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Re: [IPk] 4 vs 2 injections FAO ZOE



Thanks Gaye,
Is the idea to split the dose into two or add in extra in the morning? Just
thinking that if I decreased my nighttime dose by splitting it my bg would
be far too high on waking.
Zoe.

----- Original Message -----
From: "Gaye Tordoff" <email @ redacted>
To: <email @ redacted>
Sent: Thursday, May 16, 2002 3:28 PM
Subject: Re: [IPk] 4 vs 2 injections FAO ZOE


> Zoe
>
> Have just come on the computer for the first time in ages so apologies in
> the length of time between your message and mine.
>
> Before I was on a pump I was on two daily doses of insulatard (and later
> Humulin I) morning and night.  A lot more at night than morning.  It
> certainly improved things and you should talk it over with your diabetes
> specialists to get your dose about right.  Definitely worth a go.
>
> Gaye
> ----- Original Message -----
> From: "Zoe" <email @ redacted>
> To: <email @ redacted>
> Sent: Monday, April 22, 2002 5:06 PM
> Subject: Re: [IPk] 4 vs 2 injections
>
>
> > Tony
> > I quite agree - I won't be ruled by my HbA1c, there's more to life -
> however
> > long it is!
> > It is possible to give an extra dose of insulatard in the morning as
well
> as
> > nightime to stop bgs rising before meals - something my GP suggested to
me
> > but I never got round to trying.
> > Does anyone do this?
> > Zoe
> >
> > ----- Original Message -----
> > From: "Tony O'Sullivan" <email @ redacted>
> > To: <email @ redacted>
> > Sent: Thursday, April 18, 2002 12:11 AM
> > Subject: Re: [IPk] 4 vs 2 injections
> >
> >
> > > Abigail is right, but there is another side to the 4 vs 2 injection
> > > question.
> > >
> > > One of the big disadvantages of 4 injections a day, particularly if
the
> > > short-acting is an analogue, and the long-acting at night is a medium
> > > insulin like insulatard, is that daytime gaps between meals are short
of
> > > insulin, and bg's can climb throughout the afternoon each day, even
> though
> > > everything else is right. This is less likely with twice daily, as
there
> > is
> > > some longer-acting given twice a day.
> > >
> > > Secondly, children from the start of primary school to early secondary
> > have
> > > reasonably ordered lives, with mealtimes inevitably decided by a
> > > parent/guardian. So the twice a day regime isn't too restrictive.
> > >
> > > Third, twice daily regimens give quite good control, certainly good
> enough
> > > for modern kids with diabetes who, and I don't mind repeating this,
are
> > NOT
> > > facing a lifetime of diabetes. Studies show 2 injections to give
better
> > > control than 4 in this age group.
> > >
> > > Fourth, analogue insulins, and better mixes with subtle variations in
> > > proportion have improved twice daily treatment too, so it isn't the
> dreary
> > > conservative approach it once was.
> > >
> > > But regardless of all this, what really worries me is the 'performance
> > > anxiety' which seems to be fed to many parents to make the diabetes
> > > disappear  by keeping blood glucose within the normal range at all
> > > times....but at what cost?
> > >
> > > Professionals have a lot to answer for in raising the anxieties of
> parents
> > > about major complications age 12 if the child doesn't keep a bg below
7
> at
> > > all times. This is not how it is. Of course we should all try to keep
> good
> > > control etc, but this should be at an acceptable cost to quality of
> life,
> > > and to me that includes the quality of life of the parents! HbA1c's
> above
> > 7
> > > give experienced expert patients such as Elizabeth the heeby jeebies,
> but
> > > for most of us, and that includes kids with diabetes, they shouldn't.
> > >
> > > Most of us have been weaned onto a pump after a period of multi-dose
> > > injections, 4 or more times a day. It isn't written in stone that this
> > > should be the way. Many US clinics use the pump as the default
treatment
> > > from day 1, and for someone who is enthusiastic, and wants to combine
> > better
> > > control with the freedom (eg to eat when and what you want), it can
make
> > > perfect sense to go straight from twice a day to the pump.
> > >
> > > Am I a cynic? When I hear someone say 'I'll be happy when I have
really
> > good
> > > control', I sometimes wonder if they are saying 'I can't really accept
> > that
> > > I have diabetes'. I've experienced denial, but dealt with it in a
> > differnet
> > > way, by ignoring the diabetes. I suppose I'm basically offering a
little
> > > caution to the idea that more tech is the answer, or shaving 0.2% off
my
> > > HbA1c will improve my life. We should stop once in a while to ask a
more
> > > basic question. Can I accept this common, manageable condition for a
few
> > > more years until a cure is available, and in the meantime, which of us
> > will
> > > be in control of my life?
> > >
> > > Sorry, I should've saved it till Sunday!
> > >
> > > Tony O'Sullivan
> > > 26 yr T1, pumping 6 months
> > > ----------------------------------------------------------
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