[IPk] lots of questions from a newbie!
Hi all - I'm Louise, new member. I'm 32 and was diagnosed in January 2003
with Type 1 (after initially being diagnosed with gestational diabetes in
July 2002 and then IGT - going into DKA finally helped the medics to figure
it out!) After terrible results with Insulatard/Mixtard I was fairly
quickly put onto MDI (humalog and lantus).
My hba1c is currently 6.7% which my diabetes team seem to think is enormous
cause for celebration. However this is just a midpoint between the frequent
highs and lows. To get this kind of control I can expect about 2 hypos per
day. Also I have had to pretty much cut out bread, potatoes, pasta, rice,
I couldn't get the Lantus to work for 24 hours. Taking it at night meant
morning hypos but creeping up from mid afternoon. Taking it in the morning
meant I was waking with high BG (so feeling crummy) and hypos in late
morning. I now take it twice a day (14 units in the morning and 2 at night)
which works as long as I don't eat any carb for lunch or dinner! My team
would not give any advice or support on this so I took the decision and set
the dose myself. Does anyone else have experience of splitting Lantus?
My carb to insulin ratio seems to be about 1 unit to 5 g. This seems really
high. Most of the literature talks about it being 1:10 or 15. Does this
mean I have reduced insulin sensitivity?? (I'm not overweight). I unit of
humalog seems to lower my BG by 2.5 - 3 which seems pretty typical.
The other reason I am eating low carb is because of problems with humalog -
I get decent BG results 1.5-2 hours after a meal but it then climbs up 3-4
hours later. If I take more humalog then I go hypo, need to eat and then go
high from the snack. Does anyone else have this problem? Would Novorapid
be better or splitting the humalog?
(By the way I have stopped calling my DSN as her reaction to any of the
above is "that's diabetes for you" ....)
I am really keen to try a pump. There are some people at my clinic using
them, but the consultant seems to only use it as a complete last resort. I
am afraid that I am being discriminated against because of my perceived
'good control' - which is only achieved by testing 8-10 times per day,
giving correction doses, rigorous carb counting and carb restriction etc.
Any tips on how to persuade my team would be appreciated! I am keen to try
for another baby next year but would not dream of it with my current BG
levels and am terrified of the effect that pregnancy hormones will have on
what already feels like a roller coaster at the best of times. Therefore I
will pay (re-mortgage the house, whatever ...) for one myself. Does anyone
have experience of dealing with the pump manufacturers directly? Is it
possible to get a trial of a pump before committing to buying one? If I buy
the pump privately is there any chance of getting consumables on
prescription or will I have burnt my bridges?
I am going back to clinic in a couple of weeks time and will again try to
put some pressure on the consultant to recommend me for pump trial, but I'm
not very hopeful. (I am under Newcastle NHS - would love to hear from
anyone else in the area who has local experience).
Thanks to anyone who has taken the time to read this long message, and
special thanks to anyone who replies to any of my questions.
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