Help me define this

#21

I would call it institutional discrimination as it pertains to ADA issues. You should not be going through this.

#22

Doctors are so scarce where I live in Ontario that they can pick and choose their patients. Finding a doctor after moving was a full-time job. Finding one that was accepting new patients was difficult enough, without then being turned down three times. One doctor had taken on my non-diabetic brother-in-law the week before. :rage:

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#23

Exactly the same problem in Alberta (Calgary) @Frantastic

An estimated 30-50% of the population here doesn’t have a designated general practitioner, and go either to walk-in clinics or ER’s for any health needs

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#24

Yeah, I’m going through a session of this right now.

It’s not all organized conspiracy - just mostly. Part of it is programmers who have a constant urge to change things that don’t need to be changed, and break other things in the process, doctors who automatically blame problems with the new software on the patient’s stupidity - it’s more often the doctor’s stupidity - pharmacists, diabetes educators and others at the bottom of the nealth-care hierarchy who stomp on patients to make themselves feel more important, etc.

Just try to find a modus vivendi which will leave you lots of time for a real life.

My crazy old uncle of blessed memory used to say that in WWII they had a saying: Don’t let the bastards scare you.

Good luck.
M.

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#25

Even (or especially) the expensive insurance sees paying their share holders first as the primary goal.

#26

I am an insulin-using HNF1-alpha diabetic. I am insulin-dependent in the sense that I cannot prevent continued accumulation of death of neurological/microvascular tissues (aka “diabetic complications”) without sub-Q insulin, although I have enough endogenous insulin production not to be susceptible to (death by) ketoacidosis.
Diabetics should avoid all carbohydrate foods, because portal glucose induces positive/dysregulatory feedback that CANNOT be compensated for with insulin therapy. But dietary protein must, and can be, compensated for with bolus insulin to avoid tissue damage from transient/prandial hyperglycemia.
Insulin Regular is the only type appropriate for the prandial/absorptive interval of a protein meal. I would argue that any T2D can use NPH to pretty successfully maintain adequate basal insulin (signaling) to maintain good and reliable health. The time-release profile of NPH also works well to compensate for the dawn phenomenon, by injecting at bedtime. I inject NPH twice daily, but a T1D would probably want to inject maybe a half dozen times daily using a carefully adjusted discipline, probably including a mid-sleep, early-morning injection.
The long-lasting insulin analogs are very expensive and fragile (i.e. have poor temperature and shelf stability). I have had them prescribed in past. Even if I were a T1D, I would not choose to use them. Obviously long-lived T1Ds have been around since before the advent of these forms of insulin analog. And these days there are CGMs for safety. Regular, using a muscle shot for example, is plenty good enough for the occasional unintended basal hyperglycemic event detected by the CGM IMO. An adequate discipline will not allow inception of ketoacidosis – this requires extensive and extended precursive portal insulin deficiency and hyperglycemia.
Meanwhile, all of the fast-acting insulin analogs are meritless attempts to compensate for dietary carb. One should realize that this is impossible if one were to understand the islet endocrinology. They are a complete waste of money – a marketing and profits vehicle for insulin manufacturers, but futile for the diabetic.
I suggest using Regular and NPH – these are of minimal cost … less than $1000 yearly for ANY type of diabetic with an appropriate diet. With that, all of the politics becomes pretty much moot, no?

#27

Interesting perspective. Interesting idea about 6 shots of NPH. I have certainly never tried that before.

#28

How do you work with that regimen? Raise children? Go out with friends? Sleep? Not to mention that insulin needs change on a daily, hourly basis and are often completely unpredictable so the same dose of nph won’t work the same every day and regular insulin takes hours to lower blood sugar, meaning hours of being high when hormones or stress hijack your body. It does not seem like a realistic approach IMO