[grannynurse FNP student]

Originally Posted by bjs54321

I was responding to the forum on insulins and this popped into my head. A discussion on how to better care for a large and growing diabetic population.

Pet Peeve#1: People diagnosed with diabetes can eat sugar! or products made from sugar...cake, cookies, donuts, candy bars and chocolate. It all comes down to carb counting. All nurses should learn carb counting and insulin to carb ratios so they can better serve this population.

Pet Peeve #2: Type 1 and Type 2 are different. Although many type 2 diabetics require insulin...the action or reaction to it is different. Type 2 pts need to follow a diet regime that works with their antihyperglycemic meds. Type 1/ Type 2 on insulin can eat sugar products under the carb count guidelines and as long as there isn't excessive weight gain. Also know that exercise plays an important role in lowering blood glucose. Learn the differences so you can provide the appropriate care.

Pet Peeve #3: Although there is a large population of type 2 diabetic people, the population of type 1 diabetics and a latent onset is growing. Bone up on type 1.

Pet Peeve #4: No diabetic needs more than two insulins. Learn the onset and action of all insulins. Cater a program to work for your diabetic patient.

Pet Peeve #5: The brittle diabetics need DDAVP, not insulin.
Blood sugars can be controlled with the right program.

Pet Peeve#6: People with diabetes...DO WANT TO CONTROL THEIR BLOOD SUGARS. Contrary to popular belief...we do...it's a hard thing to do. We have it for life and sometimes...even with the best control...you still loose a limb, a retina detaches or you end up on dialysis. Oh well. But we can extend our lives as long as possible with good control.....70-120!

Can we get a Diabetic forum?
Shelly

Pet Peeve #7 ADA diet. No such animal but that doesn't stop the unknowledgeable.

Grannynurse

[truern]

Originally Posted by Psychaprn

I'm losing wt. using Byetta. It's been a wonder drug. Anyone familiar with it?

I was diagnosed with Type II diabetes less than a month ago. I've been trying to control BGs with diet and exercise....I've lost 5 pounds so far and have been stepping up the exercise, but today I had to call and report a BG of over 300 Saturday night (we'd gone to a birthday party...I had 2 glasses of wine and a smidgen of cake...sigh) and a FASTING BG of 201 this morning. My doc called in a prescription for Glucophage, but I'd love to know more about Byetta. I soooo need to lose about 60 pounds.

I'm off to look up carb counting....wish me luck

[RedSox33RN]

As a Type 1 diabetic for 9 years, and on an insulin pump for 5 of that, I can attest that it does take a lot of time to find the correct regimen.

And then as soon as you find it, it can just as quickly not be the right regimen anymore! LOL

I find my diabetes changes day-to-day. As a nursing student, with all the stress and sleeplessness that goes along with late night med sheets and never-ending careplans, and getting up at 4:30 to be out of the house by 5:30 to be at clinical at 6:30 two days a week, I find my needs are much different on those days than on my lecture days. And they are much different on my back-to-back 12 hour work days as an LNA.

Add in continuous migraines, 4 kids and a divorce, my diabetes is a CONSTANT challenge. What really, REALLY ticks me off is being labeled "non-compliant" when I'm doing my best to be compliant, and prevent/delay all the horrible complications I have to see on a daily basis.

So, as much as it is a continuing education for non-diabetics, it is as much a continuing education for diabetics also.

[cassilee30]

[quote=bjs54321]I was responding to the forum on insulins and this popped into my head. A discussion on how to better care for a large and growing diabetic population.

Very well said....THANK YOU....I am the mom of a type 1 diabetic and I get soooooooooooo tired of people saying to me, "you're actually letting him have that cake?" argh!

So, we carb count...and his A1C is 6.2....after 9 years of being diabetic (the highest A1C in that time period was 7.1...usually in the low 6's) And he drinks regular soda and loves cereal...but alas, he knows how to give himself insulin for his carbs and life is grand (actually, he's been in an insulin pump for 8 years...best invention in the whole world)

Thanks again for the great post!
Cassi

[lsyorke]

Originally Posted by wannaBEanRN

What really, REALLY ticks me off is being labeled "non-compliant" when I'm doing my best to be compliant, and prevent/delay all the horrible complications I have to see on a daily basis.

OMG, I can relate to this. Hubby was just hospitalized for an arterial bypass on one leg(diabetic for 46 years)and subsequent great toe amputation.. Renal function perfect, heart great... and in comes a first year resident telling him he has to "take better care of himself"!! This was after all the attendings told him how it's amazing that he has had so little in the way of complications.

Flucuating blood sugars don't necessarily mean noncompliance... there's usually a very good reason. The one 200 blood sugar that the resident was SO concerned about was after a fluid challenge with D5W (previous blood sugar was 40!)

I agree about the ADA diet!

[oldnurse newnurse]

I still want to know about the information regarding Type I diabetics needing DDVAP because I have been a diabetic for 24 years since age of 7 yrs. and I have never been given this medication, If you have research on this could you please share?

And how's the pump? I have not used it yet but they are recommending it since I have been a brittle diabetic for so long.

[pediatriclpn]

I have a friend whose son was diagnosed at the age of 3, he is now 13. Before the pump his sugars were very erratic, and she was the queen of carb counting. His mood swings were wild, also. They actually wanted to put him on psych meds. They started the pump, and what a god send! His behavior completely changed, he does better in school, and his A1C shows extremely stable. He absolutely loves it, and will tell anyone about it. Best of luck to all diabetics out there. My pet peeve is my mom. She was diagnosed with Type 2 last summer. Complains about the side effects of her meds all the time. Continues to bake cookies and cakes almost everyday. And eats a whole bagel with cream cheese for breakfast EVERYDAY! And then tries to educate me about diabetes. She doesn't check her sugars before a snack, but about 30 minutes after, and then wonders why they are high, DUH! Gotta love our moms, huh

[cassilee30]

And how's the pump? I have not used it yet but they are recommending it since I have been a brittle diabetic for so long.[/quote]

My son is also very brittle. He can go from 40-400 in one day, easily...however, overall, the pump has kept him stable over all. He's less brittle since the pump and it's easier to correct, I think. Plus, he has the freedom to eat what he wants when he wants it. Ever since the pump his highest A1C has been 6.7. He's 16 now, been on the pump since he was 8.

Cassi

[bjs54321]

Thanks for your reply granny. I wanted to stimulate conversation on diabetes. I hope all participate.

[bjs54321]

Pumping rules for any diabetic who is able to use it and be responsible with it.
DDAVP...I will get some research done on it for you. It has been along time since I worked with it but it really has more to do with fluid retention or shifts. I think. Not with the actual pancreatic function or cell abilities.

Maybe we will find someone more knowlegdeable about it.