[Diabetes] Lapsed Diabetic returns to the fold!

tbh

...well, in a manner of speaking

I went back to my consultant today after not going for about four years. I've spoken before about why I've not gone, but in summary, basically, the longer it went, the harder it was to go back.

Anyway, it was great to go back and get on track again - Hb1Ac was 8.2, which is obviously "sub-optimal" but the doc was happy enough - also got my feet and eyes checked, no problems at all, so it was nice to get a "clean bill of health".

Anyway, the interesting bit - He's not changed my insulin for the moment, but he said that the newer insulins were much better. He's going to admit me to St. Michaels (I think) for five days for a bit of education and to get me started in a new regime. I have to meet a dietitian first for help with Carb counting - CathyM is that what you were talking about before?

I'm quite excited to be honest, I feel like by taking it more seriously, I won't be riding my luck quite so much!

anyway, I guess the moral of the story is that if there's anyone out there who's missed an appointment and feels awkward about going back - don't be. My doc told me it's quite common, and they are always glad to see you back

robinph

I had missed the annual check-ups for a couple of years ages ago due to going through a bit of a "can't be arsed" phase at the time. I think I am still actually in that same phase now but I do turn up for the check-ups regardless now but am fully prepared for being told off for my bad numbers when I do turn up. I just got the letter through for my next appointment in a few weeks time though so now I actually have to start doing some blood testing so I've got some numbers to show the doc. Only problem is that I'm going skiing next week so I'm not expecting to be taking any useful reading during that time to be able to show them.

I might push the appointment back by a week or so just so that I've got something better to show than a few empty pages.

tbh

Every time you post I'm struck by how similar we are - I'm exactly the same, and thought tonight when I was looking at my meter "well, I won't be needing that for a while" but I'm going to make the effort, purely so as I know what I'm dealing with when I'm going for the new stuff - I'll let you know if I learn anything useful!

mike65

You're a pair of wasters! (shakes head, "I dunno...."), my man says 5 is the target for Hb1Ac so you've got some way to go.

Mike.

robinph

tbh wrote:

Every time you post I'm struck by how similar we are - I'm exactly the same, and thought tonight when I was looking at my meter "well, I won't be needing that for a while" but I'm going to make the effort, purely so as I know what I'm dealing with when I'm going for the new stuff - I'll let you know if I learn anything useful!

Same here, I guess it's kind of good to know that we are not alone in feeling the way we do about dealing with our diabetes. But then again I'm now worried that I'll start thinking "well if tbh is doing the same then it must be OK for me too, so feck it".

mike65 wrote:

You're a pair of wasters! (shakes head, "I dunno...."),

Yup.

mike65 wrote:

my man says 5 is the target for Hb1Ac so you've got some way to go.

Mike.

5!!! I thought it was 7 that we had to be below. :eek:

I think I was just over 7 last time after having had what I thought were fairly decent readings for the previous while and they gave out to me a little that time, but the time before that when my readings were all over the place I had a 6.4 or something and they said I was doing great.

I think they just make it all up as they go along .

tbh

yeah, my guy says 7 - possibly the same guy tho. I think today he was saying it's good considering the insulin you're using isn't the best, and you don't really know what you're doing I think that if I make even a minimal effort it should improve a lot, and they'll help me to do that - so rob - if I improve, you'll be under serious pressure

CathyMoran

tbh - will send you a PM tomrrow, sorry, tired. You have to look after your diabetes - whenever I feel like I am going to lapse I google the complications that can occur. Having good control really helped me while facing my current cancer battle. I normally try to keep my Hba1c below 6.5, I was personally advised to higher this limit while undergoing cancer treatment as I totally lost hypo awareness and had a few scares. I still test way too much though (10-20 times a day) as I had a really bad hypo nearly 3 years ago.

robinph

CathyMoran wrote:

I still test way too much though (10-20 times a day)

!!! :eek: !!! That has to hurt a lot.

I'm now trying to get back into the habit of doing 4 a day again, but I keep forgetting them at the moment. But even with just that number my fingers start complaining after a while.

CathyMoran

robinph wrote:

!!! :eek: !!! That has to hurt a lot.

I'm now trying to get back into the habit of doing 4 a day again, but I keep forgetting them at the moment. But even with just that number my fingers start complaining after a while.

I have a really nice blood testing machine which helps me get a rough idea of my Hba1c, that helps me as it makes me feel that I have control over my illness. I would not advocate testing as much as me, they are always telling me to test less in the hospital but the last bad hypo really scared me as I had to have glucagon.

mike65

7 is old school I'm afraid, the latest research shows that 5 is pretty much optimal and should pretty much mean a long and healthy life if diabetes is all one has to worry about. To put that number in context a non-diabetic has a base reading of 4.

Mike.

tbh

you know, I think the thing is as well, the tighter control you have, the more eligible you are for the new treatments as they come on line - so, if 5 is the number to go for, I'll give it a go

tbh

CathyMoran wrote:

tbh - will send you a PM tomrrow, sorry, tired. You have to look after your diabetes - whenever I feel like I am going to lapse I google the complications that can occur. Having good control really helped me while facing my current cancer battle. I normally try to keep my Hba1c below 6.5, I was personally advised to higher this limit while undergoing cancer treatment as I totally lost hypo awareness and had a few scares. I still test way too much though (10-20 times a day) as I had a really bad hypo nearly 3 years ago.

Hiya - wasn't sure which of your locations you were in it was because of you that I went back, so thanks for that I feel so relieved now, purely because the next time I'm going for insurance, I won't be worried about how I'll explain the absence - stupid maybe, but it works for me I'll let you know how the education thing goes.

SeaSide

mike65 wrote:

7 is old school I'm afraid, the latest research shows that 5 is pretty much optimal and should pretty much mean a long and healthy life if diabetes is all one has to worry about. To put that number in context a non-diabetic has a base reading of 4.

Mike.

Hi Mike

Do you have a link for this?

Thanks

mike65

Nope the thoughts of my endocrinologist are'nt online!

Serously though, a long-term study in Canada has shown 5 to be best for preventing complications in latter life.

Mike.

SeaSide

I had a look for it and could find naught and I hadn't had the same advise as you during my last check-up in Nov.

I do remember reading a rule of thumb that you Hb1ac reading would be about one point higher than your average BS reading and therefore to get a 1Ac reading of 5% you would have to have an average BS reading of 4 meaning that 50% of your BS readings would have to be below 4 and therefore a hypo

DrIndy

Non diabetics are usually 3.5-5.5% in their HBA1C - varying how the assay or machine measures it.

Diabetics should be between 4-6% ideally, and I'm not happy myself if I see someone who is over 6% particularily if it is consecutive as it is very important to reduce the long term complications.

Here's an interesting wee page thats pretty accurate:

http://medweb.bham.ac.uk/easdec/prevention/what_is_the_hba1c.htm

And how HBA1C compares:

HbA1c% Average blood glucose level mmol/l
13 18
12 17
11 15
10 13
9 12
8 10
7 8
6 7
5 5

mike65

Interesting.

Tighter control brings its own risks of course, as low blood-sugar episodes will occure more easily.

Mike.

DrIndy

true, this is the finetuning of diabetes. If someone comes into the clinic with quite brittle diabetes, you usually end up pushing blood sugars above the tight guidelines to prevent hypos. You also have to ask though about diet and sticking to slight tweaking of insulin with size of meal.

robinph

Well I went for my annual service this morning and as expected my Hba1c result was pretty poor at 8.7. Everything else is seemingly perfectly OK though although they wanted to do a few more blood tests as well for stuff that I've forgotten what.

I've to go back again in about a month after I've actually been taking some blood tests myself so that they can see if anything other than my general laziness towards that needs fixing.

TedKelly

Hello fellow diabetics,

Just browsing and came across this thread. I am a type 2 diabetic and was diagnosed almost 4 yrs ago now. I have missed my last 2 annual appointments and really have the attitude that "I can't be arsed with all this". I know it's wrong but just can't be bothered. I stopped taking my tablets almost a year ago and the last time I checked my blood sugars was probably around that time. I kinda hope by writing this post I'll start to get me act togethor. Anyways, all the best.

tbh

Hi Ted -

I was thinking about this recently, and I think I know why the appointments are every six months - for the month before the appointment and the two afterwards, you are on top of your game, and then you lapse a bit. So, it means that for six months of the year you are doing everything, and the other six months you're a bit off - certainly my pattern. Give your doc a ring to get a date and start from scratch again

good luck,
tbh

TedKelly

tbh wrote:

Hi Ted -

I was thinking about this recently, and I think I know why the appointments are every six months - for the month before the appointment and the two afterwards, you are on top of your game, and then you lapse a bit. So, it means that for six months of the year you are doing everything, and the other six months you're a bit off - certainly my pattern. Give your doc a ring to get a date and start from scratch again

good luck,
tbh

Cheers tbh. Think I'm gonna have to get my act togethor alright. The chemist I usually get my meds from always check the dates my Gp last signed the prescription on my green book. So obviously I'm gonna need the doc to rewrite my prescription, to start over again. Hopefully this is the kick in the arse I need.

Johnny Meagher

You have to go though, don't you? I can be sort of cheeky but we do this "you will have to try to do better" and we go "yes doctor I will try" and then we don't change at all :P I've said, "I know, but I won't" :P I mean not naughty child, I mean 15 years of messin', am I suddenly going to change??? I've always been totally honest with doctors, it's private and confidential, if you don't tell them you're an eegit they won't be able to help you. It is embarrassing alright. I've really grown to hate hypos, I worry more about getting a hypo (immediate effect) than being hyper (long term effect). I'll tell you, its just like smoking psychology, one hyper won't harm me. But you know what it's like, if you take too much insulin for your dinner you get a hypo, you're stuffed full and you have to eat more, ugh! anyway, it's one thing to mess on a daily basis but go to the appointments, you'll get a slap on the hand and you'll be good for 3 weeks and that's better than nothing! the new insulins are good, I even asked to be put on the ones I use now (basal/bolus). good luck!!

sorry I didn't see there was a second page tbh, you are good for 6 months after! I guess I've left the cat out of the bad with my "3 weeks"!

tbh

well Johnny, I just had a MASSIVE lunch including a mars bar, so maybe six months is a bit optimistic

I can totally relate to what you are saying tho, what struck me when this forum started was how average I really was - most people with diabetes have the same experience as me, good in some ways and bad in others. The stay in hospital was great for me - I started new insulin and just got myself back in the swing of things. Even better was re-establishing myself with the doc, so I'm not worrying about going back now or worried about who I'll ring if I have a problem - it's a real load off my mind..

SeaSide

TedKelly wrote:

Hello fellow diabetics,

Just browsing and came across this thread. I am a type 2 diabetic and was diagnosed almost 4 yrs ago now. I have missed my last 2 annual appointments and really have the attitude that "I can't be arsed with all this". I know it's wrong but just can't be bothered. I stopped taking my tablets almost a year ago and the last time I checked my blood sugars was probably around that time. I kinda hope by writing this post I'll start to get me act togethor. Anyways, all the best.

Hi Ted,

It's hard to consistently keep yourself motivated all the time and the struggle does get boring. Mind you I don't think the healthcare system helps as its is difficult to keep going when the medical team supporting you is so under-resourced that you only get an appointment once a year. The system in Ireland seems far better at dealing with complications than preventing them.

Johnny Meagher

well I missed my last appointment, got the days confused so they made a appt for 6 months later, so I go and I didn't even get in to get the bloods done, so she asks me how my sugars are I just look at her...:rolleyes: hmmm
so it was embarrassing, so I'll be good. had to be done!