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[IPk] NICE Guidelines again

I am very interested to hear why your consultant here in the UK, was dead
against you trialing glargine and felt you would be back on a pump in 3
months. Don't get me wrong, I think thats superb, and completely justified.
I have had a DSN ( not the one I see but I was ringing around the 2 local
hospitals just before moving here to see who would be best for me), tell me
that there was no need for varying basals becasue " you can top up with
boluses of novorapid". Fine if she meant checking BG and giving extra
overnight although it would mean sleep deprivation, but I expect that if you
woke up with a high BG you would be told to increase glargine even if it
drives you hypo later in the day and the hypo is prolonged due to the action
time of the glargine . I also asked this nurse if there had been any local
problems with GPs prescribing enough strips to type 1s. She said on one or two
occasions when people were getting through a pack a week ( ie 50 strips) which
she described as a" bit crazy". Excuse me. I do not test 7 times every day (
av 5) but there are times when I need to,when driving a lot for example or
change of routine or BGs generally being awkward to control. I found her
attitude completely patronsing. She is a specialist nurse for goodness sake
and doesn't seem to have a full grasp of type 1 diabetes and the implications
of living with this in the short or long term. Anyway, I will be attending the
other hospital where the nurse seemed to have a much better attitude....

I have 150 strips per month and so far GPs here have prescribed them
 withoutany fuss

Were you persistnatly high on MDI or would glargine subject you to frequent
hypos, or a bit of both. I am glad that some consultantscan understand the
advantage of the pump and are prepared to push for you to get funding. Mind
you the fact that "you would be back on the pumpin 3 months" sounds positive
as well - does this imply that once the PCT saw how difficult things are on
glargine you would get funding then - no probs rather than having lame excuses
" not trying hard enough/ have to give things time/ innapropriate lifestyle (
read job, hobbies, doesn't always want to live by the clock)"
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