Fab appointment with DSN

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shiv

shiv

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Relationship to Diabetes
Type 1
Hi all,

Saw my DSN today, after a couple of weeks of horrible BG levels. She started off by upsetting me greatly - said that I test far too much, I worry too much about hypos (!), I am winding myself up tighter and tighter...cue me nearly in tears.

But.

She has said that she thinks I need to trial a pump...so Sept 6th (7 weeks today!) I get to trial it for a minimum of 10 weeks 🙂 she said as long as they see an improvement in control, I should be good to get full time funding 🙂 woohoo!

I'll also be hooked up to a CGM for 5 days in August to see what the heck is going on with my levels.

Still hypoing at night - she has told me to dramatically cut my Lantus at night, and to correct the high in the morning to begin with. She said when she gets back from her holiday in 3 weeks, if I'm either still hypoing or I'm okay through the night but shoot up she'll look to switch me to Levemir.

Happy happy girl right now.

Also, she has set aside an Accu-chek Aviva Expert - basically the handset to the Roche pump, it's now available as a standalone - for me, it has a huge library of carb values in it, can suggest bolus amounts according to BG levels/carbs/insulin etc. She said she thinks it might take a little of the stress away for me.

http://www.accu-chek.co.uk/gb/products/metersystems/avivaexpertaccessoirestab.html

🙂
 
That is fantastic new Shiv, so pleased for you. That meter looks great, can you record all your carb values and injection amounts in it too?
 
good news you get to trial a pump , the avivia monitor is great and does take the stress away form working out insulin doses , you just type in the ammount of carbs youve had and it works out the ammount for you , i love that bit and couldn't live without it now , love the fact if your hypo or hi it shouts at you after the b.s result appears to get you to do something about it too lol
 
Excellent news so chuffed for you shiv, cool looking meter.
 
Sounds good Shiv 🙂 well done, its a ncie feeling to walk away from a consultation and have it go well Im sure.

Nice bit of kit too- pretty exciting! So is it the Roche pump you will have? If you like it at the end of 10 weeks can you keep it? 🙂
 
I want the medtronic, so she's going to try and get one of the loaned medtronic ones back. I'm lucky that at my hospital you can pick whatever you want!

She only gave me the meter because I'm *not* going to pick the Roche - you get one with the pump so no point!

Whether I get to keep it (or rather, they apply for funding to get me my own one) or not depends on if they see an improvement! I'm about 99.9% sure they will!!
 
Thats fantastic news Shiv- you can choose whichever one you want!! Thats rare maybe, from what Ive heard on here...? And of course I am bias, a good choice 🙂

My only reservation is that there is such an adjustment period with a pump, it will likely take you that time and then you have to give it back.....seems a little cruel. You should be allowed to keep it (in my opinion!).

Fabe news though, and I love that your DSN suggested all this new kit. What a legend x
 
Fantastic news, I'll keep my fingers, toes and anything else I can crossed for you to get one of your own at the end of the trial period. I hope it all works out well for you,
 
Sugarbum said:
Thats fantastic news Shiv- you can choose whichever one you want!! Thats rare maybe, from what Ive heard on here...? And of course I am bias, a good choice 🙂

My only reservation is that there is such an adjustment period with a pump, it will likely take you that time and then you have to give it back.....seems a little cruel. You should be allowed to keep it (in my opinion!).

Fabe news though, and I love that your DSN suggested all this new kit. What a legend x
Click to expand...


She said they give you about 6 weeks to get to grips with it, then in the following 4 weeks they look to see some kind of improvement. I don't think they just take it back off me - from the way she was talking about it, if they see some kind of improvement, they'll let me extend the trial/put me on an extended loan, whilst they look to apply for my own funding.

Edit: haha you've got me all worried now that 10 weeks isn't long enough to see some kind of improvement, but I think it will be (I hope!). I might take 3 or 4 days off work immediately after to do some serious basal testing.
 
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Great news Shiv.

Hope it all works out for you.

Just wondering... have you ever tried switching your Lantus to the mornings? I've been going through about 6-months of experimentation with Lantus trying to prevent overnight hypos.

I spoke to my DSN about injecting in the morning and she was not very keen (said it just moves the problem). BUT that has not been my experience at all. I get way steadier levels between suppertime & fbg when injecting the full dose pre-breakfast. And no post-overnight-hypo-liver-dumps either. The only problem I'm having now is post-breakfast spikes. Seems like I'm eating breakfast while the new basal dose is chugging through it's 2 hour onset period. Now experimenting with the timing of the breakfast bolus to take account of the basal onset.

Something to think about/speak to your DSN about before you get your pump test maybe?
 
Hey Mike,

I take a split dose of Lantus, because of the hypos. I take 2/3 of my Lantus in the morning and the other third over night. I had been taking it all in one go in the evenings for years, then moved it to the mornings, now it's split because nothing seems to shift these damn hypos.
 
Hi Shiv

Do you get fewer hypos with the split?

I tried that for a few months, but even 1/3 of the total dose at suppertime sent me either hypo overnight, or gave me a low fbg. I have no idea why! Something very odd seems to happen with my system and even 4u of Lantus taken at around 10.30pm...

Whole dose in the morning gives me way more solid overnight bgs and no overnight dips (so far anyway). Just these darned post-breakfast spikes to tame. Either that or go to the gym every morning as those days I'm fine...

Sounds like you've wrestled with the same problem yourself and found your own least-worst-case though. Did you ever try Levemir? I might ask to give that a go if things don't improve by the Spring.
 
I get the hypos whenever I take the Lantus, but at least with the split I can just tweak part of the basal and not mess up the whole day, as 12u in the morning works well for the rest of the day.

Yes, my DSN has said in the mean time if I still can't get rid of the hypos or I keep getting huge rises in the morning due to reducing night time Lantus so much, she'll put me on Levemir as the action of it is much shorter. She thinks that the 2 Lantus doses may be crossing over and causing the lows, although I'm not sure.
 
Just wanted to say again what brilliant news this is, I hope that you can get the funding at the end of the trial. Good luck xx
 
Glad to hear you are going to get a trial of the pump. I know some people who have changed to levemir form lantus and say it's less agressive, so it might not cause you as many hypo's. Worth trying it if it'll help even if it's only for a few weeks before the pump.
 
Well done Shiv, this is really good news! 🙂 And let's hope that the Lantus problem get sorted sooner than that...
 
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