Peppergirl
Well-Known Member
Hello
It's not as negative as the title suggests, but thought I'd post my recent experience as it just highlights to me how little the medical profession has moved on with its treatment of us type 1 diabetics. Technology has moved forward but speaking to the limited health professionals I have access to shows that they haven't kept up. I wonder if any diabetes "specialists" have ever read anything on this forum as they would learn a lot.
So I went to see a nurse (a trainee nurse was sat in with us) at my GP surgery about a month ago, for an annual review. She was very pleased with me, HBa1c dropped to 59 (6.6). I got the impression that they don't see results like that often. I got my BP and weight checked. She seemed surprised that I already had my results after asking for them before the appointment (I don't want to wait for the results!). I mentioned I am using the Libre sensor, which she had heard of but never seen. I mentioned going on to a pump and she arranged an appointment with a DSN at the hospital.
Went to see the DSN and got the same response of surprise at my results. Took some of my libre results and explained I am now a low carber so that is why on most days I can maintain very tight control (between 4 and 8mmol ). Still improvements to make, hence the pump. We talked about DAFNE which I had attended (2 hour course). She didn't seem the believe me that I have very low carbs now or that I was counting correctly. There is some truth to that. I haven't always got it right. I think my basal is about right (2 x lantus of 18u AM and PM) as if I eat my low carb breakfast and dinner, my control is generally very stable. But I have times when my BG creeps up and I correct with my novorapid. As I've been monitoring this more closely, I think that I am just not having enough novorapid, rather than it being my basal shot. Otherwise I wouldn't have days when my BG is between 4-7 mmol eating exactly the same food.
I am happy that I need a higher ratio of novorapid, definitely in the morning. Reading some of the great posts on the pump forums, I know the pump will allow more specific doses which I can comfortably manage.
The DSN wanted me to write down what I eat as well as the number of carbs, which I am fine with. She even said, which really annoyed me, that I don't mean go out and eat curry and chips, but try eating a slice of bread so you can see the number of carbs on the packet. I turn up with a good (needs improvement) HbA1c and days with an almost static BG, as a result of low carbing, and I'm told to eat bread! It reminded me of the days when I was diagnosed and told to include carbs at all meals, to eat for the insulin. Thank goodness we know better.
Anyway, I'm back with the DSN this week to discuss how I've got on. Hopefully I've done enough to get the pump. I work shifts, so that is how I got referred for a pump.
Oh, I should mention that the first thing the DSN said to me was, we don't just give out pumps, some diabetics want them as they are a new toy. You have to show that you can use it. 25 years of MDI, paying £100 a month for the libre, in what way am I not deadly serious?
It's not as negative as the title suggests, but thought I'd post my recent experience as it just highlights to me how little the medical profession has moved on with its treatment of us type 1 diabetics. Technology has moved forward but speaking to the limited health professionals I have access to shows that they haven't kept up. I wonder if any diabetes "specialists" have ever read anything on this forum as they would learn a lot.
So I went to see a nurse (a trainee nurse was sat in with us) at my GP surgery about a month ago, for an annual review. She was very pleased with me, HBa1c dropped to 59 (6.6). I got the impression that they don't see results like that often. I got my BP and weight checked. She seemed surprised that I already had my results after asking for them before the appointment (I don't want to wait for the results!). I mentioned I am using the Libre sensor, which she had heard of but never seen. I mentioned going on to a pump and she arranged an appointment with a DSN at the hospital.
Went to see the DSN and got the same response of surprise at my results. Took some of my libre results and explained I am now a low carber so that is why on most days I can maintain very tight control (between 4 and 8mmol ). Still improvements to make, hence the pump. We talked about DAFNE which I had attended (2 hour course). She didn't seem the believe me that I have very low carbs now or that I was counting correctly. There is some truth to that. I haven't always got it right. I think my basal is about right (2 x lantus of 18u AM and PM) as if I eat my low carb breakfast and dinner, my control is generally very stable. But I have times when my BG creeps up and I correct with my novorapid. As I've been monitoring this more closely, I think that I am just not having enough novorapid, rather than it being my basal shot. Otherwise I wouldn't have days when my BG is between 4-7 mmol eating exactly the same food.
I am happy that I need a higher ratio of novorapid, definitely in the morning. Reading some of the great posts on the pump forums, I know the pump will allow more specific doses which I can comfortably manage.
The DSN wanted me to write down what I eat as well as the number of carbs, which I am fine with. She even said, which really annoyed me, that I don't mean go out and eat curry and chips, but try eating a slice of bread so you can see the number of carbs on the packet. I turn up with a good (needs improvement) HbA1c and days with an almost static BG, as a result of low carbing, and I'm told to eat bread! It reminded me of the days when I was diagnosed and told to include carbs at all meals, to eat for the insulin. Thank goodness we know better.
Anyway, I'm back with the DSN this week to discuss how I've got on. Hopefully I've done enough to get the pump. I work shifts, so that is how I got referred for a pump.
Oh, I should mention that the first thing the DSN said to me was, we don't just give out pumps, some diabetics want them as they are a new toy. You have to show that you can use it. 25 years of MDI, paying £100 a month for the libre, in what way am I not deadly serious?
Not a very nice comment about giving out pumps! Maybe she was attempting 'humour'?
. 
