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RE: [IPk] BDA Oxford conference



thanks  - how do you adjust when there is no major pattern - or is
there?

> -----Original Message-----
> From:	Duckworth [SMTP:email @ redacted]
> Sent:	24 September 1999 17:53
> To:	email @ redacted
> Subject:	Re: [IPk] BDA Oxford conference
> 
> Replying to Julette Kentishes points:
> 
> Yes I am on a pump (for four years now, Humalog for nearly a year). I
> change
> sites every day, I have regular eating, sleeping, exercising and
> testing
> regime, and my insulin requirements vary by 20-30 per cent during a
> week,
> which means in practice I have to watch my blood sugar levels closely,
> despite the fact that there seem to be patterns which I think I
> recognise
> from time to time.
> 
> My specialist in Brussels where I live has other patients like me
> among the
> fifty plus at this particular hospital when I started (pump therapy is
> far
> more common here than in the UK,  but is primarily considered, since
> it is
> fully financed by the health service, for "unstable diabetes").
> 
>  I cannot , of course, comment on what  practices work for others, but
> my
> point is that for a certain category of patients (who hopefully are
> sanguine
> enough to live without the illusion that their condition is not a
> problem)
> many factors are crucial in deciding dosages, including awareness of
> that
> strange day when you appear to need no boluses, followed by the day
> you have
> to increase each one by a considerable amount. Such patients will be
> way off
> track if they regard CHO counting as a basic management tool.
> -----Message d'origine-----
> De : Julette Kentish <email @ redacted>
>  : 'email @ redacted' <email @ redacted>
> Date : vendredi 24 septembre 1999 10:00
> Objet : RE: [IPk] BDA Oxford conference
> 
> 
> >Unfortunately people with diabetes can't lead normal lives - and you
> are
> >right we keep telling patients 'control your diabetes rather than let
> it
> >control you' This to a certain degree is rubbish. Everything you do
> is
> >influenced by your injections, blood testing and what you eat. So
> much
> >for the idea of freedom from diabetes.... But to try and have a
> positive
> >approach to food and eating is still relatively important. The idea
> >behind...you can eat whatever you like - has been replaced by  - as
> long
> >as you calculate your carbohydrate and insulin accurately. Simon do
> you
> >feel you are calculating carbohydrate conent and altering your
> insulin
> >but with no benefit? Are you type 1? On a pump or injections?
> Changing
> >your sites regularly? A few different avenues can be looked at before
> >saying no matter what i do I can't predict my levels... I have a
> patient
> >who finds great difficulty with this but he is producing residual
> >insulin and at 75 has a bit of a problem ... his carbohydrate needs
> some
> >work. That enough for now... any more information or you want another
> >dietitian to add their 2 p's worth - just sing out :)
> >
> >> -----Original Message-----
> >> From: Duckworth [SMTP:email @ redacted]
> >> Sent: 23 September 1999 21:29
> >> To: email @ redacted
> >> Subject: Re: [IPk] BDA Oxford conference
> >>
> >> I'm intrigued by the correspondence on this carbohydrate counting
> idea
> >> which
> >> I also think is a highly misleading thesis - part of the "diabetics
> >> can lead
> >> normal lives" myth. it reminds me of the 1970s when I was first
> >> diagnosed.
> >> The reality for me is that there are too many variables in my
> >> condition to
> >> pass up the chance of fixing within reasonably close tolerances one
> >> parameter over which I can exercise easy control - what I eat and
> >> when.
> >> There is for me no fixed equation between insulin and carbohydrate,
> >> something I have learned to my cost during a number of years of
> >> multiple
> >> injection regimes, when I was living under the illusion that
> because I
> >> felt
> >> OK and the tests were OK (with plenty of hypos to keep the HBA1C
> down)
> >> everything was all right.
> >>
> >> I would say beware of these easy solutions and check them out
> >> thoroughly for
> >> consistency before you put your faith in them.
> >>
> >>
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> 
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help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml