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Re: [IPk] glargine: Melissa and Helen



Dear Abigail

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

YES YES YES  I have noticed that frequently they don't even mention my lows 
only the highs.  Even when I have complained about frequency of hypos 
(particularly night ones) these have been dismissed with "your Aic is OK 
come back in a year's time" - it used to be 6 months.  "You are really 
getting on OK" - " but I don't feel OK" - "your're doing OK come back in a 
year's time" - oh and I was imagining the night hypos, well he didn't say so 
but he looked it.

I know I'm too passive I just gave up on the NHS and got myself a pump 
without telling them.  I wasn't OK.

Heather






>From: "Abigail King" <email @ redacted>
>Reply-To: email @ redacted
>To: <email @ redacted>
>Subject: [IPk] glargine: Melissa and Helen
>Date: Tue, 21 Jan 2003 14:05:25 -0000
>
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>                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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