WHAT

[borderter]

recently saw dns to request change of insulin as novo just not working for me ,have been an insulin user for 25 years so know what I am doing ,during chat she looked at results and said see dietitian no said I ive been carb counting for years its not a diet problem so she consulted consultant who also said dietitian !! Told her again re carb counting and was told oh we dont want our type 2 patients carb counting ,then how do they know how much to give and please dont say mixed insulin ,she then had no answer but offered me a biosimilar of novo but when i said its a biosimilar she replied i dont think so but one hour later she rang to tell me its a biosimilar of novo DOH and finally agreed i could have apidra which id researchd and looked like it would suit my needs and its amazing but why oh why wont dns etc accept that we know our control best in most cases then just help and no I didnt need a dietitian .Rant over but it does not instill confidence

 

[Paul_]

but why oh why wont dns etc accept that we know our control best in most cases then just help

Having been diagnosed as a T2D recently, I've been in a constant state of rage at the NHS approach. The out of date advice, the constant line of "just avoid the sweet stuff" when it's all carbs, the determination to push me onto meds even if I'd have to eat more carbs to make the meds work, and the all round ignorant approach to progress made by patients themselves. Low carb has changed my life, controlled my blood glucose to normal levels in weeks, and facilitated my weight loss.

It's all about job justification. If all diabetics got advice on diets that would actually help them, we'd need about half the amount of diabetic nurses than we currently have and the other half would be made redundant. Unfortunately, at this point, in my mind I'm left with no other possible reasons or motivations for their approach.

 

[Resurgam]

If it is not cancelled again I am to see the nurse at the surgery in a week or so.
I realised quite recently that I had elevated glucose flagged many years before diagnosis, and it was never mentioned, just pushed to eat low fat high carb all that time. My weight increased and I reported many times that I felt unwell - I had skin tags removed by the GP, I was treated for thrush - never once mentioned. I only know about it now as I was given pages of printouts when I complained about having to get results by seeing a GP rather than being able to access them on line. I don't know how it was supposed to help, and I just pushed them into the file I used to keep. When emptying out the file, I looked through it all and spotted the plus signs.
I just don't know what to say about that, or if I can even talk about it reasonably.

 

[EllieM]

I'm cross posting as I'm T1, but I've got a lot of experience with insulin, and have seen a number of dieticians over the decades. Advice from the dieticians has varied, to put it mildly.
(Though to be fair I've found some of it moderately useful, carb counting booklets have changed to pdfs with carb counting )

Lots of T1s complain about "novosluggish" and get moved to a different insulin.

recently saw dns to request change of insulin as novo just not working for me ,have been an insulin user for 25 years so know what I am doing

I think your issue may be that you have a T2 label on your diabetes and the medical profession tend to assume you don't know what you are doing as regards insulin, because they don't notice that you have been successfully using it for 25 years. (Or maybe I am overly cynical? ) I notice the same thing (a little) as I get older. (Once I hit the age of 60 the medical staff started to wonder whether I was still capable of understanding how to carb count and adjust doses, whereas when I was younger they were happy to tell me that as I'd been diabetic for so long I probably understood it better than they did.)

It's really nice to see an experienced T2 insulin user post because a lot of T2s posting here get put on insulin and seem to be left in a sort of treatment limbo, with no explanation on how the insulin works and how they should adjust their doses.

As for the dieticians, I think they can do a lot of good, in the right context, it just sounds like this was not what you needed on this particular occasion. The right dietary advice could be enormously useful to a new T2, for example.

 

[Jaylee]

recently saw dns to request change of insulin as novo just not working for me ,have been an insulin user for 25 years so know what I am doing ,during chat she looked at results and said see dietitian no said I ive been carb counting for years its not a diet problem so she consulted consultant who also said dietitian !! Told her again re carb counting and was told oh we dont want our type 2 patients carb counting ,then how do they know how much to give and please dont say mixed insulin ,she then had no answer but offered me a biosimilar of novo but when i said its a biosimilar she replied i dont think so but one hour later she rang to tell me its a biosimilar of novo DOH and finally agreed i could have apidra which id researchd and looked like it would suit my needs and its amazing but why oh why wont dns etc accept that we know our control best in most cases then just help and no I didnt need a dietitian .Rant over but it does not instill confidence

Hi @borderter ,

I’m glad you had a change to Apidra, which works for you.
I’ve been absolutely gobsmacked over the years at what the average DSN believes.. some thought insulin only worked with food & that I must eat? (When mentioning correction doses for a dodgy basal.)
I’ve never had issue with Novorapid. But my basal is shocking. It seems to only work hours after it’s meant to have tailed off during certain activities at night? (With no fast acting on board to avoid the lows..) It could just be my T1 metabolism?

I have more confidence in my mechanic & the knowledgable ability to listen regarding a technical issue than the the HCPs I see regarding my condition..

Best wishes.

 

[In Response]

In my experience, there is a huge difference better DSN at an endocrine clinic and the DDN at a GP surgery.
The former really knows her stuff. She probably knows more than the endo.
The latter struggles to spell insulin. For example, after 20 years taking insulin as a T1, she asked me if I had ever had a hypo.

 

[becca59]

In my experience, there is a huge difference better DSN at an endocrine clinic and the DDN at a GO surgery.
The former really knows her stuff. She probably nows more than the endo.
The latter struggles to spell insulin. For example, after 29 years taking insulin as a T1, she asked me if I had ever had a hypo.

Those last two sentences had me laughing out loud. Ridiculous!