[Diabetes] General Chat and Support Thread

Kremin

Hey all,

Firstly some positive news, I seen today that Libre 2 is now an option to self fund and get funded from the hse! Anyone have experience with using the l2 and how it compares to Dexcom? I used the Libre 1 for a few months before I got prescribed the G7. I’d love to try the Libre 2 and potentially swap over if it worked well but they won’t even let me have a trial sensor because I used Libre 1 previously.

secondly, kind of looking for advice and/or experiences. All consultants I currently see are part of the public system. My gastro related issues are continuing to worsen and worsen which is severely impacting my personal life. I had to fight so hard just to get my appointment moved up a few weeks and the consultant barely even looked at me for more than a glance. I’m considering, if possible, asking my gp to refer me to a private consultant. I have never gone through this before, is it possible to be referred privately for one thing but also remain under the other various consultants I see in the public system? Is it worth it? I do understand the healthcare situation is under immense pressure and these clinics are always booked up for months and months but unfortunately I don’t think I can keep living and waiting 7-9 months at a time just to be dismissed by this guy again

banie01

https://www.boards.ie/discussion/comment/121472529#Comment_121472529

Hi Kremln,

On the Libre 2 option, I was in with my Endo yesterday and he said he prefers the Libre 2 to the Dexcom G7 on basis of both cost (if self funding) and the format of the reports. The 14 day sensor life of Libre 2 Vs the 10 day life of Dexcom was also something he preferred.

That said, I'm on Dexcom G7 and I'm quite happy with it now. The 1st 3 months I was using it, I had 40%+ rate of failure on the sensors. Dexcom did replace every faulty one but, I did fear the whole system was flawed in my 1st 3 months or so of usage.

On a different note. How are the insulin dependent among us getting on? I usually adjust my basal at night to try and keep Lantus need to a minimum and offset the risk of insulin related weight gain. After going over my reports yesterday, my Endo recommended a more than 10% jump in my basal.

Fully appreciate that he wants to tighten up my HbA1C, that said yesterday's was a 56 and that's better than I expected after an awful few months. I am stuck between a rock and a hard place on the insulin Vs activity issue. Ongoing pain issue mean any exercise is very restricted. My fear is that upping basal will lead to a spiral of upping basals and further weight gain.

Any tips on mitigating that? Will be very appreciated.

To all on this corner of boards. Merry Christmas and happy new year! May 2024 bring us all better control & happier Endo s😁

gary29428

Hi Folks

My 14yr old son was recently diagnosed with Type1. We are getting on top of everything now and he's doing good. He is a super keen rugby player and is mad to get back training and playing.....looking for advice on pre game/training insulin injection....have read how parents give maybe half the shot required, but what if I do that in anticipation of him playing the whole game but he comes off with a knock after 5mins....would imagine his level would spike.

Any advise is greatly appreciated, how others handle there kids sports and type 1.

Thanks

CramCycle

https://www.boards.ie/discussion/comment/121521520#Comment_121521520

Are you in a financial position you could take up less painful exercise like a spinning bike (I'm a cyclist, all I could think of, I am sure there are others). As for the basal fear, I know that concern. It's hard to give advice as everyone is different. If you can keep your bloods in range without it, then I wouldn't but if your just bolusing alot, then you are just codding yourself. This said, diet and exercise can take a big sting out of it if you can find a way around the pain issues.

CramCycle

https://www.boards.ie/discussion/comment/121543021#Comment_121543021

It won't spike, it will rise and you can correct afterwards. Be careful of correcting to quickly as bloods can spike temporarily with sudden, intense, bursts of exercise. It will be a learning curve but as he is young, don't try to get it perfect for the first while. Better to run a little high and learn what works than have a hypo.

banie01

https://www.boards.ie/discussion/comment/121551571#Comment_121551571

Thanks for the reply. I'm lucky enough to have access to a rowing machine and some other gear at home that I can use without too much pain. The nature of the pain issue rules out any cycling, even though I have a fairly decent mountain bike. Fully agree with you that additional bolusing is just kidding myself. I have another referral sent off to a neuro-urology specialist and hopefully something good will come of that.

CramCycle

https://www.boards.ie/discussion/comment/121551847#Comment_121551847

Preaching to the converted I am sure but if your aim is simply keepng your BG in check, then as much low intensity exercise as you can manage. Increases insulin sensitivity and basically ignore athlete training advice, don't feed to train or achieve muscle growth, just only want you need to get by. Try and wrap up any exercise before you get any hunger urges or bonk, thats about it. Not much else you can do. Easier said than done with persistant pain issues, but not sure there is much else to say until you get more help with that.

BlackEdelweiss

Can someone refresh my memory please. When counting carbs do I use the total carb figure or the sugars only component?

banie01

https://www.boards.ie/discussion/comment/121603069#Comment_121603069

AFAICR, at my last nutrition course emphasised that it's total carbs, not just "of which sugars".

Rulmeq

Hey guys, looking for some advice here, My HbA1c has been rising for past several months (no dietary changes, and I've increased my exercise levels considerably), to the point where my endocrinologist prescribed Semaglutide (Ozempic). I went to my usual pharmacy and they told me the only get a small allocation, and that they can't fill it for me. So I guess my question is what do I do? Should I try and find a pharmacy that does have it (not sure how I would even go about that, and I'm going to assume that since there's a global shortage, there's not going to be anyone with it). Has anyone else experienced this? Should I just go onto insulin instead, or is there some sort of a waiting list I can go on (how do I get on it)?

ohnonotgmail

try every pharmacy close to you. just phone them all. if you find one that has it ask your regular pharmacy to send it to them. there still is something of a shortage but not as bad as it was last year. i've been on it for 18 months. it has been a difficult 18 months. I wont lie. the first 12 were the worst. it has eased off since then but i still get days where the nausea is such that I cant really eat. on the plus side i am 30Kg lighter and wearing the same clothes size as i was 30 years ago.

Rulmeq

https://www.boards.ie/discussion/comment/121756848#Comment_121756848

Thank you, I will try this. Fair play to you on the weight too!

Donutz

Anybody on here taking levemir? Just heard its being discontinued.

leche solara

https://www.boards.ie/discussion/comment/121975612#Comment_121975612

only in the U.S. for now

jimmyrusseII

hi all,

have some concerns that I might be diabetic, I have the following symptoms

Constant Thirst even though I drink a lot of water (2 -3 litres per day on average)

Waking up with numbness in hands

Waking up with extremely dry mouth

Heart palpitations

Profuse sweating

These symptoms are all exacerbated when I eat too much sugar.

No, I went to my GP with those concerns and he immediately dismissed them as I am not overweight and I go to the gym regularly, I took a urine and blood test and both came back negative, but I still have the same symptoms. In anyone's experience can a diabetes diagnosis be missed by those tests?

CramCycle

https://www.boards.ie/discussion/comment/122011387#Comment_122011387

What urine/blood tests? A BG tester from your pharmacy and do fingerprick tests will give you a good indication but even if it's not diabetes, it's not nothing and needs investigation.

ohnonotgmail

https://www.boards.ie/discussion/comment/122015733#Comment_122015733

A finger prick or urine test (I presume they mean a dipstick type test) don't tell you very much on their own. You need a hba1c test. When I first went to my gp she did the dipstick test and told me I didn't have diabetes. She took some blood for a hba1c and that confirmed I did.

CramCycle

https://www.boards.ie/discussion/comment/122017654#Comment_122017654

A glucose tolerance test will give you quite a good idea actually, very simple, overnight fast. Take a test, then take a test every 15 minutes for about 4 hours. Drink a large cup of orange juice or sugary soda at 30 minutes, look at the spike and return to base time.

This aside, with those symptoms, definely worth getting a full work up regardless, hence why I asked what blood/urine tests were done. Was it a dipstick and finger prick (as you said, singularly will tell you nothing) or was it a full vial taken and a HbA1c done, antibody, C peptide etc, as well as urines sent away for metabolites, glucose, protein and more.

banie01

A little PSA for any of the folks here taking any SGLT-2 inhibitors, the likes of Jardiance, Farxiga and other drugs. If you are awaiting elective or planned surgery?

1st be sure to flag it to your operating consultant, as you will need to stop taking them pre-op. There is a significantly increased risk of DKA (still small but statistically relevant)

I had a surgery cancelled on Monday as despite providing my list of meds at a consult and again on the morning of the op, the risk wasn't spotted until the Anaesthetist was reviewing my file.

Delighted to know that the cross checking and verification worked. I was on the trolley in pre-op when it was spotted and the surgery cancelled. Frustrating of course, but far better to be safe than sorry.

https://medtruth.com/articles/fda-regulation/fda-sglt-2-inhibitors-ketoacidosis-after-surgery/

In the announcement, the FDA tells patients taking SGLT-2 inhibitors canagliflozin, dapagliflozin, and empagliflozin to discontinue the medication for 72 hours prior to the scheduled surgery. For patients taking the SGLT-2 inhibitor ertugliflozin, patients should cease taking it 96 hours prior to their scheduled surgery. For all of these medications, the FDA recommends resuming treatment of type 2 diabetes with the medication as soon as the risk factors for ketoacidosis have dissipated.

Patients are advised to never stop taking a medication without consulting with a medical professional to discuss potential repercussions.

ohnonotgmail

https://www.boards.ie/discussion/comment/122030968#Comment_122030968

this must be a new thing. i had surgery 4 or 5 years ago and this was never mentioned.

banie01

https://www.boards.ie/discussion/comment/122031155#Comment_122031155

Since 2020 in the US and not long after in the EU. The Anaesthetist said there was a case in the recent past of a patient in Tallaght unfortunately passing away with SGLT-2 medication identified as a contributing factor.

The evidence is still under review but the current practice is to stop SGLT-2 for 3 full days pre-op.

Some more reading here.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987984/

https://pharmaceutical-journal.com/article/ld/perioperative-management-of-type-2-diabetes-mellitus

Donutz

I'm under the care of the diabetes team from UL hospital group and they don't provide insulin pumps to adult type 1 diabetics. I have considered getting referred to Cork or Galway by my GP just so I can get a pump.

Does anybody know if this is actually possible to do?

Ezeoul

https://www.boards.ie/discussion/comment/122030968#Comment_122030968

Thanks for this. I'm having surgery soon, as I started on Jardiance in February so will mention it at my next appointment.

banie01

Sometimes the triggers that can spike BG should be blatantly obvious, and yet? One can labour on oblivious to it.

A case in point. My having a BG spike and slow decline in the mornings. I tend to wake high in the mornings anyway but over the past week I noticed that I wasn't getting the continued rise and slow drop that I'm used to. I had somehow stumbled into having a decent BG that plateaud and responded nearly normally.

I spent a little while wondering what had changed before I walked into the kitchen and the "obvious" slapped me silly 🤦‍♀️

I have a bean 2 cup coffee machine that was out of service for a week or so whilst I serviced it as I was waiting on a part.

Anyway it occurred tome that the improvement in my BG corresponded with the machine being out of order. I was still drinking coffee, so I knew caffeine wasn't the trigger.

Then it dawned on me. My usual morning coffee(s) were 2 big lattes made with lots of milk and 2 shots of coffee. It was the milk, I completely forgot to take the bloody milk into account!

Anyway, from now on, it's big Americanos with lattes reserved for treats and weekends 👍