Anyway, the nurse felt I should be on either a twice-a-day insulin or multi-dose regimen, although she could not help clarify what my diabetes actually is. But I now have an in-person appointment next month where there will be a consultant who can review things. So hopefully I can get confirmation then, as well as find out what my new prescription will be.
It is next month! And I saw the consultant, who referred me to speak to him! I am sure the diabetes writers will run out of cliffhangers eventually and will have provide a conclusion, but for now I should get an appointment to see him at the hospital sometime in the next month.
Some of the issues have been resolved though, which is that part of the appointment will be to start me on a short acting insulin. Which, as he said, is the important thing: to get the right treatment regardless of type. I forgot to ask about stopping tablets too, I take so many I would love to do so, but M.D.I. treatment seems to be an end point rather that the 'see if this helps' approach which has been essentially the case with everything else.
He also wants to switch Abasaglar for Levemir, not liking me taking Abasaglar twice daily (nor do I!) though he agreed with the reason why I did it. It was a pretty good experience, he wanted to go over the history to get a full background of what has been happening, which is exactly how I think. So I felt I got to explain everything and he understood it all.
The only thing I did not entirely understand is that he both disagreed and agreed with my original understanding of the C-peptide result, as meaning I can produce background insulin but not extra. He did point out that was a one-off result so I think his disagreement was with drawing conclusions from a single test. A proper twice daily basal insulin makes a lot more sense than overlapping a longer term one, though I am still not clear on why I need one at all.
But the other part of the hospital appointment will be to do some more tests, so it was not worth trying to worry about that now. My diabetes is not typical though, he said, which is annoying but ironically typical. When I was first referred for my arthritis all the tests came back negative until the ultrasound, and the lung condition and diabetes discovered in the process were both without symptoms. So having anti-bodies to give a simple explanation was never likely.
For now though, things just carry on as they are with Abasaglar twice daily until the appointment. Although he wants me to reduce the dose as though he is concerned by the post-prandial levels he is more concerned by the hypos. Particularly having had six since May 31st, so I already reduced the dose after the first four in as many days. I had put that sudden increase down to the hot weather.
It definitely highlights the point about inflexibility though, as only two of those came when I had not eaten. Meanwhile yesterday I felt I could not eat at night when I tested with a 7.1 fasting level after recent results going too high after eating. It may be a difficult month taking at least four units fewer. I am now down to 30 units in total, and when I was at that amount while titrating to get morning levels under 6 my fasting averages were 6.4 and 8.7. As much as I struggle in this weather, hopefully it will stay around to help me!
The other thing of note is my HbA1c has reduced slightly from 6.5% to 62% / 44 mmol/mol. Yay hypos! But the nurse did the test while I was there using a sample from my finger instead of needing a lab. I have not experienced that before.
Things feel very slow moving having been trying to get help for over a year and still a least month away from a confirmed diagnosis and the right treatment. But one year ago today my fasting levels were 16.3 and 15.3. This morning I was 4.9, then a 6.9 at the clinic not yet having eaten anything. So it is almost over. Apart, obviously, from it then never being over.
