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Review with DN

Alanp35

Well-Known Member
Messages
895
Location
Staines
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Cricket, golf
I've now been on treatment for exactly 3months and though I would celebrate by having a review with my DN.
We effect weekly monitoring by email; I email my results for the week on a Sunday night and she emails me on a Monday with dose adjustments, advice etc. I just thought on Sunday that we needed a face to face.
It would appear that while my levels are not yet controlled,they are heading in the right direction, very slowly and very erratically due to the other medical problems I have. While not under any visible stress by the various co-morbidities my body is and this is reflected in my results. Humalog mix25 increased again this week with instructions on how to manage for the following two weeks,while she is away. I'm quite a happy bunny to be honest, little point in getting stressed about something I cannot immediately fix ( this is how I usually manage things, the word manage figuring in a major way). My worst period of the day appears to be between noon and 6pm with results often being very high, ketones indicated for no apparent reason as I really control my food intake. We may need to introduce an additional shot to help manage this.
DN is supportive and knowledgeable.
I,was,going to finish with "Aren't I a lucky lad" and then thought better of it.
 
Maybe "luckyish" ? then Alan ! Good to read you are still making progress and remaining positive. You also seem to have very good support.
Mo
 
Well done. You are a "lucky lad" in that you have such a supportive DN! I am having a thought here (very rare, lol). I know you're on a whole list of meds and am wondering if you take any in the morning and if so, could they be having an effect on your BGs during the afternoon? Just a thought
 
Hi Beachbag
Thank you and everyone else for your messages of support - much appreciated.
What you mention above BB is why I wanted a face to face with my DN. Prednisolone a steroid does make BGs spike as do two or three other drugs that I am on, I have 13 drugs each and every morning. I have done some research into this; the possibility of introducing a "midday" jab is the result of our meeting and the discussion.
All exciting stuff - I truly feel that it is for us people with diabetes to drive the sharing of accurate information and make sure that it is shared with our professional medical counterparts.




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You and I are both on Humalog mix25, I also take some of the same meds as you, but fortunately not prednisolone! At the moment I'm ok just on twice daily Humalog and I hope to keep it that way. I sincerely hope that with careful management you continue to make good progress.....
 
You really are on a lot different meds, but why the Levoxine? It is only 50 mg, that is a starting dose. How long have you been on it? What do your thyroid hormone levels look like? fT3 and fT4 that is.

You know that it is very common to have high cholesterol when hypothyroid or rather when under-medicated ?

Have you had your vitamin D checked recently?
 
Hi Totto,
I was put on 50mcg of levothyroxine about 12 years ago by my GP. Several consultants have since said that according to my test results this should be increased. I have mentioned this to my GP and so far he has not acted. I'm not sure if it is TSH or 3/4 which is low but my last test result was so low that he phoned me up the day after the results came in. I am due a review and repeat tests in the next two week.
I have multiple co-morbidities; IHD, CHD, myxedema, rheumatoid arthritis, leukoderma, ex dam and so it goes on. The rheumatoid arthritis is managed with chemo-therapy taken once a week, powerful drugs but that is the stage that my RA is at, and 14 years taking this methotrexate, also taking 5mg prednisolone daily for the RA. When I was diagnosed as a person with diabetes, Incorrectly, in 2007 I was advised that I may have had diabetes for over 30 years and the fierce drug regime I have been on disguised this fact. T2, well controlled by diet, very limited exercise as you can imagine, even to April 2013 when all was well. From May onwards I started to feel progressively ill as each month went on. Many visits to GP and consultants with no result other than my RA consultant commented that I was rejecting all of the alternative drug therapies he was prescribing. Some of these only added to how horrificly Ill I was feeling. In October 2013 hoping that death would come soon I thought that I I would test my BGs; I had a meter and bought some strips. I tested for 4 days and took the results to my GP, I didn't bother with an appointment. Gave the results to the receptionist asking her to pass it to any available GP and I would wait in the waiting room. 4 minutes later I was seeing a GP who was horrified at the results all of which were in the upper 20s. The next morning I had an A1C test, asked to come back to the surgery on the Tuesday as the results would not be back until the following Friday. I went on Tuesday as arranged and the results were back. GP horrified as the result was 71 and asked me how this happened. I have 5 different autoimmune diseases, I wonder how it happened myself. I was seen at our local hospital two,days later and commenced my current treatment, units increasing each week. GP also stated that it appeared I had autoimmune diabetes. Confession, I am advised, is good for the soul. Not mine I should mention.
This is where I am at; not totally thrilled at the position I am in nor how I got into this position, but working very hard indeed to do my bit to get out of this dreadful pit in which I find myself. My DN has been very supportive and seems to have a good understanding of my various autoimmune problems and how the cumulative sum affects me on a daily basis. This is very reassuring. I am only 3 months now into this and have some way to go before my BGs are at an acceptable level. Keep on trucking, that's what I reckon.
If you're still awake thanks for asking.



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Pops, forgot to mention that my autoimmune system has battered my pancreas, thyroid into submission and every likelihood that I will also have coeliac disease - but I'll wait for,the dust to settle on this.



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I am hypothyroid too, was undiagnosed for over a decade I won´t bore you with the consequences, and now, after three years of lowcarbing I am pre/diabetic and I suspect LADA. Mum has PA and psoriasis, we are an autoimmune family! T2 seems a bit unlikly in my case as I have low BP, am low carbing and no overweight.

Regarding TSH, usually the only test you get for thyroid disorders, it is a lousy test because Drs don't understand it. For those on thyroid hormone replacement the free´s are better tests. Have you ever had at least fT4 tested? But fT3 is even better. And we often feel best when TSH is suppressed or at least very low range, the range usually something like 0.4-4.5. And you should never have a TSH above 1 unless you are one of the very rare who needs it that high.

I am on NDT, works far, far better than Levo for me but I have to buy it myself.

What about your vitD level? Has it been tested recently? Vitamin D deficiency is very common in AI diseases. I supplement with 5000IU per day during the dark months. At least. It has made a huge difference, much more energy, no pain in my fingers, asthma much, much better to mention a few things.
 
Hi
Vital D, I have each day as Calci-chew due to osteoporosis - many years of steroid therapy so hopefully covered on that one.



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But have you had your level tested? If not, how do you know the very small amount of vitamin D in the calcichew is enough for you?
 
Not yet - I see my GP in Feb to get next set of tests and will ask that this is included. Many thanks



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