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Medical Forum / Diseases and Disorders / Diabetes / September 2006

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Very rough day

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Cloudedbrains" <donna_williamson"@ - 27 Sep 2006 19:13 GMT
Been to urgent appt with a gp as sugars are sky high, feel sick, was sick,
sweaty, general weakness

I did call lead DSN and she sent me to the gp's but the Dr was useless

Ive called NHS direct for advice - they say call lead DSN in morning

Tested my machines ad didnt belive it but they are fine even tested mums
blood (shes not diabetic and it read 4.9)

My sugars have been around 20 all day then shot upto 30 someat then I
started throwing up and they are still over 30

Asked GP about starting the insulin now at first he said yes then no SO has
anyone got any advice
Wooly - 27 Sep 2006 19:38 GMT
>My sugars have been around 20 all day then shot upto 30 someat then I
>started throwing up and they are still over 30
>
>Asked GP about starting the insulin now at first he said yes then no SO has
>anyone got any advice

Take yourself to emergency.

+++++++++++++

Reply to the list as I do not publish an email address to USENET.
This practice has cut my spam by more than 95%.  
Of course, I did have to abandon a perfectly good email account...
Alice Faber - 27 Sep 2006 19:51 GMT
> Been to urgent appt with a gp as sugars are sky high, feel sick, was sick,
> sweaty, general weakness
[quoted text clipped - 11 lines]
> Asked GP about starting the insulin now at first he said yes then no SO has
> anyone got any advice

Go to the Emergency Room. Seriously. Do it right now.

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"and the snark alert level has reached "fuschia""
                  ---zig zigalo homes in on the meat of the matter

Cloudedbrains" <donna_williamson"@ - 27 Sep 2006 21:10 GMT
I took more anti-sickness pills which seems to have helped a little reading
is
down to a 9pm reading 19.3mmol !
I think now I stopped being sick has helped defo !
Ozgirl - 28 Sep 2006 00:44 GMT
> I took more anti-sickness pills which seems to have helped a little
> reading is
> down to a 9pm reading 19.3mmol !
> I think now I stopped being sick has helped defo !

Buy some keto sticks and test for ketones in your urine. But
really, you should have gone to emergency. Read up on DKA -
diabetic ketoacidosis.
Alan S - 28 Sep 2006 01:10 GMT
>I took more anti-sickness pills which seems to have helped a little reading
>is
>down to a 9pm reading 19.3mmol !
>I think now I stopped being sick has helped defo !

19.3 = 348mg/dl

Is it possible to get your medical advisors to bring forward
your insulin commencement?

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
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Everything in Moderation - Except Laughter.

oldal4865 - 28 Sep 2006 01:35 GMT
Cloudedbrains > wrote in message ...
>Been to urgent appt with a gp as sugars are sky high, feel sick, was sick,
>sweaty, general weakness
[quoted text clipped - 11 lines]
>Asked GP about starting the insulin now at first he said yes then no SO has
>anyone got any advice

   This is what we would call a "Twilight Zone" post in the U.S.

You need insulin injections immediately.   If your doc or DSN won't service
you,  then you need to go to the Emergency Room.

You should not be alone during this time;  ie.  you should be attended by a
responsible,  capable adult.

Regards
 Old Al
Andrew B. Chung, MD/PhD - 28 Sep 2006 01:50 GMT
Cloudedbrains wrote:
> Been to urgent appt with a gp as sugars are sky high, feel sick, was sick,
> sweaty, general weakness
[quoted text clipped - 11 lines]
> Asked GP about starting the insulin now at first he said yes then no SO has
> anyone got any advice

It would be wise for you to call for an ambulance to take you to the
nearest emergency room.

In the interim, drink as many glasses of water as you can tolerate
because it is likely your throwing up has made your dehydration worse.

May GOD keep your heart beating, dear neighbor whom I love
unconditionally.

Prayerfully in Christ's amazing love,

Andrew <><
--
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/HolySpirit

As for knowing who are the very elect, these you will know by the
unconditional love they have for everyone including their enemies
(Matthew 5:44-45, 1 Corinthians 13:3, James 2:14-17).

http://groups.google.com/group/sci.med.cardiology/msg/a77da2d26da0ab97?
Cloudedbrains" <donna_williamson"@ - 28 Sep 2006 08:07 GMT
Thanks everyone!
I did try to get the GP to start the insulin yesterday - I got the stuff but
getting permission to start early didnt happen!

Fasting bg is 17.3mmol this mrning!

I feel like a trains run me over as well!

Im gonna try to get hold of the lead DSN today!
Alan S - 28 Sep 2006 08:48 GMT
>Thanks everyone!
>I did try to get the GP to start the insulin yesterday - I got the stuff but
[quoted text clipped - 5 lines]
>
>Im gonna try to get hold of the lead DSN today!

17.3 = 312mg/dl

I'm a little puzzled.

I believe you mentioned you received the full training.
What do you need "permission" for?

I can't offer help - but there are lots of insulin users
here who could assist for the first time.

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Signature

Everything in Moderation - Except Laughter.

Cloudedbrains" <donna_williamson"@ - 28 Sep 2006 09:58 GMT
Alan Ive been shown how to do it but my start date is next Tues as
nurse wanted me to do first one with her!

Have spoke to Lifescan and meter is ok and am now waiting for DSN to call
back!

> 17.3 = 312mg/dl
>
[quoted text clipped - 8 lines]
> Cheers, Alan, T2, Australia.
> d&e, metformin 1000mg, ezetrol 10mg
Alan S - 28 Sep 2006 10:15 GMT
>Alan Ive been shown how to do it but my start date is next Tues as
>nurse wanted me to do first one with her!
>
>Have spoke to Lifescan and meter is ok and am now waiting for DSN to call
>back!

Best wishes. I understand your trepidation - but I'm afraid
I can't help remembering that Tuesday is another four days
of fastings over 15(270) and post-prandials nearly double
that.

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
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Everything in Moderation - Except Laughter.

Cloudedbrains" <donna_williamson"@ - 28 Sep 2006 11:27 GMT
Nurse has called!

Shes altered how I take my Glucophage (met s/r)!

Got to take 2 in a morning and one with late meal!

She thinks I havent lined my stomach enough with the 3rd metformin s/r!
oldal4865 - 28 Sep 2006 12:14 GMT
Cloudedbrains > wrote in message ...
>Nurse has called!
>
[quoted text clipped - 3 lines]
>
>She thinks I havent lined my stomach enough with the 3rd metformin s/r!

   This thread is becoming more and more uncomfortable.     The hypothesis
that manipulating the conditions under which one takes a 3rd metformin pill
will have an effect on sustained bG in the 20 - 30 range is mind-boggling.

If any of the DSN that I deal with had received your call,  they would have
scheduled that first shot immediately and might even have offered to come to
your residence to help.

My insulin training:    The nurse discussed how to fill the syringe,  how to
hold the syringe,  how to pinch the fat,  etc.   Then she gave herself an
injection of salt water to show how it was done.     Then she gave me a
prescription and sent me on my merry way to buy some and try it out for
myself. . . .at home. . . .alone.

Regards
 Old Al
Alan S - 28 Sep 2006 13:15 GMT
>    This thread is becoming more and more uncomfortable.

Me too Al. Thanks for chiming in. I have no expertise in
insulin use whatever - but her numbers have been way too
high for way too long.

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Signature

Everything in Moderation - Except Laughter.

Priscilla H. Ballou - 28 Sep 2006 16:47 GMT
>     This thread is becoming more and more uncomfortable.     The hypothesis
> that manipulating the conditions under which one takes a 3rd metformin pill
> will have an effect on sustained bG in the 20 - 30 range is mind-boggling.

Amen.  Something's wrong somewhere.

Priscilla
Trinkwasser - 28 Sep 2006 19:35 GMT
>Cloudedbrains > wrote in message ...
>>Nurse has called!
[quoted text clipped - 8 lines]
>that manipulating the conditions under which one takes a 3rd metformin pill
>will have an effect on sustained bG in the 20 - 30 range is mind-boggling.

Welcome to the NHS, where saving money is more important than saving
patients

(they're not all like that, just enough of them)
Laura@notmy.com - 28 Sep 2006 12:04 GMT
>Thanks everyone!
>I did try to get the GP to start the insulin yesterday - I got the stuff but
[quoted text clipped - 5 lines]
>
>Im gonna try to get hold of the lead DSN today!

Hi Donna.  I feel very worried for you.  I hope they get you the help
you need very soon.  I seem to remember that there are issues with
steroids complicating things.  Has your doc done the necessary tests
(help me out here LADA's) to make sure this isn't really T1?

Whatever is going on, I hope you feel better very soon.

Laura
rk - 28 Sep 2006 15:34 GMT
she's on very heavy doses of steriods and steriods WILL
cause her to go that high and remain that high until she
gets the right type of insulin an it certainly isn't Lantus.

Signature

Reisa, T1, Animas IR1250 Pumper
DX-5/00 ASD-7/00
A1C: 6.2% (8/24/06)
Daily CHO: 150-200gm
TDD: 34-38u

:
: >Thanks everyone!
[quoted text clipped - 15 lines]
:
: Laura
Jacqueline - 28 Sep 2006 17:04 GMT
Well, I was not given any instructions at all, of course I am a
medical technologist but we don't give shots we just run tests and
draw blood.  I came home and had to look up on the net where I could
inject.  Now the syringe and such gave me no problem I knew that but
injection sites I had no idea where they were.

I guess I would go on and start the medication, this is not advice it
is just what I would do, I am not a doctor, then on Tuesday I would
walk into that office and give my "First" shot in front of the nurse"
of course she doesn't have to know it isn't your first shot.

Just about the only time I have to take a fast acting insulin is when
I have to take steriods, like this summer when I had pneumonia. Thanks
to some people here and many on #Diabetic-Talk on Undernet I have
gotten my bg under control, well it is a little out right now but I am
quitting smoking and seem to be eating more.  Of course I went to the
doctor yesterday and he said it was great.  I just looked at him and
said great for you, too high  for me.  I maintain on Lantus alone most
of the time, no pills, no sliding scale insulin or anything and I have
very good numbers, unless I am quiting smoking or taking steriods and
or sick with something that doesn't require steriods.  

Jacqueline

>she's on very heavy doses of steriods and steriods WILL
>cause her to go that high and remain that high until she
>gets the right type of insulin an it certainly isn't Lantus.
Trinkwasser - 28 Sep 2006 19:33 GMT
>Thanks everyone!
>I did try to get the GP to start the insulin yesterday - I got the stuff but
[quoted text clipped - 5 lines]
>
>Im gonna try to get hold of the lead DSN today!

Sue the stupid bastard later, GO TO CASUALTY NOW

hvae you gone yet?
Nicky - 28 Sep 2006 13:08 GMT
> My sugars have been around 20 all day then shot upto 30 someat then I
> started throwing up and they are still over 30
>
> Asked GP about starting the insulin now at first he said yes then no SO
> has anyone got any advice

Donna,

This is going to be too late to be of use - but I was told by my GP that
anything over 30 should be taken to A&E. I really hope you're on the insulin
by now!!

Nicky.

Signature

A1c 10.5/5.3/<6  T2 DX 05/2004
No Metformin, 100ug Thyroxine
95/72/72Kg

Cloudedbrains" <donna_williamson"@ - 28 Sep 2006 19:08 GMT
The DSN alter the way I take the pills as she thinks its that making me sick
not the sugars!
I didnt want to argue as I know nought about Diabetes!

Can I ask one thing though!
When I go onto the lantus Tues should I be asking for a basal/bolus regime
is it called?
As I get the feeling I need a short acting for some circumstances!
rk - 28 Sep 2006 19:58 GMT
YES! Let me explain something to you.. You tell me if this is going to work
or not. Lantus is a LONG acting insulin, what it does is it is time
released..
This is why it did not work at all for me, even being a T1. Here's why...

I'll use my dose as example. I took 18u a night. It takes 2hrs for Lantus to
start to work. Taking 18u a night divided over 24hrs which is how long it is
supposed to stay in your system and work. That would be 18 / 24 = .75 --
This means I was getting .75u per hour of insulin from Lantus, which wasn't
what I was needing. Here is my current Basal rate via my pump.

12:00am - .525u
04:00am - 1.10u
08:30am - 0.70u
09:00am - 0.75u
09:00pm - 0.70u
total = 18.50u
fasting bg averages - 95-115mg

Now, granted I could now use a syringe that has .5u markers and take the
18.50u but, there is absolutely no way to control those varing ranges that I
get by pumping rather than taking by syringe.

Those are VERY small amounts that I need, I know Kurt even takes LESS then
I do.

You will definately need probably close to double if not triple the amount
of Lantus
that I needed. What are you going to do when you eat? Lantus isn't used to
cover
food that we eat, this is what a bolus insulin is, using Novolog (Novorapid)
or Humalog.
some still use Regular (but it isn't as fast acting) --- Even if you used
50u per day that
breaks down to 2.08u per hour which definately isn't enough for someone on
steriods
and eating food. Even if you went to extreme low carb.  Being a T1 I can eat
up to 10gm
of food without having to inject insulin because it's low enough that my
basal is enough
to cover as well as just my metabolism, etc. But for a T2, it's much
different. Most times
a T2 cannot eat more then 5gm and it will make an impact on their glucose,
being on
steriods, you probably won't get more then 2gm before it will make an
impact. This is why
testing like a mad fool with insulin and food with your meter to learn WHAT
your body can
react too.. Granted doctors tell you that you don't need to.. but yes, I
think we need to --
this gives us a great grasp on what and where we can go with what we do with
reguards
to what we eat and such.

I definately think that you should DEMAND that you get a bolus insulin, and
NOT accept them
telling you that you don't need one. I can tell you, that I have gone close
to 5yrs running at
200mg and over on a constant rate.. I still to this date have no
complications, but, I'm a T1,
I've also NOT had several years prior running high without knowing it for it
to allow damage
to begin.

You really need to understand that YOU are ONLY SLOWLY KILLING yourself..
You need then to
make your doctors and nurses understand this and if they aren't willing to
help you, say "PHUCK OFF!"
Learn what you need to do either by asking here, reading a book, going to
support groups, find another
doctor and damnit DO IT! If that means buying your own insulin and learning
how to use a damn syringe
and inject insulin the old fashion way.. but at least you're going to
live!!!!

sorry to get huffy, but phuck, this really has gone on long enough and yes I
understand you are new to this
I understand that you think you need to listen to your doctor and follow
their every word, but let me tell you
as someone who was phucked around and misdiagnosed, your damn doctors and
stupid nurse are REALLY
WRONG!!!

I wish you all the best.. and hope you quickly wake up to save your life,
otherwise, we'll be reading about you
passing on !!!!

Good luck.. just ask, we'll be happy to help you get started on your own..
if anytime this group would need to
"play" doctor, this definately would be the time.

Signature

Reisa, T1, Animas IR1250 Pumper
DX-5/00 ASD-7/00
A1C: 6.2% (8/24/06)
Daily CHO: 150-200gm
TDD: 34-38u

: The DSN alter the way I take the pills as she thinks its that making me sick
: not the sugars!
[quoted text clipped - 4 lines]
: is it called?
: As I get the feeling I need a short acting for some circumstances!
Cloudedbrains" <donna_williamson"@ - 28 Sep 2006 20:18 GMT
Reisa
Your post is extremely helpfull!

With my brittle asthma I dont accept anything I question it to hell and
back - because if I quit breathing (all to frequent) it could be fatal!

I guess Diabetes needs to be treated the same way - as life
limiting/threatening!

One thing that really upset me with the Dr yesterday is if it had been my
asthma he would have listened to me but he showed NO respect for me or bad I
felt or looked!

I have found out today from some research that stress cab raise bg readings
WELL what does all the messing around do - STRESS's me out maor!

Im still getting my head round it all!

But if anyone can help me come up with a plan of action or list for the DSN
on Tues I would appreciate it!

Thanks everyone.
Donna
Nicky - 28 Sep 2006 20:53 GMT
> But if anyone can help me come up with a plan of action or list for the
> DSN on Tues I would appreciate it!

Start injecting TONIGHT. Tell the nurse how it's going on Tuesday.

Nicky.

Signature

A1c 10.5/5.3/<6  T2 DX 05/2004
No Metformin, 100ug Thyroxine
95/72/72Kg

rk - 28 Sep 2006 21:13 GMT
: Reisa
: Your post is extremely helpfull!
[quoted text clipped - 19 lines]
: Thanks everyone.
: Donna

Hi Donna,

I'm glad to hear it was helpful, that's all I would try is to help.  Believe
me, I've
been in very simular shoes and felt beyond like sh.t like you do now and
it's NO
way to live.

I'm with Nicky, screw what the nurses at DSN say, start the Lantus
tonight!!!!
to help you get it in your system and work a bit better, I would suggest
(remember
I'm not a doctor just a dumb ol diabetic myself) but split the dose... Start
with a
full dose tonight, then tomorow morning say at 7am take half of what they
told you
to take then again at 7pm take the other half, that way in a sense you have
stacked
the Lantus and you'll get a bit more "bang for your buck" per say.

I would also suggest, if you have the ability... to purchase at your local
drug store,
regular syringes and Regular Insulin (iirc it's Insultard) hmm that might be
NPH, but
hell, it's better at this point because its faster acting then the lantus
is.. and thats what
you need. But to be able to buy it without a prescription. I know folks can
buy NPH and R
over the counter here at Walmart for like $18 a vial..

You honestly need to do something NOW! I'm so sorry that their treating you
this way.. I
know how frustrating it can get. But sometimes you need to take the bull by
the horn and
just do it yourself.. Then come back and say, "well sh.t SOMEONE had to do
something!!"

You are 110% correct that stress will ONLY raise your glucose even further.
Stress will bring
on depression also (well minor) but, coupled with HIGH glucose, depression
is a given at that
point and the stress only makes it worse.. Also, if you're having issues
with your asthma, then
the high glucose will ONLY make it worse.. I know for me, with my back
issues, that if my glucose
ran over 300 at any given point, I felt the pain in triple fold... which
that is my motivator to keep
my glucose with in range the best that I can.

Also, when we have other health issues, it's a bear to keep our glucose in
range.. sadly not all
doctors care to think this is true.. Thinking we're just bullshitting it..
when we honestly aren't.. hell
we know when we fell like sh.t. Nicky and Julie Bove can tell you that when
your thyroid is outta
whack, you have a hell of a time controlling your glucose.. It's the same
thing..

I know you don't wanna do anything without first consulting your doctor..
But think of it this way..
If your doctor told you running around the block would help you breath
easier, but you knew different
would you do it? Or would you say screw you!!! and do what you knew to be
right?

I know you're new to diabetes, but read these threads you have going.. How
many of us are saying,
"Oh your 25mmol + glucose is okay, you can wait to start your lantus.. don't
worry about it" =--- Not
a ONE of us are.. some are still very new.. then there are a few of us that
have been at it for quite
some time.. I'm only 6yrs into this.. But I had to go through a misdiagnosis
and being on oral meds for
7months, while I ran over 40mmol (450mg) all the time, then I was given an
Insulin mix that didn't do
squat for me, then I was given the NPH/R that semi helped... then Lantus and
Novolog, and until I got
to the right endo.. who ran the correct tests on me and agreed that pumping
is what I needed to do..
is when I finally got correct treatment. I had no way to get a pump
otherwise, but to fight tooth and nail
to get to a doctor... took me close to 2yrs to make that happen, going to
various other doctors trying to
get the right referals.. and when one didn't work, it was back to the
drawing board..

Please, let us know what YOU want to do.. 'we're all here to help with
whatever we can do.

As for a list.. You need to write out to your doctor.. well this is what I
would do.

Get your fasting glucose. write it down, eat, write down what you eat how
many carbs etc.. I would also
for these purposes go as LOW of carb as you can, just so you can show how
the steriods effect you even
with eating little to no carbs. then, I would get the insulin, take it and
then continue to do the same, write
down the effect it has on you with when it lowers you and such.. and then
explain to the doctor, (which I
can tell you it will not lower you at mealtime) that it isn't working for
mealtime and that you need food to
survive.. blah blah.. and that you need a bolus insulin for this reason..
and just make a full lined diary of
everything that is happening.. as well as when you take your other meds and
the reaction your glucose
has on that as well..

Good luck.
 
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