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Is MDI the right way to treat newly diagnosed T1 diabetes given the current educational model?
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<blockquote data-quote="PaulinaB" data-source="post: 1159042" data-attributes="member: 96654"><p>I think it may be tricky to give people a choice when they're newly diagnosed - how are the supposed to know what those things even mean? <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /> </p><p></p><p>I can only say from my experience. When I was diagnosed I was given Novomix and told to inject X units, record everything, etc. But I was also given a phone number and told to call in 3 days - it was a phone line to diabetic nurses in my hospital clinic. For the next couple of weeks I called my nurse every 2-3 days, told her what my numbers were and adjusted my doses as per what see said. After a while (and I mean a while, 2 months probably), I saw my nurse again and she decided mixed insulting wasn't working and I should use MDI. Best decision ever. </p><p></p><p>What were my takings?</p><p>1. It was ok that she put me on mixed insulin at first - I could get my BG down to any sort of human levels (was 50mmol/l on diagnosis) and didn't freak me out completely - I could handle injecting X units 2 times a day.</p><p>I had a chance to get to grips with the diagnosis and do my research before I was overwhelmed with practicalities. </p><p>2. I think it took way too long to put me on MDI. After first 2 weeks it was quite obvious (now that I think back) that it was not working for me and I was already aware enough of my reactions that talking about MDI at this point would not send me screaming. </p><p>3. I'm very happy on MDI, my control is great and I wouldn't change it. But am I aware that there are people for whom this is just too complicated and for whom mixed insulin may work better. </p><p></p><p>Do I think people should be put on MDI straight from diagnosis? Probably not... I'd give them mixed insulin and immediately send them to a carb counting course. Then, if there's a chance MDI may work better for them and they're up for it - go ahead.</p></blockquote><p></p>
[QUOTE="PaulinaB, post: 1159042, member: 96654"] I think it may be tricky to give people a choice when they're newly diagnosed - how are the supposed to know what those things even mean? :) I can only say from my experience. When I was diagnosed I was given Novomix and told to inject X units, record everything, etc. But I was also given a phone number and told to call in 3 days - it was a phone line to diabetic nurses in my hospital clinic. For the next couple of weeks I called my nurse every 2-3 days, told her what my numbers were and adjusted my doses as per what see said. After a while (and I mean a while, 2 months probably), I saw my nurse again and she decided mixed insulting wasn't working and I should use MDI. Best decision ever. What were my takings? 1. It was ok that she put me on mixed insulin at first - I could get my BG down to any sort of human levels (was 50mmol/l on diagnosis) and didn't freak me out completely - I could handle injecting X units 2 times a day. I had a chance to get to grips with the diagnosis and do my research before I was overwhelmed with practicalities. 2. I think it took way too long to put me on MDI. After first 2 weeks it was quite obvious (now that I think back) that it was not working for me and I was already aware enough of my reactions that talking about MDI at this point would not send me screaming. 3. I'm very happy on MDI, my control is great and I wouldn't change it. But am I aware that there are people for whom this is just too complicated and for whom mixed insulin may work better. Do I think people should be put on MDI straight from diagnosis? Probably not... I'd give them mixed insulin and immediately send them to a carb counting course. Then, if there's a chance MDI may work better for them and they're up for it - go ahead. [/QUOTE]
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