Member Advice on Diabetes
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Review of "Member Advice on Diabetes"
Having been a type one diabetic for the last 40 years, it would not be a boast to say that, as a qualified dentist, I should understand my diabetes and know how to look after it. As it happens, I have made a particular study of both type one and type two diabetes and the accompanying nutrition and metabolism that must be part of that care.
These thoughts came home to me very forcibly last week and raised some disturbing questions.
For those readers that are unaware of the details of type 1 diabetes, it is a disease that comes about because of the subject´s inability to produce his or her own insulin. To stay alive they have to inject insulin in an amount that allows their cells to absorb ideal amounts of energy from their food and in particular their carbohydrate (sugar) consumption. Secondarily, insulin regulates the level of sugar in the blood.Having been admitted into Hospital, I will not say where, after suffering a mild heart attack I was finally, after a long traumatic day, happy to contemplate relaxing with a glass of water and the prospect of something to eat. I had had nothing all day. The nurse arrived and pricked my finger for for yet another blood sample which impregnated the testing strip and entered the machine for my blood sugar level. I was not unduly concerned that she did not inform me what the reading was. A half hour later my diabetic meal arrived so I started to eat.
It was not until an hour later that I managed to get the same nurse to me again and I asked her if she had forgotten my insulin. “ Oh. No” she said “your blood sugar was alright so you do not need any.” Naturally I argued and pointed out the basic fact that all type 1 diabetics need insulin with every meal that they take. I persisted and became quite angry but all to no avail. In fairness it was not the nurses fault. She was only doing what her lords and masters told her. Eventually she said that she would get the doctor to come over to see me.As you can imagine in a busy Cardiac emergency area she probably forgot to ask the doctor, I give her the benefit of the doubt. It was almost midnight when the shifts had changed before I was able to ask the senior nurse the same questions and was given the same answer that I did not need it. I pointed out to him that after every meal, I required rapid acting insulin called “Novorapid” and that the time had now passed when I should have had a further largish dose of a long acting insulin called Lantus. “Oh we do things differently here”. I, beginning to see red, pointed out that I was not only a doctor but had been looking after my insulin requirements for forty years. At this point he dashed off and came back with the consultant Cardiologist.
This lady was all high dudgeon and repeated the same as her nurses had said. She was having none of it. Insisting that I did not need either the rapid or the long acting insulin. To cut a long story short I had to threaten to discharge myself, something I certainly did not want to do, before she agreed to test my blood sugar again. Now, of course. it was two and half times higher than it should have been. That persuaded her that I did need the rapid insulin which they gave me. Then the battle started about the long acting insulin. She was slightly more contrite and eventually but reluctantly agreed that I should have that as well.That battle was written up in red in my notes and manifested itself the next night when the nurse, having tested my blood sugar returned and without a word injected about three times the amount of insulin I was expecting. Again it was a while before I could query all this and ask about a) what I had been given? and b) What about the Lantus dose. This stared another battle which my Spanish speaking wife eventually managed to sort. Believe it or not they had given me both doses together in the same syringe, thereby destroying the rapid acting properties of the Novorapid and the long acting properties of the Lantus.
One must ask the question. How much should we trust the hospital doctors that are there to look after us. If I had been a type 2 diabetic there just might have been some valid argument in their favour but I am not and that is another and different story.
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Listed on Ciao since: 25/06/2001