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[IPk] Paradigm in the UK, glargine etc.

Hi there everyone,

Thank you. I've learnt so much reading all your information  re: pumping etc.
I have had diabetes for 35yrs. since the age of 12.  I've plodded along with
injections etc. monitoring that was available at any given time and have kept
good control as best I can.  I've got on with living, having children and
working as a neonatal intensive care nurse.  No one has ever updated my
education in diabetes here in the Uk.  Maybe it was asumed I knew as a health
professional.  However, I've kept myself reasonably informed.  I've been on
MDI regimes for about twenty years, had horrible hypos at night during 3
pregancies in the 80's and thought it was just me!!  Came round with honey and
horrible headaches and stiff limbs!! Was on actrapid  and insulatard (bd).
Then on humalog boluses and insulatard (bd) and for about 5 months glargine
and humalog. I've always been plagued with hypos (I have been able to sort
them myself) manipulated  doses of insulatard so I did not have much
overnight.  Always felt hypo at lunch time.  Trying glargine, but do not like
it much, trying to persuade consultant that a pump is made for me but it is
hard work.  I have a HBA1c 5.8 pre glargine, due I think to spending much of
my sleep time hypo! Afternoons my blood sugar drops and then rises quite high
pre evening meal, especially if we eat late as we often do due to ferrying
family about, can counteract it by late afternood bolus.  I tried to get a
paediatric diabetes nurse role but was unsuccessful as someone else applied
who was a health visitor and had some experience of adult diabetes clinics.
Applying for this job made me really look into what was happening in diabetes
care and to be honest, I don't feel the services are  anywhere near coping
with the needs for education and ongoing education in a way that is acceptable
for people with diabetes.  I may be a cynic, but I feel that maybe it is
easier to leave people less informed of choices available, and certainly
easier to teach them to have bd mixed insulin which in the 80's I believe was
done a lot without much account being taken of carbohydrate values of foods.
For sometime I've been working in the unpredictable intensive care world of
the new born and working a lot of nights plus day shifts starting and
finishing at odd times.  I used to go and inject in the loo, but now with
glargine I find I need to bolus so many more times with humalog  that I am
much more overt about injecting, but it really is not very convenient a lot of
the time.  Sometimes i get called in at short notice to cover an extra night .
I have glargine in the morning to try and prevent night hypos, so the basal is
in for 24 hrs whatever comes my way!!  The effect is supposed to be slightly
stronger in the first 12 hrs. It is totally obvious that the glargine  level I
need for when I'm asleep is totally inadequate when I'm working in a busy
stressful environment.  When I know I'm working a night I  have  a larger dose
of glargine that morning, but often need to bolus little doses of humalog to
keep things okay.  I nearly always wake up low when sleeping in the day so my
rest in inadequate! Anyway, the more I've read, the more I'm convinced  I've
been putting up with what for me could be second best so am really keen to try
pump therapy and be able to vary my basal rate according to shifts and also
the fact that I do some running.  I am sure I need a slightly higher basal
level when I run as BS tend to be high after a run but then drop later so
could lower basal for that I believe.  I've been trying to have some insulin
and eat before running but not always convenient.  Thanks everyone for all the
info I've gleaned by reading about different experiences and the trials of
getting going on a pump.  I wrote in February and have still not received a
reply!  Maybe they hope I'll forget about it!

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