[Diabetes] Just Back from St. Michaels

tbh

I recently went back to my specialist after not going for about 5 years or so. He said that the best thing would be for me to go back into hospital for five days to get re-educated and try some new insulins. I went in to St. Michael's private last Monday, and came out yesterday - just thought I'd let ye know how it went, and what to expect if any of you have to do the same.

I'm going to say what I learned in there as well, but just a summary, so please don't take anything I say as medical advice, obviously.

I went in on Monday morning and got sorted with my room, then met some people - dietitian, diabetic nurse, etc, but just introductions really. At 4, I went over to the clinic and met the wonderful [not going to say her name, jic] who had a chat with me, and talked to me to figure out how much I already knew.

She explained that I was going to be put on two different types of insulin, Lantis, a 24 hour insulin, and Novo Rapid, which is the fast acting one. She told me how this would more closely mimic the natural production of insulin in the body. My Doc came in then, and just looked at the dosage I was taking of the mixtard, and figured out my dosages. I also got a load of pens, a new blood meter, etc etc so I was delighted with that.

The rest of the day was really just hanging out and watching tv, getting my bloods checked regularly, and there was a huge improvement, even tho the actual amount of insulin I was taking was reduced by about a third. The next morning, it was very strange to get up and not take insulin straight away, as I'd been used to doing, with the new stuff, I'd wait till I was eating. This is a great advantage to me, as I can't always eat at the same time every day - and no hypos! also, it felt great to wake up with a b.g. <10

As the week went on, I learned about the insulin sensitivity factor, where you can calculate the amount to insulin you have to take to reduce your b.g by one, and the carbohydrate scale, so you learn how much to take for every 10g of carbs you are going to eat. It means that the insulin you take is pro-active, rather than reactive, which is what the sliding scale system is. I'm still on the sliding scale at the mo, but learning more about the predicitive method, and hope to be starting that soon.

It was a brilliant week, I feel great about things, although I'm a realist and I know in a couple of weeks I won't feel so enthusiastic! I just want to start getting into good habits again, I feel like the problem has been broken down in to smaller, more easily managed pieces.

SeaSide

tbh wrote:

He said that the best thing would be for me to go back into hospital for five days to get re-educated and try some new insulins. I went in to St. Michael's private last Monday, and came out yesterday

Oh Man you L33ts got it sooooo good. Us n00bs only get fifteen minutes in a dark room with maybe some foot tickling thrown in if we're lucky. ;-)

Good to hear your back on the straight and narrow

nesf

tbh wrote:

It was a brilliant week, I feel great about things, although I'm a realist and I know in a couple of weeks I won't feel so enthusiastic! I just want to start getting into good habits again, I feel like the problem has been broken down in to smaller, more easily managed pieces.

That sounds like a very constructive way to spend five days.

mike65

Sounds like cushy way to spend five days! Well done tbh, any reason why Lantus was choosen rather than Levemir or was that not discussed?

Mike.

europerson

mike65 wrote:

any reason why Lantus was choosen rather than Levemir or was that not discussed?

I've been on a four-a-day basal-bolus system since last Friday, and I've been given Lantus too. It's not going so well so far: my blood sugars are a bit all over the place, but it will take a couple of weeks for me to get used to the effects of certain amounts of Lantus and NovoRapid.

tbh

europerson wrote:

I've been on a four-a-day basal-bolus system since last Friday, and I've been given Lantus too. It's not going so well so far: my blood sugars are a bit all over the place, but it will take a couple of weeks for me to get used to the effects of certain amounts of Lantus and NovoRapid.

me too! I was a bit freaked out yesterday, they seem to be going up and down seemingly at random. I have to ring today anyway, so I'll discuss it then. They did say it would take a while to settle down, but my bloods were good as gold last week - when I was eating hospital food, of course

Mike, the nurse said that my doc has a preference for lantis because it's better at lasting the 24h hours (or something along those lines, I can't remember exactly)

BC

I'm on lantus & novorapid too.

Lantus is officially a 24hr insulin although I find it actually lasts about 20-21 hours. My doc says levemir while its billed as a 24 hour insulin is more like a 16-20 hour one.

mike65

Intersting, I'm on Levemir. when I made the switch from Insulutard my reading went mad for about 2 weeks before I got to grips with it.

Mike.

tbh

Glad it's not just me - bloods are still quite high, but one thing I've noticed is that it's a high baseline - that is, if they are 12 before dinner, they go to 17 after, and then back to 12. So I need to get them back down and keep them down - seem to be creeping back now. This diabetes eh? And people think it's all glamour

DrIndy

tbh wrote:

Glad it's not just me - bloods are still quite high, but one thing I've noticed is that it's a high baseline - that is, if they are 12 before dinner, they go to 17 after, and then back to 12. So I need to get them back down and keep them down - seem to be creeping back now. This diabetes eh? And people think it's all glamour

you may need more basal insulin, call your Diabetic CNS. how are the morning fasting sugars?

tbh

thanks for the advice guys. I rang the diabetic center at St. Michaels and gave them the story, so my basal has been increased to 26 and my sliding scale for the n/r by one - seems to be doing the trick a bit better. Morning bloods were 7.7 this morning, so it seems to be doing the trick, I'll just have to keep an eye on things. I must say tho, it's great to have the team to fall back on for advice, when I was out in the wilderness, I probably just would have ignored it and hoped it worked out, but it's good to be able to ring and question.