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RE: [IPk] meeting NICE guidelines

I do hope that you are able to get a pump.  That sounds the best solution.

 Sasha has lots of fluctuations and night time lows, we have to get up at night
and do a blood test,
 sometimes twice. We tried Lantus but that was even worse for us, many more
prolonged high readings and
 sudden lows. We have now been trying NPH twice a day, 12 hours apart and
Novorapid as a bolus which
 sometimes means 7-8 injections a day. We are getting the best results we have
ever had on a split dose
 of NPH. It also means that if Sasha has been very active in the day or eaten
much less during the
 evening we can reduce the dose of Insulatard, whereas if you are given Lantus
you cannot take it out once
 given in the morning and even Lantus given once in evening you cant really mess
around with doses on a
 daily basis as it seems to take 3 days for a full effect of an increase or
decrease to emerge. We are
 told that Sasha A1c is good usually 6.3 - 6.9 but again day to day we get
swings fairly often and some
 day are skimming hypos but less than we were before. Sasha seems very sensitive
either way food or
 insulin. Slight more food, half a biscuit or half a unit of insulin make huge
differences. Goodness
knows how we managed before we taught ourselves carb counting.

Go for a pump if you can.

Mum of Sasha age 9

> -----Original Message-----
> From: email @ redacted [mailto:email @ redacted]On
> Behalf Of email @ redacted
> Sent: 26 November 2003 08:31
> To: email @ redacted
> Subject: [IPk] meeting NICE guidelines
> Hi all
 > Went for a follow up with my consultant yesterday. Writing the letter
> all my current 'issues' was a great help as we were able to cut to the chase!
 > Told her again that it is my plan to start trying for another baby in 2004
> this is what is driving me. These were the option she gave me:
>  *Stay on Lantus/Humalog. However they have taken a decision to not keep
 > pregnant women on Lantus, but might be persuaded if control was excellent
> all the problems i've had with Lantus this is unlikely)
>  *Wait for new Detemir due out in March, but same issues as with Lantus for
> pregnancy
>  *Start Insulatard instead of Lantus (aargh). Can anyone give me a steer on
> this? Can't imagine it would be better than Lantus
> *Pump ....
 > So she is in theory up for it though not making any promises whatsoever. Next
> step is she will refer me to the pump clinic and see what they think about my
> case.
 > The big problem is my Hba1c was 6.1%!! But I am only in target about 50% of
> time. I suspected I'd been having nighttime hypos and not waking, and this
> result confirms it as there is no way my daytime readings would give 6.1%
> result. No awful hypos (fits, passing out etc.) but just waking up feeling
> 'hungover' and sometimes unexplained high bg.
>  So again the impression I am getting is that this is a fantastic result in
> their eyes and they would have no problem with me getting pregnant. However I
 > don't think I could go through the first 3 months getting the kinds of
> I currently get without having a nervous breakdown!
>  Hopefully I will get to the pump clinic before Christmas. If anyone has any
> tips on how I could play it with them I would really aprpeciate it.
>  (Of course I am only getting this "great" Hba1c by eating a very restrictive
> diet - 50-80g CHO max per day. My consultant appreciates that this is not an
> acceptable situation)
> Thanks for all the support so far.
> Louise
> 32, dxd January 2003, aspirational pumper!
> ----------------------------------------------------------
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