I would like some support through this difficult journey

[Fairygodmother]

Your gp should be able to give you a prescription for half unit pens, they take cartridges.
I know what you mean about being hungry and waiting - a bit of cheese or an egg might fill the gap before you eat carb: a stash of boiled eggs in the fridge?
Your washing up and laundry before eating trick sounds like the way Stephen Ponder says he watches for bloods to start descending before he eats - like a 45 degrees downward pointing arrow on the libre. It’s frustrating if you’re hungry, hence the egg, or cheese, or peanut butter . . .

 

[Fairygodmother]

Oh, and stevia, or truvia or the like as a sugar substitute in cooking?

 

[kitedoc]

Hi @MeiChanski,
If you find hypos and hypers too much and you are ready for a change that is when another approach
may help.
No half measures and you have already noted that protein goes not spike BSLs the way
carbs do !!

 

[evilclive]

My pens does whole units and not half units, so I have to either round up or down for carb amounts. (my pens are as old as my diabetes diagnosis ) Do you think I should ask for half unit pens?

Another reason to get a novopen echo (the half-unit version of the novopen 5) is the little display on the end telling how much you last dispensed and how long ago - when you start getting older and more forgetful, it's a very good thing

 

[WuTwo]

I use humalog and levemir. My surgery wouldn't fund a half unit humalog pen (I got told they were only for the children!) so I bought my own because I very much like the additional control I get from half units. The Levemir pen is the Echo mentioned by @evilclive. It was a few years ago so it may be that half unit pens for humalog are available on the NHS now. I hope so - the one I have will last a few years yet but it wasn't cheap and I've no reason to think the price will go down and if possible I'd like help to buy the next one.

The book I use as an instruction manual is Using Insulin by John Walsh and others. It's brilliant but pre-dates pumping so unless they've updated it, the book won't help any pumpers at all. It has an excellent chapter on basal testing and the info in it works for me, The section on working out ratios was very useful too! In fact, the whole book was a T1 education in itself. In fairness I would say it's nowhere near as easy to read as Think Like a Pancreas but I much preferred its textbook style.

 

[LooperCat]

I requested half unit pens from my hospital clinic, and then just changed the prescription to cartridges instead of prefilled pens from my GP. Didn't cost me anything.

 

[MeiChanski]

Your gp should be able to give you a prescription for half unit pens, they take cartridges.
I know what you mean about being hungry and waiting - a bit of cheese or an egg might fill the gap before you eat carb: a stash of boiled eggs in the fridge?
Your washing up and laundry before eating trick sounds like the way Stephen Ponder says he watches for bloods to start descending before he eats - like a 45 degrees downward pointing arrow on the libre. It’s frustrating if you’re hungry, hence the egg, or cheese, or peanut butter . . .

I've never really asked the GP for new pens, other than medication.
Ooo, that does indeed sound good. I'll give it a try again because my libre has ended.

 

[MeiChanski]

Hi @MeiChanski,
If you find hypos and hypers too much and you are ready for a change that is when another approach
may help.
No half measures and you have already noted that protein goes not spike BSLs the way
carbs do !!

What angle are we marching in? Indeed, I have heard that DAFNE wants to include protein along with carbs, because eastern europeans love their sausages.

 

[MeiChanski]

I use humalog and levemir. My surgery wouldn't fund a half unit humalog pen (I got told they were only for the children!) so I bought my own because I very much like the additional control I get from half units. The Levemir pen is the Echo mentioned by @evilclive. It was a few years ago so it may be that half unit pens for humalog are available on the NHS now. I hope so - the one I have will last a few years yet but it wasn't cheap and I've no reason to think the price will go down and if possible I'd like help to buy the next one.

The book I use as an instruction manual is Using Insulin by John Walsh and others. It's brilliant but pre-dates pumping so unless they've updated it, the book won't help any pumpers at all. It has an excellent chapter on basal testing and the info in it works for me, The section on working out ratios was very useful too! In fact, the whole book was a T1 education in itself. In fairness I would say it's nowhere near as easy to read as Think Like a Pancreas but I much preferred its textbook style.

I have heard stories where GPs would not prescribe new pens and the patient has to ask their diabetes team for new pens. I'll ask possible tomorrow because I don't think they have appointments at the moment.
Another reason to make me go shop on amazon, heheheh. I've seen great reviews for Thinking Like a Pancreas. Thank you so much!

 

[Fairygodmother]

I've never really asked the GP for new pens, other than medication.
Ooo, that does indeed sound good. I'll give it a try again because my libre has ended.

You could also ask the Consultant for libre on prescription when you next see them. If you show them that you test at least 8 times a day and are fighting to get better control then you might get it.
It may be that it’ll be the Consultant who has to give the go ahead for the half unit pens but you could try the DSN - email? Phone for an urgent appointment?

 

[MeiChanski]

Another update: Diabetes team called me back to say that they don't have a referral from my consultant to be asked to see a DSN. I saw my consultant on 2nd April and he put down to see me in another 10 weeks time, i'm assuming June? Also DSN appointments are fully booked, unless someone reschedules or cancels. Panic mode is still activated.

 

[MeiChanski]

You could also ask the Consultant for libre on prescription when you next see them. If you show them that you test at least 8 times a day and are fighting to get better control then you might get it.
It may be that it’ll be the Consultant who has to give the go ahead for the half unit pens but you could try the DSN - email? Phone for an urgent appointment?

Hmm, I could ask but unfortunately I won't see him until June. DSN said theres no referral from the consultant to see her or him. But I thought it was like my old hospital, where if you needed help just contact the DSN. because we only see consultants on 3-6monthly basis. I don't really know who to call at the moment and I felt like I've exhausted my current options.

 

[UK T1]

Your gp should be able to give you a prescription for half unit pens, they take cartridges.

Mention the fact that you haven't had new pens too - I got the most horrified look from my consultant when I said I'd had mine since I was diagnosed (about 10 yrs at the time) and he said the mechanism can be subject to wear and tear and can mean the dose isn't as accurate. He also said he would have expected it to break in the mean time so I had saved the NHS money by having it so long! Basically insisted I walked out with a new one from their clinic.
I find the half units on the Echo great especially for corrections, and yes the end is great as it tells you how many units you injected and how long ago.

 

[Deleted Account]

Regarding getting new pens, I hope you have spare pens as they could fail at any time.
Never go away without spare pens.

 

[Fairygodmother]

Hmm, I could ask but unfortunately I won't see him until June. DSN said theres no referral from the consultant to see her or him. But I thought it was like my old hospital, where if you needed help just contact the DSN. because we only see consultants on 3-6monthly basis. I don't really know who to call at the moment and I felt like I've exhausted my current options.

Do you have contact details for the DSN? It’s worth getting in touch if you do - sometimes we just have to make ourselves obvious and ask for attention to get the help we need. And it may be worth looking for a gp practice that has a DSN as well. It helps get things sorted in the times between Consultant visits. The practice group I’m registered with has a lovely DSN who’s very overworked, but who’ll do her best to help.

 

[MeiChanski]

Do you have contact details for the DSN? It’s worth getting in touch if you do - sometimes we just have to make ourselves obvious and ask for attention to get the help we need. And it may be worth looking for a gp practice that has a DSN as well. It helps get things sorted in the times between Consultant visits. The practice group I’m registered with has a lovely DSN who’s very overworked, but who’ll do her best to help.

I have contacted my Consultant's secretary (sounds quite posh, I would have assumed receptionist) who said she'll contact him to ask to pass my details onto diabetes centre to speak to a DSN. As I said I thought there would be a small team of people, where DSN and consultants work together and if I needed help, I could contact my DSN. So I will find out today if I can see a DSN asap.

 

[MeiChanski]

Regarding getting new pens, I hope you have spare pens as they could fail at any time.
Never go away without spare pens.

Oh boy, I was never given new pens. my ancient pens are still with me today.

 

[Fairygodmother]

Oh boy, I was never given new pens. my ancient pens are still with me today.

Oh yes, spares of everything - I even halve a spare accuchek mobile but that was only because I thought I’d lost it, bought another, and then found the first under the seat of himindoors’ car

 

[MeiChanski]

Oh yes, spares of everything - I even halve a spare accuchek mobile but that was only because I thought I’d lost it, bought another, and then found the first under the seat of himindoors’ car

Oh dear, I guess another reason to charge into the DSN office to ask for spares.

 

[MeiChanski]

Another update: my consultant's secretary referred me onto the diabetes team to see a DSN. but by the sound of it yesterday, the diabetes team are fully booked and won't be able to see me until June. Panic mode is still on.

But I got some new pens, it doesn't feel like the same quality as my ancient pens. very plastic, very wow.