[OliveVinesRN]

Originally Posted by Psychaprn

As a diabetic and a nurse I really appreciate this discussion. It's a tough disease to live with and sometimes you just want a vacation. I'm an insulin dependent Type 2. It's so nice to see the support here. I'm so tired of people who think it's easy to eat right etc. I'm losing wt. using Byetta. It's been a wonder drug. Anyone familiar with it?

Yes!! My mom has been put on Byetta. And you're right, it works wonders. Her blood sugars have gone from the high 300s to the low 100s and lower. I am so proud of what it does. I believe it will become more mainstream as time goes on. My mother was really doing what she could to control her blood sugars, but her oral hypoglycemics alone were not doing the trick. But, finally, with Byetta, her blood sugar is finally under control. And this is within less than 3 months.

[scubarn]

I am a nurse and am on an insulin pump. When I first put the pump on, I noticed a weight gain of 15 # within the first 2 weeks - and I was eating LESS carbs than I did before the pump was put on. I've noticed edema in my face, hands, and feet. I took off the pump and lost #12 in 2 days. I now take the pump off every couple of weeks for a few days so that I can drop the water weight and then put the pump back on. I've not been able to find any info on insulin edema. My doctor thinks I'm fabricating all this......any info you might have would be helpful to me. Also, can U500 insulin be used in a pump? What is DDAVP and Byetta?

[ednurseintraining]

Just wanted to contribute and say that I like this site and especailly all of the opportunities to learn from other nurses. I was unaware of the many treatment for diabetes. My students will be informed about changes d/t your information and to the fact that they need to keep up with the changes.

[Psychaprn]

Originally Posted by truesn

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

Talk to your MD or a Certified Diabetes Educator about yopur food plan and/or Byetta. It's an injectable med supposed to work with oral meds and may promote some wt. loss..My insur. co. just denied it but I'm appealing and my Dr. will give me samples. It's helped dec. my Sugars and I've lost about 12 lbs. over the last mon. I think you also have to havve a AIChgb below 9 to qualify for byetta. good luck!

[Psychaprn]

Originally Posted by caroladybelle

Brittle Diabetes is the term used for very unstable diabetes mellitus, in my parts of the Country.

Diabetes Insipidus is a very different animal.

Perhaps the OP could clarify?

I agree-I always thought DI was caused by meds-i.e. lithium, steroids, etc. and that it was reversible.

[Psychaprn]

Originally Posted by lsyorke

Nope, "brittle" diabetes and diabetes insipidus are two completely different diseases.

Yeah, I always thought DI was caused by a med like Lithium or Steroids and was reversible-Anyone know more about Diabetes Insipidus?

[Psychaprn]

Originally Posted by rn/writer

I think one of the biggest obstacles to "compliance" (geez, I hate that word), is that you can use all the scare tactics in the world, show pictures of gangrenous feet about to be lopped off and post-mortem shots of shriveled kidneys, tell horror stories about blindness and heart attacks and neuropathy, cite statistics about early death, and all the rest, and it JUST DOESN'T GET IN.

Why? Because it's theoretical. It's out there somewhere applying to all those other people.

We need to find ways to show people what is happening to them, inside their own bodies, to mark the wicked progression in ways that make it real that this isn't something out of a textbook or a government pamphlet, but changes that are taking place right now to them.

With gentle but thorough questioning we need to help patients evaluate their energy level, changes in sensation, and even their sexual function. If they can begin to see the micro-alterations occurring to THEM the rest of it may finally seem real.

Then, once they have this personalized awareness, we need to ASK them what they want for their own future. Some patients are willing to combine constant vigilance and vigorous efforts in pursuit of nearly perfect numbers. Others are less so. It isn't for us to decide which route they will take. They are the ones who have to live with the work and the consequences.

Too much of diabetic education and monitoring is adversarial. All that attitude does is build opposition and defensiveness. Patients end up not only insulin-resistant but help-resistant as well. There is an all-too-pervasive lack of respect for diabetic patients that often starts out being patronizing and ends up with both sides exasperated.

Two things are necessary to overcome this exercise in frustration. First, teaching methods that supercede denial and help each patient evaluate the very personal course the disease is taking inside them, and second, the recognition that the battle belongs to the patient, not the doc or the nurse or the educator. Even an effectively informed patient may still make the "wrong" choices. We need to be okay with that, even as we communicate sadness because they matter to us.

Or maybe the information does get in and bombards the diabetic-leaving them to think the hell with it-this disease is going to kill me no matterr what and it will rob me of one organ or limb at a time-I might as well eat whatever I want. We need to remember diabetics can have clinical depression or eating disorders that need tx. too.

[one03grad]

Hi everyone

I have been a type 1 diabetic for 12 years and have had a pump for 4. My classmates are always trying to get on me about eating a cookie or anything sweet and i have to try to make them understand that is CHO not just simple sugar.Anyways, has any one heard about the new inhaled insulin that was approved by the FDA to treat type 1 and 2? How exciting. I am going to ask about that to my endocrinologist. Its not going to be available until this summer though and you may have to supplement one or two injections. If the effect controls my BG as well as the pump then i say " BRING IT ON". It would be nice not to carry my "beeper".

[rn undisclosed name]

Originally Posted by Psychaprn

Yeah, I always thought DI was caused by a med like Lithium or Steroids and was reversible-Anyone know more about Diabetes Insipidus?

I am a nursing student and have been told that some causes are
(1) head trauma/injury, (2) cerebral infection, (3) anything that can cause pituitary gland destruction (hypophysectomy, tumor that grows and obliterates the function, etc…).

I have not heard of Lithium or steroids causing it. I'm not quite sure how that would work because ACTH is produced from the anterior pituitary and ADH is produced from the posterior pituitary. Hmmmmm


Oh yeah, it is reversible by correcting the cause or administering vasopressin (in an acute situation) or desmopressin (long term use). You can also give thiazide diuretics with or without diabenese. The rationale for that is thiazide diuretics and oral hypoglycemic agents potentiate the effects of ADH that is already present in the body and makes it more effective. In order to use the thiazide diuretics you need to have part of the posterior lobe and it must be the mild form of DI.

I could tell you more but I think I'll stop here.

Kelly

[grannynurse FNP student]

I have not heard of Lithium or steroids causing it. I'm not quite sure how that would work because ACTH is produced from the anterior pituitary and ADH is produced from the posterior pituitary. Hmmmmm

Steroids cause a rise in one's blood sugars. I don't know how many times I have heard steroids cause diabetes, which they do not.

Grannynurse