Friday 29 October 2010

Diabetes Services, How Good Is Yours?

When your child is first diagnosed, I suppose you never question the hospital service, you are relieved that your child is feeling better, yet devastated as your child has been diagnosed with Type 1 Diabetes(same for adults). As this will involve between 2-5 injections a day or pump therapy.

The age of the Internet has allowed us to see what is out there, rather than just relying on the medical profession.

Knowledge is a very powerful tool and frustrating at the same time. Insulin Pumps & CGM's amazing technology yet depending on where you live and the personal beliefs of your diabetes team dictates what you are allowed. Then the next hurdle is the funding from the PCT.

Claudia was referred to Leeds Diabetes Specialist Team. I walked in ready to do battle!! having been told on many occasions that it was down to Claudia's state of mind.

We arrived, well what can I say!! It was lovely, normally I feel we are on trial and come out without any ideas for resolving the hypo's Claudia is having.

What we found out:

Gluten free pasta and crackers are not as long lasting as "normal pasta & cracker", in fact this is the case with most gluten free food. ahhh as longer lasting carbs and low GI foods are so good for people with Type 1.

Basal Rate: To evaluate if your basal rate is correct , they recommend you check this every 6- 8 weeks. Basically you delay a meal and choose a time when your BG is in range 4-8, then check every couple of hours to see if your levels are within a couple of mmols. If so then your basal rate is effective, if your blood glucose levels rise or fall dramatically then you know to adjust the basal rate at that period of the day. You then move on to delaying lunch, then dinner, then overnight.

The above is very basic and I have been given a full set of instruction to follow.

Once the basal is checked you can then go onto your bolus. They suggested a bowl of cornflakes & milk or toast. Check Bg, before meal and then 2 & 4 hours afterwards,we have done this before
but never in conjunction with the basal rate check.

It makes perfect sense to me, my question is why has nobody suggested the basal rate check regime before. It may or may not resolve the problems of Claudia's hypo's but at least it's a start.

For the first time, we were told how good Claudia's levels were, how to interpret all the data downloaded from the pump and blood glucose meter(we had an idea, but we were not 100% sure) I know how to estimate Claudia's Hba1c from the blood glucose meter readings on her BG meter.

We were told to correct at 8 and above, which I agree with.

They agreed the hypo's needed to be reduced, we were given email & mobile phone contact details for the DSN and Dietician

I came out feeling for the first time in months, that there was light at the end of the tunnel, even if Claudia's hypo's are not resolved immediately I have faith that with the support and experience of the Leeds team we will get there!!

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