[bonnie690]

Are they any diabetologists registered in this forum, preferably from the UK!

[JediSkipdogg]

Just a question? Do you mean Endocrinologist? And Endo is one that specializes in diabetes.

[bonnie690]

Basically in a nut shell, someone who is qaulified to talk about diabetes and knows the ins and outs of insulins, i know this forum is for people who suffer with diabetes to get together and discuss it, i was just wondering if there was an professionals on here.

[JasonSmithMT]

Originally Posted by JediSkipdogg

Just a question? Do you mean Endocrinologist? And Endo is one that specializes in diabetes.

There is such a sub specialization of endocrinology called diabetology. A diabetologist is a endocrinologist who specialized in diabetes. The hierarchy goes like this: Diabetology is a subset of Endocrinology which is a subset of Internal Medicine.

Bonnie - I don't believe we have any physicians who contribute on this forum but there is a fair amount of people on this forum who know the "ins and outs" of diabetes and who more than deserve honorary diabetologist classification in my opinion. Feel free to ask your questions.

Jason

[duck]

Originally Posted by JasonSmithMT

There is such a sub specialization of endocrinology called diabetology. A diabetologist is a endocrinologist who specialized in diabetes. The hierarchy goes like this: Diabetology is a subset of Endocrinology which is a subset of Internal Medicine.

Bonnie - I don't believe we have any physicians who contribute on this forum but there is a fair amount of people on this forum who know the "ins and outs" of diabetes and who more than deserve honorary diabetologist classification in my opinion. Feel free to ask your questions.

Jason

...and I would qualify JasonSmithMT as one of the members here who deserve "honorary diabetologist" status...so yes, please ask away!

[bonnie690]

Dear Duck,

Question: what re you views on mixtard 30 insulin?

Question: do you think someone can have good control by being on a 2 a day insulin such as mixtard 30?

Question: when using the pump, do you at anytime take it off (like when you shower or sleep) or is it worn at all times?

Thanks!

[JediSkipdogg]

I know you asked for Duck but I'll give you my opinion on them.

Originally Posted by bonnie690

Question: what re you views on mixtard 30 insulin?

It's stupid, because you have to give a set amount based on the long acting part. Therefore you can't change the fast acting part and that means you must eat enough carbs to cover and no more, no less.

Originally Posted by bonnie690

Question: do you think someone can have good control by being on a 2 a day insulin such as mixtard 30?

Your control will greatly improve on 2+ a day shots instead of a mixed insulin.

Originally Posted by bonnie690

Question: when using the pump, do you at anytime take it off (like when you shower or sleep) or is it worn at all times?

I take mine off for showers only. You cannot take it off while sleeping as the max recommended time off is 1 hour.

[seacomp]

Originally Posted by JasonSmithMT

Bonnie - I don't believe we have any physicians who contribute on this forum

Certainly not openly. It would be a shame if there were not a few doctors who lurked here. They could learn alot.

[jeggeman31]

Originally Posted by bonnie690

Dear Duck,

Well I am not the Duck, nor do I play a duck on T.V.

Originally Posted by bonnie690

what re you views on mixtard 30 insulin?

Myself I feel that mix Insulin is ****. I was on it at one time and had very poor control over my diabetes. I wish they would stop making that stuff as I don't think it works. Mixing Long and Fast acting insulin in the same shot just does not work anymore.

Originally Posted by bonnie690

do you think someone can have good control by being on a 2 a day insulin such as mixtard 30?

Your control does improve on 2 plus shots a day. Getting rid of that mix insulin was the best thing (pre pump) that I ever did.

Originally Posted by bonnie690

when using the pump, do you at anytime take it off (like when you shower or sleep) or is it worn at all times?

I take mine off when I shower and get lucky with the wife. Those are the only 2 times my pump is off. My control has in-proved 110% over the last 7 1/2 months being on the pump. The pump has let me take back my diabetes and it no longer controls me, I control It.

[jeggeman31]

Originally Posted by seacomp

Certainly not openly. It would be a shame if there were not a few doctors who lurked here. They could learn alot.

:dito: Amen to that

[duck]

Originally Posted by bonnie690

Dear Duck,

That's me! As you can see, we have a lively crowd here.

Question: what re you views on mixtard 30 insulin?

In theory, it may work for some. In reality, I cannot think of a single person I know in person or on the WWW who seems to even have a little bit of success with the "mix" insulins. At best, they lock you into a pattern of "feeding your insulin". At worst, they leave you without control. Going on Multiple Daily Injections (MDI) of lantus or levemir for basal (long-lasting) insulin along with Novolog/Humalog for meals will yield more flexibility for your lifestyle and more flexibility on when and how much you can eat.

Question: do you think someone can have good control by being on a 2 a day insulin such as mixtard 30?

As stated, in theory it is possible. In real life, I have yet to read about anyone who does have good control.

Question: when using the pump, do you at anytime take it off (like when you shower or sleep) or is it worn at all times?

Thanks!

I disconnect as needed (showering, sometimes when I participate in sports, and um *intimate* activities). I sleep with it attached, the nice thing about a pump is that once you get the "basal rate" dialed-in, you can sleep in without hypos, etc. We are a very pro-pump crowd here, most of the pumpers here are in love with their pump.

BTW, with the water-proof pumps nowadays, you can shower with the pump attached, you can go swimming, etc. I am more concerned about the heat of a shower ruining insulin than I am about the water ruining my pump, so I disconnect.

[bonnie690]

whats the difference between a type 1 and a type 1.5? as far as i know there is only type 1 and 2 in England

[DeusXM]

Question: what re you views on mixtard 30 insulin?

Good for the newly dxed, since it introduces them to the general idea of injecting. However, it's certainly not an insulin you'd want to stay on if you want to have any semblence of a normal life.

Question: do you think someone can have good control by being on a 2 a day insulin such as mixtard 30?

No, it's physically impossible. Firstly, Mixtard 30 is 30% Actrapid, 70% Insulatard. Actrapid simply doesn't work fast enough to match the rate of digestion. If you eat any food after you've injected Mixtard, your BG will rocket up to around 10-11, before coming down to around 8, and then very gradually returning to around 5ish (in an ideal world) after about 5 hours. This isn't good control. You might be returning to a safe BG level eventually but diabetes damages you whenever your BG is high.

Compare this with the MDI system. You take Humalog or Novorapid, and a basal insulin (preferably Lantus or Levemir). When you eat, you inject your bolus insulin and eat, your BG will probably go up to around 8ish, then return back to 4-5 within two hours. And then it'll stay there and won't move, ideally. This is precisely how someone without diabetes has their blood sugar work. The difference is that your periods of elevated blood sugar work out to be about 2 hours in 24, compared to probably nearer 8 or 9 hours on a two-jab system. With MDI you can get an A1C of between 5 and 6. With Mixtard you'll be lucky to get below 9. And remember, above 7 is guaranteed leg-loss and blindness territory.

In addition to this greatly improved control, you also get your life back. When you take Mixtard, you HAVE to eat at the same time each day and you HAVE to eat pretty much the same amount every day. In a lot of cases this means you'll probably put on weight since you'll be eating much more in order to prevent hypos later on. It also means that you can't do anything spontaneous or eat anything different - not unless you fancy going blind or losing a leg in 10 years time. With MDI, you can eat what you want, when you want. You also don't have to eat if you don't want to. Instead of insulin ruling you, you rule the insulin. Plus, if you make a mistake, it's much easier to correct. Running slightly high? Fine, take a couple of u's of your bolus insulin and forget about it.

With multiple jabs you'll be able to live a normal life as if you weren't diabetic and you'll get much better blood sugar control. Insulin pumps are really just an extension of the theory behind MDI. The problem with MDI is that your average rate of glucose release varies slightly throughout the day - for instance, your liver probably releases more glucose in the morning than it does in the afternoon. With MDI you have a basal amount that nearly corresponds with the level of glucose release but won't match it exactly, so your control will not be perfect. A pump lets you specify at exact times how much insulin is going into your system so that users can match their insulin requirements exactly to their glucose release.

However, with new insulins like Lantus and Levemir the difference in control between MDI and pumps is decreasing. Pumps will get you a better A1C but we're talking about getting an A1C of 5.5 instead of an A1C of 6. The real advantage of pumps now is more to do with convenience (although those with very pronounced variations in glucose release will certainly get better control).

[jeggeman31]

Originally Posted by bonnie690

whats the difference between a type 1 and a type 1.5? as far as i know there is only type 1 and 2 in England

We have a 1.5 sub forum that has some good threads. You can find the threads at this link http://www.diabetesforums.com/type-1-5/


However to respond to the above, below is a quote from one of the threads from the above forum.

Latent Autoimmune Diabetes in Adults (LADA)
Autoimmune diabetes (Type 1A diabetes) occurring in individuals who are older than the usual age of onset of type 1 diabetes (that is, over 30 years of age at diagnosis). Sometimes, patients with LADA are mistakenly thought to have Type 2 diabetes, based on their age at the time of diagnosis. However, positive antibody tests would help make the diagnosis of LADA.

[bonnie690]

I can see your all pro pump and pro MDI insulin on here. I have just spent the last year on MDI and could not for love or money get use to it, you say lyou can eat what you want when you want, but for me personally, that didn't work. if you live out of packet food which tells you the exact carbs your about to eat thats fine but if like me you like on freshly prepared food its hard, and i found it hard to look at my plate and work it all out, you say your damaging yourself when your blood level goes up. when i sometimes would get it wrong my sugar would go up to 20! or the other end of that scale it would go down to 2! and i found that the sugar wouldn't maintain itself it would always slowly drop. it just goes to show that all diabetics are different, different strokes for different folks as the old saying goes!! i've just been put back on mixtard30, so i'm gonna see how it goes its nice that you all have your opinions but i'm sticking by my guns for now!