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Re: [IP] First Day of Training

On  4 Mar 99 at 16:55, Natalie A. Sera wrote:

> > ... there are also many of us on tighter control that shoot for 2
> > hour targets of 120.
> Really? How achievable is that for how many people? I would be worried
> that if I got a 2-hour PP, I'd be low at 4 hours, which is about how
> long Humalog lasts for me (I know other people are different). 

Pretty achievable on the pump.  It's one of those YMWV (hour by hour!) things. 

> Or is this going to be one of those experiment type things that I'm
> going to have to work out for myself?

Diabetes management is all done by trial and error - we try something, figure 
out the errors, and try to fix the error without breaking the original 
effort...  All by trial and error, but mostly by error...

> ... And I continue to have enough insulin production
> to tide me over the rough spots so I don't go into DKA or have
> astronomical BGs. (Diagnosed at age 44, I want to make it for 50 years
> with DM!!!!)  :) 

Have you had the antibody test to proove that you aren't type 1 autoimmune?
Most type 1 people have a decreasing level of insulin production for years 
after diagnosis - and many of us still have a residual level... 

> > 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
> > years...
> What does that mean?  I've already been through the "messed-up"
> diagnosis in the sense that they tried all the type 2 D+E and sulfs
> stuff on me -- and with the agreement of the endo, I refused the
> metformin my GP was interested in. I will never try Rezulin, either --
> it's fairly clear to me that I don't need them!

If they put you down on the records as a "noncompliant type 2" or "difficult" 
then it could cause you some problems down the road.  Or if they put down that 
insulin isn't a "medical necessity" for you ...

> This must sound weird to the Type 1 folks on the list whose diagnosis
> was clear from the start -- in some way, I guess it must have been a
> good thing to have that certainty, even though it was an unhappy one.
> With me, the flounderings around left me very confused and frustrated
> for what seemed forever!

The classic diagnosis  pattern around here was if your bg level was over 180 
(fasting) and you were under 50 years old, you were type 1 and were given 
insulin.  If you were over 50 you were called type 2 and initially given oral 
meds, then migrated to insulin as punishment or to maintain better control.  
Since the antibody and c-peptide tests have become available they are being 
used to more accurately diagnose people.

Randall P. Winchester
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