Hi rayray, your dispraxia is teasing me ... ability!
2 hrs after eating is great, as you say to see how it goes. I haven't worked out what 'parents' means, but think I've got the spirit of what you're saying. Anyway, 3 meals per day plus 2 hrs later = 6 tests, minimum. I usually expect also to test as I get out of bed (unless I use that reading for my breakfast bosul and before I go to sleep to see if I need a sleep time correction. Hence you could need a minimum of 7 or 8 test strips daily. I drive, so I need extra for driving.
Agreed.
Not sure what point you are making here. But if the opening remark that 'you are currently getting round it' means that you've found a solution - then fine. The longer that you can make that 'getting round it' work, the more you are creating a precedent for testing at a certain frequency and the harder it becomes for your GP to try and enforce a reduction. Sometimes, the GP needs a precedent to justify to the Practice CCG why they are prescribing above the guideline that they get from either NICE or the CCG. Its playing 'politics' and is a game that we, the Patients, should not be dragged into - but it happens!
Was that a GP Surgery nurse or a DSN? If the DSN is challenging you then there is a deeper problem, since a DSN should understand T1 needs to check frequently; whereas a Practice nurse sees diabetes from the perspective of T2s, and frequently GP surgeries have a policy ( wrong sometimes) of discouraging T2s from testing - then transfer that thought process into what T1s should do (also wrong).
Yes, absolutely right in my opinion. I drive and wouldn't consider making a long journey without a working fuel guage. And I won't cross the road without checking for traffic immediately before I cross, rather than looking and crossing 10 mins later!
Truthfully, I'm not sure what point you are trying to make in this paragraph:.
Adjusting your Levermir and making informed decisions means, to me, that you might need to make extra finger pricks.
If running higher then an extra half unit makes sense
I've lost the plot, sorry.
Yes there is merit in using the more flexible Levermir, but adjusting your basal is something of an art, rather than a science.
You have to assess (guess really) what your forthcoming day's activity is likely to do to your BG - or have a fixed morning basal and regulate through the day by snacks and bosul. Then in the evening assess (again guess) what your day's activity is likely to do to your sleeping BG and apply an adjustment. This is tricky and needs, in my opinion, several weeks of experience and tight record keeping to understand when the day has (or hasn't) affected your overnight patterns. I personally wouldn't trust a single 24hr experience and would want a lot of repetition before drawing a conclusion and making adjustments. All of this is so much more difficult without Libre.
I think that is jumping the gun. When you get the go-ahead for a pump then the change of insulin can be pert of the actual fitting process. But, you are now on Levermir, so moving on ...
I'm assuming you mean the Levermir wears off over 12+ hrs, if you got the dose wrong.
Actually you don't know that MDI isn't the best option for working, you are assuming that. Everything that I read suggests there is a lengthy transition process from MDI to pump and with your somewhat irregular working patterns finding the right moment to make that transition is going to be challenging. Also, if in the early days of that transition pumping is a bit wrong, will your work regime allow you to pause and make pump adjustments? Then pause again and check you have the adjustment right.
Last week my Endo said he fully supported the posssibility of my moving onto a pump BUT not yet. He felt I needed to get beyond all my current diabetes erratic behaviour before taking on what would be a challenging few months moving onto a pump. For instance he's suggested further changes to my carb:insulin ratios, my timings for prebosul and a slight tweak to my bosul. He did this after a lengthy study of my Libre data on LibreView and pointing out trends that he was spotting with his experienced eye. I am happy to accept his advice; it made sense to me. So even if I get a yes in 6 months time, it could still be a long time before the pump is actually funded and with me.
Well done on persisting with the fasting checks.
I'm still a little concerned for you that you seem to be accepting that you are running high and not working to lower your BG. One observation that my Endo made to me, was that if I'm low, but have good hypo awareness and able to respond quickly with Jelly Babies (or similar), then the risk to me is very limited. Repeated lows could affect my hypo awareness, but that is correctable. The likelihood of me going into a coma is very, very slim - not least because I have Libre and a CGM app. But the damage to me, particularly my narrowest blood vessels, by being high for too long is a bit more of a risk. Now, I'm nowhere near that risk at present, but I don't intend to let that become a risk. He did remind me that the first 2 simplest ways of lowering BG is by staying fully hydrated and being active, options I presume available to you. Of course also using extra insulin to correct, when appropriate.
Long post, hope the dialogue helps.
