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[IPk] glargine: Melissa and Helen

               some people rave about it. I'm sure these are people who if on
a pump would only need one or two basal rates, either v similar or varying at
a time which can easily be averted by novorapid

It would not work for me: basal overnight: 0.6 to 0.7
8 am to midday: 0.8
midday to around 6 pm 0.4
sharp rise from about 7 to 10 pm 1.1
10 pm onwards 0.6
and sometimes temporary basal decrease to 8o% most of the day and 60 % midday
to 6 pm
ie basals vary as much as 0.88 to 0.24
it's a little worrying that someone not doing well on glargine could be
labelled as awkward or non compliant. With my profile I could possibly avert
some of the problem by getting up and taking a big dose of novorapid at 7.30 (
basal and supplelmentary bolus) taking very littel nov or possibly none at all
at midday and having a fairly fixed lunctime +/- afternoon snack and another
big bolus at 7 pm and fairly rigid dinner time.Probably then I would be
patronised by the clinic and told I don't need to do this. I could still find
myself hypo and non functional in the early afternoon where if I am at work I
need to have my faculites ( seeing patients at home, driving, house calls etc)
and if I am on a day off I often want to excercise or do housework..If this
happened ie frequent hypos affecting my work would I be told I was lying,
having psychological probs and trying to avoid work and denied benefits? S0,
if someone in this situation cant afford a pump are they feckless,
irresponsible and non compliant and a burden on the NHS if they run their "
basal" low and are high much of the time so they can still go about their day
to day life?
Part of th e problem is that glargine does reduce night hypos and people for
some reason are always most afraid of these. But as long as you either wake up
or have someone with you they are possibly less of a problem than waking hypos
( less disruptive to work patterns and don't affect fitness to drive apart
from due to the effect of reducing daytime awareness). Any hypos on a frequent
basis can affect awarenss so surely this would still be a problem if the basal
profile did not reflect ones needs. And so what if you are hypo aware but
still have frequent prolonged episodes whre the glargine drives you low. You
still can't drive, excercise or get on with your life when this occurs. The
only thing is you don't present to A and E or to your doctor . And to be
cynical I belive that hypos are overlooked by the profession as long as they
don't directly cost in terms of workload for them ..People on this list have
said that their clinic have accused them of lying when they complain of
frequent hypos
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