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[Diabetes] General Chat and Support Thread

tbh

Hey guys - I've created a single "chat" thread for all the diabetics for any topics of conversation that don't fit in the existing threads.

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Snake Plisken

Alanstrainor wrote: »

The article states that the pump was functioning correctly, and that there was a self administered 68 units of insulin. My pump is configured to only allow a max single bolus of 10 units. This was the default value, it is however possible to increase this to 75units. I would wonder if she attempted a set change while intoxicated and primed the pump while attached?

That being said, the article is clearly off when it states that paramedics gave insulin when they arrived. It also strikes me as strange that her husband didn't know how to react to this scenario, a shot of glucagon was called for, but even still it might have been too late.

I wouldn't let this article put anyone off a pump, it's obviously a tragedy, but it sounds like alcohol coupled with user error caused this.

It would kind of Putnyou off the pump, I think I will stick to administering my own insulin.
Some things don’t add up and it would be good to see a better report but did her husband not try and test her bloods?
Did the paramedics give her a shot of insulin? Did they check her blood sugars on arrival?
If drinking alcohol would you be better off removing the pump and manually administering insulin?

Buford T. Justice XIX

CramCycle wrote: »

When I was a student many moons ago, another student died (in a different college), without much publicity. Diabetic, night out. Found a few days later. Best guess is massive hypoglycaemia. While I was not directly involved or knowledgable (I knew a guy in his class), two scenarios played out in my head from people who knew him. He left early, rake of pints, wanted a chipper on the way home. Took a shot of insulin on the way and the chipper was closed when he got there. Walked back, fell asleep, never woke up. The other option was his bloods appeared high when drinking and he took a corrective dose that was not necessary.

It is the one benefit of a pump or those devices that let you know how much you injected recently. My pump has stopped me double dosing plenty of times when I am busy. I wouldn't have double dosed with a pen because it would not have been on me in work but having a machine that I look down at over coffee, that says, hey you, you took a few units 45 minutes ago, no need to correct that slightly elevated sugar, just ride it out, is brilliant for me.

Yeah, the records are brilliant. I'm pretty flat out this week and next and sometimes, being tired, don't remember if I took a bolus or not. And working alone wouldn't be the best situation for getting an unexpected hypo either.

I couldn't recommend a pump enough to any one if they have the option. It really has made my life so much simpler since I got one.

CramCycle

When I was a student many moons ago, another student died (in a different college), without much publicity. Diabetic, night out. Found a few days later. Best guess is massive hypoglycaemia. While I was not directly involved or knowledgable (I knew a guy in his class), two scenarios played out in my head from people who knew him. He left early, rake of pints, wanted a chipper on the way home. Took a shot of insulin on the way and the chipper was closed when he got there. Walked back, fell asleep, never woke up. The other option was his bloods appeared high when drinking and he took a corrective dose that was not necessary.

It is the one benefit of a pump or those devices that let you know how much you injected recently. My pump has stopped me double dosing plenty of times when I am busy. I wouldn't have double dosed with a pen because it would not have been on me in work but having a machine that I look down at over coffee, that says, hey you, you took a few units 45 minutes ago, no need to correct that slightly elevated sugar, just ride it out, is brilliant for me.

Alanstrainor

feedthegoat wrote: »

Shocking article. Would put a small doubt in you mind about pumps and was it a pump failure. Irrespective of what it was a terrible tragedy for her family.

The article states that the pump was functioning correctly, and that there was a self administered 68 units of insulin. My pump is configured to only allow a max single bolus of 10 units. This was the default value, it is however possible to increase this to 75units. I would wonder if she attempted a set change while intoxicated and primed the pump while attached?

That being said, the article is clearly off when it states that paramedics gave insulin when they arrived. It also strikes me as strange that her husband didn't know how to react to this scenario, a shot of glucagon was called for, but even still it might have been too late.

I wouldn't let this article put anyone off a pump, it's obviously a tragedy, but it sounds like alcohol coupled with user error caused this.

CramCycle

I once woke to find a nurse about to inject me with Insulin intervenously. It would have killed me, or put me in a coma. I don't think paramedics would have insulin or administer it, so I presume it is an error in the article.

feedthegoat

Shocking article. Would put a small doubt in you mind about pumps and was it a pump failure. Irrespective of what it was a terrible tragedy for her family.

C-Shore

Snake Plisken wrote: »

Wow this is scary poor lady

https://www.independent.ie/irish-news/courts/diabetic-motheroftwo-died-of-brain-injury-after-blood-sugars-dropped-to-fatal-level-36632990.html

“She was drooling and I was worried she’d gone into a diabetic coma,” he said. He called paramedics who administered insulin on arrival.

I assume the bit about administering insulin is a mistake in the report?

Really sad either way, to mistakenly take 68 units, plus the issues that alcohol can give with hypoglycemia anyway.

Snake Plisken

Wow this is scary poor lady

https://www.independent.ie/irish-news/courts/diabetic-motheroftwo-died-of-brain-injury-after-blood-sugars-dropped-to-fatal-level-36632990.html

Alanstrainor

In it's very simplest terms, an insulin pump is a device which is worn at all times day and night which constantly delivers insulin via tubing which is connected to your body via an infusion set. The infustion set is typically comprised of a small plastic canula which sits just under the skin which delivers the insulin into your body. Most infusion sets do not have a metal needle which remains under the skin, however a metal needle is used to insert/change the infusion set every 3 days or so.

The insulin pump contains one type of insulin, in my case Nova Rapid, but it will always be a quick acting insulin. The pump is programmed when you receive it to give you doses measured in Units per Hour. For example, my morning units look like this:

00:00 0.7U/H
03:00 0.725U/H
09:30 0.9 U/H

So this means between midnight and 3am my pump is constantly pumping a dose of 0.7U/H. Which means that every few minutes the device pumps a very small amount of insulin. And then as my needs change during the day the amount of insulin per hour changes.

This is one huge advantage of the pump, you can get a very minute control over your dosage. You can even use a temporary basal to change these on the fly if you are going to play sports/do exercise. You can quickly tell the pump to only deliver 50% of your dosage for a set time (1 hour for example) until your activity is complete.

Then you have your bolus insulin. Your insulin given for food and blood sugar corrections. This is pretty self explanatory, but whenever you eat carbohydrates, you input the amount of carbs you've eaten into the pump, and it uses your pre-programmed carb to insulin ration to calculate your insulin requirements. You can add in your current blood sugar too, to allow the pump to give more or less depending on what range you current sugar is in.

And to add to this, most current pumps come with a CGM (Continuous Glucose Monitor). This is an additional device which you wear (usually on your abdomen). This is a system which constantly reads your blood glucose throughout the day and can warn you about highs and lows, and in my pumps case it can automatically take action to prevent a low. The pump screen shows you a graph with all your readings for the last 24hours and it tells you the CGM's most recent reading. It is important to note that despite it's name a CGM is not actually reading blood glucose, it uses the interstitial fluid just below your skin to obtain a sugar reading which closely relates to your blood glucose.

Buford T. Justice XIX

banjobongo wrote: »

hi all
Im just curious about pumps, I know nothing about them. Im Type one and I inject my insulin every day (4 times a day) and my control seems to be pretty good. Can anybody let me know the basics of what pump is, is it for everybody with Type one or only for certain types of diabetes, the advantages and drawbacks? JUst curious to learn a bit more!
Thanks!

I was on the same regime as you, 3 fast acting insulin shots and a nighttime basal to last for 24 hours and was put on a pump 2 years ago.

It's all short acting on the pump so you will have a small basal shot of fast acting every few minutes to replace the big basal shot you were on before and a bolus shot every time you eat or have a high blood reading.

You can adjust your response to the insulin according to the time of day as well. I am still on very low basal doses during the day and fairly high in the evenings as my responses differ at different times.

You will have a patch glued onto you for 2 or 3 days before needing to change it which holds the needle in place which sometimes comes loose but I would be fairly active at work and have only lost it a few times.

banjobongo

hi all
Im just curious about pumps, I know nothing about them. Im Type one and I inject my insulin every day (4 times a day) and my control seems to be pretty good. Can anybody let me know the basics of what pump is, is it for everybody with Type one or only for certain types of diabetes, the advantages and drawbacks? JUst curious to learn a bit more!
Thanks!

Alanstrainor

CramCycle wrote: »

Let us know how you get on with the CGM on it ( I presume it is CGM). I think my upgrade is due in 6 months.

Will do. Give me a week and I'll do up a mini review and post it here with pictures, reports etc.

CramCycle

Let us know how you get on with the CGM on it ( I presume it is CGM). I think my upgrade is due in 6 months.

Alanstrainor

I got my new insulin pump yesterday. A Medtronic 640g, which I upgraded to from a 530g Veo. It's a nice bit of kit, the colour screen is a welcome addition and the extra smart guard feature seems like a good one. This feature predicts low blood sugars and suspends the pump before you go low in an attempt to prevent it. And the pump will then resume insulin delivery itself once your sugars return to a normal level.

Although this is the first time in 12 years I've had a pump that's a new shape with a new style screen, for the most part the functionality really is rather similar to what I had before. I definitely need a few days to get used to it. I was so hard wired to the vibrate motor in the last one, that this one will take a while to get used to!

graflynn

Caros wrote: »

Hi guys, I've been type 2 diabetic for the last few years and on glucophage and diamicron. My last hba1c's were 12.4 (!) in January, and my gp said she'd refer me to see an endicrinologist about going on insulin - still waiting. Blood sugar levels are all over the place, 17.2 at 9.30p.m. last night, 11.4 this a.m. I feel at this stage if I eat a lettuce leaf my bloods are going up.
I don't have medical insurance or a medical card, but I do have a long term illness card. Can anyone tell me if I go privately to see the endicrinologist would it get me in quicker?

You can sign up for a free diabetes education course called CODE through Diabetes Ireland. A lot of members in our type 2 diabetes meet up group ha e done it and they all say it was really good for figuring their diabetes management out.

ebbsy

Xofpod wrote: »

I went to my consultant today who was very happy with my HbA1C level of 56, which I had thought was too high. For T1, she's happy with anything between 53 and 57; anything under that and the risk of hypos is too high. Makes sense to me but what kind of steer are other people getting from their consultants/clinics?

My reading at the doctors was 45. He said anything up to 48 was within normal range ?

C-Shore

thehorse wrote: »

I’ve been told I’ve a small amount of macular odema in my left eye. I’m Diabetic almost 20yrs and my hba1c is 41% at last check which is in the almost non Diabetic range.
The doctors said they will discuss my issue as injecting the eye is risky and cause other problems.
My eyesight is perfect in both eyes.

Just wondering has anyone had this problem and have they got it treated ?
My belief is that odema comes and goes

Thanks a mill

Had a very similar scare back in August, so I feel your pain/fear/anxiety/sadness.

My HbA1C was 46 at the time, and since then has come down to 34, so it was quite a surprise to me, which I imagine is the same for you.

Here's my timeline, hopefully it helps you.

Noticed mid-August that my right eye was blurry in my center vision when reading, where I'd had perfect vision in both eyes until then.
Called the Mater Hospital DRT Clinic (finally separated from the emergency eye clinic) and got an appointment for the next day.
Got my OCT scan and saw the ophthalmologist all within 20 minutes.
He said that I'd had an aneurysm (macular edema) in a vessel very close to the fovea of my right eye, and this was causing the blurryness
Booked me in for lazer surgery about 4 weeks later to close the leaking blood vessel.

After that, I of course spent 48 hours straight reading everything about retinopathy and maculopathy and all of the treatment, and freaked out.

With lazer treatment, there are two methods. Focal targets one vessel, and scatter is a kind of "ring" of defense to stop vessels getting bigger, but that's for very advanced retinopathy.

So with focal lazer treatment, there is a chance of impaired vision, but the impairment is said to be far less than the impairment from untreated aneurysms. Plus, you can come out of the lazer treatment without any problem at all.

So, after reading this, I went to David Keegan in the Mater Private for a second opinion because the original opthalmologist was extremely nonchalant about something that to me was the biggest scare I've had in my life.

Turns out David Keegan is actually the head of the retina screening programme, and really knows what he's talking about.

He reviewed my OCT scans, talked about my control and blood pressure, and said that because the aneurysm is so close to the fovea (which is essential for sight) that lazer would be risky, so it could be better to wait and see. He emphasized that wait and see was only really possible thanks to tight control and good pressure.
Obviously I don't know what your situation is or where the aneurysm is, but it was what I did.

So, I waited and seed!

I went back a few days before Christmas to the DRT in the Mater, and did the OCT Scan again. At this stage, my eyesight was perfect again, no blurring, so I was quite optimistic.
Turns out that waiting was the best thing. The bleeding had stopped, and the fluid was starting to clear from my eye, and there were no new aneurysms.

Eventually, if my control and blood pressure stay good, it should all clear up and there should be no further problems.
The interesting thing was that they put a strong emphasis on blood pressure being almost as important as blood glucose control. So just something else to consider.

So if you want, you can wait and see, or certainly insist on another OCT before they start the lazer/injection treatment.
The injections are a little less risky than lazer, but I think they only do the anti-VEGF injections if you're showing new aneurysms and leakage.

So that's my one and only experience with it after 15 years of diabetes. Hopefully it's been somewhat helpful to you. Feel free to ask any other questions.

CramCycle

Your body needs insulin to function properly even if you are not eating, hence why pump users have a basal rate and injectors have a basal insulin. When I was first diagnosed I came up with the idea, at the age of three, that if I didn't eat, I didn't need injections, therefore everything would be hunky dory. This was due to consultants thinking the truth was too complicated for a child (as well as the insulins not being as nice easy to use as they are now).

This was a terrible plan.

Alot of your cells have transporters that are indirectly activated by Insulin. No insulin, no uptake of glucose (or at least severely reduced). Therefore high blood sugars but also that lethargy we all get, as your cells have no energy despite the amount of glucose in your blood stream.

I was looking for a nice GIF on google but they are all a bit too intense for the simple premise. Insulin attaches to the cell at an insulin receptor, this sets off a signalling cascade within the cell (sort of like knocking over dominoes only they use more sciencey words), these dominoes eventually hit the GLUT4 transporter which moves glucose across the cell membrane, and, ta dah, your cell has energy.

Without insulin it is like being at a rock concert where they have not opened the doors on time, loads of people waiting to get in and get rocking but other than one or two who sneak in, everyone else is stuck outside doing nothing except getting annoyed.

Wanton

banjobongo wrote: »

hi all.
I was diagnosed with type 1 about 1.5 yrs ago. Pretty well under control, last few 3 mths readings were 53.
This week I had a scheduled colonoscopy, which involved fasting from 9am onwards for 1 day and until the procudre was finished the following day. So the advice from my diabetes nurse was half units for the morning on the first day and then no more insulin until next meal, just keep an eye on the blood sugar levels.
I was expecting to see my levels get low, but no, they went high, around 18 - 20, for both days, so I guess is shows me I need the insulin to keep it manageble.
Still, it was a surprise to me.

I am very much open to correction here, but I think you saw an increase in blood sugars when you didnt eat as your body still continued to burn stored fats/energy to keep your body running while fasting. This will be less than if you had eaten, but will be uncontrolled as you havent any insulin to control it.

banjobongo

hi all.
I was diagnosed with type 1 about 1.5 yrs ago. Pretty well under control, last few 3 mths readings were 53.
This week I had a scheduled colonoscopy, which involved fasting from 9am onwards for 1 day and until the procudre was finished the following day. So the advice from my diabetes nurse was half units for the morning on the first day and then no more insulin until next meal, just keep an eye on the blood sugar levels.
I was expecting to see my levels get low, but no, they went high, around 18 - 20, for both days, so I guess is shows me I need the insulin to keep it manageble.
Still, it was a surprise to me.

thehorse

I’ve been told I’ve a small amount of macular odema in my left eye. I’m Diabetic almost 20yrs and my hba1c is 41% at last check which is in the almost non Diabetic range.
The doctors said they will discuss my issue as injecting the eye is risky and cause other problems.
My eyesight is perfect in both eyes.

Just wondering has anyone had this problem and have they got it treated ?
My belief is that odema comes and goes

Thanks a mill

Xofpod

CramCycle wrote: »

Currently sitting through a LO. It is weird to still be sort of OK. My eyes are suffering the most, with a weird fisbowl thing going on, like I am triying to convey LSD in a movie. Hands are really numb as well.

I have taken stuff. Weird though as I do not have my normal, crazy,devour everything sensation I get when I am only around 3.5

Think I double dosed before the commute.

Hope you're feeling better. Ill effects of a hypo are normally very short lived for me.

Xofpod

I went to my consultant today who was very happy with my HbA1C level of 56, which I had thought was too high. For T1, she's happy with anything between 53 and 57; anything under that and the risk of hypos is too high. Makes sense to me but what kind of steer are other people getting from their consultants/clinics?

CramCycle

Currently sitting through a LO. It is weird to still be sort of OK. My eyes are suffering the most, with a weird fisbowl thing going on, like I am triying to convey LSD in a movie. Hands are really numb as well.

I have taken stuff. Weird though as I do not have my normal, crazy,devour everything sensation I get when I am only around 3.5

Think I double dosed before the commute.

CathyMoran

33 years since I was diagnosed with type 1 diabetes - I used to get upset as a child but got into the habit of only allowing this day to be upset about it - I stopped getting upset about it years ago as a result. I do have other medical conditions which are worse so the diabetes gets downplayed. I do work on it all the time as my diabetes is brittle from cancer surgery but looking after it is like breathing to me.

MrMacPhisto

pew wrote: »

I was started on new tablets 850mg metafornin a week ago.

Since then my sugars have been stable, they seem to be staying in and around 7.

Until today, went to the gym on an empty stomach and they shot up from 7 to 10.4. I'm hoping they should go back to normal, or else I may need to rethink my routine and start going to the gym after work.

https://www.youtube.com/watch?v=P7089-2Tje0&t=5s

Worth a watch re exercise and diabetes. While its primarily aimed at T1 diabetes, it gives a good explanation of how blood glucose reacts to different types of exercise and how to plan around this.

ohnonotgmail

CramCycle wrote: »

My answer was for type 1s but, depending at what stage you are with type 2, a not too dissimilar effect will occur. For most type 2s, unless it has progressed quite a bit, I imagine would return to normal after awhile.

I was referring to Makikomi.

CramCycle

ohnonotgmail wrote: »

one of the people who replied to you is type 2 i believe.

My answer was for type 1s but, depending at what stage you are with type 2, a not too dissimilar effect will occur. For most type 2s, unless it has progressed quite a bit, I imagine would return to normal after awhile.

Wanton

Meauldsegosha wrote: »

I emailed my TDs about it and I got a standard response from the HSE about it.

The Minister will be answering questions about it in the Dail today at 5.00pm.

So I got reply from Charlie Flanagan's office on Saturday (who knew they worked 6 days a week!)

Anywho, was asked to pass on my mobile number and that "Charlie has raised the issue with Minister Harris" and they will revert to me with an update, or I can call his office this week some time.

Sure all we can do is keep putting pressure on them.

ohnonotgmail

pew wrote: »

That was me asking initially I think part of the answer was related to type 1 as in be careful with the dose of injection, whereas I'm type 2. It should go back to normal anyway.

one of the people who replied to you is type 2 i believe.