I hate the label brittle diabetic

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1

I hate the label brittle diabetic am I going to break? After all I and many others have been thru I doubt it is a term I know but still I am not fond of it just a nice way of saying I am difficult. My A1C tests have been all over 6/2009 10, 10/2009 11, 1/2010 11, 3/2010 8, 7/2010 11 and still have not got the answer on the latest one and I will get another one in 12/2010. With numbers staying so high and an average bgL of 320 a month and 319 for 90 days it is very frustrating to keep trying all the time. Now I have found hope on all this with help in the fight. As I say over and over a good doctor is the key to help you manage your diabetes and I say your because everyone’s is different and theirs to manage. Ok not trying to jump the gun just yet but had a new PCP which is an internist, endocrinologist and dietician a short time and things are getting better and quickly. I like the idea of this one doctor for all of it and that way he knows what is going on with me without all the questions, sending for records and looking for what others have done. One he changed medicines. Two he and I worked out an eating system that works for both of us as soon as I get used to it. I do not discredit my previous PCP as he does a good job, but he is just an internist. I am not endorsing any brands or such this is just what I have to eat or medicines I take personally. It is an 1800 calorie per day eating plan that is meant to cut out as much as possible fats and carbs. There is R for every meal that is not listed.

Get up and take bgL 07:00

Eat before 08:15

1. Oatmeal, raisins, butter, and toast

2. Cheerios with banana and milk

3. Shredded wheat with milk

4. Take Humalog 70/30

Take bgL 09:00-09:30

Eat Lunch 10:00-10:30

Nature’s own sandwich rounds

great value cheese

deli fresh oven roasted ham or turkey

Helmand miracle whip lite

veggie straws

great value mixed nuts

Take bgL 11:00-11:30 Take Lantus

Take bgL 01:00-01:30 Eat a yogurt 3 times weekly and fruit 3 times weekly

Take bgL 03:00-03:30 Depending on level eat a snack

Take bgL 05:00-05:30 Eat dinner

Take bgL 07:00-07:30

Take bgL 09:00-09:30 Take Lantus and Humalog 70/30

If at any time hunger occurs eat raw vegetables and it will be seen less in time.

Always eat dinner as early as possible, but never later than 7pm.

Plan what to eat depending on the exercise that will be done.

After two (2) weeks numbers are down and insulin adjustments are going to have to be made which is a good thing as I think I take way too much at the moment. With all three of them I am over 180 per day but if that is what it takes to maintain control then that is what I have to do.

Previous attempts on meds have been Metformin (Brand names: Fortamet, Glucophage, Glumetza), Januvia, Novolog, Novolin, and Levemir 70/30

Now:

Lantus 40x2, Humalog 70/30 40x2 and Hum R 20 part at each meal depending on levels.

Here is a chart on insulin’s

http://diabetes.webmd.com/diabetes-types-insulin

Ok now after rambling on for all this time here is the good news from all the above information. My 30 day average is only 250, 14 day average is only 200, 7 day average is only 160 and on Friday November 05, 2010 I seen a 79 in the mid-day for the first time in over 5 years, that I can recall, I have been below a 120 ever. So I am hopeful and excited that with some tweaking on food, exercise and medications I can really feel normal again.

2

I can agree with that! I HATE that term! I’m alkways in the 8 somethings on my A1C. My dr (had him for 26 years now) agrees with me it is a personal desiese that what works on one DON’T work on another. Just my 2 cents worth

3

The term “brittle” or “labile” describes a diabetic whose blood sugar has large unexplained variances. Are you sure that is who you are? I don’t see you as “brittle.” I think is wrong to call you brittle. I think at least part of the problem is that you have been told to eat a pretty high carb diet and then been given a pretty bogus insulin regime. But that is my opinion.

4

“Brittle” is an outdated term that is used less and less these days and for good reason. You don’t seem to have rapid changes in BG levels. If you were, you’d have hypos followed by hypers. From what you’ve written, you seem to be on the right path and you are doing well with it. You should be very proud of the improvements you made. We all have to handle this differently from one another in some way. Congratulations. Job well done.

5

My doc prefers labile… but I do have blood sugars that have large unexplained variances…cgm has proven.and helped managed…and its the darn sneaky lows that were the worst. And although my A1c is higher than before the CGM, my vriance is MUCH smaller…so I am not on the space montain bg roller coaster now

6

Thanks for the comments so far. The nurse is the on that used the term and not to me directly to the other nurse about me. My next appointment is the November 15, 2010 so that all can be looked at and changes made. There will be many changes in the next few months I can see for most of my work is in the winter before and just after Christmas and then I am less productive as there is less work to do. So i will have to get diet adjusted so that I have enough of everything when I need it and in the summercut way back as I will not need so much.

7

Brittle is a term i hate but i have large unexplained drops in my blood sugars. The most frustrating thing is that i have an A1C of 6.8 and they say im uncontrolled because of all the lows that i have even though i am in the range i need to be. Im always trying to get a lower A1c. Looks like you have made improvements and i know how hard it is. My own doctors don’t like to change my dosages so i have figure them out on my own which works well for me. Keep up the good work and you will get there.

8

Trying to identify a “brittle diabetic” is an attempt to categorize patients into pigeonholes and have an in hand treatment. Watching the problems and comparing my few difficulties with the feeling that diabetes is still poorly u
nderstood and has marked variability across the spectrum of patients and within each patient. The patient must understand their own reactions and deal with the doctor. Glad you found a doctor who seems to have a grasp of all this. good luck.

9

I dislike it when an Endo misdiagnoses a Person with Brittle Diabetes. Do we outgrow it?? I certainly have not been Brittle for a lot of years. I was dxd. with it about 30 years ago. Not because I actually was Brittle but because I didn’t know much about Diabetes or it’s care and my Endo back then was not helpful in teaching me. So I had to learn slowly by myself mostly. No internet or D Groups back then. Oh and my Endos have improved alot or maybe I have by knowing what questions to ask and different info or alternative that I should receive because of the D-OC and we discuss stuff.