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Re: [IP] First Day of Training

On  3 Mar 99 at 17:13, Natalie A. Sera wrote:

> I had to train the trainer ..... I oughta be charging THEM!!!!  :)

Be sure you get the right coding on the bill you send them....

> According to her, the goal for post prandial, 2 hour BGs is to stay
> under 150. We both agreed that a goal is not necessarily achievable at
> all times, but I was rather surprised because it's the first time I've
> heard a Nevada CDE say anything like that! I've been told I'm obsessive
> because I want my postprandial BGs below 200!

That's kind of odd, because the protocols and standards used around here talk 
about a 2 hour bg below 140.  That's what many patients are being told is the 
top end goal, but there are also many of us on tighter control that shoot for 2 
hour targets of 120.  

> They were also very confused because they couldn't figure out whether
> I'm Type 1 or Type 2 -- I repeated to them that I just have an unusual
> type of DM -- neither classic 1 NOR 2 -- but it seems to be hard for
> them to think outside the box.

There seem to be an increasing number of people who are not typical type 1 or 
type 2.  I've talked to a couple of doctors and CDE's who think that it is 
because the designations were too simple to begin with.  One doctor has a 
couple of children among his patients who are Type 2 - he said that a few years 
ago it would have been almost impossible to get that diagnosis to stick because 
the definition of type 2 said "elderly"...  Then you get the strangeness of 
people who are still producing some insulin themselves - even though type 1 
they are not fully insulin dependent yet.  The problem is that the box was 
built wrong and needs to be totally replaced!

> So the trainer came to the conclusion I'm Type 2, and the dietitian that
> I'm Type 1, and guess what, they're BOTH wrong! :)

That's why they are the "professionals" and you are the "patient"...  
> So anyway, tomorrow I'm supposed to start with saline -- and on March 17
> I officially go on insulin. 

Hope it goes well and keep us posted.

> They did tell me I'm the first non-Type 1 they've ever had -- one of
> them seemed doubtful about my going on the pump at all, but I think that
> all insulin users should have it as an option. 

Make sure that they don't mess up your records with crossed diagnosis and 
recommendations!  They could really mess things up and cause you trouble for 

Randall P. Winchester
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