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[IP] Dieticians and hospital personnel etc.
We need to remember that the hospital personnel have had much, much more
contact with Type II diabetics. These are the majority seen in the emergency
80%. The majority of these are totally non-compliant. These patients never
think about carb counting and test their blood glucoses once a week. They
guesstimate their insulin dosages and rarely know the names of the insulin
they are taking...the clear one or the cloudy one is a usual response. Usually
they cannot even tell you the usual dosages they take. Frightening huh.
The majority of Type I's are not much better. They often have the same stories
and the complications that accompany them are just more advanced at an earlier
Those on this site are the Diabetics and their parents who read the "Insulin
Pumpers Book" as a basic function and refer to it weekly. Not only do you
check blood sugars several times a day, but would feel guilty if you skipped a
day because you realize how you are mistreating your body, plu you end up
feeling lousy. Carb counting is basic math to you now. Bet most of you even
weigh your food to be extra sure. Not only do you know the types of insulin
you take and the usual dosages but can calculate the drop in BG per unit of
insulin you usually experience. You can handle an unexpected situation with a
smart solution on your own almost every time. You belong to this group so you
can do everything you can to promote your health and each others health as
well. You are a unique group, but a small minority (I believe I read there are
~3000 at this site now), among the thousands and thousands of diabetics in
this country. You are probably every endocrinologists dream patients.
When you go to the hospital or to the dietician the immediate assumption is,
and with just cause, that this is a patient who is non-compliant most of the
time and is in a big, nasty mess. The best course of action for hospital
personnel at that time is to quickly start from scratch and get things under
control as quickly as possible before the patient takes a nose dive fast. We
all know how quickly things can go from bad to "oh dear God" with diabetes.
Take this as your opportunity to teach the staff about pumps, most have never
seen one, let alone a person who can put it through its paces the way you can.
Most of you sound as if you rebuild them if they are not functioning
Be ready to assert your knowledge of your diabetes from the get go. If the
staff are rigid or down right dangerous, ask for another doctor, nurse or
dietician...that is part of your patient bill of rights. Assert your rights to
participate in your care. Go with all your glucometers, spare parts for
everything...they will not have spare tubing for your pump there. Insist on
using your equipment..if you are sure it is working. There is not one item
written anywhere that says you must use the hospitals glucomemter. You can
give you own insulin shots if you are mentally alert enough to do it.
We have run into Dr. and nurse Rigid before and let them know that our day to
day knowledge of Sara's care was far beyond theirs, politely of course.
Usually when they see you are competent and compliant the power struggle will
cease and you can work together. The dieticains seem to all be geared for Type
II's with late life onset. Not great for pre-teen Type I's. But, this is the
vast majority of patients they see. Also, they ar etrying to teach older "dogs
new tricks." I can imagine this would be much more difficult than teaching
younger Type I's healtier eating styles.
Just try to keep in mind the bottom line they are used to dealing with every
day. Every Diabetic is different and you are the only one who can impress upon
them your differences. As always, if you get a complete jerk you and your
family can demand someone else.
Plus, do not ever take boluses or not take a bolus without telling the staff.
Insulin can be added to IV's to titrate out in a prescribed amount. It could
easily happen that you received insulin you were not aware of. Be a team, for
your health and safety.
Pam, mom to Sara age 15
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