This is a Journal entry by Phil

Visiting Hours

Post 1

Phil

So time for another trip to the hospital. Only a few months since the last one. I think it's because the doctor wanted to see if changing part of my regime makes a difference.
Last time he suggested upping the basal done by a couple of units each shot (I use Detemir twice a day at morning and teatime). I think this has been working well for the most part till recently. Over the last week I've been getting high numbers on waking - between 10.5 and 13.5 mostly. One morning I woke much about 5am feeling funny went and tested and I was 2.8 Not a good number. So as I seemed to have been waking around that time for a while I wondered if my teatime basal shot was too much. I've dropped the dose back down to 16 units and for the last couple of days I've been getting good numbers (below 10 and today below 8 smiley - smiley). Lets hope I can keep it up. At least the doctor agreed it seems to be what's going on (dawn phenomenon/Somogyi effect) and what I'm doing isthe right way to try and tackle it.
As for the other bits and pieces the nurse could find any blood in me smiley - yikes so someone else had a go and got some My weight has gone up a couple of kilos and my BP was up to 140/96
The doctor thought that I should be seen about the BP as it seems to have been going up for a while (when I get it done at the gp surgery it seems fine). So I've been refered for 24 hour BP monitoring, now to wait for that appointment. Of course I should lose some weight and do more excersise which would help all my numbers. Other than that it's come back in 8 months time - feb 08 - and we'll see you again then.


Visiting Hours

Post 2

Titania (gone for lunch)

Never having heard of the Somogyi effect, I had to look it up. On diabetesselfmanagement dot com it says:

'People who wake up with high blood sugar may need to test their blood glucose levels in the middle of the night (for example, around 3 AM).'

What is it with that hour between 3 and 4 am? In Sweden, we call it the 'wolf hour' smiley - fullmoon - Ingmar Bergman even made a film with the title 'Hour of the wolf'. The film has the following (freely translated) prologue:

'The wolf hour is the hour between night and dawn. It's the hour when most people die, when the sleep is deepest, when the nigthmares are most real. It's the hour when the sleepless is haunted by his severest anxiety, when ghosts and deamons are at their mightiest. The wolf hour is also the hour when most babies are born.'

There, a piece of trivia for free smiley - winkeye

Good luck with your BP monitoring - I hope it was only temporarily high!


Visiting Hours

Post 3

Titania (gone for lunch)

*discreetly snatches the and replaces it with a smiley - cheerup muttering something about 'preview'*


Visiting Hours

Post 4

Phil

I agree, they should add to give the same effect as smiley - cheerupsmiley - biggrin
I hope it is just white coat syndrome (high bp only when at the doctors/hospital) for the BP numbers but I can only wait and see. And try not to worry about it - that will make it worse for sure!

The dawn phenomenon (where the body readies for the day by releasing hormones just before waking, thus for someone with diabetes it can mean higher blood sugar and that it's harder to bring down) and somogyi effect are just another couple of things to think about and juggle when trying to keep numbers under control. And then people wonder why some diabetics get obsessed by the numbers and chsing the dream of perfect control...


Visiting Hours

Post 5

Agapanthus

I suffer majorly from white-coat-syndrome, in regards to BP. Most practitioners I've met are sensible enough to leave teh cuff (loosely) on me and talk to me about trees or holiday plans for a few minutes before trying again, at which point the ol' BP is always utterly normal. Did they do it twice? If not, and if it is always OK at the GPs, I'd say it absolutely is iatrogenic and really, they ought to know better.

*Makes an 'obsessed with numbers' face* Well, I jolly well would be obsessed too. What on earth is there to wonder about? Some people seem to have all the common sense and empathy of a house-brick.


Visiting Hours

Post 6

Phil

I'd probably agree Ag, about the white coat thing, but it has been creeping up over the last couple of years so fair enough to check I think.


Visiting Hours

Post 7

Phil

And I suppose I should have called the journal title visiting hour as I was only there for about an hour, rather than hours that I could have been. I think they're getting a bit more efficient at seeing patients.

Have you been to see a doctor about your blood test result yet Ag? And if so what is the result (and I guess you're still waiting on a date for your surgery).


Visiting Hours

Post 8

Galaxy Babe - eclectic editor

smiley - cuddle

I've had my fill of hospitals this year as well!smiley - yikes


Visiting Hours

Post 9

Agapanthus

True, it's always worth checking everything twice.

Well, no date on surgery, but it appears, from my blood test results, that I am definitely, no two ways about it, insulin resistant. Some medical debate now going on as to whether to prescribe me metformin right now, or make me do a fasting/ glucose tolerance test and THEN prescribe me metformin. *Allows head to drop to desk with loud bang*.


Visiting Hours

Post 10

Phil

blimey Ag. You need to get on the metformin as soon as you can. Hope you can persuade them you don't need the tests, though you could agree to the tests if your gp will prescribe you the drugs there and then.

smiley - hugGB Hope it's all ok and you can be told everything is clear soonsmiley - hug

I went and got the blood results from the doctor that I had done a couple of weeks back and everything there (liver function and routine bloods) is fine. I might look up some of the tests at some point because I've got a printout from them. No need to have more taken till september when it's the anual cholesterol and routine diabetes tests (HbA1C). I might pester them about the hospital results before then though.


Visiting Hours

Post 11

Wand'rin star

Sorry I didn't see this earlier. You've always been so supportive and helpful with my similar results. I am similarly waking early in the morning with lows. My chap has suggested a pre-bed aplle or something similar (low GI) and this seems to have helped. He put up my BP meds as he didn't seem convinced by "whitecoat syndrome". He has also given me Reductil to try and shift some weight. I lost a kilo last week, but there's a long way to go.
It seems that it really IS exercise AND better timekeeping - I am still reluctant about eating at the same time every day, but that's obviously what it takes. The dietician has also bullied me into writing feelings in the food diary and I feel slightly better. All this being good is just so boring. But, considering what the alternative is....
So - returning all your kind thoughts - I'm sure this is a blip and hope the weather improves enough to enable you to do a bit more walking. Very best wishes smiley - starsmiley - star


Visiting Hours

Post 12

Phil

Thank you smiley - starsmiley - hug
It is hard work isn't it. Last night I forgot to reduce the evening dose to 16 so I took 18 units of the detemir. This morning I wake up with 3.9! Still that's easier to deal with than the 12s and 13s I had the other week.
Oh well onwards we go.


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