Started Victoza. Insulin in autumn

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Rosiecarmel

Rosiecarmel

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Relationship to Diabetes
Type 1.5 LADA
So I had a long appointment with my DSN yesterday. She really really wanted me to try Victoza so I agreed. I'm on 0.6mg til I see the dietician on 22nd July then I'm going up to 1.2mg. She also stopped the sitagliptin as it's clearly not doing anything. I asked her if this would push me to the back of the list for insulin and she said no. She called the community diabetic team (of which she is not a part of!) and they said the average time for anyone referred to them now to start insulin would be a few months. In autumn. Apparently no matter what happens it'll be at least autumn. She wanted to see me again in October to discuss the Victoza and whether I need a referral. I strongly disagreed and said I want to see her again at the beginning of September. She agreed but made it known it's sooner than she'd like but she's doing it to appease me basically. I also said I'm pre-empting that the Victoza won't work and would like a referral made as soon as possible. If, it turns out, that the Victoza works, she can call the community diabetic team and discharge me. But I told her I want to be on their radar well before September even if I don't SEE them before then. She reluctantly agreed but said she understands why I'm so frustrated. So not quite as planned but I'm happyISH with the results.
 
Well, she obviously doesn't understand how you feel, otherwise she wouldn't still be sticking to what may be a totally unrealistic timetable for you, healthwise 😡 The idea that someone who has 'been referred to start insulin' would have to wait until October is completely nonsensical - if you need it now, what is the point in waiting? They are happy for you to run very high levels for three months for the sake of a ten minute session? Because that's all I got when I was discharged from hospital, and it was enough to get me started. If I had had to wait for months before I got insulin I would be dead :( I suspect that you are like me in the months prior to my diagnosis, with high levels, but not yet getting pushed to the limits of your pancreas' ability to keep you functioning. What really worries me is if you were to become ill with a virus, as I did, then you would become very ill, very quickly :(

None of this makes sense to me, I'm afraid. Insulin would get your levels under control and there's little to choose cost-wise between that and Victoza. If the Victoza is going to work you should see improvements fairly quickly once you are up to the maximum dose. Hopefully, this will happen and you won't suffer side-effects, but they absolutely should be prepared to act immediately if it isn't showing any significant improvement. This policy is bureacratic and unsafe, in my opinion :(

Grrr!!!! Sorry Rosie, I just get so wound up by this sort of thing, it's not 'best practice' and it should not happen this way.
 
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Hope the Victoza works for you Rosie.
 
So have I got this right? Sitagliptin and Victoza both work by stimulating more insulin production from existing beta cells. The Sitagliptin hasn't worked, suggesting you don't have enough insulin producing cells for them to work on. So your DSN thinks the Victoza will work ...how? I can't believe that after this length of time, they are still faffing about experimenting with things that may or may not work, when you need results NOW!
I assume that if the Victoza does work, it'll become apparent quickly, and if there's no change, you'll be straight back to your GP. I'm just so sorry you're having to go through all this, when your levels should have been sorted months ago.
 
If your BG levels are above 15mmols then get yourself down to A&E, tell them that you are on what your on and they will most probably start you on insulin there and then.
Mine were at 31++ and my GP and others thought it was fine to wait it out a few months at these levels, my Misses made me go A&E as she knew that was way to high.
Sadly going to A&E seems more and more like a viable alternative to GP care these days, waste of our time, and A&E's time all because GP's are becoming so ineffective.
 
Rosie I don't understand why you are accepting this I really don't? You obviously need insulin. A short sighted mole could see this from 10 miles away. I don't wish to frighten you and I know that you know this already but all of the time that your glucose levels are elevated, certainly to the daft, high points that yours are reaching it is potentially causing you harm. I hope that you can get a better resolution than the plain bonkers one that these bloody clowns are offering you. I hope that you can get it very soon.
 
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palmoff said:
If your BG levels are above 15mmols then get yourself down to A&E, tell them that you are on what your on and they will most probably start you on insulin there and then.
Mine were at 31++ and my GP and others thought it was fine to wait it out a few months at these levels, my Misses made me go A&E as she knew that was way to high.
Sadly going to A&E seems more and more like a viable alternative to GP care these days, waste of our time, and A&E's time all because GP's are becoming so ineffective.
Click to expand...

My BGs are never UNDER 15...
 
Must restrain self otherwise I'll have another post edited for un parliamentary language. Grrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
 
Well done for staying calm Rosie, and well done for handling the situation with the nurse well, it's not easy to assert yourself when a medical professional is quite adamant but you've done that. So the Victoza is probably not going to help if other beta cell stimulating drugs haven't worked, but hopefully she will be processing that referral quickly which means you're on the radar as you said. Did she give you a timeframe for assessing if the Victoza is doing its stuff? I know we've got the dietician appointment as a line for increasing the dose, but once it's increased what a reasonable time to consider whether it's working or not? If she didn't say could you ring her and ask? What I'm thinking is don't let up, make an appointment for roughly that time scale with her to review the progress? That's what my friend had to do and that did the trick. I think they basically gave her the insulin to shut her up, but hey it's working and she's coping very well. I went to that appointment with her, and it was a wee bit harder for the nurse to look me in the eye when I said "I was hospitalised when I had blood sugar that high and everyone was hysterical, can you explain why blood sugar in the 20s is a problem for me but not for her". Quite unfair of me I know, because high blood sugar may be more immediately dangerous for me due to DKA but at that stage they didn't know if her issue was insulin resistance or if her beta cells had basically given up. It was actually quite useful though because I could do bad cop without her making a pain of herself. I do think the whole situation is ridiculous and half of my brain wants to say handcuff yourself to a chair in her office till she relents, but the other half is saying you're fighting a good battle, so hold the line Rosie, hold the line and keep pushing forward and hopefully you're nearly there 🙂
 
Rosie. I think you are being treated putting it mildly very shoddily .
If you don't see a swift improvement with Victoza , then please cut out the middle man and like others have said , take yourself to A&E and tell them how rough you are really feeling.
 
I hope Victoza works for you. People should be aware that Victoza works in 3 ways, 1 is by stimulating the pancreas to produce insulin, 2 is by slowing stomach transit so as to avoid peaks in blood sugar and 3 by reducing the amount of sugar produced by the liver.
It can be used in conjunction with basal insulin injections.
 
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