Calling All Diabetic Experts

[Sheryl]

Mobi,

Gerd has a good point about your equipment. Verify that it is calibrated appropriately if you haven't already. If in any doubt at all, get a new one.

Secondly, I suggest you start taking a snack immediately before bed. High protein food would be best as it will provide a modest but fairly sustained boost to your sugar while you sleep.

The amount of insulin you are taking at night seems quite high relative to the BS.

You probably know this, but -- hypos are very, very dangerous. In fact they present a more immediate threat than high BS does, and if one has to err somewhat it is better to err on the side of a slightly higher BS than to risk a hypo...especially one during sleep.

Aside from killing you, hypos can leave you with permanent brain damage. You could wind up in a vegetative state for years. The last thing anyone wants to risk.

Please see one of the specialists I mentioned, as well as ensuring your meter is accurate and adding a bedtime snack. Your evening insulin dose needs serious adjustment.

[Mobi]

Mobi,

Gerd has a good point about your equipment. Verify that it is calibrated appropriately if you haven't already. If in any doubt at all, get a new one.

Secondly, I suggest you start taking a snack immediately before bed. High protein food would be best as it will provide a modest but fairly sustained boost to your sugar while you sleep.

The amount of insulin you are taking at night seems quite high relative to the BS.

You probably know this, but -- hypos are very, very dangerous. In fact they present a more immediate threat than high BS does, and if one has to err somewhat it is better to err on the side of a slightly higher BS than to risk a hypo...especially one during sleep.

Aside from killing you, hypos can leave you with permanent brain damage. You could wind up in a vegetative state for years. The last thing anyone wants to risk.

Please see one of the specialists I mentioned, as well as ensuring your meter is accurate and adding a bedtime snack. Your evening insulin dose needs serious adjustment.

I doubt whether my equipment is faulty as it is fairly new and I use Optimum One Touch which seems to be favoured by most hospitals. I actually have a second one, so I will get it out and check one against the other.

I used to take around 18 units of longer acting insulin overnight, but due to high blood sugars in the mornings, it has been gradually increased.

I am aware that it is better to have slightly high B.sugars than these life threatening hypos. Last night I cut my insulin back to 22 units, and I was fine. I think I might cut it back a bit further tonight.

The night snack is a good idea. High protein eh. Any suggestions?

As for the specialists - well yes I will go to see one, but I have no confidence.The latest one just kept increasing my night B sugars until it nearly killed me. I just don't think they have their eye on the ball too much, and they just go through the motions. They do all the standard blood tests, and tell you to increase you insulin if your BS is high and reduce it if you are having hypos. Then they tell you to lose weight, take more exercise, and eat less, and eat the right food. Then they prescribe additional medication for high cholesterol etc, and refer you to a heart specialist if you have high blood pressure. It's all a million miles from the personalised treatment I used to get in the UK. These docs never ask about life style, stress, or even if I am drinking heavily, or if I have stopped, and a dozen other questions that they should be asking to properly assess my medical situation. I always try to volunteer additional information that i feel may be relevant, but they are just not interested. I once told my specialist that my libido had dropped in the last few months. She prescribed testosterone shots, without considering the effect this may have on my enlarged prostate, and other adverse factors.

I also suspect that these diabetic specialists are quite happy to keep their Thai patients' blood sugars a bit high , as it will cause less problems in the short term. Every Thai diabetic i have met, is either on tablets (because they are scared to inject themselves) or they have one insulin shot a day.This is all very old fashioned. The doctors are aware that farangs would not be happy with this, but they don't have the experience to deal with patients who wish to keep thier blood sugars as low as possible to avoid long term complications. I've yet to meet a Thai who is on a similar regime to me - 4 shots a day and daily blood testing.

Then they have the Arabs, who presumably only come to BKK every six months or so, so they probably don't feel much responsibility for them. Maybe many only ever come once or twice.

That's what I reckon, anyway.

Sorry, I' guess I'm in a bad mood today......

[Sheryl]

Mobi,

You have described quite accurately exactly what a good doctor should do, so you will know one when you meet one. They do exist in Thailand, altho of course they are in the minority. So keep looking. With a chronic condition like this it is worth the effort to keep shopping around until you find a doctor you are fully satisfied with.

As for the protein...don't know your eating habits but if you're not a vegetarian, and as I gather your lipids are a bit high, then baked or broiled chicken or fish, or perhaps a soup with chicken or fish or tofu plus vegetables (substantial soup, not broth...be sure to get a least a few oz of the protein source). A large glass of soy milk would also work but of course would need to get hold of some that doesn't have sugar, and that might be hard.

Also, keep some sweetened fruit juices right by the bed, can get those UHT ones that don't need refrigeration. That way no need to get to the kitchen if your BS dips during the night.

Good luck, and hang in there.

[lopburi3]

Meters do read bad and suspect they may sell fake test strips on the local market. We have an Ultra OneTouch with local bought test strips that new strips (in date and meter set for) started to test 25-35 higher than expected and check at Hospital showed it was reading very high. Bought an Accu-Check Aviva on eBay (more for less blood requirement then anything else - this model not yet available in Thailand) and test strips from UK and it is providing exactly same readings as hospital tests.

I noticed a physical difference in the new strips for the Ultra when first started using them as they seemed to be of poor construction (pulling apart at end) and after Google search find lot numbers seem to match fakes found elsewhere. Take meter/strips and have it checked to be sure.

[donna]

mobi, is it worth being admitted into a good hospital so that they can monitor your levels throughout the night? (im not diabetic, nor a doctor, so dont know how possible this is without sticking you with pins all night).

i wish you would get to a doctor sooner rather than later - before its too late.

good luck.

[Mobi]

Mobi,

You have described quite accurately exactly what a good doctor should do, so you will know one when you meet one. They do exist in Thailand, altho of course they are in the minority. So keep looking. With a chronic condition like this it is worth the effort to keep shopping around until you find a doctor you are fully satisfied with.

As for the protein...don't know your eating habits but if you're not a vegetarian, and as I gather your lipids are a bit high, then baked or broiled chicken or fish, or perhaps a soup with chicken or fish or tofu plus vegetables (substantial soup, not broth...be sure to get a least a few oz of the protein source). A large glass of soy milk would also work but of course would need to get hold of some that doesn't have sugar, and that might be hard.

Also, keep some sweetened fruit juices right by the bed, can get those UHT ones that don't need refrigeration. That way no need to get to the kitchen if your BS dips during the night.

Good luck, and hang in there.

Hi Sheryl,

Thanks for the protein advice, and no I'm not vegetarian.

I'll keep up the search for a good Doc, but my daughter and her boy friend are arriving on Monday for 6 weeks, so it's going to be hard to do much until they're gone.

And thanks for the good wishes - I feel better already

[Mobi]

Meters do read bad and suspect they may sell fake test strips on the local market. We have an Ultra OneTouch with local bought test strips that new strips (in date and meter set for) started to test 25-35 higher than expected and check at Hospital showed it was reading very high. Bought an Accu-Check Aviva on eBay (more for less blood requirement then anything else - this model not yet available in Thailand) and test strips from UK and it is providing exactly same readings as hospital tests.

I noticed a physical difference in the new strips for the Ultra when first started using them as they seemed to be of poor construction (pulling apart at end) and after Google search find lot numbers seem to match fakes found elsewhere. Take meter/strips and have it checked to be sure.

Sorry, yes I meant to say that I use One Touch Ultra, made by Lifescan.

I have two machines, because one stopped working after 2 months and I bought another one (because I needed it urgently) and the local pharmacy sent the broken one back to Lifescan who replaced it with a new one for free.

The two machines have given me similar readings, so I think there is nothing wrong there.

I buy my test strips from Fascino, which is a very large and reputable outfit, and is the company who got my faulty machine replaced, so I think my strips are the real thing.

It seems that it's my body that's all over the place - not the test equipment

[Mobi]

mobi, is it worth being admitted into a good hospital so that they can monitor your levels throughout the night? (im not diabetic, nor a doctor, so dont know how possible this is without sticking you with pins all night).

i wish you would get to a doctor sooner rather than later - before its too late.

good luck.

Hi Donna, the same thought occurred to me - but I'm really not convinced that they would do a good job, and come up with some meaningful results and recommendations.

Thanks for the suggestions anyway.