How can I persuade my Diabetic Doctor to change my insulin?

Question

I am on Novorapid and Levimir and I am finding these too erratic. Either there is a very long delay in reducing sugar levels in my blood, and then there is a crash, or other days I am crashing four or five times a day. I have no warning. One minute I can be fine, next minute nearly passing out at 1.4!

When I asked the nurse (doctor is rarely there) she just says, well, you might be allergic to animal insulin! I was put on the "human insulin" almost 6 months after my diagnosis and have had trouble with it ever since, but there is nothing "human" about it.

Discussed it with pharmasist again and again who says it should not continue like this and that I should talk to GP/Nurse/Consultant, but none will talk about it.

I feel like giving up insulin altogether, but having done that in the past I know the consequences!

Because I have a very complicated history I cannot change doctors. There are only 3 doctors in the surgery. None of them will discuss it with me. The Diabetic Nurse in the surgery says go to the hospital clinic. The hospital clinic nurse is aggressive, tells me not to come in when I have had an infection - practically all the time - last time I asked about this she turned her back on me.
The other one there is equally set on"human insulin". I am so depressed now I want to die.

I live in the UK. While appreciate answers from abroad, UK does not have the same systems as other countries and I am at my wits end.

I have even said that I am prepared to go to a different hospital miles away though I am disabled. I was told this is not an option.

I have just settled into a new flat and am very happy with the area I am living in, just not the flipping medical profession!

Answer 1

Get your copy of the "My Visit Planning Tool," a handy pocket-sized booklet sponsored by the Association's Doing Better Initiative. Take this booklet with you to every office visit, and use it to keep track of medications you're taking, as well questions or concerns you want to ask your doctor. To get your copy of the "Visit Planning Tool," call 1-800-DIABETES and ask for "A Visit Planning Tool."

Answer 2

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Answer 3

How is your carb counting skill? Are you correctly counting grams of carb and the units needed to cover only what you are ingesting?

The levemire is a long acting insulin with virtually no spike. But it may need to be split dosage, 3/4 in the morning and 1/4 in the evening? I just talked my doc into this to see what will happen. It is working better for me.

Do not ever take the Novorapid more than about 15 minutes before eating and make sure you are eating the correct amount of carbohydrate for the amount of insulin you are injecting. If necessary doesn't the package insert say you can inject after eating?

Crashing is absolutely no fun. Did the doctor say "take this amount. end of argument!" on the novorapid? That rarely works unless you eat exactly the same thing at exactly the same time every day without fail and do not get stressed or do more exercising than normal.

Most of the others have said, Find a new doctor. Yes, if you can't talk to this one, find another one!! This one is apparently too busy to answer your questions and problems.

Answer 4

You're not alone. Many people find it impossible to live with 'human' insulin and rely on animal insulin.

Sometimes doctors assume you aren't doing it right: they assume you're forgetting to eat, or taking your insulin at the wrong times, or snaffling sweets to climb out of the hypo and then getting a meter result of 15 and taking extra insulin (cue Trouble).

Healthcare practitioners really need to listen carefully to diabetic patients to ensure they fully understand what's going on. In your case it sounds as if the combination of Novorapid and Levemir just isn't going to work. What did you take before? If you took something before that worked, insist on going back to that (or a similar insulin if the one you used to take as been discontinued).

There was a move among some healthcare professionals a couple of years ago to try to get most patients onto 'human' insulin, but many patients didn't take well to it and went back to animal insulin.

If your GP won't discuss it, see another GP at the practice. If the other GP won't discuss it, say you're not managing on your current insulin and ask for a referral to the Diabetes Nurse Specialist or to the Diabetes Clinic at the nearest hospital that has one.

Good luck!

Answer 5

Make sure you teste your sugar every time you crash so they know exactly how low you are going.

It sounds to me like you might have the genetic form of diabetes MODY (maturity onset diabetes in youth) (you can get it later in life too though) . I have it and some times I am high and other times I get a low patch, even though my diabetes nurse said that "diabetes doesn't work like that". Ask your doctor/nurse about having a genetic test done to make sure. Depending on the type you might need a pill rather than insulin.

Answer 6

It is your choice to find a new Dr. if you're not happy or satisfied with the one you have. I've had to do that. I didn't agree with something my Dr. said once and he tore a strip out of me, degraded me and asked me when I got my medical degree and became a Dr. He told me HE was the DR. I've been better ever since not seeing him anymore. I was a Medic in the Canadian Armed Forces and an RNA on the street. Surely a person learns something in 40 years. Besides that I was more up on things, newer techniques and procedures than he was. Your Dr. is not always right. Especially if most or all of his life is spent in the office.

Answer 7

These exercises will help your diabetes and over time you will need less and less insulin. You will know in weeks, because you take your sugar reading everyday.You will feel better that you have found a natural way to control your diabetes.Do these exercises everyday and reap the benefit.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril
then – close left nostril with two fingers and breath-out through right nostril
then -keeping the left nostril closed deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 20 to 30 minutes twice a day(maximum 60 minutes in one day).
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 20 to 30 minutes twice a day.(Max 60 min/day) Not for pregnant women. Seriously ill people do it gently.
Also everyday press the centre point of the palm of your hand 40 times with the thumb and press the tips of all fingers 40 times each.

Answer 8

hi there im on novarapid and lantus and with my novarapid my nurse told my i can adjust my novarapid to what im eating so for ect if im just eating toast for breakfast i would give myself lets say 15units then say for lunch i would have somethink like a big pasta or a chinese i would give my self an extra 2/5 units to what i would usally give myself, and so on so if i ate somethink little i would reduce my inserlin by 2/5units i hope this helps, im findind my diabetes hard one min i can be really low 1.3 then the next really high 20.9,, ive been in hospital with dka we just have to live with it untill they find somethink better then injecting lol hope all goes well xx

Answer 9

Hi,you need to demand that your insulin is changed if the doctor will not change it.Then go to citizens advice or change your doctor.Good Luck

Answer 10

I find it surprising that your doctor won't talk about it. What does he/she say when you raise the point? Your doctor's rarely there? Sounds odd. Doesn't he have surgery hours?

If I were you I'd find another GP, if what you say really is the case.