Wanted back to our period of time diabetes advice column, Ask out D'Mine, hosted by veteran type 1 and diabetes author Wil Dubois in NM. Hither, you can ask every the burning questions you may not want to ask your Dr.. Speaking of which, possess you ever felt corresponding you've needed a dictionary when confronted with all those medical acronyms and abbreviations? Now, Wil has some insights to help reach at to the lowest degree some of it a piece easier to understand.

{Got your possess questions? Email United States at AskDMine@diabetesmine.com}

Ladie, case 3 from Pelican State, writes: My pa was diagnosed with type 2 diabetes about 10 years ago. He has newly been prescribed Toujeo for his high blood glucose. The physician asked my father to go by a slippery scale leaf. 100mpd would quits 40 units, and 80mpd atomic number 2 was told to take 42 units of Toujeo. I am a Medical Assistant and this typewrite of slippery plate is foreign to Pine Tree State. My dad of course has high blood pressure, also. He also still likes to corrode fat greasy Southern someone food regularly. I've substituted some baked for fried foods and Copra oil instead of Vegetable. I would greatly appreciate your reply and clarification of dosage needed.

Wil@Ask D'Mine answers: Here's the thing: This is near a medical examination question. And unfortunately, we've been getting much of those lately in our inbox hither at Ask D'Mine. It can be hard sorting out which questions in the humankind of uncomplaining medical experiences free fall into general education and understanding (part of our charter), and which questions run the hazard of running aground on the rocky reefs of aesculapian advice. Monitor: I'm no doctor. Questions about "how much to take" and their cousins are questions best put through to docs operating theatre their staffs, non an advice columnist. Partly this is because I mightiness not know the answer, and the longer I've been away from the medical institution trenches the less I know and remember, but mostly because any lack of pellucidity about a therapy plan needs to be addressed right away past the person who has all the facts, so that no matchless gets scathe.

So this is just a friendly reminder to all our readers: If you deprivation to roll in the hay the science behind how "SuperShot UltaMax" Insulin works, I'm your man. You want to know how some to drive, what to do if you take too a good deal, or what to do if you miss a blastoff: Call your doctor!!

But like I said, yours was almost a medical question, so while I can't bear upon the part about "clarification of the dosage needed," I can talk a bit about sliding scales in general—and the one unexpected agency in which they can be superior to more modern methods.

But first… mayhap I harbour't had enough coffee nonetheless, or maybe I drank overly galore beers death night. (I heard on TV that some men like beer.) Or maybe my diabetes has triggered early onset dementia. Only I fundament't I stimulate heads or tailcoat out of your first question, because I can't figure out what "mpd" is an abbreviation operating theatre acronym for.

In context it would seem to be some sort of whole of mensurate or range, only it's not, you know, resonating any bells. So like any favorable confused citizen, I woke up Uncle Google.

And he told me, through Wikipedia, that MPD stands for lots of things. Apparently, it can miserly marrow packing district, managed pressure drilling, multiple personality disorder, retentiveness protection device (I gotta nonplus Pine Tree State one of those), heart rate repetition frequency, methylphenidate—a.k.a. Ritalin, the South American nation political party Movimiento Polular Democrático, music wreak daemon, mesoscale precipitation discussion, and assorted police departments including: the Milwaukee Police Department, the Minneapolis Section, the Memphis Police Section, the Miami Police Section, the DC cops' Metropolitan Police District, and the Mumbai Police Department.

That's non much assist.

Regarding "sliding scales," there are umpteen out in that respect. All of them strive to create variable dosing that's adjusted to reflect the environmental conditions at the time of the dose.

Oh my.

That sounded overly clinical, didn't it?

In plain English, a sliding scale is a way of revealing people how a lot insulin to take based—by and large—on the level of their blood glucose. The high the carbohydrate, the high the dose. Simple pimple. They used to be used in hospitals very much to ensure that the nurses didn't make whatever math errors. I put on't know why. All the nurses I've proverbial are pretty lancinating cookies when IT comes to math.

In any case, sliding scales are straightaway more often than not regarded as an old-designed and down-of-date approach, but this misses the fact that the slide has one advantage ended its sometimes to a greater extent precise cousin the correction factor, and that's the fact that the slide can be non-linear. Bear with Pine Tree State. Atomic number 3 most people with diabetes can attest, very high sugars are often more stubborn than get down high sugars. A "bad" high can be tenacious, requiring bolus aft bolus after bolus to bring the all-day sucker back off again. A grasp physician can easily build a top-of import sliding scale to pitch a heavier clout to a tougher opponent; while most ratios, factors, and physical science calculators are amazingly dumb in comparison, applying the very math, regardless of the elevation of the numbers being addressed. The only twist I tooshie recall that was designed to deliver insulin in a not-bilinear way was the deplorably now-defunct Deltec Cozmo 1800 insulin pump.

There are probably a thousand shipway to set up a swoop, and slides are almost e'er misused for fast-acting insulin to fix above-target line sugar. But Toujeo is a long-acting dense basal insulin. It's just superintendent-sized Lantus. And so sliding an insulin that whole kit and caboodle for a total day is… well, novel at the very least. I've seen adjust-to-target approaches to radical, where the patient is told to increase the basal by one unit a day until their morning sugars wait good. But I don't recall ever eyesight this rather ongoing adjustment of basal insulin earlier. It's also confusing that the shell seems backwards, with Thomas More insulin for fewer MPDs, whatsoever they are. So, please, delight, please reach resolute this doc and draw sure that there's not some sort of miscommunication leaving on here.

Now happening to food, where I'm on safer terra firma, advise-wise. First, you need to know that research project has proven that changing your eating habits is harder than changing your grammatical gender. No offense intended to the sexuality-challenged, just food carries huge emotional, multiethnic, and mental components that most of us don't recognize.

So pace lightly. Interrogative individual to deepen their dieting is interrogatory for deep changes in their life, soul, and personhood. Who they are, and how they pertain to the world. My advice? Slow, supportive, baby-footmark changes that void the wholesale "attractive away" of beloved foods. To that end, you're inactive to a good start by seeking to modify your father's recipes in changing oils and swapping much baking for sauteing. I cast around to look for encourage ideas to help you out and came across two that impressed me.

The cringingly-named Living Chirpy website has gathered ten low-carb solutions to Southern comfort foods, and the experts at South-central Livelihood (who would be intimate better?) give birth knocked the fat out of much of the fattier Dixie plates. They even used some cookery hoodooism to get peewee and grits lowered to 235 calories with but two grams of fat! What the….? It's inundate trick, I tell ya.

Right away, recipe modification is only one approach. Sometimes information technology works great, and folks are happy and healthier. But other times they're miserable. I underestimate information technology depends on their taste buds. If diet alteration fails, Don River't forget that a legitimate alternative to eating right is feeding naughtily, just in smaller portions. Simply put, some people have better luck reduction the serving sizes of the foods they love, rather than changing what they eat.

You john also take trembling up the elements of a meal so that your dad has one portion of upright ol' South-central soul food with two healthier sides. This way he doesn't see the changes A pure sacrifice.

So call in the doc about that MPD crazy slew, and give yourself a high-5 happening your superb mould helping your dad slide into better eating.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that noesis from the trenches. Bottom Production line: You still need the guidance and care of a licensed medical checkup professional.