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[IP] Re: Insulin and Karen

> Karen:
> In my humble opinion, I think you need to find an endo you are comfortable 
> enough with to be honest and straight forward in your discussions together.  
> This is your health you are dealing with!  How can you expect this endo to 
> handle an emergency if your actual treatment is different from what he/she 
> thinks it is?  You need a diabetes team who will listen to your concerns and 
> who you respect enough to discuss options with and then follow the course you 
> have decided is best based on input from BOTH of you.  Why does this doctor 
> feel that he/she must be so controlling that you have to fax your test 
> results in each week for him/her to adjust your doses?  Perhaps you need a 
> doctor who will provide you with more information and more self-reliance.  
> Lois

Lois and Karen,
Although I agree with you that faxing in blood sugars every week, all
time, is a bit excessive and undermining to your self-reliance, I don't 
think in this situation it is really that bad.  The doctor had just
started Karen on UL instead of NPH which is a much different long
insulin.  Even L stays in the system longer and peaks later then NPH.
So a lot of tweaking would need to be done to the short acting insulin
Karen was taking.  The doctor wanted her to fax the sugars in so that
she would know how Karen was doing and make any suggestions.  When I
went on a 4th shot a day at lunch, my doctor SUGGESTED I fax my bgs
in once a week or once every other week so that he could see my
progression and make any  SUGGESTIONS to help tweak it.  I was very
open to that since my insulin dosages changed drastically over the 
whole of the day when that shot was added.  It was a big help to have
someone else look at the numbers and see what the problem was. Over
a few months this was reduced to once every three weeks or so, and then
to phone calls whenever I had a question.

However,I agree that lieing about these numbers is counter productive.
And lieing about the type of insulin is also.  If the doctor feels that
nothing is working on adjusting for the highs and lows, and/or the
doctor finds out that you have been uncooperative it could cause
them not to support the pump because they feel you are not open
to change or suggestions from your current treatment.  Also, if you
want your records switched to a new doctor, the new doctor may find
a note in your old file saying the same.  Which may hurt you with a
new doctor and getting the pump.  I hope this doesn't happen to Karen.

The last thing I wanted to say/ask was why would the doctor choose
to use UL?  I am not as familiar with it since I have been using
NPH for all my 19 diabetic years.  However, my understanding is 
that it takes a long time to peak and a long time to leave your 
system.  Is the advantage that the peak is less severe then with
NPH and the doctor feels this will immitate a basal rate?  Just
curious, and I am probably asking the wrong crowd about it. :)
Hee hee hee.  Oh well.

Sorry so long,
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