Consultant wanting to change my regime

[C&E Guy]

The new consultant wants to change my regime. He wants to get my Hb1C down a couple of points even though I have been getting on fine. I've been Type 1 since 1964.

At the moment, I am on Actrapid morning and evening, as well as Tresiba in the evening.

I have a well-worked routine in the mornings involving getting up, preparing breakfast (putting the kettle on), toilet, check blood, shave, clean teeth, wash, get dressed. I go downstairs, have a quick check of the News, eat breakfast and go to work. In the evening, I'm at home. I inject and have my dinner about an hour later.

He wants me to go onto a very fast acting insulin - one which works in minutes. That might work at home in the evening - but it would be difficult to fit in my morning dose - as I have a routine that works, and am racing against the clock to get out the door. My right hand is very stiff and I think it would be difficult to undo my cuff and roll up my sleeve once I am already dressed and ready to eat. I can't bear to inject in my stomach so that's a no-no.

There is nowhere at work to do a lunchtime injection or glucose test. I work in a huge office with 30 people. The loo area is very small and is always busy at lunchtime - unless the cleaner is in. Then it's out of bounds. That would be a bit impractical.

If we go out for a meal at night, I certainly can't inject at the table. At the moment, I inject in the car before going into the restaurant, or even at home before going out. I have time to do that. Convenient and easy. So I wait until we get back out to the car afterwards?

Sorry to go on at length. How do others manage with this regime?

I have told him all this but he is getting insistent.

 

[Sprogladite]

What insulin is he wanting to switch you on to?

 

[Mark T]

There is just shy of under 200 in my office, if you think that would stop me from testing my BG... Certainly at meet-ups I'm not shy 😉

However, my father always finds a private room, even at home. So I understand where you are coming from.

Technically you company is forced by law to make adjustments for you, so if there is a private office somewhere then they should let you use it.

 

[C&E Guy]

First question - some very rapid insulin that works in 5 minutes, and is taken before every meal or snack. Can't remember the name.

I can't even inject or test my blood in front of my own family. I am too self conscious. I really don't want a big fuss at work. Going every day to an Occ Health room - not for me. Most colleagues don't even know I am Type 1! Just a few.

 

[pav]

I am hoping to switch to insulin and do test regularly as on hypo meds, we are all different in how we feel like sticking needles in ourselves and around who is around us.

I would definitely not use any toilets to inject in, espec work ones where I used to work had to be the most un-hygienic and dirtiest places in the workshop. When out and have to test I try and do it discretely at a table or where ever I am and would do the same if injecting. at the moment I go out a lot with a friend, and she has no problems with me and is more concerned that I am ok, I even let her stick me and do a test as she was that concerned if I was ok and now she knows what to do. On the other hand there is another friend who does not like seeing anyone being tested and as he is diabetic and on hypo meds who rarely tests for some reason and always at some point has a dig at me testing. When he is around I just try and be more discrete, but at the end of the day it's my body my illness.

I am not sure what the work requirements are, but they can't penalise you for injecting, and if there is no clean area where you can inject, I would just do it at my desk. A bit like asking work colleagues how would they feel if a doc / nurse took them into the toilets and give them injections in there.

 

[C&E Guy]

Sorry - I just could nor bring myself to inject at my desk with any number of colleagues sitting about. I just couldn't.

And I'd have the same issue with not being able to undo my cuff and roll up my sleeve. My fingers are so stiff that I can hardly sign my own name. I can type but find writing too difficult, these days. I'd need to overhaul my entire wardrobe and wear short sleeved shirts all year round.

I especially don't like loos in restaurants. Even more so loos abroad. Eek!

These excuses might seem pathetic to some of you. It's just me being over practical.

 

[AJLang]

I have been through all of the various insulin regimes since 1971. I found that going onto that suggested by your consultant was the most liberating (well until I got the pump). I assume that he wants you to reduce your HBA1C to reduce the risk of complications - I'm not saying this is you but complications are something that we sometimes fear but equally don't think will affect us...until they do. I certainly wish that the medication tools had been available to me to get a lower HBA1C so I hadn't developed diabetic gastroparesis. As the consultant wrote in the ten years leading up to the gastroparesis my average HBA1C was 7.5 which, at the time, I thought was good. But it didn't stop the gastroparesis starting nine years ago and subsequently affecting me and my BG control virtually every day. I now do everything I can to keep my HBA1C around 6.5-6.7 to reduce the chances of future complications. The reason for this long message is to say please try to focus on what the benefits may be to your longer-term health of changing to what the consultant has suggested.

 

[pav]

Sorry - I just could nor bring myself to inject at my desk with any number of colleagues sitting about. I just couldn't.

And I'd have the same issue with not being able to undo my cuff and roll up my sleeve. My fingers are so stiff that I can hardly sign my own name. I can type but find writing too difficult, these days. I'd need to overhaul my entire wardrobe and wear short sleeved shirts all year round.

I especially don't like loos in restaurants. Even more so loos abroad. Eek!

These excuses might seem pathetic to some of you. It's just me being over practical.

We are all different, what some can do others don't feel comfortable doing. Is there anywhere that's clean the bosses could make available for you as and when needed?

 

[Sprogladite]

Sorry - I just could nor bring myself to inject at my desk with any number of colleagues sitting about. I just couldn't.

And I'd have the same issue with not being able to undo my cuff and roll up my sleeve. My fingers are so stiff that I can hardly sign my own name. I can type but find writing too difficult, these days. I'd need to overhaul my entire wardrobe and wear short sleeved shirts all year round.

I especially don't like loos in restaurants. Even more so loos abroad. Eek!

These excuses might seem pathetic to some of you. It's just me being over practical.

Have you considered moving onto an insulin pump if injecting in public is an issue for you? Just thinking it might be more discreet for you? That is, of course, if you fit the criteria for one, but worth asking about?

 

[C&E Guy]

I took part in a 3 week trial of a pump away back in the 1980s. It kept bleeping during the night whenever there was a blockage in the tube. That was a complete nuisance.

Have they improved since then?

 

[Sprogladite]

I took part in a 3 week trial of a pump away back in the 1980s. It kept bleeping during the night whenever there was a blockage in the tube. That was a complete nuisance.

Have they improved since then?

Yes, massively. They even have pumps now that don't require tubing at all - the Omnipod is one of them.

 

[C&E Guy]

Just Googled Omnipod. Had never heard of such a thing. That is so different from the pump I tried years ago.

Is it easy to have showers etc with that on?

 

[Sprogladite]

Just Googled Omnipod. Had never heard of such a thing. That is so different from the pump I tried years ago.

Is it easy to have showers etc with that on?

Yes as far as I'm aware you can leave it on while showering etc 🙂

 

[C&E Guy]

Does it "get in the way" when rubbing on soap?

 

[Sprogladite]

Does it "get in the way" when rubbing on soap?

I'd have thought it's somewhat similar to wearing a Libre - they offer 'Demo pods' people can try to see if they'd get on with them here: https://www.myomnipod.com/demo?link=2&ctoken=70150000000DYhrAAG
Might be worth a go?

 

[C&E Guy]

I'm seeing a nurse tomorrow afternoon. I'll mention it.

Thanks for all the advice.

 

[stephknits]

Hi, I'm on the omnipod and shower fine with it on. Also swimming etc. Any questions, ask away

 

[trophywench]

Well any normal 'tubed' pump absolutely needs to tell us when we aren't getting any insulin because it delivers our basal and bolus insulin, ie that very fast-acting insulin your consultant wants to see you using. So if it stops delivering it (they give us insulin a teeny drip at a time every 3 minutes or so, like the human body does itself when it has a fully functional pancreas) it isn't very long at all, before we start suffering - a bit like starting all over again pre-diagnosis.

It really is life threatening - a bit like you just not bothering to inject any insulin at all!

Having said that - I've had a pump since 2009 and I've had an 'occlusion' (blockage) only twice - both my own fault and I appear to have learned from my mistakes, don't I?

I don't know how the 'pod' pumps indicate a malfunction cos I've never had one - but I'm certain they must have some sort of alarm since it really is life threatening if they suddenly fail for whatever reason.

 

[C&E Guy]

Thanks guys for all the info.

As I said, I'm seeing the nurse this afternoon to discuss this. I really do feel like an old dog refusing to be taught new tricks, but my wife just says that I am putting obstacles in my way when I shouldn't.

I just wanted to sound out some others for a bit of practical advice.

 

[stephknits]

Yes, my omnipod alarms if not working.