Hi there, feeling a bit cheesed off and frustrated today... I've normally been very impressed with my diabetes team but today I just feel like I wasted a morning on a carb-counting refresher session.
I actually had a check up with the consultant on Tuesday, which went fine, HBA1C down to 7.1% from 7.7%, which she was pleased with. After going through my BG diary and talking about all the exercise I do (am training from the Greath North Run) she advised me to drop my Lantus from 8 to 6 as I was having hypos most days. So I've tried that for 2 days now and it seems to be working fine.
Then today I went on the carb-counting refresher course, and they just had all these formulae that they were trying to apply to everyone, regardless of how your BG was or what your lifestyle is. So the DSN said your basal units should be 50% of your total insulin daily dose (i.e. basal + all boluses) so for me (typical day 6 lantus, plus 6,7 and 10 Novorapid = 29 total) that works out at 14units, so when I said I took 6 she said "well, that's not enough" without asking me anything about how active I am or how good my levels currently are! Then she said your carb-insulin ratio is 500 divided by your total daily units, which gives 1 unit Novorapid for 17g carbs for me. I currently take 1 unit per 10g carbs, which works fine. But she was adamant that if I took 14 units lantus, I'd need less Novorapid, but I think taking over double my Lantus units would probably put me in hospital!
Surely if these formulas are valid, they'd only apply to the average person, and there would be a range of ratios and doses which work for different people. Any statistical distribution will inevitably have outliers, people at both ends of the normal range, and she wasn't willing to take that into account at all! Sorry I'm getting a bit mathematical here, but I'm a scientist and I like to appreciate that there is uncertainty in this kind of calculation.
To top it all, she rambled on beyond the scheduled end time of the session, and a guy went hypo, felt really sick and looked very shaken and spaced out and they had to rush in nurses to look after him. The poor man must have been very embarrassed about it all.
Sorry, just needed to rant to people who might understand my frustration at one professional saying one thing and one saying the total opposite 2 days later. I think I'll go with what thye consultant said for the time being, since she'd actually looked at my lifestyle and what was going on with my BG levels.
Does anyone think these formulae fit their doses at the moment? I'd be interested to know!
I actually had a check up with the consultant on Tuesday, which went fine, HBA1C down to 7.1% from 7.7%, which she was pleased with. After going through my BG diary and talking about all the exercise I do (am training from the Greath North Run) she advised me to drop my Lantus from 8 to 6 as I was having hypos most days. So I've tried that for 2 days now and it seems to be working fine.
Then today I went on the carb-counting refresher course, and they just had all these formulae that they were trying to apply to everyone, regardless of how your BG was or what your lifestyle is. So the DSN said your basal units should be 50% of your total insulin daily dose (i.e. basal + all boluses) so for me (typical day 6 lantus, plus 6,7 and 10 Novorapid = 29 total) that works out at 14units, so when I said I took 6 she said "well, that's not enough" without asking me anything about how active I am or how good my levels currently are! Then she said your carb-insulin ratio is 500 divided by your total daily units, which gives 1 unit Novorapid for 17g carbs for me. I currently take 1 unit per 10g carbs, which works fine. But she was adamant that if I took 14 units lantus, I'd need less Novorapid, but I think taking over double my Lantus units would probably put me in hospital!
Surely if these formulas are valid, they'd only apply to the average person, and there would be a range of ratios and doses which work for different people. Any statistical distribution will inevitably have outliers, people at both ends of the normal range, and she wasn't willing to take that into account at all! Sorry I'm getting a bit mathematical here, but I'm a scientist and I like to appreciate that there is uncertainty in this kind of calculation.
To top it all, she rambled on beyond the scheduled end time of the session, and a guy went hypo, felt really sick and looked very shaken and spaced out and they had to rush in nurses to look after him. The poor man must have been very embarrassed about it all.
Sorry, just needed to rant to people who might understand my frustration at one professional saying one thing and one saying the total opposite 2 days later. I think I'll go with what thye consultant said for the time being, since she'd actually looked at my lifestyle and what was going on with my BG levels.
Does anyone think these formulae fit their doses at the moment? I'd be interested to know!
