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[IPk] antibodies, poor control, lack of doctors

if you are on optimized MDI with frequent monitoring and some type of scheme
for meal ( carb or calorie or whatever,) assessment or control, leading a
healthy lifestyle etc, then it's obvious that the regimen is at fault, not

Have you considered trying different insulins eg novorapid instead of humalog
and novo's equivalent of whatever long acting you are using( or change to a
different type of longacting ieNPH to lente)?
Would your GP be willing to swap or would this mean waiting for another
Ask if you can be referred as a matter of urgency. If health professionals are
keen enough on good control to make you feel guilty when things go pearshaped
then they should also be receptive to the fact that you need to see someone
who knows what they are talking about( and preferabley someone familiar with
pumps as you are considering this option)

more detailed analysis of food ( eg covering protein as well as carbohydrate
or keeping protein relatively consistent so as not to confuse things) and 2
injections of long acting (if you currently only use one) may improve things
but possibley at the risk of more hypos. If the problem is not due to
antibodies and can't be dealt with by a change in insulin type/ species it may
be that your diabetes educators have not been thorough enough( regrettabley
the norm rather than the exception). It may be that MDI is just too clumsy a
tool for you. Or it may be a combination of both of these

Bad control can really make you feel like cr-p can't it? And yes, I've been
there too ( the naughty child bit) when just over 2 years ago I went to see my
GP to change over to humalog and explained that I was going to try a pump
because I was concerned about my control. My GP is carrying a considerable
spare tyre and I should imagine at risk of type 2 himself, but stated that
surely my control ( or lack of) was due to my lifestyle. Mildly insulted at
this I reasoned that I was careful about my food, monitored BG regularly, and
tried to make sense of my shift par\tterns and adjust accordingly but still
suffered from frequent hypos and hypers, with an A1C of 9.6. We parted on good
terms and he's been fine since. So far they have not complained about the
number of strips I use, at least( touch wood) and he persuaded me later to go
to a different clinic with pump expertise

It still smarts though to be expected to do the same job as a pancreas with
only subcutaneous insulin and spot BG checks, and to be blamed if A1c is less
than perfect.

Any doctor or nurse who blames lack of control wholly on the patient being non
compliant without being a " fly on the wall" , has a denial problem themself
and should not be involved in diabetes care
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