Opinion difference with endocrine

Hello,

I do not know if it will have happened to you but when I spend things that I should not, even calculating the insulin doses as much as possible and putting the slow and everything as always, I get up with levels of 250/300 and several endocrineAfter so many hours it is impossible that it is due to dinner, because many hours have passed ... What do you think?

That the endocrines do not know anything.

Hi Maribel, endocrine are determined to make us believe that diabetes is an exact science where 2+2 = 4 and in the control of diabetes 2+2 never, or almost never, they are 4 because we are within a chaotic system.
What happened to you depends on many factors, as always: if you have taken fast or slow absorption hydrates, the glucose level you had before starting dinner, the insulin sensitivity you had at that time, etc.If you have taken slow absorption hydrates, it can happen that first when the insulin gets, the glucose is enough and at 3 hours that stops taking effect, start up and dawns with high values, also in the dinners it usually takes longer to do the digestion(Although you don't say it, I assume that the one you increase is the dose of ultra -granted insulin).What I do in these meals/dinners is that if I start dinner with low glucose values, around 60 p.ej. The calculations that I make of additional insulin usually do quite well, but if I am in normal values ​​of 100 or120 p.ej., I put 1 or 2 more units than additional calculated because if I do not stay short;And when I take slow absorption hydrates at a dinner, I usually inject the fast up to an hour after having drew its effect more.I hope all this can give you something.

@"Maribel Andrade" of impossible anything, and the eminence that tells you that or lies or does not findTomorrow, for example the pizza, which according to this one made a rush, or Chinese food.Meals with a lot of fat in general.This goes in clear bodies, and in organizations, but of course that the high value of the morning, in those cases, is "blame" of dinner.With the pump you can stop by climbing the basal to sack during a long section, or using expanded bowling.Sometimes they take us for fools, it is like when they sworn and perjurad that the lantus did not towards peaks, that it was impossible if it was well adjusted that produced hypoglycemia at night and that it is not necessary to take right.Years later, the evidence has shown that they were wrong.

It can happen perfectly, the other day I ate 1 salad with a mogollón of things and fats, 1 hamburger with potatoes and 1 chocolate brownie, I deserved it that I had done sports, you do not think I do it every day !!And with 5 -A extras to correct, I arrive at dinner at 180 mg/dl ... If you dinner at something with fat, you can not worry ...

I don't know if you know enough diabetes, probably not.But I assure you that how much or little it is known, the endocrine knows

=)) =)) =)) =)) =))

Few endocrine seems to have seen you.The last one I went was 10 minutes looking on Google that it was regular insulin, the normal of a lifetime, since I had no idea.

Obviously there are very good endocrine and others who leave a little to be desired, I have found everything, but curiously the best endocrine always say that those who know most about diabetes are the patients themselves.

@"Runing50" totally agree with you, that textual phrase heard it say, 15 years ago, a fantastic pediatric endocrine, Pedro Martul of the Cruces Hospital.

If you spend a timely day, it may be for extra dinner, but, if it happens to you every day, you will need slower.
There are extra dinners, which still with good values ​​after dinner, can go up later, either because they contain more fat or for having delayed a lot, as usually happens when dinner out of home.
And it is true that the best endocrine know that whoever knows their reactions is the diabetic itself.

I consider my endocrine a very good professional to the order of the day in MCG and insulin bombs but there are things that I tell her that she tells me will be your imaginations of yours !!!As when I tell her that when I click on my leg the absorption of insulin is not slowbe, and I ask him?How many punctures are you put in your legs ...?I do not have them calculated but more than 1,000, and with that I shut his mouth a little ...

@"Maribel Andrade".Good morning.All colleagues are right.In my short experience I have learned that not all endocrine know about diabetes 1, especially those who attend in private.

Thank you all for your messages !!I no longer feel a weird bug !!By the way, eating fat does not affect me at my levels at all, I can eat a wedge of cheese that I do not need to prick if I have started to eat it with a good level.Of course, without bread, a dry stick.

@"Maribel Andrade" because I notice to consume foods rich in fat or protein (although they do not contain HC or contain very few, as is the case of cheese) if it affects my glucose levels more or less evident, andIt does it enough hours after ingesting them.That is, it does not notice in 1 or 2 hours, but in the successive ones.I have experienced it with cheese.I usually (and except in specific moments of glucose tendency to descent) everything I do with HC and under the influence of fast insulin, and it is much better!).

Good Maribel, maybe it is obvious but I tell you the main factors that influence morning hyperglycemia, basics and some of those that are not usually taken into account:
1- Change of usual insulin injection.Fast to + slow: abd> arms> thigh and buttocks
2- Inadverted carbohydrates.
3- Excess correction and rebound effect (Somogy).Indeed there are people who, before the mouthwash, go with insulin and we see a bounce hyperglycemia not due to lack of insulin
4- Lack of slow insulin
5. Exercise of strength in the afternoon (yes, weight type exercise increases glycemia, unlike aerobic)

6- Increased requirements due to fat and protein increase.It is indeed known that both delay the post-comparative glycemia peak (due to delay in digestion-absence) but also because from them carbohydrates are manufactured (or cease to consume both the ingested).To solve this problem, "UGP" or "protein fat unit" is used, which are 100kcal fat or 100 kcal protein and equals 1 ration of carbohydrates.Eg if your ratio is 1ui/ ration and you eat 3 r of HDC + 2 r of UGP, in total they touch you 5 IU.
It is a relatively novel and unleashed concept, but that is very useful, especially for pump patients.

My recommendation is that values ​​1-5 and if you think nothing fails, that you try to apply the UGP little by little and start with the meals in which you are sure that you have adjusted the hydrates well.
As always in diabetes, changes must be progressive and caution.He also understands that it is a new learning when counting, so, calmly and without demanding much, that sometimes the most expert patients can frustrate themselves when they are "rookies again."

P.S:
1. I agree that whoever knows the most of "his own diabetes," is the patient himself.But to think that endocrine we face innumerable situations of innumerable patients with diabetes, maybe something remains after all!

All the best

Thank you so much!I will take it into account !!

I have also had my "wars" with the endocrine/nurses when they tell me that this of diabetes is "very easy" to get correct levels between 70 and 120. I already went sincere with them and I give them the reason like thesilly saying yes, yes, yes, of course, blah, blah, bla ........ if I speak with sincerity exposing that this is very difficult to regulate and more in my case that I have been eating everything without everything withoutI worry about anything since even little my pancreas worked normally (I am 47 years old and only 2 with diabetes), because that is impossible for me, I have tried to lower it but as I tell you, eating everything.Without obsessing me.

I recommend that except your endocrine is real competent and worry about your diabetes from a "human" and not "scientific" point of view, do not contemplate the truth and tell everything that if, that is, that we diet the diet to theMaximum, sport like a triathlete, which we do not know what a donut is eating in years, a Bigmac, an ice cream cone, a piece of pizza, etc.

I also recommend never putting the hyperglycemic values ​​of more than 200 on the annotation sheet, which then glue our anger and ask us why? As if it were easy to answer and avoid those peaks .....an we go!I take the machine to the consultation and if they start consulting it, when they see that there are more than 10 controls a day, they do not check more than 3 days because they are fed up with giving the bowl to move forward in the historic.Total dogs come on.

Greetings and do not overwhelm the endocrine.Almost none is diabetic and does not know what it is because of its own meats.

Running 50, totally according to what you say.As our endocrine says something gets from all the diabetic patients that visit him.My experience is similar.As a patient, I had the opportunity to visit a good group of internist and endocrine doctors, from several provinces, over the years.I learned something from everyone.
But, obviously the one who knows the most about my diabetes is me.Open to all the suggestions that champion for this forum.Very attentive to the advice and opinions in my semiannual visit to my endo.Always learning, open to everything, I think it's important.
I count all the tricks or avatars of all kinds with my dB on a day -to -day basis.I let me say and maybe my comments are also useful.We all won.
As Running says the big problem is that DB is not an exact science, but there is no choice but to attack it in that way.Equivalence between rations and insulin units, for example, something insufficient and wrong.

There are many variables, and a single objective or result, Normaglycemia.

Perhaps the success in the treatment of this disease, consists of going of failure in failure and not to despair.It transcribes the philosophy of an English politician when he said that "success in life is to go of failure in failure and not to despair."

That these heats, especially, in the southern zone, do not end with us.

Greetings.

narciso said:
I have also had my "wars" with the endocrine/nurses when they tell me that this of diabetes is "very easy" to get correct levels between 70 and 120. IIf they are honest with them and I am right like fools saying yes, yes, yes, of course, blah, blah, bla ........ if I speak with sincerity exposing that this is very difficult to regulate andMore in my case that I have been eating everything without worrying about anything since until little my pancreas it worked normally (I am 47 years and only 2 with diabetes), because that, that it is impossible for me to control myself in meals andToday I keep eating everything, I have the glycosilada in 7, I have tried to lower it but as I tell you, eating everything.Without obsessing me.

I recommend that except your endocrine is real competent and worry about your diabetes from a "human" and not "scientific" point of view, do not contemplate the truth and tell everything that if, that is, that we diet the diet to theMaximum, sport like a triathlete, which we do not know what a donut is eating in years, a Bigmac, an ice cream cone, a piece of pizza, etc.

I also recommend never putting the hyperglycemic values ​​of more than 200 on the annotation sheet, which then glue our anger and ask us why? As if it were easy to answer and avoid those peaks .....an we go!I take the machine to the consultation and if they start consulting it, when they see that there are more than 10 controls a day, they do not check more than 3 days because they are fed up with giving the bowl to move forward in the historic.Total dogs come on.

Greetings and do not overwhelm the endocrine.Almost none is diabetic and does not know what it is because of its own meats.

And what do you get ???I just fooled yourself, the endocrine cares 3 noses to deceive him, he has hundreds of patients and above all he does not suffer from the disease, so it is almost better that you do not go to consult and manage themselves, because goingTo deceive the endocrine is nonsense.But the recommendations you give are not beneficial at all, that you want to take your diabetes, it seems perfect, but that you recommend it as if it were the best .. I no longer seem so good, because far from benefiting the most likelyIt is that they harm and that is not helpful.We have all had our more or less with endocrine, nurses and educators, with the passage of time with the disease the best endocrine and educator is yourself, but for that you must gain experience with diabetes, read a lot about it, know a lotTo oneself, your body, organism, etc.of those who are not against response what is usually said to "leave in evidence" you can have the career you want in a matter, but what is clear that each diabetic is different and you cannot want to create a general treatment protocol becauseIt is impossible and must be each personalized and independent many different factors in the day to day of one diabetic to another and all have their relevance at the glycemic level.

With continuous meters they are all learning a lot. The Broncas are over ...