Slinky wrote: ↑Tue Feb 03, 2009 12:25 am
I'd like to hear from our diabetic members just how they were educated, instructed and trained to monitor their diabetis including insulin shots if necessary.
WHO did the educating and training?
I was (mis)diagnosed as type 2 diabetic at age 70 in 2011 by my PCP with a fasting blood glucose of 289 and an A1c of 11.5. She gave me a sample diet to follow. I tried it for two days and my BG shot up to 548 both days. I ended up going to the emergency room, where they lowered it and sent me home after about 6 hours, telling me to see my doctor again by the end of the week. Needless to say, I dropped her silly sample diet idea in favor of my own, which had been lower in carbs than hers all along. She put me on type 2 oral meds, and sent me for a one-hour consultation with a nutritionist. That was largely a waste of time, as much of the time was spent on such things as how to read food labels and the like - things I had been teaching my junior high home economics students some 15 years earlier before I retired.
In spite of the type 2 oral drugs she had me on, I had to drastically curb carbs and calories to keep my A1c at or under 7.0. It wasn't until I got down to a scrawny 106 pounds that I finally decided I simply couldn't afford to lose more weight, ate more carbs and got a higher A1c, that she finally agreed to refer me to an endo. That was 18 months after original diagnosis. He tested me and found that I was actually type 1. I should have been on insulin the whole time.
During the one hour appointment with the endo, he immediately put me on insulin, demonstrated how to use the insulin pens, gave me starting ratios for bolus and basal insulins, and was then going to turn me back over to my PCP for any further guidance. I had zero faith in her ability to get things done in a reasonable time frame, so got on the internet and started self educating. I was directed by members of a diabetes forum to get the book
Using Insulin by John Walsh, which I did immediately. From that I learned to test and adjust my insulin doses. (And I've had an A1c of between 5.5 and 6.1 for the five years since.) As it turned out, I needed only 75% as much basal insulin initially as my endo started me at, but I needed three times as much insulin per gram of carb of fast-acting! I got my ratios figured out and had things pretty well under control before I even went back to see my PCP. I assume she thought the endo had directed me in all of it, and I didn't let on that I'd done all the adjusting myself. Because before she even referred me to the endo, she had said that she didn't want to put me on insulin because she feared I'd try to adjust it myself. LOL. When I later told my endo that, he said, "But that's what you are
supposed to do!"
The other major portion of my early diabetes training was also self directed. I signed up for an internet class on diabetes offered by Coursera. This particular class was offered through the University of California San Diego branch primarily for students in medical related fields, but patients were also allowed to enroll. I just audited it, as I had no need for the credits and that way it was completely free to me. It was a very worthwhile course.