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Diabetic nurse rant...

britincali

britincali

Well-Known Member
Messages
170
Type of diabetes
Type 1
Treatment type
Insulin
I had my first official appointment today with my diabetic nurse, I was diagnosed T1 in October and have seen a few different doctors and nurses but this one is apparently my long term nurse.

As a bit of background I'm an quite analytical person and am defiantly not stupid so after two weeks of blood sugars from 12 to 16 by injecting the recommended 4 units of novorapid per meal decided to do something about it and started studying the condition big time, I found here and have not stopped learning.

I've cut down on carbs and now stay clear from refined carbs as much as possible, Ive also been counting carbs and adjusting my novorapid per meal, anywhere from zero up to 16 units, my sugars would constantly be 3-4 mmol higher after sleeping so I adjusted my lantus up from 6 units to 8 at night. I've also learned i'm 1:5 insulin to carb ratio.

According to my meter and phone app my average blood sugar is now 6.6 mmol with a HbA1c of 6.5 (not checked just according to my app) My lowest reading ever was 3.9 with my highest in 2 months at 12.1. My sugars stay within 1 mmol after a nights sleep.

Well she went nuts, was NOT happy, apparently i'm being dangerous and irresponsible doing what i'm doing and she couldn't believe I was adjusting my doses, she asked where I learned to count carbs and I told her online, I got a big roll eyes... She asked where or who told me to adjust my insulin and same thing just a big sigh and another speech about how im going to have a massive hypo.

I tell her I haven't had a hypo yet, she grabs my meter and shows me a 3.9 reading, she said sternly anything under 4 is a hypo, to which I argued what about the 15% meter innacuracy? I told her I felt it coming and had a digestive to adjust, she told me no that's wrong I should have had 5 glucose tablets or a bottle of lucosade, I said I would have been sky high after that much and all I needed was one biscuit to bring me back up to 5, even though the meter confirmed this she said I was just lucky that time.

All she kept doing was writing in her book about how my average BG reading was 5 to which I argued and showed her the 6.6 on the meter and how she had warned me verbally about what I was doing.

By now im getting angry and this woman giving me **** for having (as far as im concerned) pretty **** good numbers, I told her I wasn't your average thicko and have spent countless hours researching.

She also tells me in testing too often and not to let diabetes take over my life.

She then makes me another appointment for 4 month away, if i'm killing myself as bad as she said why the hell wouldn't she want to see me in a week?

She sent me home with a blood vial thing to get a HbA1c done then on the way out the door said 'your doing good keep it up' to which I stopped and glared at her.

I left feeling angry, upset and frankly just wanting to go on the **** all afternoon.

How the hell do they get away with telling people such complete and utter ****?
 
Last edited by a moderator:
Don't worry, you did great job. You are the first person who need to fight with Diabetes and it's really great to hear that you are interested to keep it in normal range. For me counting carbs is the best thing you can do and luckily it was the first thing I was learned when was diagnosed. Being T1 on recommended units of your fast acting insulin is stupid, because every day is different. You will never have same meals (gram of carbs), exercises, stress level... It's not copy/paste thing. Also try to do your Hba1c tests every three months, because on this apps it can be unreliable just because when you are low or high you will check few times more than usual and it can reflect on this results. Also if you are newly diagnosed be careful because there is always chance to get in honeymoon period (time when your pancreas start to produce some insulin again) and you could go low (it doesn't happen to everyone, but you never know). Over time everything will become easier and you will know how your sugars react on situations you are having everyday
 
strangely enough my diabetes story is almost the same as yours with the one exception that all of the HCP involved have had the opposite reaction to your nurse.

spoke to my consultant yesterday and after explaining how I'd been adjusting my basal she simply commented "excellent"

by the way your numbers look excellent, or at least similar to mine and I got told what a good boy I was so you must be good too
 
You are right and she is wrong. My lovely DN showed me carb-counting at the same session she started my Bolus. It took 10 minutes and she gave me a leaflet showing types of food and their carb content. She said start at a 1:10 ratio and take it from there. To start anyone on fixed carbs is pretty dumb unless the person is obviously thick or nervous. I was 4.3 this morning as I keep my Basal shots quite high but I know when I'm hypo'ish as I was this morning and like you had some fruit and then breakfast; I also have glucose tablets nearby. Your nurse is obviously insecure and needs to be in control. My lovely DN has left so I'm dreading my next one being like yours...
 
Funny enough i had two of em on my back when i brought my HbA1c down from 7.4 to 6.5..
they wanted me back in 3 months.. The hypo thing was the concern.. I wasn't having any more than usual & i'm fully aware even when asleep.

Keep it up. you know your own body!
 
britincali said:
I had my first official appointment today with my diabetic nurse, I was diagnosed T1 in October and have seen a few different doctors and nurses but this one is apparently my long term nurse.

As a bit of background I'm an quite analytical person and am defiantly not stupid so after two weeks of blood sugars from 12 to 16 by injecting the recommended 4 units of novorapid per meal decided to do something about it and started studying the condition big time, I found here and have not stopped learning.

I've cut down on carbs and now stay clear from refined carbs as much as possible, Ive also been counting carbs and adjusting my novorapid per meal, anywhere from zero up to 16 units, my sugars would constantly be 3-4 mmol higher after sleeping so I adjusted my lantus up from 6 units to 8 at night. I've also learned i'm 1:5 insulin to carb ratio.

According to my meter and phone app my average blood sugar is now 6.6 mmol with a HbA1c of 6.5 (not checked just according to my app) My lowest reading ever was 3.9 with my highest in 3 months at 12.1. My sugars stay within 1 mmol after a nights sleep.

Well she went nuts, was NOT happy, apparently i'm being dangerous and irresponsible doing what i'm doing and she couldn't believe I was adjusting my doses, she asked where I learned to count carbs and I told her online, I got a big roll eyes... She asked where or who told me to adjust my insulin and same thing just a big sigh and another speech about how im going to have a massive hypo.

I tell her I haven't had a hypo yet, she grabs my meter and shows me a 3.9 reading, she said sternly anything under 4 is a hypo, to which I argued what about the 15% meter innacuracy? I told her I felt it coming and had a digestive to adjust, she told me no that's wrong I should have had 5 glucose tablets or a bottle of lucosade, I said I would have been sky high after that much and all I needed was one biscuit to bring me back up to 5, even though the meter confirmed this she said I was just lucky that time.

All she kept doing was writing in her book about how my average BG reading was 5 to which I argued and showed her the 6.6 on the meter and how she had warned me verbally about what I was doing.

By now im getting angry and this woman giving me **** for having (as far as im concerned) pretty **** good numbers, I told her I wasn't your average thicko and have spent countless hours researching.

She also tells me in testing too often and not to let diabetes take over my life.

She then makes me another appointment for 4 month away, if i'm killing myself as bad as she said why the hell wouldn't she want to see me in a week?

She sent me home with a blood vial thing to get a HbA1c done then on the way out the door said 'your doing good keep it up' to which I stopped and glared at her.

I left feeling angry, upset and frankly just wanting to go on the **** all afternoon.

How the hell do they get away with telling people such complete and utter ****?
Click to expand...
ma
 
maybe as a new diagnosis, she felt wrongly, that you weren't capable of making sense of all the information and juggling that is thrown at us newbies. I have to admit i was swamped with my initial diagnosis and needed all the support my brilliant diabetes nurse gave me, but since then have really found the support of this forum fundamental to my management of my levels. As she won't be seeing you for a while, I'd carry on doing what is obviously working successfully for you - after all, we have to manage ourselves 24 hours a day. Good luck
 
You are doing brilliantly; and this is just the start. You already know more than you DN just keep going, and in a while you'll know more than your consultant.

The worst advice I ever got was that my HbA1c of 5.8% was too low and I should raise it. Like a fool I did.

You know what you are doing; keep doing it!

Best

Dillinger
 
Well done!

I had the same, people think newly diagnosed diabetics are unable to grasp the concepts and strategies of coping and the fact that insulin needs can fluctuate. How wrong they are!

Well done on ur brill control! You'll eventually see a doctor who is more uptodate. The one I last saw said "I wish all my patients were like you".

If your blood sugar results are that good keep up the good work!
 
@britincali, your doing great for someone who has only been diagnosed for a short space of time, I don't know why your DSN is taking this stance as your avoiding hypo's and recognise the symptoms when your bg does go low.

The whole idea of basal/bolus is so you can adjust your insulin doses to the carbs in your meals, sticking to fixed doses and fixed meals is fine for some who have difficulty grasping things in the first few months, but as you have done your own research and taught yourself to carb count I can't see where the problem is.

Well done and keep up the good work :)
 
Well done. You've proven your DSN wrong. She probably is used to people without your get up and go. Your approach will keep you fit and healthy for a long time beyond them!
 
Thanks for the kind words guys :)


I just can't get over how much really bad advice is spouted by so called professionals, the dietician lady told me I should be eating at least 30% carbs per meal and sugar was fine in moderation :(
 
Well done you. I would kill for figures like yours. Remember you get good nurses and bad ones. I think you have a pretty good handle on how diabetes works, trust in yourself. I suspect when you see a consultant you will get a pat on the back and a gold star. Keep it going.
 
Ditto what everyone else has said. You're doing far better than could ever be reasonably expected for someone so new to diabetes. She clearly doesn't know what she's talking about, like most DSN's I've encountered.
 
It's called diaconnect, it's really easy to use and tracks everything carbs, workouts, basal bolus and corrective insulin and puts it all into tables/ graphs/pie charts and all the info can be emailed via pdf, here's a screen shot of today..

 
Cheers for turning me on to this app @britincali . Just put it on my iPad mini. (I only use my windows phone for calls & text.)
Seems to be add free which is good. The app when open somewhat looks like the BBC weather app visually & only holds in "landscape mode". But looks fool proof to me. May even help settle my score with my two D nurses..? Though in fairness they aren't too bad. Just what we all term a "professional disagreement". As I remind them, I work at D HQ full time! Lol

Nice find..! :)
 
I wouldn't worry about it. I had the same after I was diagnosed and started to do more or less the same as you.
I think it comes to an experience thing and they get nervous with newbies taking that much control from the get go.

What seemed to get them to settle down a bit was when I did a DAFNE course, that way they had some "official" training on file for me and they seemed to calm down at that point. I did subsequently have a Dr go off on one saying I was clearly having hypos all the time so they fitted me with a CGM for a week. When they pulled the numbers and found they were good that also went into the file.

Give them a little bit of slack and try not to take it too much to heart. They really do struggle with those of us that can actually calculate what changes we need to make instead of titrating like they usually do. Once they get used to you and have more evidence on file they should leave you be and not get as uppity.

The Dr's are a different story though, DSN's seem to be a little more practical about things as far as my experience goes.

/A
 
That silly witch can go fiddle herself as far as I'm concerned, here's today's effort. (Including 2 pints of carling and a bottle of wine from 6 to 9.30pm)



:)
 
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