DeusXM
01-17-2006, 06:11 AM
This morning I went to my clinic to speak to my diabetic nurse about changing basal insulins. I'm starting to come to a similar conclusion that most of you here already have about Insulatard. I appear to have hit a wall whereby if I take any more I'm going to be having hypos far too often, but it's simply not covering my basal needs. I'm also getting very pronounced DP and then hypoing a couple of hours later.
Basically I'm looking to either giving Levemir or Lantus another shot. Given my experience of Levemir I'll probably end up on Lantus again and run the risk of the attendent problems I had before. Given the choice between either being depressed, or blind at 30 and depressed, I'll take the former.
I could already tell I was off to a bad start with my nurse the moment I said the words 'Dawn Phenomenon'. Her reaction made it perfectly clear that I wasn't supposed to know about things like that, and I told her I'd already ruled out the Somogyi Effect from blood tests. So that put her on the back foot.
Next up was my A1c. My last was a frankly terrible 7.6, which she tried to tell me was 'very good'. I somewhat disputed this and said I would rather have my A1c under 7, and preferably under 6.5. She then tried to tell me that this was impossible for people with T1 to acheive without having lots of hypos. I then suggested to here that I knew plenty of people with T1 who were perfectly capable of having A1cs below 6 without any major problems. She then suggested that I would lose some quality of life with that sort of control. Again, I'm fairly sure 'not going blind' might be an important part in maintaining quality of life.
Indeed I was so particularly concerned about going blind that I raised the point that clearly my A1c couldn't be that great given that my optician claims to have spotted a micro-aneuryism in my left eye. I am being screened next week to to check this out. She then said it was about par for the course for someone who's had diabetes for seven years or so, and it was nothing to worry about because if it was problem then it would probably be treatable.
As you can probably understand, this didn't exactly reassure me, and I believe I may have been quite strident on this lack of reassurance.
Bascially though, because I've just started a new job and now I'm no longer working stupid shift hours, she's decided to go on a 'wait and see' approach - namely that if things hadn't improved in three weeks, we'd reconsider.
Given that today I had a hypo at 11, lunch at 12 and am now running at 10.6 a good two hours later, I think it's fairly obvious that waiting isn't really going to make any difference.
What annoyed me most though, even more than her callous 'it happens' approach to diabetic blindness, is that she seems to think that changing to a shorter needle length was apparently the solution to my problems, which is why I now have 30-odd 6mm needles in my jacket pocket like a druggie.
Basically I'm looking to either giving Levemir or Lantus another shot. Given my experience of Levemir I'll probably end up on Lantus again and run the risk of the attendent problems I had before. Given the choice between either being depressed, or blind at 30 and depressed, I'll take the former.
I could already tell I was off to a bad start with my nurse the moment I said the words 'Dawn Phenomenon'. Her reaction made it perfectly clear that I wasn't supposed to know about things like that, and I told her I'd already ruled out the Somogyi Effect from blood tests. So that put her on the back foot.
Next up was my A1c. My last was a frankly terrible 7.6, which she tried to tell me was 'very good'. I somewhat disputed this and said I would rather have my A1c under 7, and preferably under 6.5. She then tried to tell me that this was impossible for people with T1 to acheive without having lots of hypos. I then suggested to here that I knew plenty of people with T1 who were perfectly capable of having A1cs below 6 without any major problems. She then suggested that I would lose some quality of life with that sort of control. Again, I'm fairly sure 'not going blind' might be an important part in maintaining quality of life.
Indeed I was so particularly concerned about going blind that I raised the point that clearly my A1c couldn't be that great given that my optician claims to have spotted a micro-aneuryism in my left eye. I am being screened next week to to check this out. She then said it was about par for the course for someone who's had diabetes for seven years or so, and it was nothing to worry about because if it was problem then it would probably be treatable.
As you can probably understand, this didn't exactly reassure me, and I believe I may have been quite strident on this lack of reassurance.
Bascially though, because I've just started a new job and now I'm no longer working stupid shift hours, she's decided to go on a 'wait and see' approach - namely that if things hadn't improved in three weeks, we'd reconsider.
Given that today I had a hypo at 11, lunch at 12 and am now running at 10.6 a good two hours later, I think it's fairly obvious that waiting isn't really going to make any difference.
What annoyed me most though, even more than her callous 'it happens' approach to diabetic blindness, is that she seems to think that changing to a shorter needle length was apparently the solution to my problems, which is why I now have 30-odd 6mm needles in my jacket pocket like a druggie.