Diabetes Educator (your advice needed)

[dragonfly1113]

I love my diabetes educator as a person but I want to scream when it comes to my pump, carbs, ratios, ect.
she does not even want to look at or consider anything I ask of her.
Unused insulin rule- I thought that explained most of the lows I experience. Thought it was a cool chart. she wont even consider looking at it. Her reply... "everyone is different"

I am new to this pump thing but I dont understand since I have the pump why I went from 1 carb ratio to 3. I thought you just adjust your basal and that was to help with highs or lows here and there. She wont consider setting more than one basal. Now I am to do 3 different carb ratios. 1:12 for breakfast, 1:20 for lunch and everything else is 1:15
Someone please explain to me about different basals. I also asked about the worksheets to figure out what basals are needed when and she said "dont fool with them, we dont use them" I told her about the worksheet for my carbs and it has a graph, I said I will bring it next time I come so you can look at everything I am doing. Her reply " I only want to see your bg numbers not the graphs or anything else. Okie dokie.

silhouette problems... needles bend every time I insert. When I do manage to get one in it causes pain and I changed one today that I put in the night before last because it got infected. she was upset because I took it upon myself to call MiniMed and get quick sets. She doesnt even know how to use them. Knows nothing about them. I was changing my site when she called to check on me. She threw a fit. Said she needed to show me how to use them. I said, they have instructions and I can read how to do it. Told her there was no way I was using the silhouettes for another week and a half. Messed up 4 sets trying to insert without the needle bending the last time for it to only last a day and a half. those sets cost money and my ins only allows so many then I have to pay.

Sorry, I needed to vent. If she had of explained to me all the things that go with pumping maybe I wouldnt be sitting here going huh? I really do need to understand the basal thing. After breakfast I go high and sometimes after lunch. If I work in strawberries then I go low very quickly.
Susie

[Tony]

Susie It doesn't sound like you are getting off to a good start here. Don't worry about venting, we could use some vents in here.:)

First off you might want to think about a new diabetes educator. It kind of sounds like she doesn't know to much about the pump.

As far as I know carb to insulin ratio will stay the same. When you first go on the pump you need to check if your basal rate are right. Also from time to time you may need to test them.

Has she told you how to test your basal rates or carb to insulin? If you don't know I will be glad to tell you.

I was going to tell go with the quick sets. I only god knows why they put you on silhouette.

[dragonfly1113]

Originally posted by Tony
Susie It doesn't sound like you are getting off to a good start here. Don't worry about venting, we could use some vents in here.:)

First off you might want to think about a new diabetes educator. It kind of sounds like she doesn't know to much about the pump.

As far as I know carb to insulin ratio will stay the same. When you first go on the pump you need to check if your basal rate are right. Also from time to time you may need to test them.

Has she told you how to test your basal rates or carb to insulin? If you don't know I will be glad to tell you.

I was going to tell go with the quick sets. I only god knows why they put you on silhouette.

Tony,
I asked her if I could test my basal rate. they have worksheets included with the pump for that purpose. She said no, they didnt do those there. I am trying not to piss her off but to her I look like someone who doesnt want to obey her. The way I see it is... I am the one on the pump. Not her. If a set bothers me then I should be able to change. She chose that set because she knew about it. I dont know how to test carb to insulin. I would very much like to know. My understanding was the pump was suppose to make things easier. Having 3 carb ratios is hard to keep up with. I said, cant we just adjust my basal rate. She said no that that didnt have anything to do with my after breakfast rise or my lunch time rise. If I work, then I do go low but if I dont then I go high.
I love the new quick sets. My first one bothered me a lot. It itched and my readings went high. 2 hours after Dinner I was 300. So I changed my site and now it is coming down. I must have not done something right with my first one. But I am learning.
Susie

[Vic L]

I would be totally honest with this educator and explain to her that you feel and believe her advice is a bit outdated and request another educator. Speak with your Endo and tell him the difficulties your going thru. I totally understand what your going thru, I haven't started my pump therapy yet but when I moved to Austin, my doctor was a bit like rainman. He had a twitch and looked funny. I thought to myself this guy looks all messed up. I listened to him the first appointment and he suggested I take humalog 75/25 when i was using lantus and had pretty good bgls. He said since i was just diagnosed, he needed to verify this was the best method. I would ask him questions about the pump and he would ignore me. I would send my bgl to the office and not hear a thing from him. When he had me change my regimen my bgl were up and down and I was feeling like ****. I couldn't take it anymore and told him his services were not needed anymore and to consider updating his practice. It felt great but then I ran into the wall of finding a new doctor.

I do hope you consult with your Endo and get another DE to assist you with your transition. I always say to myself " does it have to be so **** hard?" My wife, god bless her, says "**** no we're going to find a doctor who cares and wants to help make our life easier. " I suggest you do the same, remember your paying them!

[Tony]

I would test my basal first. This way you know they are not causing any highs or lows. Skip a meal. Bg should be under 150. Test every hour until the next meal time. Bg's shouldn't move no more than 30. Stop test if bg move more than 30.

To test your carb, Count your carbs, take your insulin, test every 1 hour for two hours.

Each test you do should be tested 3 times different days. So there is no quick adjustment.

[pacon]

Originally posted by Tony
Bg's should move no more than 30. Stop test if bg move more than 30.
I don’t have a pump, but I read this thread and I wonder, how are you supposed to do this test with an ordinary blood glucose meter for home usage? The fault with all these meters is +- 20% within normal blood glucose range.

[Tony]

Thanks for Quoting me! I put should instead of shouldn't. I'm going to edit my post.

Thanks

Originally posted by pacon
I don’t have a pump, but I read this thread and I wonder, how are you supposed to do this test with an ordinary blood glucose meter for home usage? The fault with all these meters is +- 20% within normal blood glucose range. I don't think that matters to much. It is just like any time you test. The meter has to be pretty close. Each test has to be done three times. If not more. You would end up test more then three times before you have the right basal rate. So by the time your done, it would be right. Then you would also now when you have your ha1c done.

[Gina]

susie i have to tell you !!
I hate your CDE, she sounds like a moron and you should get a new one asap....dont let it go too long because you are still new to all this and she isnt helping you get the best care that you need