severely uncontrollable type 1 diabetes

Marina Samir said:

@RuthW yes that is right after a great amounts of i.v fluids & i.v insulin therapy every thing is good but as i starting my s.c insulin doses every thing gets bad again very high bg, Kenton bodies can reach to +3 , paroxysmal breathing & sometimes loss of consciousness that is occurs daily
i tried every thing you can imagine with no result, i eat very little amounts of food ,i afraid of food , afraid of eating, somedays my meals is only salad

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I've really no idea what the healthcare system is like in Egypt but you do need to see a diabetes specialist so they can get you on the right treatment path, but in the mean-time try and do some basal tests to get your background insulin (lantus) set at the right dose as its likely that your dose is too low if your bg levels are high in the absence of food or very little food.

The following explains what a basal insulin does and why it is important to get the dose right above all else:

http://integrateddiabetes.com/basal-testing/

Hi marina
I do hope you are able to get some medical advise very soon ...just sending you my best wishes ...
Let us know how you get on ....we are all thinking of you ...bestbwishes ..kat

If people want to discuss the rights and wrongs of other people's posts then please use the PM system.

U500 is a different strength insulin and would enable persons that are uncontrolled on large amounts of U100 insulin to get better control (hopefully).

Some diabetics are profoundly insulin resistant and require large insulin doses to achieve optimal glycaemic control. However, large volumes of subcutaneous conventional U-100 insulin can cause discomfort at the injection site, resulting in poor concordance with insulin therapy. One therapeutic option is the use of U-500 insulin, thus reducing the insulin volume by 80%.

The regular concentration of insulin is 100 units per ml (U100). The higher concentration insulin is 500 units per ml (Humulin R U500), and is used in patients requiring higher doses of insulin. Therefore, it is really important that you are aware that Humulin R U500 insulin is five times the strength of regular insulin.

donnellysdogs said:

Some diabetics are profoundly insulin resistant and require large insulin doses to achieve optimal glycaemic control. However, large volumes of subcutaneous conventional U-100 insulin can cause discomfort at the injection site, resulting in poor concordance with insulin therapy. One therapeutic option is the use of U-500 insulin, thus reducing the insulin volume by 80%.

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DD, I have never heard of this before, is it a new thing or has it been in use for a while, it's interesting to know.

Thanks, RRB.

Its been around quite a while.. Although, guess what...not many GP's or Consultants consider it!!! Or even know about it.

Jaylee said:

There is a U40 strength too.. "Vetsulin" use it for dogs..

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Only for dogs and cats though isn't it? Not humans?

Robinredbreast said:

I don't think ( as a forum and not medically trained) telling a member who is such state with her diabetes that she needs to go very low carb. We don't know what other medical conditions she may have, her weight, possible kidney, eye problems as we have no idea what is going on in her life, physically or mentally. The huge BS readings should be seen by her medical team ASAP.

Best wishes RRB

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Point taken

The fact of so much varying basal and still having DKA etc is making me just wonder that it cannot be one device that isn't working.. Incorrect storage and wrong temperature is to be considered. However, it maybe that a U500 could be considered.

donnellysdogs said:

Its been around quite a while.. Although, guess what...not many GP's or Consultants consider it!!! Or even know about it.

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Jaylee said:

Yes. I think so.. Had a mate with a diabetic Jack Russel.

OK. We digress...

Starting with injections...
With the OP's issue I am thinking the problem could be due to incorrectly stored insulin. Gone off? Or a device itself at fault? (Are pens used?) Maybe even a weaker strength insulin administered in a device like a syringe marked for more concentrated strength dosage?
I'm not familiar with Egyptiian medical protocol.

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Apparently it is not good. especially the public hospitals, as this was told to me today, by my Egyptian friend. Need to say, I have never been to Egypt or been in another countries hospital.
Hoping Marina can get the right help and support very soon.
RRB

Robinredbreast said:

I don't think ( as a forum and not medically trained) telling a member who is such state with her diabetes that she needs to go very low carb. We don't know what other medical conditions she may have, her weight, possible kidney, eye problems as we have no idea what is going on in her life, physically or mentally. The huge BS readings should be seen by her medical team ASAP.

Best wishes RRB

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I quite agree, I know this poor lass is asking for advice but the best, and safest, we can give her is to get seen by her medics as a matter of urgency and get them to review her condition and sit down and take time to discuss it with her both her medication AND diet. Just discharging her as soon as her levels are back down isn't helping.... My suggestion would be to take her current meds into hospital with her (if she doesn't already) so that the hospital can see what she is on...... Even in the UK hospitals never seem to have a record of my current meds and ask that I take a repeat prescription in with me whenever I've been in for surgery. Luckily not diabetes related.....

@Marina Samir - sorry if I have appeared to be talking "about" you instead of "to" you. It's just the way I picked up on the thread.... Please make sure your doctors discuss your medication with you, how to take it, how much and when and as someone else mentioned check that you are storing it correctly. I hope you can get your levels under control soon. it must be awful for you at the moment.

Big hugs

Morning Marina, how are you today, are you feeling the same or has there been any positive changes? Thinking of you and hoping we hear from again. Please take good care x

Best wishes RRB

Marina Samir said:

@Robinredbreast first iam from egypt, i introduced to about 40 doctors & about 5 hospitals many times with no result

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Marina,

I think that is your problem right there. You don't need to do anything special. Just go and see a SINGLE doctor regularly. It is early after your diagnosis so you need to see the same doctor regularly and establish communication with him or her. You speak English well, so you are educated and you can deal with your doctor confidently. You need to keep a food diary so that your doctor can help you with your doses of insulin in relation to your diet.

Also, I live in Turkey, and I have friends living in Egypt, so I can guess that there is a problem with hidden carbs. The diet in Egypt and Turkey is quite similar. My first advice would be that you can eat most "normal" foods (including rice and bulgur), if you eat them in moderation, but avoid the pastries for a while - they are deadly for your blood sugar. Just tell people your doctor doesn't allow them, and keep on saying that.

Also, I had big problems with Lantus in Turkey. I came to the conclusion it is not stable. And like you, I could not stop my blood sugars from rising. My doctor eventually suggested Levemir. In the end I didn't switch to Levemir, I switched to a pump. But whatever you use, I think you need to to be seeing your doctor ( and dietitician) weekly for a while.

Marina Samir said:

@Robinredbreast thank u for ur great concern, i really introduced to alot of endocrinologists but they fail to manage me >

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Morning Marina, can I ask what type of hospital you attend, public or private ? Can you get some help from the Egyptian diabetes support forum on line.
How are you today? has there been any changes.? You have had some great posts regarding your Insulin, is it cool enough, is it out of date, do you just buy what you can afford and then that's it? until you can get some again? Sorry if it's too personal, but I have learnt a little bit about the Egyptian medical side of care.x