Ketones DR seems very concerned

[donnellysdogs]

That is much better treatment from your GP!! If you have test done and it does come back as type 1 then I would advise that you ask GP for a Consultant referral.

GP's should be doing everything to avoid unplanned admissions to hospital.

How's readings now that you've ate?

 

[orchidlady]

BS around 16, ketones under control, thanks to all that water, glucose strip reading incredibly high. It could be better but also could be whole lot worse. This latest GP has been excellent,

 

[donnellysdogs]

Pleased that you got better GP. Let us know how you get on tomorrow. You will be feeling better soon. Make sure that you will have plenty of strips on prescription, if not then see if you can get an increase ASAP.

 

[orchidlady]

Well all kitted out now. Nurse spent along time with me yesterday. Have been given. Levermir and NovoRapid. Am still slightly terrified but have injected 3 times, am being overly careful but sure my confidence will build. Hope I start to feel better soon, not sure how quickly I should expect to see improvements.

 

[AndBreathe]

Well all kitted out now. Nurse spent along time with me yesterday. Have been given. Levermir and NovoRapid. Am still slightly terrified but have injected 3 times, am being overly careful but sure my confidence will build. Hope I start to feel better soon, not sure how quickly I should expect to see improvements.

Well done orchidlady. Some things just have to be done, unfortunately.

I couldn't speculate how long it will take for you to feel better, but hopefully pretty soon.

 

[donnellysdogs]

Well done!! Glad u found a gp that took responsibilty and that your nurse appears to have given you some time!!

Got to confess... 30 years ago.. They sometimes gave an orange to practice with.. When I was taken into hospital, I asked them for something to numb my leg with!! Got told "don't be so stupid!" All within 30 mins of going on to the ward I'd had my first injection... And no, it didn't hurt even with the 12mm needles we had in those days!!

Well done orchid lady. Were you given pens and a box of cartridges. If not get them on your repeat prescription quickly anyway.. Go back to your good gp for this!!

 

[donnellysdogs]

Well done!! Glad u found a gp that took responsibilty and that your nurse appears to have given you some time!!

Got to confess... 30 years ago.. They sometimes gave an orange to practice with.. When I was taken into hospital, I asked them for something to numb my leg with!! Got told "don't be so stupid!" All within 30 mins of going on to the ward I'd had my first injection... And no, it didn't hurt even with the 12mm needles we had in those days!!

Well done orchid lady. Were you given pens and a box of cartridges. If not get them on your repeat prescription quickly anyway.. Go back to your good gp for this!!

 

[orchidlady]

Goodness don't like the sound of 12mm needles, things are so much easier nowadays.

. Yes was given pens and cartridges and new Blood monitoring machine. Still getting to grips with things just tested 2 hours after food and on 18.4 oops, just taken correciont dose. Nurse always on tap for advice. Trial and error I suspect. Bit scared to eat any carbs right now.

 

[donnellysdogs]

If you dont eat now for 5 hours after that correction injection you will see whether it was high enough dose or not..

Your target should be to come down to 6.0bg by end of 5 hours.

 

[donnellysdogs]

Basically if you get down to 6.0'within 2 hours then you stand a risk of hoing hypo before 5 hours. So too much correction insulin.

If you not down to 6.0 by 5 hours then not enough.

However, I doubt if the nurse wants you to get down to levels of 6.0 at the moment.. When do you next see her?

 

[phoenix]

Its great that you now have someone on tap for help.

Re DDd story. I left the GPs surgery with instructions to go to the hospital, I still thought I had T2 and that it wasn't a terribly serious condition. I t assumed that they had fitted me in at the end of a clinic. We even stopped for a quick cup of coffee on the way. When we got there we found that we were supposed to have gone to A and E where the doctor was waiting for me . He then proceeded to take a huge number of vials of blood.
I was taken up to a room, had a cannula stuck in my stomach and a pump clipped to my clothing (didn't really know what it was. They then put a drip up for fluids gave me a 2 litre container and told me I had to wee in that for the next 24 hours. All the time they were of course speaking in French so I didn't understand most what they were saying. I was completely dazed.
By the time I was asked to start injecting myself I'd had so many tests and procedures that it seemed quite a minor idea. I did say weakly I'll try. The doc retorted that if I didn't do it myself then I'd have to have then nurse visit twice a day, I'd be stuck at home and I wouldn't like that

 

[orchidlady]

*donnelly* That makes sense, though I felt 18.6 after 2 hours was way too high so gave correction dose. Will be checking again soon as need some lunch.
*phoenix* What a nightmare experience, were you on holiday.? At least when I got put on a drip last week I was being informed what was going on., still they still let me leave with BS of 18, that had continued ti creep up whilst on drip, should have been a clue that something was wrong.

 

[donnellysdogs]

Orchidlady, is nurse contacting you daily orevery couple days to asvise you how to change doses? Or has she given you instructions on how to adjust yourself?

 

[orchidlady]

I can call her whenever I like, gonna see how levels go, think levemir is low, starting slowly to be safe. But I an getting mt head around how to correct, managed to get down to 8.6 before lunch, unheard of for me.

 

[donnellysdogs]

Wow! That a good result pre lunch!! Fantastic.

They will want you to gradually come lower to avoid sending you in to hypo's.

There another point... Did nurse explain symptoms of hypo's and advising DVLA if you drive?

I was made to run up and down 4 flights of stairs before I left hospital! Didn't go hypo, and they gave up and sent me home! but had one the following week!!

See if you can wake up at 3am for a couple of nights to check your readings. This will give you an idea whether nightimes you are going near hypo level or hyper or get DP.

So glad you got your levels better.

 

[orchidlady]

Wow! That a good result pre lunch!! Fantastic.

They will want you to gradually come lower to avoid sending you in to hypo's.

There another point... Did nurse explain symptoms of hypo's and advising DVLA if you drive?

I was made to run up and down 4 flights of stairs before I left hospital! Didn't go hypo, and they gave up and sent me home! but had one the following week!!

See if you can wake up at 3am for a couple of nights to check your readings. This will give you an idea whether nightimes you are going near hypo level or hyper or get DP.

So glad you got your levels better.

 

[orchidlady]

Well been on insulin for over a week really struggling to get reading down. I am following guidance re carbs , I had a ready meal the other day so know exactly how many cards and still had a reading 18. Also how to manage snacks. Think this will take me a little time to get sorted.

 

[donnellysdogs]

The general rule for a bolus basal regime is "if you rise between 2-3 hours after your bolus then you need to amend your ratio bolus". Have you amended any ratios for your bolus?

Do you need to snack?
On mdi you should not need to snack and in fact my consultants advised me to try and go 5 hours between meals without snacks so you can see how your meal time bolus's are working......
You shouldn't need to snack unless you are in fear of hypo... Ie within 2-3 hours of your bolus you have come down to 5bg.
I'm surprised that you are still getting levels of 18 a week on.

Have you adjusted any rates of basal or bolus?

 

[orchidlady]

I have always been a person who little and often, just don't like big meals, so see this might be a problem. I have actually fogotten to take slow release a couple of times, I need to be little more orgnanised and think take a little more insulin

 

[jack412]

@donnellysdogs is helping you a lot, and this isn't to over ride what is being said, it' just may help to understand what is said

this might help with a bit of background and will keep you busy for a week I'm only T2 but it helped me get my head around it

There is an online course for background and an idea to it. Free to register
http://www.bdec-e-learning.com/
This set of workbooks are worth reading and practising working examples of carbs and doses and corrections
Don't change dose without nurse approval
Workbook 1
http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
Workbook 2
http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

Carb list
http://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf


Diary
http://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf


Basal testing
http://www.diabetes-support.org.uk/info/?page_id=120


Sick day rules
http://www.diabetes-support.org.uk/info/?page_id=141
http://www.diabetes-healthnet.ac.uk...flet_-_Sick_Day_Rules_for_Type_1_-_Nov_13.pdf

Sick day rules flowchart
http://www.leicestershirediabetes.org.uk/uploads//documents/Type1 Sick_day_rules_InsulinV3.pdf

A workbook with USA numbers and math rules, but it has a good trouble shoot at the end
http://www.bd.com/us/diabetes/download/insulin_adjustment_workbook_complete.pdf