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Insulin users on fixed doses?

D

Daibell

Master
Messages
12,677
Location
Hertfordshire, England
Type of diabetes
LADA
Treatment type
Insulin
There have been several posts recently from insulin users who have been put onto a fixed Bolus regime where they are told to match their meal carbs to a fixed Bolus dose three times a day. Some seem to have been on this regime for many months. Anyone any idea why an HCP would want to recommend this as you still have to work out meal carbs but end up being forced to eat a quantity you may not want and likely to put on weight or go hypo. Am I missing something?
 
I think (although I may be wrong) that they do this to people who are newly diagnosed until they are comfortable with adjusting their insulin themselves, also children are often given fixed doses as it suits their routine with school meals and such.
 
???? Beats the hell out of me. Have noticed newly diagnosed on this as well as long term diabetics from posts on here.

Can remember when I was newly diagnosed, let out.of hospital on fixed amounts, no meter. All I had before discharge was a brief visit from I think a dietician, I discussed what I usually ate on a daily basis and told thats fine carry on. 2 days later went ro lloyds pharmacy for them to test my bloods (i know) and in the 20s. Straight to doctors, seen there diabetic nurse, who said much the same thing but at least gave me a metre. No one advised on carbs at all. A week later seen hospital dsn who briefly went through counting carbs and I learnt everything else myself, researching basal checking which led me from 18 units to 0 due to honeymoon period a few weeks later, despite being told I need basal and reduce bolus, yet I knew it was right due to overnight readings. Good job really cause id of either done a lot of damage from highs or worse, suffered a major hypo.
surely newly diagnosed should not be let out with set amounts and taught at least the basics in hospital to be confident to test and adjust.


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2 hours in hospital, sent on my merry way with fixed doses and a dietician appointment for 2 weeks later.

Luckily I knew the basics already well enough from my cousin and so went in ready to tell them I wanted off fixed doses and be free to change. They had no issue with that.


Blogging at drivendiabetic.wordpress.com
 
I was diagnosed end of November and was on fixed amounts. I'd then contact my dsn every week with my figures and she's increase my insulin as necessary. However my meals differed greatly each day due to shift work and I was never told to match my carbs to the insulin. I got fed up and started carb counting myself 2 weeks ago, best thing I did and wish I'd started sooner


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First week after leaving hospital was a nighmare. Fixed dose of 10 u Novorapid was causing hypos after every meal. i learned everything from internet and never had any proper training from my hospital.
 
RosieDred said:
I was diagnosed end of November and was on fixed amounts. I'd then contact my dsn every week with my figures and she's increase my insulin as necessary. However my meals differed greatly each day due to shift work and I was never told to match my carbs to the insulin. I got fed up and started carb counting myself 2 weeks ago, best thing I did and wish I'd started sooner


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I've never met my DSN once in my almost year of diabetes. Occasional brief email saying I have an issue, get a 1 liner in return saying I'm fine and to "adjust as necessary"


Blogging at drivendiabetic.wordpress.com
 
I put myself on a fixed dose several years ago.

I don't have to count carbs.

My blood-sugar is nearly always near normal.

I don't have hypos.
 
For school kids or those that generally stick with the same meals, fixed dose is fine as in theory nothing should change. Most people though with a varied diet/lifestyle should certainly go straight for basal/bolus.


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My dsn wanted to keep me on fixed when I asked her. I'd been on fixed for 18 years and didn't really have a clue that there was any other option until I looked on the web.
She did grudgingly refer me...
 
hale710 said:
I've never met my DSN once in my almost year of diabetes. Occasional brief email saying I have an issue, get a 1 liner in return saying I'm fine and to "adjust as necessary"


Blogging at drivendiabetic.wordpress.com
Click to expand...

I've met mine once, a few days after getting out of the hospital after diagnosis. We then spoke once a week in the phone up until a month ago when she said everything was fine so she'll see me in a month.

I have an appointment to see her tomorrow and I haven't told her I'm carb counting yet so going to do it then. I hope she's okay with it, I just couldn't stick being on fixed units anymore


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