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[IP] Doctors needing control (was:Sliding Scale Insulin Dose)


I think that you are right about the doctors wanting to have some control.
The last endo I had tried to get me off the pump, after 13 years! on to MDI
- set daily dose, no sliding scale, adjust your life to the insulin, not
the other way round (because it is "cheaper and just as effective as the
pump")  :'P  You have defined something that I am having a problem with
now.  My endo wants me on one basal rate, so that he always knows what my
rate is, regardless of the time of day.  He moved me from 4 basal rates to
one, and it is not working!

At least, I think it isn't - he is okay with the fact that my sugars are
now ranging 12-21 mmol/l (216-378 mg/dl) instead of the 5.5-8 mmmol
(100-150 mg) that I had before.  He is still working on this but after a
month, I was dangerously close to giving up on the whole control thing. I
made it through the last crisis with the help of Janet and Mary Jean.  This
group is what is keeping me going, not the "professional" help.  I have my
"Pumping Insulin" book out and am considering my options.  If he doesn't
like what I choose, which will likely be to go back to 4 rates and modify
from there, I will drop him.

I think we really need to pay attention to how we feel and make our views
known, even though that can be hard sometimes.  We have the right to have
control, and the doctors will just have to learn to live with people having
input into their diabetes treatment.

type 1, 18 years
pump, 13 years

>I believe your gut feeling is right, and your endo is wrong. I've used a
>sliding scale for years, long before the medical profession started saying it
>was a good idea. I think of an injection as a Janus with 2 faces: one looking
>forward to what you're about to eat, and one looking back to what's already
>happened. My endo accused me of incessantly fiddling with my doses. It's a bit
>of a power game really: if a doctor's treating you for cancer or a broken leg,
>he's in control. But with diabetes he's not. He has no idea what you're doing
>with your diabetes every hour of the day. I think deep down they try to retain
>some control, by dictating precise doses and eating patterns, and not having
>to rely on your intelligence and responsibility. Pork and beef insulins
>possibly work too slowly to correct bg's in this way, but Humalog is excellent
>for the job.
>I say shave off that high with an extra unit of insulin!
>Best wishes
>John Neale
>Type 1 for 21 yrs. MM507+Humalog since Dec 97. Still in 'euphoria' stage!
>Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/

Vancouver, BC, Canada
email @ redacted


Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/