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Re: [IPk] Consultant appointment

Hi Phil

Here's a general checklist for diabetes consultant appointments, which
will make you look very well organized and competent :)

1) List of all current medications/supplements (prescription &
non-prescription), with daily dosage amounts. In the case of your
insulins: the times of day, the amounts you inject, any correction and
carb factors you regularly use to figure rapid-acting doses
2) In addition to BG logs (printed out from your meter should be
fine), knowledge how much/what types of exercise you've done in about
the past 2 weeks. Do you make changes to your insulin or food/drink
intake to accommodate exercise? If so, what do you do?
3) Although you are not meeting with a dietician, if you can
generalize about the amounts and types of food you usually eat in a
"regular" day (as opposed to a special occasion), that may be helpful.
Write a list starting with breakfast. If you regularly must have a
snack in order to prevent a hypo, put a note by it that you aren't
hungry for that food but it's to prevent a hypo.
4) How many times a month or week do you have highs and lows in your
bg level that cause problems or delays in terms of work or other
responsibilities (family, social, driving etc.)?
5) Do you wake up hypo in the night? If so, how often has it happened
in the past 6 months or so?
6) Do you need extra insulin to correct your bg when you first wake up
(fasting)? How much, how often?
7) How many times in about the past 3 months have you done a 3 am
blood glucose check? (This is not a question with a "right" or "wrong"
answer - it just indicates whether you might *need* to do some in
order for your consultant to help fine-tune your regimen or whether
you are already doing them and there's not a very clear pattern in
terms of overnight bg fluctuations...also a possibility.)
8) When you have a hypo, how do you treat it? Do you go up high
afterwards on a regular basis? High enough that you have to inject
more NovoRapid to fix the high bg? (This is important because you may
have to gain discipline in treating hypos or change your hypo
treatment - so many people overtreat a hypo and put themselves in a
cycle of low-to-high-to-low bgs.)
9) If you are carrying around some extra weight, don't be offended if
the consultant remarks on it. If the reason you're heavy is you are
unable to exercise as much as you'd like, a pump may really help. If
you are underweight, you might be able to keep more weight on with
more physiologic insulin therapy. If you are normal weight, good for
10) What's your family life like? (If your family are supportive
regarding your diabetes self-care, it can make a big difference in
health compared to them not being at all concerned or being negative.
If you live alone, it's not entirely clear what difference it makes
but it's good if you have someone who would check on you if you were
ill or seemed to be missing in action some day.)

I know that sounds like a lot, but if you want to be prepared for
anything at least it's comprehensive....

Type 1 15+ years; MiniMed pumper 7.5 years; Animas pumper 4+ years
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