Advised to not have basal insulin

Hi

I recently spent a night in hospital - GP thought I might have pneumonia but fortunately I was just being knocked for six by a cough/cold/near flu and was home the next day with instructions to rest properly and get better.

I'd had a few hypos (caused by an antibiotic) and had reduced my background by more than 20% - from 9 units twice a day to 7.

I was admitted to the ward at 8pm and my blood sugar then was 7.1. At 10.15 I said the the night nurse that I was going to have my Background Insulin (in case he needed to record this). He said that my BS at 7.1 was too low to be having a dose of insulin. I said it's OK, it's my Background which just keeps me going, like oil in a car, it won't make me hypo. I thought he agreed and accepted this but if he hadn't I felt too ill to get wound up and argue - but didn't think there was a need to argue anyway - so I had my insulin. The 7.1 test had been 2.5 hours earlier anyway and at 9.30pm it was 6.8, and then 7.8 at 23.00.

At 1.30 I was hypo; not a bad one and I had juice and he got me a sandwich, saying it was my own fault for having my insulin!!! I said I hadn't had any tea which might have had more to do with it!!!

Was I wrong? I felt terrible but think I would have felt a whole lot worse without insulin. I'm absolutely sure that a basic rule is don't stop your insulin when ill. Now I think I should probably have reduced it again maybe to 6 units or maybe asked for a bedtime snack, but I didn't think.

Thank goodness I wasn't more poorly; I did feel able to make my own reasoned decisions but sometimes it's hard to be sure whether I'm right.

To not have your basal insulin it just wrong surely! I sympathise with you because I've experienced unfortunately several times the ignorance general nursing staff have about diabetes. It amazes me. I know they have a hard job and I don't expect them to have an in depth knowledge of diabetes, but you would think that they understood the principle of having two different insulins, one to counteract food and one to keep you going, like as you say oil in a car.

I had an op recently and spent one night in hospital and the nurse said to me "can you do your own blood tests and injections?" and I said yes. OK that is good that they let me do it myself but it also meant they seemed to relinquish ANY interest. I did my tests, sometimes they asked about them, sometimes they didn't. They didn't ask if I had injected or eaten.

I think that blood sugar goes up and down due to the mere fact that you've had an operation. So even MORE reason to take basal to try and keep things steady. I had my op about 6pm and my sugar rose all evening, but at 6am I was hypo, 3.1. I had biscuits and glucose tablets. I must have fallen asleep again practically straight away. I woke up and hour later realising that no one came to check on me - the nurse that I had told had finished her shift and gone home and not recorded it, told anyone.. That is wrong.

So it seems even though you are ill/having an op and not totally with it all the time obviously, you have to be, otherwise god knows what could happen. I want to put my faith and trust in them, but sadly from my experiences I don't

My personal feeling is that I am an expert on my own body and its needs and requirements. Unless I am given an excellent reason for changing what I know works for me, then I will not change it. If I am being attended to by an endocrinologist, then I will happily listen, but a GP or hospital doctor has to be a jack of all trades, and there is only so much they can know about each condition and disease. Unless they can back up what they are saying with facts and excellent reasoning, then I'll be in charge of my insulin intake. That is not to belittle GPs and doctors - they do an excellent and very difficult job - but they have their limitations.

My understanding of insulin delivery is that you always need your background, this will still apply in hospital, unless they are feeding your insulin in by some other means......

The concept is simple and should have been no problem to understand by any medical professional......

Warwick, I feel the same as you, I am the expert about my diabetes, I even feel my knowledge is superior to that of my diabetes team, at least about my care personally.....

hypos happen all the time, sometimes for no known reason, especially so when you are on a fixed dose of background once or twice a day, as your background needs change by the hour.....

you were right to take your insulin, and were also prepared to treat the hypo.....just a normal day in the life of a diabetic....

well done......

I totally agree that each diabetic knows his own body better than anyone. It's the BASIC knowledge that they lack that annoys me. Surely they should know that a hypo is a very low blood sugar and you know, someone should have checked on me, let alone considering my BS was unstalbe because of an operation Not trying to be a drama queen, but I was just a bit shocked in my case that they knew I had gone hypo but never came back to check on me, to see if I was basically ok let alone what my blood sugar was. Nurse had gone off shift without telling anyone or recording it. Hey ho will just put it down to experience

Thank you all.
The next morning the nurse on duty knew all about DAFNE and was completely relaxed around me!! I'd heard the staff expressing consternation during their handover about the idea of adjusting your dose according to what you eat! It makes total sense to me after all!

I had to have a operation in 2006 and "my" nurse was someone whose daughter had Type 1 - it was so reassuring as she understood everything and let me get on with it. The hypo thing is so scary - especially when high BGs will impact on recovery and also make the staff look at you all horrified It's bad that it seems to be luck and chance and there doesn't seem to be a protocol to follow - the staff will of course be much more used to people with Type 2 but that's not the same at all .