GP scary advice - Act II scene 1

[miguel81]

Apologies - brevity is not one of my accomplishments.

I suffer many UTI's, my doctor prescribes Araxacina which is basically Ciprofloxacino and is the common antibiotic for infections of the urinal tract.

On my way to the surgery on Tuesday morning last to get some antibiotics - approximately 500 metres away, I was taken very ill, could not breath or stand up. Once again it was a flashing blue light and screaming siren job and I was taken to HDU in the hospital 20 km away. Six drips, three in each arm, one coming out from a bladder catheter. I spent until Friday night in the hospital and I got home at 8 pm last night. During my discharge interview the doctor asked for my insulin history,how much Novorapid and Lantus did I inject each day. I told him that my doctor had suspended my Novorapid injections late last year. His jaw nearly hit the floor. He has now given me a letter to give to my GP insisting that a Novorapid regime must be re-introduced.

The worst bit - I asked him if they had eliminated the UTI and how best to eliminate future UTI's and he just said - you are a diabetic, it is badly controlled and diabetics are prone to infections - just keep taking the tablets!

So, surgeons can now do face transplants, re-attach limbs and digits but, because I am diabetic, there is nothing they can do to eliminate UTI's.

I give up.

I am now having to use the new MyStar Express meter but I have no idea what the readings mean. Last night I was 327, this morning after 5 units of Novorapid last night I was 223. Means nothing to me except that it is lower.

This morning I emailed Sanofi asking if there was a table that I could download that compared m/mol with whatever system their meter used,but it is Saturday and I don't expect any sort of reply until Monday at the earliest. I can't search the Internet for information because I don't know what these new readings are called.

Can anyone tell me what they are called and whether or not there is a comparison table available?

I'm being a nuisance I know but I am completely lost.

Thanks.

 

[Northerner]

Michael, I am so sorry to hear this In order to convert the numbers you are seeing, divide them by 18 to get the equivalent in mmol/l. So:

327 mg/dl = 18.2 mmol/l
223 mg/dl = 12.4 mmol/l

I hope you are feeling much better very soon.

 

[AndBreathe]

Try here: http://www.onlineconversion.com/blood_sugar.htm

Put your number in the top line, click convert and it does it for you.

 

[Andy HB]

This may be a silly question, but can't you reconfigure the meter to show results in mmol /L rather than mg /dl?

 

[miguel81]

Try here: http://www.onlineconversion.com/blood_sugar.htm

Put your number in the top line, click convert and it does it for you.

Oh, that's fantastic. Thank you so much. I can now work out what to inject before dinner this evening. I'm very grateful and have saved the website to 'my favourites'.

 

[miguel81]

This may be a silly question, but can't you reconfigure the meter to show results in mmol /L rather than mg /dl?

The meter came with no instructions so I don't know if it will do that.

In any event my GP wants me to record the readings that are familiar to him - and m/mol ain't.

Sigh.

 

[Pumper_Sue]

The worst bit - I asked him if they had eliminated the UTI and how best to eliminate future UTI's and he just said - you are a diabetic, it is badly controlled and diabetics are prone to infections - just keep taking the tablets!

The above is a very silly statement/belief for anyone to have. As long as you learn to control your diabetes then there is no reason to get infections waterworks or others.
Taking antibiotics all the time is not good practice as all you do is build up resistance to them, so when most needed you have nothing to help you.

 

[Redkite]

Michael, people with poorly controlled diabetes (persistently high blood glucose levels) are more vulnerable to UTIs because the bacteria thrive in the glucose-rich environment. I would hope that if you can get back onto a proper basal-bolus insulin regime, and achieve BG levels closer to normal, that you should experience far fewer UTIs. Try also to get into the habit of drinking plenty of water and emptying your bladder frequently - don't get dehydrated or hang on when you need the toilet, because this gives any bacteria in the bladder plenty of opportunity to multiply in the glucose-rich environment.

 

[Laura davies]

Dear Michael, uTIs are miserable. You get better control with Your blood sugar measurements and you will feel so much better. Drinking lots of water i swear by. I am glad you got the blood sugar conversion. People on here are so helpful. Hope you feel better soon x

 

[miguel81]

Good morning. I'm trying really hard - promise.

Last night at 6 pm my reading was 274. I had dinner which was just 2 slices of seed bread, a smidgeon of butter and a smidgeon of mayo with just one small slice of cheddar and a tiny teaspoon of papaya chutney (I hate 'dry' sandwiches). I injected 4 units of Novorapid as per the hospital doctors advice. 2 hours later before bed my reading was 390 which left me rather despondent. I had 24 units of Lantus instead of the 28 I was asked to inject as I was a bit scared. This morning my reading was 107 and I felt happy and
I injected 4 units of Novorapid and had a slice of toasted seed bread with a little marmalade. My reading 2 hours later was 241. I was hoping for a lower reading but no such luck. I'll keep at it.

Thanks again everyone for support and advice.

 

[Sally71]

107 = 5.9 so that's the sort of level you need to be aiming for.

It will presumably take a while to get your doses properly sorted but you will feel much better with insulin than without! It's awful to hear how you are struggling along without much help. If you have time keep posting here what you've eaten, what you've injected and what your readings are and people will help you. Others will undoubtedly be able to help you more than I can, I have hardly any experience of MDI; but I would like to wish you well and hopefully our friends here will offer some good advice. Stick at it! 🙂

 

[Abi]

It sounds as if the high racing afar the evening meal was due to a high reading prior
You would have a better idea of whether basal and bolus doses are correct if you checked 4 hours after eating/ novorapid injection.
It could be that the lantus dose of 24 units was still too high causing a large drop over night- but it may be that this dose is fine and the drop was due to the novorapid still being active for another 2 hours. A sandwich - assuming approximately 40g carbs, "typically" may required about 4 units assuming a ratio of 1 unit per 10 g carb- although this may vary hugely between one individual and another. (If 4 units has covered this amount of carbs and caused a drop in blood glucose in addition it could be that either your ratio is much lower - i.e. much less insulin required per carb portion , or again that you have too much lantus on board
Sorry you are having such a struggle but diabetes control is "do able" and compatible with a normal life i.e not too many hypos and not having to be too regimented with mealtimes and content
A book such as "using insulin" by John Walsh would be invaluable to you right now- very detailed but explains everything
If you are more comfortable with mmol/ l can you keep 2 separate diaries one for your doctor and one for yourself

 

[AndBreathe]

To position myself, I'm not T1, and don't take any meds, so please bear that in mind in my comments.

Some of those numbers look pretty high to me. Have you considered trying a reduced carbohydrate way of eating? I reason I suggest is that the carbs we eat are what mainly fuel the rises in our bloods, requiring the insulin to bring the spikes down.

To my simple way of thinking fewer carbs are likely to lead to reduced spikes, thus requiring less insulin?

For we T2s the physiology is a bit different, but the carbs spikes are not our friends either.

It's just a thought, with the potential to smooth some of the spikey waves you must be seeing.

 

[katie]

Hi Michael, have your bloods been any better? I hope you are doing ok 🙂

 

[miguel81]

Hi Michael, have your bloods been any better? I hope you are doing ok 🙂

It's kind of you to ask. didn't want to follow the suggestion that I post my readings 'cos frankly I didn't want to bore the pants of people.

There have been ups and downs and I am not fully recovered yet from the other problems I have. I have found it hard to keep food down, lots of vomiting, especially inn the wee small hours.

I have decided to follow the advice of my hospital doctors rather than that of my GP and so am injecting Novorapid regularly. Not much, 3/4 before breakfast, 4/5 before lunch and 5/6 before dinner.

On February 1st I started an Excel chart to record readings and injections.

First set of brackets is before breakfast and 2 hours after, second set is before lunch and 2 hours after, third set is before dinner and 2 hours after.

1/2 (107 - 241) (240 - 360) (249 - 317)
2/2 (79 - 245) (300 - 306) (221 - 168)
3/2 (66 - 242) (270 - 200) (306 - 215)
4/2 (77 - 180) (193 - 233) (209 - 310)
5/2 (124 - 139)

Michael

 

[katie]

I'm so glad you are taking your Novorapid now 🙂

These levels look so much better and at least you havent had any awful hypos.

Is there anywhere you can be referred to where they know more about Type 1 Diabetes and carb counting? Your GP clearly doesn't know much about it...

 

[miguel81]

The nearest diabetic specialist is in the capital - Jaen City - and needs a GP referral, he's not keen to do that. I feel like I'm getting somewhere now, my dietary habits have had to change and I didn't think that I would be able to do it at my age and habits, but I have changed. I don't like it very much because I miss my main evening meal, what I'm doing at the moment I label 'snacking' rather than eating properly - but I'll stick to it.

 

[trophywench]

I've got to do this, I don't divide by 18 in my head very easily and whilst I know '100' is good, and '90' fantastic -I tend to get lost if it's harder than that!

1/2 (5.9 - 13.4) (13.3 - 20.0) (13.8 - 17.6)
2/2 (4.4 - 13.6) (16.7 - 17.0) (12.3 - 9.3)
3/2 (3.7 - 13.4) (15.0 - 11.1) (17.0 - 11.9)
4/2 (4.3 - 10.0) (10.7 - 12.9) (11.6 - 17.2)
5/2 (6.9 - 7.7)


You are getting there Michael.

If I were you I should leave this alone for a bit cos although the post breakfast results weren't brill for the first 4 days, that last morning is excellent. Did your lunch and dinner readings improve equally yesterday too ?

Slow but sure gets there faster!

Well done.

Annoyingly - diabetes does tend to behave better with 3 meals a day, none of them 'vast'. It's OK missing one or the other occasionally, but say I miss one - it does tend to **** up the rest of that day at least if not longer, BG wise. I've had to be more careful with this as I have aged - which is even MORE flipping annoying!

 

[miguel81]

Well, last night, tired of what I call 'snacking', I made a Thai chicken curry with fragrant rice. It made 2 meals and I really enjoyed the one I ate but having taken a look at the rice I decided to up the Novorapid to 8. At 4 am this morning I had the tell tale signs of a hypo in the making so had 2 jelly babies and a biscuit or two. As a consequence my reading this morning was 130. Can't win 'em all!

 

[Northerner]

Well, that isn't too bad Michael, it equates to 7.2 mmol/l 🙂 Good to hear you enjoyed your meal!