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Re: [IPk] NICE

> on glargine - in fact I was told by my DSN that she didn't think it would
> suitable for me as my BG was fluctuating too much.

Thank goodness for a healthcare professional with a rudimentary
understanding of physiology!!

I had a long and interesting discussion with a DSN ( shan't go there for
clinic) who was very pleasant and approachable but could not concieve how a
pump may be superior to glargine and novorapid nd then conceded that it
suits my lifestyle. I have yet to undertand the full definition of the
ideological diabetic lifestyle. Presumably only exists in wives/ mistresses
and offspring of millionaires or those who are prepared to struggle along on
income support

 This has been proved to
> me since starting on the pump and the fact that I've had to have various
> different basals during the past month.

could be your body getting used to the pump, or due to hormones!. If the
latter you may have had someindication of this on MDI even with erratic
absorption and peaks

There also seems to be a huge
> emphasis on hypo's and not on whether you've had problems with high BG's.

Yes but I expect that they assume if you are not having severe hypos and
have an A1c in target rane you are ok. Any prolonged highs without lots of
hypos to lower acerage readings would push up A1cs. Highs for short periods
of time , i think the jury is still out on how harmful these are
To be honest I have heard of people who have more normal and beeter QOL with
complications than those due to hypo unawareness. I suppose it depends on
your employment opportunities and general support, availability of public
transport in case of hypo unawarenss/ visual problems and social
circumstances. Sorry to come out with such a blasphemous statement. I hope
not to experience either

> don't know if I could now give the pump back if I'm refused funding after
> having seen a dramatic improvement in my day to day control.

Could you afford one if push came to shove? You shouldn't have to pay as
recurretn severe hypos needing help are one of the criteria for funding

> Just an after thought - am I right in thinking that if you're on glargine
> you bolus every time you eat via pen or syringe?  >

Yes, it's a basal insulin. you would use eg novorapid for meals. Type 2s can
sometimes just have the glargine and their oral meds, but short acting is
needed for type 1. There is confusion regarding this. glargine is known as a
once daily basal insulin but many UK medics don't understand basal bolus
regimens so they interpret it as once daily full stop even in type 1s. Also
some people on MDI with eg insulatard for long acting give 2 injections of
this to cover basal needs as traditional long acting insulins run out in the
afternoon/ evening so "once daily basal" means 4 injections per day ( one
long acting) as opposed to 5 ( 2 long acting)
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