[dragonsden923]

a couple of people have indicated that the question of "what would you do differently?" is a little difficult to answer, as i'm sure we all have things that we would have done differently, had we known then what we know now. I guess what i mean is,

"what would you have changed about the way you were taught about diabetes?"

I know that i would have loved to have someone actually sit down with me in the hospital and explain exactly what was going on. instead, what i got was basically "lay off the sugars, here's an orange and a syringe for you to practice with."

So let me know! And thanks again for everybody's help!

[xMenace]

<rant warning>

My initial teachings are so long ago ... I got a workbook thingy and hands on instructions for urine testing (get your minds outa there!). Back then we used test tubes. It was a big process.

My latest adventure was when I received training for my pump. It was rather like starting over. At least I treated it as such.

There was definately a gap in my pump training. I see that gap just about everywhere whether it's pumpers or mdiers, and IMO it really needs addressing. The #1 thing they fail to teach us is how to match our dosages to our needs.

What they teach us is how to select foods, how to count carbs, how to test, how to identify and treat hypos, how to operate the equipment, etc, etc, etc. It's all necessary stuff, but it is not the guts of the matter. Typically they tell us to contact them for adjustments until it's all settled. Then every three months when we see our doctors or DE's they tell us to bring in our records so they can make more fine tunings. What they don't us is how to make these fine tunings ourselves. It's like that infamous saying "Give a man to fish, he eats for a day
Teach a man to fish, he eats for a lifetime." They are feeding us, not teaching us. In order to successfully treat ourselves we have to resort to books and the web and forums such as this. Worst of all we have to do it by trial and error. Too many times I'm looking up at a white-coat saying "oops, I guess I ****ed that up royally!"

Their matching programs consist of testing several times a day, looking for patterns, and adjusting to those patterns. That works for some, even many, but for lots of us, good control requires finer detail. The vital thing, the point of failure, is not separating basal and bolus needs. These are the two general sources of blood sugar and the two general insulin treatments, yet most educators lump them into a single manageable pot. They demand to be separated. IMO there needs to be up front education and insistance on separate basal testing and treatments. Only once this has been accomplished can you successfully set proper I:C ratios. When you have everything settled, not only can you drop your A1C to near normal levels, but you can minimize hypoglycemic incidences and you can actually adapt your routine as needed to social and lyfestyle demands. You can party all night, you can run a marathon, you can play competetive sports, you can do whatever you want except for what they won't let you do.

Too many of us come away with no idea how to manage ourselves.

[painthorse]

Originally Posted by xMenace

<rant warning>

My initial teachings are so long ago ... I got a workbook thingy and hands on instructions for urine testing (get your minds outa there!). Back then we used test tubes. It was a big process.

My latest adventure was when I received training for my pump. It was rather like starting over. At least I treated it as such.

There was definately a gap in my pump training. I see that gap just about everywhere whether it's pumpers or mdiers, and IMO it really needs addressing. The #1 thing they fail to teach us is how to match our dosages to our needs.

What they teach us is how to select foods, how to count carbs, how to test, how to identify and treat hypos, how to operate the equipment, etc, etc, etc. It's all necessary stuff, but it is not the guts of the matter. Typically they tell us to contact them for adjustments until it's all settled. Then every three months when we see our doctors or DE's they tell us to bring in our records so they can make more fine tunings. What they don't us is how to make these fine tunings ourselves. It's like that infamous saying "Give a man to fish, he eats for a day
Teach a man to fish, he eats for a lifetime." They are feeding us, not teaching us. In order to successfully treat ourselves we have to resort to books and the web and forums such as this. Worst of all we have to do it by trial and error. Too many times I'm looking up at a white-coat saying "oops, I guess I ****ed that up royally!"

Their matching programs consist of testing several times a day, looking for patterns, and adjusting to those patterns. That works for some, even many, but for lots of us, good control requires finer detail. The vital thing, the point of failure, is not separating basal and bolus needs. These are the two general sources of blood sugar and the two general insulin treatments, yet most educators lump them into a single manageable pot. They demand to be separated. IMO there needs to be up front education and insistance on separate basal testing and treatments. Only once this has been accomplished can you successfully set proper I:C ratios. When you have everything settled, not only can you drop your A1C to near normal levels, but you can minimize hypoglycemic incidences and you can actually adapt your routine as needed to social and lyfestyle demands. You can party all night, you can run a marathon, you can play competetive sports, you can do whatever you want except for what they won't let you do.

Too many of us come away with no idea how to manage ourselves.

Very well said!!!!

[solox316]

Originally Posted by xMenace

Worst of all we have to do it by trial and error. Too many times I'm looking up at a white-coat saying "oops, I guess I ****ed that up royally!"

Too many of us come away with no idea how to manage ourselves.

How true what you wrote is... I am going on year 9 with my pump, and I am just now learning about basal testing and timings of when to bolus... Any most of this is because I ask questions to my endo that I have gained interest through reading here and other places online...

It is very much a "teach yourself" or "trial and error" approach to management, as long as you have the ability and gumption to go at it yourself...

So, to answer the initial question, I would have changed the detail of my pump therapy, learning how to do it, and not what to do...

[SugarLife]

I was educated very well at the youth hospital at the time. They didn't only explain to me that I needed insulin, but also why I needed it, and how the different types worked - not everything at once, just when I needed it, but they would ALWAYS explain why something was done the way it was. That's given me a good understanding and grip on things, and especially as a teenager I found their approach helpful. They also always asked how I was doing (and really wanted to know), and they always asked what I thought was the worst thing about having diabetes and then trying to make that better in some way (if possible). This helped me to understand what they were teaching me, because I felt much more involved. Now I'm not sure if I would still appreciate THAT much attention as a grown-up, but some openness to my experiences always helps a lot - gives me the feeling that it's about me and my health, and not about them trying to get smart-looking results for themselves, which I hate. So it's not only WHAT they taught me, but also HOW they did. And I'm very content.

[Mich]

A long post--a little history, a little opinion

I was diagnosed in 1960. Our family had no insurance and not a lot of money. Our family doctor diagnosed me and sent me home with urine testing tubes and tablets, glass syringes and stainless needles and a bottle of NPH and one of Regular insulin. I was the kid who had three months of sleepless nights knowing a polio shot was coming up...I learned basically to suck it up and be brave or die. Scary into. I had just turned 13.

My mom and I read a lot of directions. I reacted to the prescribed insulin quickly and in two days was hospitalized for a whopping insulin reaction.

In those days, hospitals were very adult. There were three adult women sharing my room. The only education I received was a booklet put out by the ADA and the orange inection training. I thought it was silly because of course, an orange isn't YOU and feels nothing.

For years (all through my teens and early 20's) I rarely even heard of another diabetic. I read everything I could and like John, practiced a lot of observation and correction. I was following the ADA exchange diet. We had no meters then and I never coould see any pattern in my urine sugar spillage (always 4 plus), so I had to go on how I felt. I stumbled upon Atkins' book and began low-carbing, feeling better immediately. At the time, the ADA was recommending high carb, low fat diets with (ironically) NO SUGAR. But orange juice was ok, just NOT SUGAR. It took them 25 years to change that.

Trial and error. That was it. Since the urine tests and A1c's were pretty useless with day-to-day management, I really had no feedback upon which to base my decisions other than how I felt. The fastest acting insulin at the time was regular which had a 30 minute to 6 hour profile for me. Timing was crucial and I spent a lot of time feeding my insulin peaks and valleys. I didn't know about liver dumps, although I could feel the results of stress.

My first meter, a Lifescan boxy thing in about 1982, changed everything for me. I learned to fine-tune according to my results and tested often. I was lucky einough to have a family friend who was a Doc who fed me research, and a good endo who I saw every three months who did the same. Education has always been up to me. My current endo is a partner to me who knows much more than I about medicine in general. He keeps me up on reaearch and gives me pointers about how to find certain topics (which journal.) Every visit is a conversation with questions and answers going both ways. He pretty much advises me but lets me run the show day-to-day. After my diabetic history, I couldn't have it any other way.

In my opinion, the education experienced by SugarLife sounds excellent. I wish I had been "eased" into the whole thing, but they really didn't know that much at the time. Basing my opinion on thirty years of teaching, I think listening to kids, explaining with diagrams and introducing them to other diabetics is the very best thing you can do.

Mich

[alicat61]

Hi
I can relate to most of this. In 1982 I was diagnosed and put into hospital for 9 days. As I was a nurses aide (just finnished training in a childrens home that you couldn't change a bandaid without supervision) They thought I should know it all.
My saving grace was a few student nurses who taught me to give insulin. Blood glucose monitors where new (the lady in the bed next to mine new the fellow who developed one of the first in New South wales) It was urine strips watch for glucose and ketones. I was given a couple of books told all bad things that can happen to you and sent on my way.
Went back to work and told I couldn't do Night shift etc They had less knowledge then me.
Thank goodness I went to different Dr who sent me to a bigger hospital with one of the best Diabetic Educaters I have ever met.
Over the years I have become a registered Nurse and have done courses with this lady. Their aproach is to make learning as fun as possible. Not to make anyone feel bad. They try to get the would be educaters to think like they have diabetes.
I work mainly with Kids and being in a small hospital we send them to the larger centres in Sydney or Canberra. This way they can get a uniform education rather then bits and peices from people who really have NO IDEA.
As for the injecting Oranges I have gotten the kids to practice on a real arm MINE.(They do a better job then most Doctors and RNs)
all I can say thank goodness things have changed and sorry for raving on