Round the block on insulin

[bonnie690]

I've been round the block on insulins, i was orginally on pork mixtard30 back in the 1980s then pork mixtard30 with lenatard, then with isophane, then got moved to novomix30, then novomix30 with insulatard, then novorapid and lantus and now practically full circle now on human mixtard30. My question was has anyone else feel man-handled, the reason to go to a specialist (whether they are young or old) is that they are a specialist and if you speacialise in anything you should know the background of it, mixtard30 may be viewed as old school insulin but it is still a main stream insulin, i was on 4 a day injections for a year and it turned into a pain, the fact that everytime you wanna eat something you have to injection is not my idea of fun, i am probably old school style because i prefer the 2 a day injection routine, and i know i'm not the only one. i would rather take a gamble with 2 a day injections than go back on 4.
:fight: <<---- me and the doctor!! lol

[JediSkipdogg]

Have you ever thought of a pump? Using any kind of mixed insulin in my opinion is mistreatment. Because you are allowing the treatment method to control your lifestyle. You can't give something like mixtard30 to cover your daily body produced glucose without having to eat something to cover the fast acting part of the mix. And even then, you have to eat a certain amount to cover the insulin. You can't go above or below that or you're run high or low.

That's why myself, and many others, think mixed insulins are bad. You are stuck in a schedule of this is what you give and this is how much you must eat to cover the fast acting insulin. Personally, I'd rather do 4 shots a day than be forced on what to eat and when.

[DeusXM]

The reason you've probably had problems with the specialist after going back to Mixtard is because basic science says it's a phenomenally bad idea.

Look, I get that you find it a pain to have to inject every time you eat but you're not gambling by going onto Mixtard - the end result is guaranteed. Mixtard is a mainstream insulin in the same way that L-plates and stabalisers are mainstream. It's a good insulin for people who are getting used to the idea of injections but for long-term treatment it's not a good option. If you get an A1C under 9 with Mixtard then you're doing extremely well, all things considered. Although in terms of your health, you're still doing badly.

Having said that...

...your specialists have to juggle very carefully what's best for your health and what's best for your lifestyle. Like yourself I've regressed back with insulins - I went back from Lantus to Insulatard. However my specialist recognised that this was in my best interests because of the bad side-effects Lantus was having on my psychological health. They were also perfectly willing for me to try Levemir when it first came out, and when it turned out I was one of the few people it doesn't work for, I was straight back on Insulatard.

Now I'm back on Lantus because Insulatard was starting to destroy my life by making me have up to 9 hypos a day. In fact my specialist didn't really want me going back on Lantus (because of my history on it) but in the end we both agreed that in terms of my health and my lifestyle, Lantus was the lesser of the two evils.

The problem is that your specialist is tied down by their job. Their job isn't to give you what you want; their job is to keep your healthy. Doubtless your specialist cannot see any practical health benefits from you going back to Mixtard. That's why they're being difficult - you're asking them to violate the 4th item of the Declaration of Geneva, 'The health of my patient will be my first consideration'.

The GMC also have similar rules - 'make the care of your patient your first concern' and also 'respect the rights of patients to be fully involved in decisions about their care', which is the reason why you've been allowed back on Mixtard.

[bonnie690]

Thats you! This is me! as boring as it seems i'm a pretty scheduled person and its easier for me to be slightly time tabled than not! :girl:

[DeusXM]

Yes but Mixtard still doesn't give you good control. You can also have a timetabled routine with MDI too - you just don't have to if you don't want one. However, you cannot have good diabetes control with just two injections a day. Seriously, what was your last A1C on Mixtard? If it was over 7 then you need to change to MDI.

[Erin]

Yes but Mixtard still doesn't give you good control. You can also have a timetabled routine with MDI too - you just don't have to if you don't want one. However, you cannot have good diabetes control with just two injections a day. Seriously, what was your last A1C on Mixtard? If it was over 7 then you need to change to MDI.

Deus... I feel your comments are slightly unwarranted. Since when does messing up an a1c mean you need to overhaul your whole life? I was at 7.something last time... does that mean I need to go onto a pump? Something that I am fundamentally opposed to? No, it means I need to change a few things, and above all else, keep better records!

But, Bonnie, I am unsure what you want from us. We are a primarily MDI and Pump using group. That doesn't mean you can't get good advice from us about the other aspects of living with diabetes (exercise, food, the general suck-ness of it all) and a sense of community. But it seems like you are looking for someone on here to validate your choice. Only you can do that for yourself. It seems like you know a 2 shot a day plan works for you... good! Now ask us how you can make it work *better*

[Erin]

Thought of something to add, but the time limit on editing posts has expired...

Bonnie, it was suggested in another one of your threads that you try switching from the pre-mix, to using two insulins that you mix yourself. (Still keeping you on a 2 shot a day plan). This has many advantages over the pre-mixes. You can have a different mix in the morning than at night (advantageous if your metabolism isn't consistent over the day) you can also add a few units of the short acting insulin if you are eating an abnormally large breakfast or dinner. And if you are running super high before bed you can take a correction shot (I know you don't want more than 2 shots a day, but this is just a worst case scenario correction shot, that you don't HAVE to do every day, just if you need it)

Think about it. It might be something worth suggesting to your doctor.

[duck]

Bonnie, I agree with Deus...The pre-mixed insulins *just* don't cut it for the VAST majority of Type 1's. Deus gets straight to the point, and he is very aggressive about treating this disease, because otherwise we lose limbs and semi-important organs like kidneys and eyes. I agree with this approach, and I would encourage you to take more than two shots a day. Yeah, it's literally a pain, but probably not as painful as say...going blind. Or being tired all the blasted time. Or feeling lethargic.

This disease is literally trying to kill you, let's not let that happen!

[seacomp]

Erin's advice above strikes me as wise.

[bonnie690]

Erin's advice to me is nice advice, deus and duck's forceful approach to me is not advice its bullying, your not giving advice through being forceful. i know what diabetes is i'm not asking for justicifaction for actions i have taken myself i'm sharing my experience and asking for views. But all i get is, you've done a bad thing you should do this! blah blah blah. Us brits obviously have a different approach to things than americans do.

[duck]

Erin's advice to me is nice advice, deus and duck's forceful approach to me is not advice its bullying, your not giving advice through being forceful. i know what diabetes is i'm not asking for justicifaction for actions i have taken myself i'm sharing my experience and asking for views. But all i get is, you've done a bad thing you should do this! blah blah blah. Us brits obviously have a different approach to things than americans do.

Deus is British.

Bonnie, I am not being "forceful". I am just dispensing advice, I once was on the two-shot a day regimen (it was not with the pre-mix, but my doctor prescribed an exact amount that I was not allowed to tinker with, so for all intents and purposes, it was pre-mix). The two-shot doesn't work well. It WORKS, but until you've done it another way, you won't realize how poorly it worked.

I'm only trying to help. I'll back out now, because I DON'T want you thinking anyone here is bullying you, that's NOT what this place is about.

[Lynne1]

It WORKS, but until you've done it another way, you won't realize how poorly it worked.

I wholeheartedly agree with that statement. I was on NPH and N for a long time and thought the pump would just be a convenience. It's such an improvement- I don't know what I was waiting for. Any improvement in control is worth extra work because it makes you feel so much better.

[Erin]

Deus is British.


And I'm American. :)

[Erin]

Bonnie, I am not being "forceful". I am just dispensing advice, I once was on the two-shot a day regimen (it was not with the pre-mix, but my doctor prescribed an exact amount that I was not allowed to tinker with, so for all intents and purposes, it was pre-mix). The two-shot doesn't work well. It WORKS, but until you've done it another way, you won't realize how poorly it worked.

I'm only trying to help. I'll back out now, because I DON'T want you thinking anyone here is bullying you, that's NOT what this place is about.

Duck, I don't think you were bullying.

But I think you are mistaken about a 2 shot a day regimen. I did it quite successfully for a number of years back in the "bad old days" I had a sliding scale for my R (fast acting) that accounted for fasting bsl, a set amount of NPH (long acting) that I took (which the morning shot covered lunch) and I even had a system of + or - units (off of my sliding scale) worked out for the meals I usually ate. Pasta was +3, chicken with a bit of rice and veggies was -2.

Of course I had to get up at the same time every day, eat basically the same things every day, eat snacks 2 hours after each meal, and eat those meals on schedule every day... It was hard...and I hated it... but it can be done.

[duck]

Duck, I don't think you were bullying.

But I think you are mistaken about a 2 shot a day regimen. I did it quite successfully for a number of years back in the "bad old days" I had a sliding scale for my R (fast acting) that accounted for fasting bsl, a set amount of NPH (long acting) that I took (which the morning shot covered lunch) and I even had a system of + or - units (off of my sliding scale) worked out for the meals I usually ate. Pasta was +3, chicken with a bit of rice and veggies was -2.

Of course I had to get up at the same time every day, eat basically the same things every day, eat snacks 2 hours after each meal, and eat those meals on schedule every day... It was hard...and I hated it... but it can be done.

Egad...the inflexibility...:afraid:

I guess what I wonder is...well, maybe that's not right either. Okay, I'll just say it: WHY would anyone want to live like that?

[Ailsa]

Egad...the inflexibility...
Actually this isn't a problem for everybody.
Having used acrapid/protophane for around 20years, I can see how a routine has advantages. It worked fine for me, as I got up everyday at the same to go to work anyway & if I got up a bit late at the weekend it didn't matter that much. The clock watching for meal times used to bug me a bit, but the funny thing is that now Iv'e been using Lantus for a year I still stick to pretty much the same routine on a day to day basis. Some of the same issues still cause things to go haywire (long car trips & visiting people who sit around a lot)
I think the food routine also has the advantage that (unlike someone suggested otherwise) you have good weight control as you are never over eating. I have wondered seeing how many on this board have shots for extra snacks, how good their weight control is, especially as they get older?
Of course there are obviously thing I don't miss (like the 3am hypo) or I wouldn't have changed.
I am wondering if it is the insulin that you don't like Bonnie, or the extra shots?
I think those are 2 quite different issues. If it's the number of shots, a pump would seem to be a good answer. You may be ableto get one on a trial basis to see if you like it

[bonnie690]

[QUOTE=Ailsa]It worked fine for me, as I got up everyday at the same to go to work anyway & if I got up a bit late at the weekend it didn't matter that much. The clock watching for meal times used to bug me a bit, but the funny thing is that now Iv'e been using Lantus for a year I still stick to pretty much the same routine on a day to day basis.

And that is what i was doing, i grew up on 2 a day insulin so when they changed me to 4 a day i kept the same routine, the annoying thing was when i would have a small snack in between a meal i found it annoying i had to do an njection! thats why 2 a day suits me, and i agree with the weight control part of your statement, on 2 day because you eat the same ish food your weight maintains itself, whereas i found on the 4 a day i had a little voice in my head that said "if you want extra judt do a bit more insulin" and my weight did go slightly up!:tee:

[gettingby]

Bonnie, if 2 a day works for you, then more power to you. What Duck is doing is not in the least bullying. He is just sharing his personal experience. I have to say that I honestly believe 2 shots a day were killing me (NPH & Regular). My control got better on multiple (more than 2) injections and personally, I would never go back to just 2 injections. I never had a sliding scale until starting on Humalog and Lantus. I had to do what the doctor said to do, not what my body said it needed. Make sense?
I took your post as you were asking for our experiences. If that was not the case, then I humbly apologize.
Diabetes is a varied disease. What works for one of us does not necessarily work for all of us. I have been dealing with this for over 20 years and when I am asked my opinion, that's just what it is : MY OPINION AND MY EXPERIENCES !!!! You believe in what works for you and I believe in what works for me. Please don't discount any of our opinions as wrong. It's what we believe.

[DeusXM]

Fine, call it bullying. Frankly I've seen far too many people sat in my clinic with no legs or on oxygen tanks or whatever precisely because they couldn't or wouldn't sort themselves out.

Unfortunately (and now I'm really going to p*** everyone off with this)....

.....diabetes is NOT a condition where 'oh, everybody's opinion is valid'. It is a SERIOUS, POTENTIALLY FATAL MEDICAL CONDITION. Everyone's personal preferences are only really valid if they either result in a below-7 A1c OR they've decided they're not fussed about complications. If you're not fussed about complications, then do what you like and put up with them. If, however, you want to avoid complications, then you have to choose a treatment regime that will do that. If your regime isn't bringing you below 7 and you're trying to avoid complications, you need to re-evaluate it. That doesn't mean necessarily going on the pump though.

It has been proved that if your A1C is not below 7 most of the time, you ARE going to lose a leg or an eye or at least be very lucky to see your 50th birthday. So yeah, in answer to other questions here - if your A1C isn't below 7, you need to turn it up a notch. I've managed to bring mine down from a horrific 7.6 to a passable 6.8 and I'm looking to drop another 0.8 within the next year because I do NOT want to end up like everyone else in my clinic.

I make no apologies for sounding harsh because I think it a very bad idea to sugar-coat (pun intended) the truth because the sad fact is that diabetes is an evil, terrible condition if you don't sort it out. The fact that I'm apparently giving you a hard time is proof that I'm actually supporting you - because I'm assuming you rather like the ability to see and so I'm telling you exactly what will let you continue to do that. If I wasn't supportive I'd just ignore you and let you make your own mistakes.

[BoBo]

Deus how old were you when you were diagnosed, how long have you been diabetic, what was you hba1c when you diagnosed?
And plus dude i'd hate to attend your clinic sounds like the walking wounded! My clinic is just normal people, young, old, fat, thin!

[DeusXM]

I was dxed when I was 14, so come this August I'll have had diabetes for 8 years. Therefore I haven't quite been through the trenches to the same extent as some people on this board, but I've seen far too many people who've just returned from the front in a very bad way. God knows what my A1C was when it was dxed - I was never told that information straight off and when I was dxed I wouldn't have known what to ask for.

My clinic isn't quite like a wartime infirmary, but it sure as **** isn't far off. I can say with quite a massive degree of confidence that I'm by far the healthiest person in the room apart from the doctor when I'm waiting - and I'm a long way off perfect right now, with a steadily creeping BMI and a couple of micro-aneurisms which I've been told 'should' heal. Most people there just tend to be rather tubby and seem to have trouble breathing. A few usually have some sort of walking aid with them, and I've also counted four amputations (two feet and two below the knees) and one woman who nearly died in her wheelchair when her oxygen mask fell off whilst her husband was in the toilet and one of the nurses had to run to put it back on her face.

All this whilst I'm sat there waiting for my appointment.

When I was in the juvenile clinic I was always told that I should eat lots of starchy carbs and it was dangerous for me to have my A1C go below 6.4 and I should aim for between 7 and 8. The DCCT blew that all away and the worst thing is that I can see the end result of that bad advice on the people who've followed it for far longer than me. I just count myself fortunate that when I was 18 I went to university and found a clinic that actually knew what they were doing - RDE Hospital/Peninsular Medical School in Exeter, which incidentally is probably the most advanced diabetes research centre in the UK.

[Erin]

Deus...

Not for nothing but they used to recommend we shoot for 8, and most people who did that still have two of everything they are supposed to have two of and one of everything they are supposed to have one of.

I also am writing my thesis on Children with diabetes in the school system, and in the course of my research found lots of evidence suggesting that overaggressive therapy (shooting for below 7) causes increased rates of hypoglycemia and numerous cognitive difficulties in children less than 12 years old. So the advice you received at your juvenile clinic was spot on. Maybe not spot on for adults, but for kids, it was right. I'd rather have my brain functioning, even if it means when I'm 60 I lose a foot.

I've been riding this wild ride for 16 years, and i'd guess I spent maybe 5 of them (non-consecutively) below 7. Another 6 (also non consecutively) below 8. There were 5 years where I was all over the board (always below 10 tho). I've still yet to get a complication.

Diabetes is about keeping your A1c as low as it possibly can be. And of the years I was in your golden below 7 A1c level range, MOST of them were on 2 shots per day. If your treatment regime doesn't mesh well with your values and your lifestyle you are probably not going to follow it. So yes, Diabetes is a "everybody's oppinon is valid and you have to make your own rules" disorder.

[Ailsa]

My clinic isn't quite like a wartime infirmary, but it sure as **** isn't far off. I can say with quite a massive degree of confidence that I'm by far the healthiest person in the room apart from the doctor

I'm assuming that your clinic is like the ones here. That would mean that most of the attendees are T2. Many of them have complications at diagnosis as they've had it 10 yrs or so before they find out.
Also (I'll probably get shot down for this, but it's a statistical fact) around 80% of T2s tend to not take their condition as seriously as they should because they can't see it or can't adjust to being ona diet. I have met MANY who don't even own a meter so have no control at all. There are also those of both types who try to pretend ot doesn't exist & end up as you say. Sure there are also some unlucky ones amongst us who try as hard as, & still get a bad deal, but I think it is better for our mental health to relax a bit more about it. At the time I was diagnosed we got one shot a day & had no blood testing meters. You did a urine test that told you if there was sugar in your urine, but not how much! & if there wasn't any you were probably hypo. Despite that 40yrs later I've got no complications. I've also NEVER had an A1C below 7.2
I live in a place where almost no one uses pumps as there is no insurance or funding for either the pump $7,500, or consumables $2,500 p.a.
Lantus has only been available for 18 months. You may be unaware of it, but when Lantus was first released there was not enough to supply more than the US & a couple of other countries for the first 3 years & it has only filtered down here that long ago. Lantus is also not widely used as it also recieves no funding.
I believe very few people can manage an A1c below 7.0 using means other than Lantus/Detimer or pumps. It's only a few years ago that 7.0 was the recommended target, but at the same time acknowledged that it was extremely hard to stay that low for any length of time.
Obviously it's better if you can be lower, but I think stressing out over it, is just as bad in other ways.
I know lots of people like myself who have been around a while & are OK.

[Shotokan]

I'd like to throw out another suggestion. If you want to only stick yourself once every three days, NOT go on a pump, and still do MDI, there is a way. My CDE recently showed me something that looks like an infusion set that pumpers use. It is approved by the FDA for use up to 3 days. However, you inject your insulin into it with an ordinary insulin syringe.

It's a new product that my CDE just recently learned about. I can't remember the name of the product or the manufacturer, although I think it was Dutch. My CDE thought highly of the product for diabetics who want to stay on MDI but don't want to do the pump. Before I started doing my pump trials about 6 weeks ago, she showed it to me and, since I was doing 8 to 10 injections a day (Lantus, Novolog, and Symlin) she thought it would be a perfect compromise because I've resisted the pump for several years, but my abdomen was getting very sore from all the injections.

Let me know if you're interested and I'll ask her for the name of the product and the manufacturer.

[bonnie690]

Hi Ailsa,
What would you say is the best hba1c result to aim for in an adult on 2 a day insulin?
thanks
:itsme:

[DeusXM]

in the course of my research found lots of evidence suggesting that overaggressive therapy (shooting for below 7) causes increased rates of hypoglycemia and numerous cognitive difficulties in children less than 12 years old. So the advice you received at your juvenile clinic was spot on.

Given that I was 14 when I was diagnosed and 16 when I was told of this target (plus the laughable suggestion that 'people who have A1Cs under 6.4 have a lot of hypos), I'm not so sure.

There were 5 years where I was all over the board (always below 10 tho). I've still yet to get a complication.

And you should know that's because it takes longer than 16 years for reasonably controlled diabetes to manifest itself in the form of complications. Most of my A1Cs have been over 7 in the last 7 years and I've no obvious complications. Oh, apart from a couple of microaneurisms that I was told rather unconvincingly 'are about par for the course for someone who's been diabetic as long as you have'. If I'd kept my A1Cs under 7 (as the DCCT, the definitive test of A1C relationship to complications, suggested) I doubt I'd have those MAs.

Diabetes is about keeping your A1c as low as it possibly can be.

No, good diabetes treatment is about keeping your A1C at a level where it won't cause you complications in the long-term. Cancer treatment isn't about making the tumours smaller, it's about getting rid of them. It's the same with diabetes. The DCCT confirmed that an A1C of below 7 exponentially reduces your risk of complications. The DCCT also clearly demonstrated that the two jab system simply isn't a good treatment plan when compared to intensive insulin therapy. With a two-jab system, you are 76% more likely to suffer from eye disease, 50% more likely to suffer from kidney disease and 60% more likely to suffer from nerve damage - http://diabetes.niddk.nih.gov/dm/pubs/control/

The intensive group aimed for an A1C of around 7%. Granted, the follow-up on this suggested that the intensive group was more at risk from hypos, but this was a trial done 1983-93 when we didn't even have Novorapid, let alone Lantus. Look, I'm not bringing this stuff up to just be difficult - it's a totally established medical fact that if your A1C isn't below 7, you're really putting yourself at risk.


Therefore the best treatment plan for diabetes is to aim for an A1C under 7 and the ONLY way to do this with insulin effectively is to opt for multiple daily injections or an insulin pump.

[bonnie690]

[QUOTE=DeusXM]Oh, apart from a couple of microaneurisms that I was told rather unconvincingly 'are about par for the course for someone who's been diabetic as long as you have'.



I've been diabetic for over 19 years and other than the fact that i'm short sighted i have never had complaints with my eyes and my optometrist (who has been doing it for over 30 years!) said i shouldn't have any complaints to do with my eyes from my diabetes

[bonnie690]

And Dues just before you jump down my neck and ask why has i asking ailsa what she thought an adult on 2 a day insulins should aim for, i am simply just asking her opinion nothing more i would ask you but you'd go all hilter on me!

[duck]

[QUOTE=DeusXM]Oh, apart from a couple of microaneurisms that I was told rather unconvincingly 'are about par for the course for someone who's been diabetic as long as you have'.



I've been diabetic for over 19 years and other than the fact that i'm short sighted i have never had complaints with my eyes and my optometrist (who has been doing it for over 30 years!) said i shouldn't have any complaints to do with my eyes from my diabetes

You should have an opthamologist doing your diabetic eye exams, not an optometrist. There is a difference, ask Cinnabon (another member here), her horror story still freaks me out...:dong:

[DeusXM]

i would ask you but you'd go all hilter on me!

Yes, that's right. Hitler is well known for dispensing medical advice that saves lives.

Leaving aside 'opinion', medical science says that an adult should aim for an A1C of below 7, irrespective of treatment.

As for your eyes, I'm assuming that you're annually scanned at the hospital or your GP for retinopathy, right?

[Erin]

Deus...

I'm gonna agree to disagree with you on this one. You and I see the same facts (and I suggest if you haven't, you should actually read the DCCT for yourself, as the results are often manipulated in secondary literature) but we have different interpretations. The only thing I will caution you is using 7 as your magic bullet. 7 is an arbitrary limit. The fellows at the DCCT could have easily set the limit at 7.5, but then their numbers wouldn't have been so impressive. The fact of the matter is, the lower your A1c, the longer it is going to take you to develop complications. It is not as if people with A1cs of 8 get 90% more complications than people with A1c's of 7. The DCCT was comparing people with an A1c of 7 to a bunch of people with really bad control. It is not rocket science to figure out that the ones with the better numbers will have less complications.

And incidentally the reason they set it at 7 was because below 7 the incidence of severe hypoglycemia increased exponentially, while the health benefits were minimal. (this kind of calls the wisdom of aiming much lower than 7 into question)

[Ailsa]

What would you say is the best hba1c result to aim for in an adult on 2 a day insulin?


I don't know that it's really possible to answer that, as it's an individual thing.
As I said earlier I don't think it is achievable to get below 7.0 for any prolonged length of time using other than Lantus/Detimer or a pump, & I think that is pretty much accepted by the medical profession.
I was generally getting around 7.2 - 7.5 depending on how "dedicated" I was up to at the time. I used 2/day up until 12 months ago when I switched to Lantus. My brother on the other hand has used 4/day (not using Lantus) for a while & his results are around 7.8 or so.

Despite what Duess thinks, the doctors here think it's amazing if you can get as low as 7.0!

I think what worked for me was that I had very set working hours & meal times, so that fitted with my needs.

I think Deus with all due respect, that you are
a) missing the point that some of us DESPITE BUSTING OUR GUTS & working at it just as hard as you, can not achieve A1cs below 7.0!
b) not considering that it can actually result in depression if you are not happy with how your treatment is working for you. I think this is a very important consideration as all of us who have had it for a while will have had our ups & downs on this one, especially since those who have been around longer have had more treatment changes in their lives.

It took literally years for my GP to talk me into switching from once a day to twice. There was no way I was jabbing myself twice a day!

[Ailsa]

I'd like to throw out another suggestion. If you want to only stick yourself once every three days, NOT go on a pump, and still do MDI, there is a way. My CDE recently showed me something that looks like an infusion set that pumpers use. It is approved by the FDA for use up to 3 days. However, you inject your insulin into it with an ordinary insulin syringe.



I had a try of something that sounds like that.
It was called an isuflon. The one I used was not "purpose designed" for insulin. That meant it had some lumpy bits on the end which were uncomfortable. In the end for myself I decided I could put up witht he jabs since needles have got so much shorter & thinner it's not that much hassel.

I'm not sure how similar it was to an insertion set as I've actually never seen an insertion set other than in pictures.
If it was purpose designed it would be better. I'd be interested to find out.

[Harold]

Interestingly on this DCCT link (http://diabetes.niddk.nih.gov/dm/pubs/control/) I found no mention of a HbA1c value.

However this UKPDS Summary link (http://www.dtu.ox.ac.uk/ukpds/faq.html) mentions that there is less diabetic tissue damage with a 7% HbA1c than with 7.9% HbA1c. Then says that levels in the range below 7% are advisable. It does not say there is no damage at or below 6.9%.

From the 2002 American College of Endocrinology Consensus Statement
on Guidelines for Glycemic Control (http://www.aace.com/meetings/consensus/dcc/pdf/dccwhitepaper.pdf). On page 7 they have this to say about the Hemoglobin A1c Target.In the epidemiologic analysis of the UKPDS data, the
risk for occurrence of microvascular and macrovascular
complications was shown to increase at HbA1c values of
6.5% or more. In the 6-year follow-up data of the
UKPDS, the two-step progression of retinopathy was
increased more than fourfold in the middle tertile of
patients with HbA1c values of 6.2 to 7.5% in comparison
with the tertile with HbA1c values <6.2%. HbA1c values
>7.5% were associated with little additional progression of
retinopathy beyond that seen for the range of 6.2 to 7.5%.
A few smaller cohort trials further corroborate the
significance of HbA1c elevations that exceed 6.5%........No differential effect of hyperglycemia
on rates of occurrence of microvascular complications
could be observed between the data obtained in
patients with type 1 and those with type 2 diabetes. The
data from the DCCT showed a relationship between
HbA1c and the incidence of retinopathy, similar to that
seen in the UKPDS. Moreover, in both studies, glycemic
reductions yielded similar benefits with regard to the incidence
of retinopathy and nephropathy for equal degrees of
HbA1c reduction.
On page 8 under Risk-to-Benefit Ratio;Under some circumstances, these guidelines may be
modified for individual patients whose functional state or
risk for other adverse treatment effects (such as hypoglycemia
unawareness) is thought to outweigh the benefits
of optimal glucose control. All the aforementioned large
prospective interventional studies demonstrated an
increased risk of hypoglycemic episodes in patients with
tight glycemic control—particularly with use of insulin or
insulin secretagogues. Nonetheless, the panel believes that
the current spectrum of therapeutic strategies and the
available monitoring devices allow more precise titration
of blood glucose, which is associated with a reduced risk
of hypoglycemia. For example, the new rapid-acting
insulin analogs (such as insulin lispro and insulin aspart)
have been shown to produce higher serum insulin levels
earlier with a shorter duration of action than regular
human insulin. This effect not only decreases the
degree and duration of postprandial hyperglycemia but
also reduces the incidence and severity of hypoglycemia.
Furthermore, Lalli et al demonstrated that
lower HbA1c levels can be achieved without an increased
incidence of hypoglycemia when insulin lispro is used.
The safety and efficacy of the new rapid-acting oral secretagogues
(for example, repaglinide and nateglinide) have
also been demonstrated in numerous clinical studies.
In summary, new medications and technologies
facilitate tighter control of glycemia without increasing
the risk of hypoglycemia.

[bonnie690]

[QUOTE=bonnie690]

You should have an opthamologist doing your diabetic eye exams, not an optometrist. There is a difference, ask Cinnabon (another member here), her horror story still freaks me out...:dong:

thats what i meant - i am sorry i spelt it wrong!

[bonnie690]

Yes, that's right. Hitler is well known for dispensing medical advice that saves lives.

Leaving aside 'opinion', medical science says that an adult should aim for an A1C of below 7, irrespective of treatment.

As for your eyes, I'm assuming that you're annually scanned at the hospital or your GP for retinopathy, right?

the hilter thing was a figure of speech.

Do ou not have conversations with people just to find out their opinion without having to involve medical god **** science.

I get my eyes done at a private clinic which i am sent to by my hospital

[DeusXM]

And incidentally the reason they set it at 7 was because below 7 the incidence of severe hypoglycemia increased exponentially, while the health benefits were minimal. (this kind of calls the wisdom of aiming much lower than 7 into question)

Not any more. As I already covered, the DCCT was carried out when people still only had the older isophane insulins and Regular. The survey and its findings don't take into account the increased control offered by Lantus, Levemir and synth insulins.

The fact that there are several members on this forum with T1 on insulin who are able to get A1Cs of below 6 without suffering from severe hypos suggests that it is perfectly possible to bring your A1C to a non-diabetic level (4.5-6.5) without having to compromise on life.

Despite what Duess thinks, the doctors here think it's amazing if you can get as low as 7.0!

So do mine. Having seen the results of that attitude in the waiting room, I'd much rather amaze them than satifsy them, if only for my own benefit.

I think Deus with all due respect, that you are
a) missing the point that some of us DESPITE BUSTING OUR GUTS & working at it just as hard as you, can not achieve A1cs below 7.0!

Just because I'm advocating it doesn't mean I find it easy. My last A1C was 6.8, which was my best ever. I'm just aware that there's plenty of room for improvement in my treatment plan and I'm not afraid to admit it.

b) not considering that it can actually result in depression if you are not happy with how your treatment is working for you. I think this is a very important consideration as all of us who have had it for a while will have had our ups & downs on this one, especially since those who have been around longer have had more treatment changes in their lives.

I'm not really the one to talk to with reference to depression and treatment changes. Having been on pretty much every single insulin that's been developed since 1998 (Mixtard 30, Mixtard 70, Actrapid, Humalog, Humalin I, Lantus, Novorapid, Insulatard and Levemir) and also having depression caused by the Lantus, I'm more than aware of the ups and downs of diabetes.

It's just that the way I figure it, I can either work really hard on my treatment and possibly get depressed as a result, or I can footle along in mediocrity, go blind and maybe lose a leg and then definitely get depressed. I'm just trying to keep myself in the best condition possible until the cure comes along, and that's going to be a long wait.

If your treatment goals are different from mine then fair enough, but perhaps you should say so.

Do ou not have conversations with people just to find out their opinion without having to involve medical god **** science.

Not when it comes to my health, no.

[bonnie690]

Not when it comes to my health, no.[/QUOTE]

then what a sad life you do lead.

[duck]

thats what i meant - i am sorry i spelt it wrong!

Cool, the difference is CRITICAL for those of us with this ****ed disease...

[SueM]

I use the old fashioned isophane and regular/neutral but it is the bovine varity. Used 3 times a day(neutral) I find I have good control with very few hypo problems and no complications from my diabetes.
If I wasn't on steroids all the time for Addison's disease I wouldn't need the extra insulin at lunch time my average A1c is 7%.
As is the norm there is no right way to go about the task of diabetes control it is up to the person who has the condition to work out what suits them best. I have never let my diabetes rule my life and never will. Consultants/GP's who ever, can only tell you what they learnt from a book and in all honestly most of the books seem to have been written in 1066. They do not live with the condition every day 24/7 so they can say/write what ever they like about blood sugar levels and optimum goals we are not machines. Life is for living with a bit of sense it can be as normal as a non diabetic. What's normal?:hmmmm2

[DeusXM]

then what a sad life you do lead.

Not really. No-one's 'opinion' has led to me being able to take insulin or monitor my blood glucose or in fact, lead a healthy life despite having a serious medical condition. Diabetes isn't a problem that can be solved through opinions, unfortunately. Otherwise it would certainly be cured by now, given the amount of conflicting opinions going around.

Having said that, given that your nurse gave you a hard time when you want to switch back to Mixtard, I've given you a hard time, and an entire message board of people with diabetes around the world have have universally decried 2 injections as an ineffective way to control diabetes...do you not think that just maybe one of us just might have a point?

The fact is that you've come here looking for validation of your treatment plan, which you had doubts over because of your nurse's response, and you haven't found it. In fact, you've found quite the opposite.

I might, according to you, 'lead a sad life', but at least it'll be a long and healthy sad life, and at least doctors, scientist AND people with diabetes back up my choice.

[spudgun]

Deus

All well and good making sure you diabetes is under the tightest control you can humanly manage to make sure you live to a rip old age, but you could walk out your door and get hit by a bus, life is for living.

[duck]

Deus

All well and good making sure you diabetes is under the tightest control you can humanly manage to make sure you live to a rip old age, but you could walk out your door and get hit by a bus, life is for living.

I don't think anything I read in Deus' response said life wasn't for living? :confused:

[Funnygrl]

I use the old fashioned isophane and regular/neutral but it is the bovine varity. Used 3 times a day(neutral) I find I have good control with very few hypo problems and no complications from my diabetes.
If I wasn't on steroids all the time for Addison's disease I wouldn't need the extra insulin at lunch time my average A1c is 7%.
As is the norm there is no right way to go about the task of diabetes control it is up to the person who has the condition to work out what suits them best. I have never let my diabetes rule my life and never will. Consultants/GP's who ever, can only tell you what they learnt from a book and in all honestly most of the books seem to have been written in 1066. They do not live with the condition every day 24/7 so they can say/write what ever they like about blood sugar levels and optimum goals we are not machines. Life is for living with a bit of sense it can be as normal as a non diabetic. What's normal?:hmmmm2
I suspect the reason you can get away with that is the Addison's disease. Addison's disease lowers blood sugar.

I don't know for sure, but I suspect you would have a hard time managing diabetes on N and R if it wasn't for the Addison's disease.

Nonetheless, having anohter hormonal disorder does complicate things.

[DeusXM]

All well and good making sure you diabetes is under the tightest control you can humanly manage to make sure you live to a rip old age, but you could walk out your door and get hit by a bus, life is for living.

Yes, I'm fully aware of that. Thanks to MDI, I can have tight control without having to compromise on either my diet or my life. Despite having diabetes, I've already dived the Great Barrier Reef, been a published writer, worked with the producer of The Young Ones and Red Dwarf, flown a glider, won a paintball tournament, become editor of a magazine, backpacked around Eastern Europe, got into all sorts of drunken fun at university, been at the very front to see Oasis, Greenday, Feeder, Kaiser Chiefs, The Ordinary Boys (and frankly far too many other bands to mention here) and all going well I should be sky-diving within the next two weeks as part of my magazine's feature on extreme sports.

Controlling your diabetes doesn't have to be at the expense of your quality of life. You just have to find the treatment method that lets you get the best A1C possible yet still lets you do whatever the **** you want. If you've got any suggestions other than MDI or a pump, I'm listening.

[SueM]

I suspect the reason you can get away with that is the Addison's disease. Addison's disease lowers blood sugar.

I don't know for sure, but I suspect you would have a hard time managing diabetes on N and R if it wasn't for the Addison's disease.

Nonetheless, having anohter hormonal disorder does complicate things.
Well considering I have had diabetes for 41 yrs and addison's for either 3 or 4 years then that doesn't add up.
I didn't have a problem before addison's on 2 injections a day. I just have the extra insulin at lunch time due to steroid use for the addison's.

[Ailsa]

Deus,
I think we all really agree with you, that the best A1c we can achieve will be better for our health. It's just what we can achieve to suit our own selves is important.

I'm not really the one to talk to with reference to depression and treatment changes. Having been on pretty much every single insulin that's been developed since 1998 (Mixtard 30, Mixtard 70, Actrapid, Humalog, Humalin I, Lantus, Novorapid, Insulatard and Levemir) and also having depression caused by the Lantus, I'm more than aware of the ups and downs of diabetes.


I think this is am important issue that we are all prone to, but isn't probably discussed enough. In my case the worst depression was in my early 20's. I had a notion in my head that I would be starting to go blind/ on dialysis about 15 years after diagonsis at age 25! which resulted in a vision of me being unable to work & living on social welfare for the next miserable 10 years until I died at 37 or there abouts. Given the treatment options available at the time, you will understand this was a reasonable viewpoint.
The turning point for me was when I was around 27 & it dawned on me that I was in perfect health & could throw all my misconceptions out the window.
I've never ever let fear of those issues bother me again.
I'm now 51 & consider that I am in better health than most non D people I know. A close (nonD) friend died last year & I now realise I will outlive many of my non D friends. I quess that's the advantage of a healthy life despite adversity.

While it is true that some people who have low A1cs do get complications regardless, some with higher levels do not. I think some of that is up to your genetic disposition,which is beyond your control. I don't think dwelling on all the bad things that can happen to us is helpful for our happiness, or particularly constructive. Since I've thrown that out the window for myself, my motivation has improved.

[DeusXM]

I think this is am important issue that we are all prone to, but isn't probably discussed enough. In my case the worst depression was in my early 20's. I had a notion in my head that I would be starting to go blind/ on dialysis about 15 years after diagonsis at age 25! which resulted in a vision of me being unable to work & living on social welfare for the next miserable 10 years until I died at 37 or there abouts. Given the treatment options available at the time, you will understand this was a reasonable viewpoint.

Precisely. I know it's a cliche but it's never been easier to get a good A1C as well as having a good, full, normal life. It's a fair point that possibly some people may genetically be able to withstand higher A1Cs and not sustain problems but it's not a bet that I'm willing to take, especially since it's a bet that I don't need to take.

Don't get me wrong, it's not like I spend my entire waking life panicking that I'm going to go blind or lose a leg. I'm just aware that it's a possibility and that it's avoidable.

As for depression....well, that was an allergic reaction to Lantus rather than any other trigger. Having said that, I'm back on Lantus now because unfortunately I hit 'the wall' with Insulatard. Given the choice of either having 8-9 hypos a day, poor control and a bleak future, or going on Lantus, running the risk of redeveloping depression but a much brighter future, I've gone for the latter.

[bonnie690]

Hey Deus
i know i'm not your fav person but when you say allergic reaction to lantus made you depressed, how because i always felt depressed on it and people i know on it feel depressed as well.

[DeusXM]

Your best bet for finding out about Lantus side-effects is here - http://www.diabetesforums.com/diabetes/1212-all-lantus-users-please-read-immediately.html

Basically it seems that there is a small but significant number of people who have 'problems' with Lantus, a sort of allergic reaction. Generally the reaction manifests itself as increased body temperature and perspiration, but for a 'lucky' few it also seems to create depression or low mood. I had both - Lantus also makes me more aggressive and withdrawn at the same time. I've mentioned this to both my clinic in Exeter and my current one in Gloucester and they both seemed to be aware of the problem already and had seen it in some of their patients.

Why the problem happens is open to debate. The major difference between Lantus and other insulins is that Lantus is more acidic but I've accepted the wisdom of other members that the relatively small amount of Lantus isn't enough to totally distort the pH of the body.

As I said, the sad bad news for me was that Lantus has now become my only treatment option since the isophanes were starting to kill me and I'm one of the lucky people for whom Levemir doesn't work for. However, I've been relatively fortunate - I manage my moods with St. Johns Wort which takes the edge off things and thankfully I haven't ended up like a couple of people I've been in contact with who've either ended up in court for Lantus-aggrivated violence or on Prozac for depression.

If people are feeling depressed and on Lantus it doesn't necessarily mean that Lantus caused the depression - it may be a general symptom of diabetes. However, if the depression started off pretty soon after they got onto Lantus, then it may be that insulin. My gut feeling is that Lantus enhances predispositions in the brain - if you are predisposed to say, depression or aggression, then Lantus might exacerbate those problems.

If your friends are concerned about Lantus and its side-effects then I recommend they give Levemir a try because it functions very similarly to Lantus but doesn't appear to cause the same problems. The only downer with Levemir (so far) is that for some people it doesn't seem to work - when I was on it, it literally just sat there inert in my system and didn't do a thing to reduce my BG levels.

It might be worth mentioning depression and Lantus to your doctor - you may be rather suprised by the reaction you get. It's usually a vigarous denial or a knowing 'hmm'.

About 3 years ago it used to be the denial but now it's more likely to be the 'hmm'.

[Erin]

As I said, the sad bad news for me was that Lantus has now become my only treatment option since the isophanes were starting to kill me and I'm one of the lucky people for whom Levemir doesn't work for. However, I've been relatively fortunate - I manage my moods with St. Johns Wort which takes the edge off things and thankfully I haven't ended up like a couple of people I've been in contact with who've either ended up in court for Lantus-aggrivated violence or on Prozac for depression.


Deus,

I don't want to be the bearer of bad news for you, and complicate what seems to be a lifeline for you (St. John's Wort), but as you are worried about complications I feel like I should tell you that St. John's Wort has been reported to cause problems with some of the same organs that are struck the hardest by diabetes complications (most notably the kidneys... and as you're a drinker, and that is not code for alcoholic, as you don't strike me as that type, I'll also mention the liver)

Because it's herbal, it's not been studied as extensively as the pharmaceutical variety of anti-depression agents but there is some evidence to suggest these risks. The stuff works (i took it during some particularly dark times in high school) but be careful.

I know it is difficult to get a pump where you are, but is there any way for you to kind of put pressure on your doctors, or the economic powers that be, citing your depression as an unacceptable side effect? I wish money wasn't the deciding factor in this disease!!!

[jillsp]

Deus, hi I'm new. After reading through this entire combative thread I'm intrigued about your depression claims with Lantus (not saying they aren't true). Did your doctor offer an explanation how Lantus could effect brain funtion or emotions? Insulin is in no way metabolized through any organs that would effect your hormone levels or whatever that could effect your mood.....right? I just can't seem to make the correlation to insulin changing mood. If it were your thyroid meds or a statin or anything else it would seem more likely b/c of they way they are metabolized. I'm not trying to start an argument so please don't jump all over me, I am truly curious as to the explanation you have found for Lantus and Lantus alone being the cause of your depression. Do you think when you switched back to your old insulin there was a bit of a placebo effect or psychosymatic response to you losing your depression? I have never EVER heard of anyone being depressed once being placed on Lantus and I work in the field. If anything, I have seen quite the opposite. I would love to hear what your physician said exactly. Thanks so much for your reply.

[DeusXM]

My doctors have never given an 'official' reason why Lantus may cause depression. This is probably because it's not listed as an official side-effect and indeed there does seem to be some sort of issue between doctors reporting problems with Lantus and the response from Aventis. Some doctors continue to assert that there are no major side-effects whatsoever and that their patients are silly for suggesting it. There was a time when I suspected some sort of consipiracy behind all this but I'm not convinced now.

Basically, every doctor I've seen in the last 3 years seems to have recognised a tangible link between Lantus and depression. It first came to my attention when another member here suggested it and I recognised a lot of myself in his story. When I mentioned it to the doctor who put me on Lantus, she herself said that she'd seen a worryingly large number of her own patients with the same problems and basically forced some Inuslatard and a Novopen into my hands right there and then. I've since mentioned it to my GP and my new clinic and they seem to be 'aware' of a general problem.

However, I would say it's not the 'insulin' part of Lantus that causes problems. I'm switched on enough to recognise that a naturally produced hormone isn't going to have that effect. My gut feeling is that there's something in the Lantus that causes a small number of people to have an allergic reaction to it - usually this seems to result in increased perspiration, and perhaps with depression, it inhibits seratonin levels. How, I don't know. What I do know is that Lantus acts as a mood 'enhancer' for me - if I'm feeling down, then I really feel down. If I feel angry, then I feel really angry.

Simply put, it's never been explained to me why Lantus had/has an effect, other that generalised speculation, but everyone I've spoken to in healthcare has seen it and knows that there can be an effect.

St. John's Wort has been reported to cause problems with some of the same organs that are struck the hardest by diabetes complications (most notably the kidneys... and as you're a drinker, and that is not code for alcoholic, as you don't strike me as that type, I'll also mention the liver)

Thanks for the heads-up. I've just starting taking Lamasil for a nail infection and I've been told that can affect liver function, so I think I'll lay off the SJW for the next 3 months and see what happens.

I know it is difficult to get a pump where you are, but is there any way for you to kind of put pressure on your doctors, or the economic powers that be, citing your depression as an unacceptable side effect? I wish money wasn't the deciding factor in this disease!!!

For me, it's not. I'm actually eligible for a pump on the NHS because of the problems I've had with all the basal insulins, but I turned it down because I'm just not comfortable with the idea of having something permenantly attached to me. I've looked into the unteathered approach which may be of use to me. The problem is although I recognise that the pump would make my life easier, I have a moderately active lifestyle which I can see trashing my pump. I go to a lot of gigs and clubs, and I can't see a pump surviving too many of them.

I may reconsider in the future, but for now Lantus is giving me good control and at the moment that's enough to keep my head level.

[Erin]

For me, it's not. I'm actually eligible for a pump on the NHS because of the problems I've had with all the basal insulins, but I turned it down because I'm just not comfortable with the idea of having something permenantly attached to me. I've looked into the unteathered approach which may be of use to me. The problem is although I recognise that the pump would make my life easier, I have a moderately active lifestyle which I can see trashing my pump. I go to a lot of gigs and clubs, and I can't see a pump surviving too many of them.

I may reconsider in the future, but for now Lantus is giving me good control and at the moment that's enough to keep my head level.

I feel the same way about pumps. Actually it's not the idea of the pump that bothers me, it's the tubes. but anyway... that's neither here nor there.

If you ever decide to try the pump out, I know a lot of guys with pumps who keep them in their trouser pockets, and cut a hole in the pocket lining to pull the infusion set tube through, so the pump is entirely covered. That might be a way to protect it at a club or gig. (No external tubing to get snagged on anything) Just remember not to keep money in your pockets after you cut holes in them.

[bonnie690]

How do women hide their pump? can you still wear dresses and stuff, i saw on one site a woman puts it in her bra, she buys one thats too big and stuffs the other cup, personally that sounds a bit silly!

[Lynne1]

How do women hide their pump? can you still wear dresses and stuff, i saw on one site a woman puts it in her bra, she buys one thats too big and stuffs the other cup, personally that sounds a bit silly!
I usually wear mine clipped on my pants or in my pocket. I put the pump in my bra if it looks awkward with the outfit I'm wearing.

[Funnygrl]

How do women hide their pump? can you still wear dresses and stuff, i saw on one site a woman puts it in her bra, she buys one thats too big and stuffs the other cup, personally that sounds a bit silly!
I have done mine in my bra before, and it works. You can also put it in stocking or clipped to underwear, boxers, or shorts under skirts.

Mine is usually in my pocket or my jeans. It works there.

[DeusXM]

That might be a way to protect it at a club or gig. (No external tubing to get snagged on anything)

Interesting - not sure whether or not it'd protect it in a mosh pit though.

Actually, the main snag (no pun intended) with a pump at a club for me is less about in the club and more about what happens afterwards. Maybe I'm just really cynical but I reckon that to a woman, nothing says "You've made a mistake! Kick him out of bed now!" quite like the sight of a man unwiding tubing and needles out of his side. Sadly (and understandably), not everyone is going to be quite so cool with being shocked like that, and frankly I've enough trouble with women as it is without either having to make some sort of serious declaration on the way out from the club or by shocking the **** out of them.

Or maybe I'm just too self-conscious...whatever, I guess I'm just reasonably happy with my treatment plan, and as long as it's getting me good A1Cs (and improving - my last A1C was 0.8% lower than the previous one) then I don't really have enough of a problem to need to change.

[Erin]

Actually, the main snag (no pun intended) with a pump at a club for me is less about in the club and more about what happens afterwards. Maybe I'm just really cynical but I reckon that to a woman, nothing says "You've made a mistake! Kick him out of bed now!" quite like the sight of a man unwiding tubing and needles out of his side. Sadly (and understandably), not everyone is going to be quite so cool with being shocked like that, and frankly I've enough trouble with women as it is without either having to make some sort of serious declaration on the way out from the club or by shocking the **** out of them.

Or maybe I'm just too self-conscious...whatever, I guess I'm just reasonably happy with my treatment plan, and as long as it's getting me good A1Cs (and improving - my last A1C was 0.8% lower than the previous one) then I don't really have enough of a problem to need to change.

As somebody who's suffered bouts of depression, I see anything that causes that as something that needs to change NOW. There are countless medicines that cause depression, especially in people who are prone to it, and I've ditched plenty of them. (birth control and certain NSAID's, most notably). But like everything else related to Diabetes control, your treatment plan is your decision, and if you're cool with it, then go with it! It's funny... me trying to convince you to keep an open mind about a pump... as I'm so anti-pump myself. But if I had the same side-effects from the lantus, I have no idea what I'd do.

It's funny your reasoning for not wanting the pump. Pulling out the Lantus (which I still use a traditional vial and syringe for) in the bar or club or party or whatever, is part of my screening process. If the dude freaks out, he gets my ex-boyfriend's phone number instead of mine, that is if he still asks for it. (nothing gives me greater satisfaction than annoying two a**h*les in one fell swoop). You'd be surprised tho, most people are more open minded about medical issues than you'd think. And women are almost attracted to that stuff... we like to "take care of" our men.

[jillsp]

I agree with Erin in that I wanted nothing to do with anyone that couldn't hack my diabetes. How can you potentially look at spending time with someone that right off the bat isn't open to the "real" you. Not something I ever wanted to just spring on someone, but I've also never really been very self concious about my diabetes. I don't think it's that big of a deal. It could be worse, I could have HIV, cancer, MS, Parkinsons etc. Our life is so livable and treatable. I would tell you Deus that the way you went on and on about multiple injections vs 2 a day shots you should know that pump therapy is THE GOLD STANDARD for basal bolus treatment. I could NEVER EVER get my AIc below 7% until I got on my pump. Again, a very personal choice but science backs up pump therapy over MDI. I was resistant to it due to all the same reasons as everyone else, not wanting to be attached to something 24/7 etc but I HONESTLY don't even think about it anymore. I would shoot someone who tried to take my pump away. But, the thing that pushed me to get it was I wanted to have a baby, and in order to have the tightest control and easiest pregnancy, the pump was my only option. So I did it for that and I could kick myself for not having been more open to it earlier. Just food for thought. You'd be surprised at how tough pumps are, mine has been dropped, banged, submerged in water etc and I have never had a problem.

[seacomp]

But, the thing that pushed me to get it was I wanted to have a baby, and in order to have the tightest control and easiest pregnancy, the pump was my only option.
I tend to doubt that Deus wants to even think:rolleyes: about having a baby, even by proxy.

[jillsp]

I tend to doubt that Deus wants to even think:rolleyes: about having a baby, even by proxy.

touche' I guess the point I was making was that I can understand being resistant to the pump and basically was forced to go on it to have a family. However, in the end, I'm so happy I was forced to!!! Not trying to suggest medical miracles by Deus becoming not only the first pregnant male, but the first DIABETIC pregnant male. Thanks for the laugh....

Again, very personal decision and was just sharing my story.

[Jan2306]

Erin: I'm new to all this but you're the first person I've heard say they're opposed to the pump. Can I ask why?

I'm also new to this forum and not sure if I'm suppose to start a new thread if I go off topic on the current thread. Any advise would be appreciated.

[DeusXM]

Jill - your reasoning for going on the pump are sound. If you cannot get an A1C below 7 with MDI, then yes, the pump is the ultimate option. Indeed yes, I'm aware that it's the closest thing we've got to a cure at the moment. However, in my position there aren't same health benefits for me. I've already got an A1C of under 7 (and getting better all the time) on MDI and once you get below about 6.2 the overall effect is markedly less.

Basically, if someone drops from 8 to 7, they will massively reduce complications. If someone drops from 7 to 6, then they still reduce complications even more, but by a much lower factor. If dropping another 1% on my A1C would reduce my risks significantly then I wouldn't be arguing against me getting a pump.

Also, in answer to your questions about significant others accepting your diabetes - yeah, that's obvious. I wasn't necessarily talking about people I'd be involved with long-term.

However, if anyone wants to help contribute to the Get Deus Pregnant fund, then please contribute. I'm not entirely sure about the mechanics of it just yet (and if it involves having to find a father for the kid then sorry but it'll have to be cancelled). But I'm sure with a hefty research grant, (enabling me to remain in bars and clubs for a long time), I'll figure something out.

[Erin]

Erin: I'm new to all this but you're the first person I've heard say they're opposed to the pump. Can I ask why?

I'm also new to this forum and not sure if I'm suppose to start a new thread if I go off topic on the current thread. Any advise would be appreciated.

This thread is already so off topic I think it's ok. :)

I had quite a few medical issues pre-diabetes, which had me hooked up to IV's and other assorted tubes and bags and things for quite a long time. I am just rather happy to be "disconnected" and don't want to go back. Couple of shots every now and again doesn't bug me. A1c hangs around 7 right now, so there's no real strong motivating factor to make me get one. And technically I think Deus was the first person you've heard say they didn't want a pump. :)

And Deus... I like to screen people, even if I'm not going to spend any measurable amount of time with. How they react to diabetes is a good indicator of their character. but I guess that is less important if the gender rolls are reversed.

If you figure out how you're gonna get pregnant, let us know, I think we'll all donate to the cause to make it happen.

[duck]

For those who freak out a little at the thought of having A1c's under 7 (because obviously that means a lot of lows, right?), after I went on the pump, I realized that with a little bit of effort, sub-7 A1c's were easily achievable and did not require many nights waking up in a sweat or having to stop what I was doing to get a "fix". I can consistently wake up with blood sugars between 90 and 120 with a pre-sleep sugar between the same ranges. I imagine I could get even tighter on those numbers, but that was my goal and at this point I am relatively happy with my control.

Erin, I had the same concerns about bags/tubing/cords/needles/devices hanging off me, etc. Within a month it all became second nature, and even before that I was feeling so much better, I would have put up with it all just for that.