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Feeling frustrated!

audsital

audsital

Well-Known Member
Messages
99
Location
Northern Italy, but am from Scotland
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Not being able to eat carbs!
Hi all, I am looking for a little advice if anyone through experience might be able to help.
I am lada and was put on insulin from diagnosis, the other night I had a high bg reading and my monitor was telling me to check for ketones. As I don't have any means of testing I just drank loads of water and went to bed.
Today I went to the doctors and explained what happened and I asked to be prescribed the testing sticks for ketones. He told me that they did not prove someone has ketones as the only way to do that was through a blood test. He offered to send me for the test,to which I said I didn't think I have ketones right now as today my bg has been good. I said I would like to have the strips for the next time my monitor tells me to check for ketones and again he reiterated about the blood test.....uff!.
I then asked what I should do then the next time my blood that high, should I take a unit of insulin or not ,to which he replied my insulin is fixed and you do not just change it even if your blood is high!!!
They do not have dafne or anything like that here in Italy so I really don't know what to do, I've been reading on the forum about people taking extra insulin when needed and also adjusting their insulin to carbs. I am 45 and was only diagnosed in Jan of this year. All I want is to try and keep myself from getting complications in the future but what chance have I got :(
 
The nurse gave us a ketone blood meter as its more accurate to check for ketones as they show up in your blood way before the urine strips pick it up.maybe ask your nurse for the meter we have only use it a few times when Chloe has been ill but its a god send to put your mind at rest x


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Depends what insulin regime you are on. Basal/bolus known as mdi(multiple daily injections) are designed so that you have a fixed basal insulin (long acting) to keep you stable through the night and when skipping a meal or eating different times of day , and a qa (quick acting) which doses are adjusted according to the amount of carbs you are eating at a meal time. This should ideally be discussed with your dsn/consultant and a good idea to to a dafne course if using this. Other regimes are available requiring fixed doses, working well if eating save amount of carbs at same time each day.
Regarding the ketones, all type 1s should have a blood monitor which also tests for ketones. Not all monitors accept the test strips for ketones. basically these monitors test for ketones exactly the same way as sugar levels, via a finger prick blood test. Again, see your dsn/consultant who should tell your gp to prescribe you the relevant strips. Your dsn should give the appropriate monitor. ketones should be tested for alongside high sugar readings and when ill.
The other way to test fire ketones is through a uterine stick test, which can also be prescribed.
My advice would be to discuss all of this with your dsn/consultant and find a new doc in the meantime.

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You need to take more insulin to bring your blood sugar down if its that high it's called a correction dose and I think you need to carb count to understand how much insulin you need to bring you down to a normal level . My daughter has 0.5 units for every 5mmol she is over 10 but it will vary for everyone .maybe see a different gp or ask to see nurse and dietician who can help your rite to want to help yourself as much as possible . P.s I'm coming to Italy on Sunday,what a beautiful place


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Hi. It seems you are having very poor support. Can I assume you are on Basal/Bolus i.e. both long and short acting insulins? If so, many of us would advise varying the rapid insulin dose to suit the meal carbs i.e. carb counting. Also, of course, ensuring that the Basal dose is about right to have a good level on waking e.g. between 5 and 7 mmol. If you cannot find better medical support then it's your decision on whether to vary your rapid insulin dose for meal carbs. My nurse started me on 1 unit per 10gm carbs and I have slightly lowered this with her agreement and my measurement experience. Some people will have a bit more or less than this; perhaps quite a bit more if overweight. Whatever you decide you must, of course, measure your blood sugar to avoid hypos and to understand what your body needs. If possible do get better medical support. BTW you can buy ketone strips at any pharmacy and many people use them if worried about very high blood sugar levels. If you are on a mixed insulin, then changing insulin dose is more difficult than with separate Basal/Bolus
 
Hi and thanks for all the great advice. I take humalog with meals and lantus at night, i am going to try matching the carb to insulin ratio and see how it goes. Usually i have good bg control but have had a few occasions like tonight i ate half an apple after dinner and my bg went high again. I thought i was being healthy:roll: i will enquire in the chemist here to buy the testing strips. Its just so frustrating here as i was diagnosed after being taken to a&e, then i was in hospital for 6 days,given a 4 page printed diet guidance sheet to follow (1800 calories a day!) Insulin and sent on my way. I remember asking what they meant when they said my anti.bodies had attacked my pancreas and the diabetologo told me not to worry about it! There are no courses here to guide you. Sorry to moan. I know i just need to get on with it. Its just i read things on the forum about taking corrective doses etc and hit a brick wall here when i ask about it. They dont seem to have a proactive appproach and its kind of black or white n that's it.

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audsital said:
Sorry to moan.
Click to expand...

You have a right to moan, you're getting very out of date treatment. The doctor is dead wrong to say that "insulin is fixed".

Order some books online, "Think Like A Pancreas" is a great start, the author (Scheiner) also has another book,"The Ultimate Guide to Accurate Carb Counting".

Maybe start a monthly meeting with local diabetics frustrated with the situation! If the doctors won't help you you have to help yourselves.


Cheers
 
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