets set for them to achieve for type 1's to have carb counting dafne courses..
It was only thanks to iHs that I mastered my pump so quickly. I got it August 13 4 years ago and realised by October that yheir sets were faulty... The nhs staff put it down to me.... No carb counting course as I could prove that I did this for past 30 years.

It is amazing though that through both our abilitys for 30 years to be able to carb count and adjust our insulins from day one that neither iHs or I have diabetic complications... I personally do t think thats down to luck. We portion control our meals and keep active and fit...

I must admit I can't see a strong need for DAFNE other than to explain diabetes in a broad sense to newcomers. My excellent DN prescribed insulin when tablets finally failed. She just gave me Basal for a few weeks and asked for my meter readings. We looked at them and we agreed to add Bolus. She gave me a Roche carb-counting leaflet and said to look at the web as well. I've been doing it for a year with no hypos and an HBa1C of 6.3%. Why would I have needed a course at great expense to the NHS instead of this simple but adequate surgery advice and support?

 

[mrman]

I must admit I can't see a strong need for DAFNE other than to explain diabetes in a broad sense to newcomers. My excellent DN prescribed insulin when tablets finally failed. She just gave me Basal for a few weeks and asked for my meter readings. We looked at them and we agreed to add Bolus. She gave me a Roche carb-counting leaflet and said to look at the web as well. I've been doing it for a year with no hypos and an HBa1C of 6.3%. Why would I have needed a course at great expense to the NHS instead of this simple but adequate surgery advice and support?

I don't get it either.
surely makes sense to understand carb counting before being let loose with insulin, not.months/years/never

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[Crimsonclient]

I must admit I can't see a strong need for DAFNE other than to explain diabetes in a broad sense to newcomers. My excellent DN prescribed insulin when tablets finally failed. She just gave me Basal for a few weeks and asked for my meter readings. We looked at them and we agreed to add Bolus. She gave me a Roche carb-counting leaflet and said to look at the web as well. I've been doing it for a year with no hypos and an HBa1C of 6.3%. Why would I have needed a course at great expense to the NHS instead of this simple but adequate surgery advice and support?

I was put on to insulin in September after everything failed and was told to keep ringing diabetes clinic every other day until my insulin was working for me, never been given any advice other than that so whether a leaflet or a course would be good as I haven't got a clue about carb counting


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[donnellysdogs]

""I must admit I can't see a strong need for DAFNE other than to explain diabetes in a broad sense to newcomers. My excellent DN prescribed insulin when tablets finally failed. She just gave me Basal for a few weeks and asked for my meter readings. We looked at them and we agreed to add Bolus. She gave me a Roche carb-counting leaflet and said to look at the web as well. I've been doing it for a year with no hypos and an HBa1C of 6.3%. Why would I have needed a course at great expense to the NHS instead of this simple but adequate surgery advice and support?""

There is a difference for type 1's... They cannot be sent away for a few weeks on basal....which is why it is so important to have the dafne course as a minimum. You forget that the vast majority are young people with worried young parents....


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[jordanjones]

It would be interesting to get the forum memberships views on the advice we received when newly diagnosed so here is a question for people to answer if they wish to join in.

Question

Do you think that the importance of reducing the total amount of carbohydrates eaten needs to be made more clear by health care professionals to newly-diagnosed diabetics?

Please answer using the POLL tool shown at the TOP of the thread.

If you have been kind enough to answer this question then perhaps you would like to answer this one as well

http://www.diabetes.co.uk/forum/threads/diabetes-diet-question.54418/

Thanks

Yes its actually important for both people to know the amount of carbohydrates as they carbo foods are the ones that broken down into sugar first.

 

[xyzzy]

An unsubtle bump to catch any stragglers who may wish to cast their votes.