Friend going on Mixed Insulin tomorrow

[Monica]

Hi All

You remember about my friend who had gestational diabetes 12 years ago, but it didn?t go away afterwards (I?ve only got to know her properly since Carol?s diagnosis)? She was on MDI, but on fixed doses. Her HbA1C has always been high. She never seemed worried, even though she got told off by the docs. BUT something must have sunk in when I was talking about Carol?s diabetes and what we?re doing etc. I was even very outspoken one day and said to her that she doesn?t want to end up like the woman on ?This Morning? who lost her limbs. She?s now at last had a proper test whether she?s type 1 or 2. And the result was Type 1 (which I?d suspected all along, but never said anything). They?ve then told her she?s been put on the waiting list for DAFNE. So I gave her a carb counting list the hospital gave us to help her along. She?s been carb counting ever since, but I don?t really know how she was doing with it, apart from the fact that her HbA1C has come down a little bit.

Now, after only 3 months of trying to get to grips with it, the hospital want to put her on MIXED insulin!!!!!! I told her, that I know it?s none of my business, but why on earth are they putting her on Mix. That?s the worst one to use. She just said ?I?ll try anything?. So tomorrow she?s going to change her insulin to mix, which I don?t think suits her lifestyle at all.

 

[Northerner]

That seems like a very big step in the wrong direction! What reasons have they given? For an adult Type 1 who has already shown some success and got to grips with MDI I can't think of any reason why you would want to go onto mixed

 

[everydayupsanddowns]

Very confused by that if it wasn't requested by her...

I wonder what reasons they gave - surely it will be less flexible and precise for her, which sounds like exactly the OPPOSITE of what she needs, and if she's waiting to go on DAFNE then she'll have to switch back when her course comes through...

Very odd.

 

[Monica]

I thought it odd too. I don't know too much detail, as I don't see her very often anymore. Our kids now go to a different school. She's coming round this afternoon for a cuppa and I'll "grill" her about it.

I really don't understand it at all unless she's been telling me fibbies about how well she was doing.

 

[Caroline]

I hope your friend gets on well with everything. She is very lucky yo have you for support.

Is there any chance your friend might register on here? She may benefit from it.

 

[Monica]

Is there any chance your friend might register on here? She may benefit from it.

I doubt that will ever happen. I have given her the web address though.

 

[Caroline]

I doubt that will ever happen. I have given her the web address though.

The main thing is she has been given the opportunity. Do let us know how she gets on with things.

 

[Ellie Jones]

Yes it does sound as though it's a pretty old fashioned step backwards, but perhaps there is method in their madness..

If she is struggling to gain control with MDI this could be that she's not able to grasp the relationship between food, exercise and insulin which is making it very difficult for her to do the calculations etc needed to gain good control..

By returning her to a old fashioned more rigid regime it may well help to stablise her control and safeguard her health, but provide the necessary breather for her so that she can start seeing the relationship between dose of insulin, food and exercise.. She be able to see the woods from the trees..

The shame about it though, is that they've not decided to go back to basic's and teach her how to draw up insulin from a vials and inject using a syringe, as this would enable her team to adust the ratio of background and quick insulin to suit her needs better... As I bet the reason they using a pre-mix is purely down to insulin pens and injecting two insulins at the same time!

 

[Monica]

Victor Meldrew here!!!!
Apparently she can't go on DAFNE, because her HbA1C is too high😱

I thought the purpose of Dafne was to learn how to do things properly and then the HbA will come down.

They are putting her on the mix, because she doesn't eat regularly. Because she gets up and gets her kids to school before having breakfast. Have lunch whenever and dinner/tea at about 9pm. I thought that's what MDI is good for. Unbelievable!!!
She thinks her clinic is rubbish and wants to leave. She apparently told her GP, who is also a diabetes "specialist", that she didn't like it there, but the GP just said they follow what the clinic says.
I told her that she has a choice, she can go to GP and tell her she wants to be transferred to another clinic and the GP has to do it. Well, we'll see.....

 

[Northerner]

Victor Meldrew here!!!!
Apparently she can't go on DAFNE, because her HbA1C is too high😱

I thought the purpose of Dafne was to learn how to do things properly and then the HbA will come down.

They are putting her on the mix, because she doesn't eat regularly. Because she gets up and gets her kids to school before having breakfast. Have lunch whenever and dinner/tea at about 9pm. I thought that's what MDI is good for. Unbelievable!!!
She thinks her clinic is rubbish and wants to leave. She apparently told her GP, who is also a diabetes "specialist", that she didn't like it there, but the GP just said they follow what the clinic says.
I told her that she has a choice, she can go to GP and tell her she wants to be transferred to another clinic and the GP has to do it. Well, we'll see.....

I think she definitely needs a second opinion and to ask to be referred to a different clinic. Her 'specialist' GP is probably mostly familiar with non-insulin dependant Type 2s. How can you put someone on an insulin regime that forces you to have regular meals, when your meals aren't regular????!!! Makes no sense to me whatsoever. And why does teaching someone about their diabetes only apply to those who know how to control it well already? Madness! 😱

 

[novorapidboi26]

I was 11.8 before it, if I was 12 then I wouldn't have been allowed........

Not entirely sure why, but maybe because they dont want you to go from really bad, to really good, or better, that quickly as it brings its own problems......

And they may assume that being so high means your a long way off ready to start education and that you would need to actually sort out the basics first....like actually injecting....🙂

 

[Monica]

I was 11.8 before it, if I was 12 then I wouldn't have been allowed........

Not entirely sure why, but maybe because they dont want you to go from really bad, to really good, or better, that quickly as it brings its own problems......

And they may assume that being so high means your a long way off ready to start education and that you would need to actually sort out the basics first....like actually injecting....🙂

Her last one was below 12.
Well, we'll be "ladies who lunch" tomorrow, as she had a physio appt. at 11 and then her diabetes one at 2. I'll then see if she'll inject.

 

[everydayupsanddowns]

From what youve said Monica, mixed will be a disaster for your friend. Quite possibly dangerously so (when I was on mixed years ago I was caught out by many a hypo because I mistimed regulation snacks).

 

[Monica]

From what youve said Monica, mixed will be a disaster for your friend. Quite possibly dangerously so (when I was on mixed years ago I was caught out by many a hypo because I mistimed regulation snacks).

That is my opinion anyway!!!
I did warn her that she might experience a few hypos. I have a feeling that she's actually scared of them too.

Apparently the clinic said that it would bring positives to go on a mix. Well, I said, the only positive is that you only have to inject twice a day.

 

[elliebug]

monica, is your friend under hull nurses? i only ask cos i am and they seem very switched on and up to date, but them i'm only 1 patient!!!

 

[Monica]

monica, is your friend under hull nurses? i only ask cos i am and they seem very switched on and up to date, but them i'm only 1 patient!!!

No Ellie, she's at the "Westwood" (I'm guessing you'll know where that is). I told her she should change to "Brocklehurst" if she hates it at the Westwood. Carol goes to B and the team there are very good. I've met a few of the adult team too, as the Kids/Parents diabetes support group held an evening talking about transition clinic.

What are the appointments for adults like at B? The teenage clinic is only on a thursday afternoon and I think transition in the evening.

 

[elliebug]

i'm at B the team are great, so when carol has to move up she'll be fine. they have a special pump clinic and were really good when i said i wanted to have some babies, sorted everthing out really quickly (not that im suggesting carol would need this soon/ever/at all backtrack, backtrack) just an example!!! and they have a number you can ring and they are good at getting back to you. i've worked with h and t on kids team (but one of them had retired since then) and they were lovely 🙂 so i think B if def the place to be!!

 

[Monica]

i'm at B the team are great, so when carol has to move up she'll be fine. they have a special pump clinic and were really good when i said i wanted to have some babies, sorted everthing out really quickly (not that im suggesting carol would need this soon/ever/at all backtrack, backtrack) just an example!!! and they have a number you can ring and they are good at getting back to you. i've worked with h and t on kids team (but one of them had retired since then) and they were lovely 🙂 so i think B if def the place to be!!

H was Carol's DSN. I liked her. The new one is ok too, but Carol doesn't like her much. I'm glad they have a pumping clinic. I hope Carol can stay on at B.
And if the appointments are also available in the morning I'd definitely suggest to my friend to change to there. She hasn't got a car and going by train is a pain (I know it as I do that, last time we missed the train back by 2 minutes), especially if you have to be back for school pick up time at 3.20

LOL, I hope Carol won't have babies for a few years yet😱

 

[Monica]

Well, that was a waste of time.

When she got there, it was the wrong nurse seeing her. This nurse can't prescribe insulin. I don't even think she's a proper diabetes nurse. She gave my friend a new blood tester and told her she'd need different strips for it. When I saw the tester I 😱 and told her that that was rubbish, it uses the same ones.

The next appointment is in November.

P.S. We went out for lunch and she had an almost carb free salad. She did inject.

 

[elliebug]

oh my. my nurse can't prescribe but the fills in a form for my gp and they prescribe it, or she goes and finds a dr to do it for her!! what a waste of an appt!! did your friend say anything about moving to B?
i don't know if they have am appts, mine have always been pm but they are usually on time!!