Re: Vicki goes hypo

[Guest guest]

Hi, group...a few days ago I mentioned the unpredictability of this

disease...well, here's a perfect example. Last night I went to a potluck.

Now, potlucks are usually a minefield for me but I thought I had it down to a

science...I just had a little dab of everything and stayed away from the

obviously carb-heavy stuff such as pasta salads. Main dish was barbecued

gardenburger eaten open faced (only one side of bun). Well, I did have a

VERY TINY piece of chocolate torte for dessert (couldn't resist)...I gave

myself twice my usual dose of pre-dinner lispro insulin, which usually

suffices when I eat out. Before dinner my BG was 90.

At bedtime 3 hours later (10 p.m.) my BG was 211...high of course, but I knew

it'd be okay in the morning. I did my usual 10 p.m. dose of 4 units of NPH,

went to bed. Skipped bedtime snack since BG was so high. Woke up at 1:45

sweaty and with heart beating wildly...it took a few minutes to realize I was

hypo. Dragged myself out of bed, took BG sample and my BG was 37.

I took 3 glucose tabs, waited 15 minutes, measured again. It was 67 so didn't

take any more glucose tabs, instead had two peanut-butter pretzels and went

back to sleep. This morning at 6:30 BG was a nice 90,

My question is: why did my BG decline so precipitously between 10 p.m. and

1:45 a.m.? (from 211 to 37 in 3-1/2 hours? I didn't have ANYTHING (that I

know of) that was obviously fatty...I've had tiny bits of chocolate stuff

before that didn't affect me like this. Help! I don't want this to happen

again...am I doomed to have to give up potlucks forever? Vicki

[Guest guest]

Hi Vicki,

I don't know if this is the answer but some of the barbecue sauces have alot

of carbs,its just one possibilty

[Guest guest]

In a message dated 99-08-15 12:08:58 EDT, you write:

<< i Vicki,

I don't know if this is the answer but some of the barbecue sauces have alot

of carbs,its just one possibilty

>>

Nope, that's not the answer...didn't have any barbecue sauce on it, just

mustard and a slice of tomato...V.

[Guest guest]

Susie, thanks for your input... you may not remember but the whole reason I

was started on insulin was because I was pretty strictly low-carbing for well

over a year and my weight went down so much that my doctor got alarmed (down

to 117 and I'm 5-8 " )...as long as I was strictly low-carbing I was losing

weight and this didn't stop until I started insulin. And although I say

" strictly, " low carbing, I never got as low as Bernstein advocates (6-12-12)

Also, I was still having big jumps between highs and lows though I stopped

having hypos when I went off the sulf...

Since I've been on insulin my control has been much better...my average last

month was 116 and I suspect it may be lower this month...the only other time

I experienced a middle-of-the-night hypo was also a time when I had a high

count at 10 pm because of overindulgence and decided to forego bedtime

snack.

So maybe the lesson here is...even if I'm really, really high at bedtime I

shouldn't forego bedtime snack? (Of course, better would be not to go

really, really high at all) Interestingly, though, when my bedtime BG has

been around 120 I skip snack and everything seems to be okay...if it's

between 100 and 110 I've been having a very small snack, like a half a graham

cracker...if it's below 100 (which it's been a few times) I'll have two

graham crackers with peanut butter in between. All this seems to work fine.

Also, I am taking Glucophage 2000 mg. a day...I was taking Glucotrol XL but

stopped that as it's a sulf; tried Precose but that didn't work at all. I

know there's a lot of new meds out there that I haven't tried, of course...

Do you have any idea as to why my BG declines so precipitously when I'm

really high but not under the above circumstances?

In a message dated 99-08-15 12:55:11 EDT, you write:

<<

We don't yet know your C-peptide status ... once you know that, I think it

will be easier for you to judge. I think your personality and lifestyle is

that you don't want to have to live your life totally structured ... and yet

you want excellent control. So the only options I see for you are to get

that C-peptide and, if you still have pancreas function, to take pills which

improve your insulin resistance and be more watchful of your carbohydrate

intake. >>

[Guest guest]

Vicki wrote:

<< Help! I don't want this to happen

again...am I doomed to have to give up potlucks forever? >>

Vicki, I am writing this before I have my thoughts organized, just because

you are my friend and I am so concerned about these wild bg swings you are

experiencing. In a nutshell, my gut reaction is that insulin is " bad " for

you. I don't know if that makes any sense, but I have this feeling that

somehow you would be better off without injecting insulin ... if you can

possibly do it. It's all instinct at this point ... Just wanted to toss this

out.

Hugs,

Susie

[Guest guest]

In a message dated 99-08-15 14:10:08 EDT, you write:

<<

Vicki, it's gotta be your liver ... Your body senses that you are too high

and tries to counteract it ... but it is overreacting. That is what we call

the glucose rollercoaster.

>>

So do you think maybe it could be the Glucophage? (which works off the

liver)?

It is also true that before dinner I had a martini then with dinner about an

eight ounce glass of beer....(bud did neither of these on an empty stomach)

....could this have caused the problem?Vicki

[Guest guest]

We don't yet know your C-peptide status ... once you know that, I think it

will be easier for you to judge. I think your personality and lifestyle is

that you don't want to have to live your life totally structured ... and yet

you want excellent control. So the only options I see for you are to get

that C-peptide and, if you still have pancreas function, to take pills which

improve your insulin resistance and be more watchful of your carbohydrate

intake.

The problems have been associated with restaurant meals and eating " mystery

foods. "

Susie

[Guest guest]

In a message dated 99-08-15 16:37:43 EDT, you write:

<< Vicki, it's gotta be your liver ... Your body senses that you are too high

and tries to counteract it ... but it is overreacting. That is what we call

the glucose rollercoaster. >>

so if this is the problem, having a bedtime snack at 10 bedtime isn't going

to help things at all...the only way to get around this is when I have really

high highs at bedtime is to set the alarm for maybe midnight or 12:30,

checking BG and if it's heading downward, that's the time to do a snack?

Would that work? Vicki

[Guest guest]

In a message dated 99-08-15 17:00:34 EDT, you write:

<<

Bingo!! Liquor ties up your liver. Its general tendency is to temporarily

pull your glucose levels down.

>>

But the high reading was three to four hours AFTER I had the booze and I had

food in that time period....and the hypo wasn't until seven or eight hours

later than the ingestion of both food and booze. Could it have caused the

hypo that much later?

However, if this is what caused the problem I'll gladly give it up. Vicki

[Guest guest]

Vicki, it's gotta be your liver ... Your body senses that you are too high

and tries to counteract it ... but it is overreacting. That is what we call

the glucose rollercoaster.

Susie

[Guest guest]

Vicki wrote:

<< It is also true that before dinner I had a martini then with dinner about

an

eight ounce glass of beer....(bud did neither of these on an empty stomach)

....could this have caused the problem? >>

Bingo!! Liquor ties up your liver. Its general tendency is to temporarily

pull your glucose levels down.

Susie

[Guest guest]

Hi, Susie...actually, I DON'T think of myself as a type I...I suspect you're

right about being an " atypical type II. I'm most anxious to have that

C-peptide test so I can find out once and for all...I did ask you on another

post what I'm looking for on this test but I don't think you answered. How

does it tell me whether I'm a 1 or 2? Is it if there is no pancreas function

and is that what the test will tell me?

As another indicator, I don't think I'd die without the insulin ... when I

skipped a day because of 24-hour fasting because of sigmoidoscopy, my BGs

stayed in a very nice range...of course I didn't eat anything! (So the

answer to keeping my BGs down is don't eat :-)

so I guess that makes me a type II...but I started wondering about it again

when you mentioned somewhere that typically type IIs need large amounts of

insulin which put me back to " what type am I " since I only take an average of

14 units a day (in four doses).

As as far as you being " just a truck driver, " well, you're one who's

extremely knowledgeable and have done a humungous amount of research on

diabetes and are willing to share your knowledge with us...and we all really

appreciate this!

In a message dated 99-08-15 17:51:46 EDT, you write:

<<

Vicki, I'm a truck driver - not a doctor ... I'm just muddling my way

through this ... hahahaha ... But my guess is that you are tending to think

of yourself as a type 1 because we other type 2's talk so much about

obesity. So you are focusing on the insulin you inject. But if you are an

untypical type 2 (as I suspect), the few units of insulin injected at night

don't make a hill of beans, really. The foods you eat and - yes - the liquor

consumed - have more of an impact than it would on a type 1. And you are

taking large doses of glucophage, and I would look at the glucophage as the

source of your mysterioso bg swings, rather than the insulin injections.

How does that sound to you? >>

[Guest guest]

In a message dated 99-08-15 18:10:13 EDT, you write:

<< So you must accept the ups and downs. Your life is variable;

therefore, your diabetes control is going to be variable. But I think it

will improve your focus is you can make up your mind that you are an

untypical type 2 and not a type 1. This indecision is causing you a lot of

worry. >>

Yup. I've gotta stop being such a worrywart! I'll try not to bore you-all

any more on this subject. Thanks for being so patient. Vicki

[Guest guest]

Vicki writes:

<< so if this is the problem, having a bedtime snack at 10 bedtime isn't

going

to help things at all...the only way to get around this is when I have

really

high highs at bedtime is to set the alarm for maybe midnight or 12:30,

checking BG and if it's heading downward, that's the time to do a snack?

Would that work? >>

Are you a type 1 or a type 2? If you are a type 2 who is not

insulin-resistant (approx. 15% of type 2's fall into this category), you are

probably producing somewhere in the range of 40 units of insulin on your

own. Whether you inject 2 or 3 or 4 units of insulin at bedtime won't matter

much. If you are insulin-resistant, your body could be producing 100-400

units of insulin daily (but then you would probably be battling obesity,

like the rest of us Syndrome X diabetics). If you stopped taking insulin,

would you die? A type 1 would. If you are a type 1, you would be be on

insulin alone ... not sulfonylureas or glucophage.

Vicki, I'm a truck driver - not a doctor ... I'm just muddling my way

through this ... hahahaha ... But my guess is that you are tending to think

of yourself as a type 1 because we other type 2's talk so much about

obesity. So you are focusing on the insulin you inject. But if you are an

untypical type 2 (as I suspect), the few units of insulin injected at night

don't make a hill of beans, really. The foods you eat and - yes - the liquor

consumed - have more of an impact than it would on a type 1. And you are

taking large doses of glucophage, and I would look at the glucophage as the

source of your mysterioso bg swings, rather than the insulin injections.

How does that sound to you?

What I am saying is that one graham cracker at night or whether you inject 2

units or 3 units of insulin before bed aren't doing much ... it's the

accumulated glucose load of what you ate all day long - compounded by any

alcohol - and the reactions are weirded out by all that glucophage.

My guess is you have been trying to fine-tune your control by micro-fiddling

with 2-1/2 units of bedtime insulin vs. 3 units of bedtime insulin, when the

Big Picture is 2000 mg of glucophage, combined with variations in the amount

of carbohydrates eaten daily, compounded by alcoholic drinkies.

Susie

[Guest guest]

Vicki wrote:

<< But the high reading was three to four hours AFTER I had the booze and I

had

food in that time period....and the hypo wasn't until seven or eight hours

later than the ingestion of both food and booze. Could it have caused the

hypo that much later? >>

Yes ... During the first 3-4 hours, your liver was tied up with the drinks

.... when they wore off, your glucose levels rose, probably because some of

the foods you ate contained fat, which greatly postponed your glucose

reaction to the carbohydrates that were also in the foods you ate. And you

did take 2000 mg of glucophage that day, didn't you? My guess is that is

what caused the hypo.

Vicki, do you consider yourself a type 1 or a type 2? I think it's those

" big picture " issues that need to be examined, rather than each component.

If you consider yourself a type 1, you are focusing on the insulin and the

glucophage and carbohydrates may not be receiving enough consideration.

What I keep saying is that, as an untypical type 2 (my guess), your

nighttime insulin shots aren't mattering very much. You could probably

discontinue them or injecdt 10 units and still have the same variations in

glucose response.

The hypo probably kicked in after the fat wore off - if that makes sense. A

purely carbohydrate meal can be in and out in two hours ... no sweat. But

you add fats and the bg spike can last 10-11 hours. You never said what you

ate ... I am just guessing here.

Look at EVERYTHING. You ate mysery food ... you added alcohol, which

confounds things ... you are taking high doses of glucophage ... and you

added insulin ... and you added a snack. Nearly every time you have run into

trouble, it has been after a restaurant meal containg Mystery Food - or a

party. Diabetes control will never be Perfect. That is the nature of the

disease.

There are two paths to follow ... you can stop going to parties and going to

restaurants and carry your own food with you and carefully weigh and measure

everything ... but you and I have discussed that and you don't want to live

like that. So you must accept the ups and downs. Your life is variable;

therefore, your diabetes control is going to be variable. But I think it

will improve your focus is you can make up your mind that you are an

untypical type 2 and not a type 1. This indecision is causing you a lot of

worry.

Susie

[Guest guest]

Vicki wrote:

<< I did ask you on another post what I'm looking for on this test but I

don't think you answered. How

does it tell me whether I'm a 1 or 2? Is it if there is no pancreas

function

and is that what the test will tell me? >>

Try going to http://www.altavista.com and do a search using " C-peptide " in

quotation marks.

<< (So the answer to keeping my BGs down is don't eat :-) >>

What did you eat last night?

Susie

[Guest guest]

Vicki wrote:

<< (So the answer to keeping my BGs down is don't eat :-) >>

I have already written you eight posts on the subject today. If you didn't

get them, I will bundle them up and send them in private email. But never at

any point did I or anyone else in the group suggest that you not eat.

I suggested you look at the quantity of glucophage you are taking. I asked

you specifically whether you have ever reduced the amount to 500 or 1000

mg - and you didn't answer.

I suggested that you have focused a great deal of attention on your

nighttime insulin, when I doubt that that particular aspect of your diabetes

management affects your readings very much. I said that adjusting your

glucophage and your diet would probably have more of an impact. You did not

comment on this.

I asked you if there was ever a time lapse between the time you took the

sulfonylureas and the insulin - and you didn't answer.

I suggested that if your glucose readings were good on a low-carb diet and

the only problem was weight loss, you could correct that by increasing the

amount of fat in your diet - and you didn't respond to that.

I asked you what you ate last night - and you didn't respond.

Only YOU know the answers to the questions I keep asking. I can't keep

posting if you won't respond to the questions.

Susie

[Guest guest]

Hi Vicki,

You are not boring me. Since I have been recently diagnosed, I have been

like a sponge soaking up all the diabetes info I can because I don't want to

take any more pills. Susie has very generously supplied me with a lot of

very good sites, but I still like to hear anecdotal responses to certain

situations. If you write about your experiences it benefits me because if I

then find myself in a similar situation I will have an idea of how to handle

it.

My highest level today was 212.4 (11.8 on my meter) and my lowest so far

today was 102.6 (5.7). I have been writing everything down that I have

eaten just as Susie has suggested. I have also put in the time. I am

getting prepared to show the dietician. I am trying very hard but for all I

know I starved my self for nothing today. I wasn't even hungry until I had

breakfast then I was ravenous. Would it be because of the 1c. of porridge,

one toast with 1tsp becel, 1tsp of " All fruit strawberry spread " & 1/2

glass of skim milk? It is very hard for me to figure out what to eat between

a low salt, low cholesterol, low triglyceride, low carbohydrate and low

calorie diet. And my biggest problem is if I eat any raw fruit or

vegetables it feels like I have swallowed battery acid. I sure hope the

gastroenterologist that I see at the end of Sept. will come up with

something better that the medications that I am on now.

About drawing blood for testing, I get a good sample drop from my index and

middle finger, however every time I have tried my ring finger and baby

finger I get next to nothing. Do you guys always use the same finger or

what? I have been testing a lot to try to see if I can find a pattern

before I see the dietician. While I'm on the subject of fingers my ring

finger and baby finger have gone numb once in while. I have always assumed

that this was from the OA in my neck. Could it be from the diabetes? And

could that be the reason there is little blood in those two fingers?

I hope everyone is doing better today than yesterday. I'm going to go to

bed now so maybe I can get to sleep before I get too hungry.

~~~Faye~~~

>>>>>>>>>>>>>>>Snip>>>>>>>>>>>>>>>>

> Yup. I've gotta stop being such a worrywart! I'll try not to bore

you-all

> any more on this subject. Thanks for being so patient. Vicki

[Guest guest]

Raye writes:

<< I wasn't even hungry until I had

breakfast then I was ravenous. Would it be because of the 1c. of porridge,

one toast with 1tsp becel, 1tsp of " All fruit strawberry spread " & 1/2

glass of skim milk? >>

That all sounds pretty high-carb, Faye. The carbs set up food cravings among

insulin-resistant type 2's.

<< It is very hard for me to figure out what to eat between

a low salt, low cholesterol, low triglyceride, low carbohydrate and low

calorie diet. And my biggest problem is if I eat any raw fruit or

vegetables it feels like I have swallowed battery acid. >>

For now, since you are working on gaining goodcontrol of your diabetes, you

may just have to focus on avoiding the fruits that are tearing your stomach

up so badly and avoiding high-carbohydrate food items.

<< Imy ring

finger and baby finger have gone numb once in while. I have always assumed

that this was from the OA in my neck. Could it be from the diabetes? >>

You might want to go to a good search engine like http://www.altavista.com

and check out " Reynaud* syndrome "

If you put it in quotation marks like that, and add the asterisk, you should

get plenty of hits - all about Reynaud's.

Susie

[Guest guest]

In a message dated 99-08-15 21:35:01 EDT, you write:

<<

What did you eat last night?

>>

At the potluck...hard to remember...as I said, I stayed totally away from the

obviously carby things like pasta salads...had an open-faced veggie burger

with only mustard and a slice of tomato...about a tablespoonful of some

unidentifiable salad that from taste turned out to be a cold potato and

shrimp salad (very good)..had some cucumber salad (nothing in it at all that

would be carby except maybe the dressing had a little sugar in it), about a

tablespoonful of some kind of garbanzo salad...don't remember what else .

But I do remember very thin slice of chocolate ganache which was probably the

biggest culprit (besides the half bun and maybe the veggieburger)...

I actually passed up more than I ate. And the amounts were very

conservative. What I probably should've done was eaten dinner at home first

then gone to the potluck to socialize only...and skipped the booze. I know,

I know...Vicki pushing the envelope again :-)

[Guest guest]

Ooo, Susie, I was only joking when I said don't eat (didn't you see the

smiley face at the end?)

I didn't answer some of your major questions yesterday because I was really

short of time and some of them required checking back into my old records. I

work on Sundays and I was gone in the morning and checked my email on

five-minute breaks during work time I fully plan to do it today (Monday) and

here I am. Sorry,mea culpa!

More to follow. Vicki

In a message dated 99-08-15 21:59:27 EDT, you write:

<<

I have already written you eight posts on the subject today. If you didn't

get them, I will bundle them up and send them in private email. But never at

any point did I or anyone else in the group suggest that you not eat.

I suggested you look at the quantity of glucophage you are taking. I asked

you specifically whether you have ever reduced the amount to 500 or 1000

mg - and you didn't answer.

I suggested that you have focused a great deal of attention on your

nighttime insulin, when I doubt that that particular aspect of your diabetes

management affects your readings very much. I said that adjusting your

glucophage and your diet would probably have more of an impact. You did not

comment on this.

I asked you if there was ever a time lapse between the time you took the

sulfonylureas and the insulin - and you didn't answer.

I suggested that if your glucose readings were good on a low-carb diet and

the only problem was weight loss, you could correct that by increasing the

amount of fat in your diet - and you didn't respond to that.

I asked you what you ate last night - and you didn't respond.

Only YOU know the answers to the questions I keep asking. I can't keep

posting if you won't respond to the questions. >>

[Guest guest]

Susie, it's going to take me a little while to establish the chronology of my

meds and insulin so I'll respond to this as soon as I have a little more

time. Vicki

In a message dated 99-08-16 12:42:50 EDT, you write:

<< Did you ever go for any length of time when you

were on neither sulfonylureas or insulin? Curious about how you did then. Do

you think you could do the diabetes on diet and glucophage alone? Have you

tried cutting back on the glucophage? Etc.... )

>>

[Guest guest]

Hi, Susie, well, I went back over all my logs since diagnosis (12/97) and the

short answer is, there was no time when I was not on either sulfs or insulin.

I started out on Glucatrol XL only, 5 mg. then increased dose up to 20 mg.

daily by February 98; in February started adding Glucophage 500 mg. gradually

increasing up to 2500 mg. Reduced Glucatrol starting 11/98, ending 3/4/99.

Reduced Glucophage from 2500 to 2000 mg. on 3/29 with resultant BG rise.

Tried Precose briefly from 1/21 to 2/15 with no results. Started insulin on

2/15 with gradual but small increase in number of units taken.

During this entire time I never had a week without at least one BG reading

over 160 and the average was more like 4 to 6 times per week.

What's missing in this equation is when I started practicing low carbing. I

know by June of '98 I was definitely making a strong effort but the only way

I can be sure is by going back over my food diaries and I just don't have

time to do that today. But just looking at the information above, it

doesn't seem like there was any time when it was Glucophage and diet only.

And no time when it was diet only, either , though I remember when I was

really concentrating on low-carbing WITH meds and still having trouble with

high numbers -- I could see some improvement but never did have a complete

week without going too high . (Well, I never low-carbed as low as Bernstein

recommended but I think I was able to keep it down to 25 carbs per meal max

most of the time).

And yes, I tried cutting down of the Glucophage -- actually cut off 500 units

(lunchtime dose) but my insulin needs went up, (ratio of insulin to carbs

doubled) even though I was basically eating the same way. I didn't want to

take huge doses of insulin so I just kept the Glucophage dose at 2000 units.

I think at that time I put a question to the group as to which was

better...more Glucophage or more insulin...and I don't remember the answer.

Obviously I decided to stick with the " more Glucophage " though my insulin

needs have increased slightly since then.

Incidentally, with my increased dose of NPH at bedtime for the last two weeks

I haven't had a fasting BG above 125, most of them between 105 and 115, a few

lower, a few higher. . This is success!

In answer to your last question, Susie, the only way I think I could get by

on diet and Glucophage alone would be to do Bernstein STRICTLY -- and I don't

think I have enough discipline for this. :-( ...I love eating out too much.

And the insulin allows me to do this. Vicki

In a message dated 99-08-16 12:42:50 EDT, you write:

<< Did you ever go for any length of time when you

were on neither sulfonylureas or insulin? Curious about how you did then. Do

you think you could do the diabetes on diet and glucophage alone? Have you

tried cutting back on the glucophage? Etc.... ) >>

[Guest guest]

Vicki wrote:

<< I actually passed up more than I ate. And the amounts were very

conservative. What I probably should've done was eaten dinner at home first

then gone to the potluck to socialize only...and skipped the booze. I know,

I know...Vicki pushing the envelope again :-) >>

We are similar in spirit, girl ... ) Some folks adapt to restrictions

and schedules very readily ... I'm surely not one of them. I just have a

hunch that the nighttime insulin isn't having much impact except - and maybe

this party was an example? To drive you hypo when you are experiencing a

delayed reaction to the carbs you ate because there was something added

(fats? a few drinkies?). Did you ever go for any length of time when you

were on neither sulfonylureas or insulin? Curious about how you did then. Do

you think you could do the diabetes on diet and glucophage alone? Have you

tried cutting back on the glucophage? Etc.... )

Susie (always full of question ...)

[Guest guest]

From: WHIMSY2@...

<< Hi, Susie, well, I went back over all my logs since diagnosis (12/97) and

the

short answer is, there was no time when I was not on either sulfs or

insulin.

I started out on Glucatrol XL only, 5 mg. then increased dose up to 20 mg.

daily by February 98; in February started adding Glucophage 500 mg.

gradually

increasing up to 2500 mg. Reduced Glucatrol starting 11/98, ending 3/4/99.

Reduced Glucophage from 2500 to 2000 mg. on 3/29 with resultant BG rise.

Tried Precose briefly from 1/21 to 2/15 with no results. Started insulin on

2/15 with gradual but small increase in number of units taken.

During this entire time I never had a week without at least one BG reading

over 160 and the average was more like 4 to 6 times per week. >>

It's not unusual to spike over 160 occasionally. When I was trying to do it

on " healthy complex carbohydrates " alone, I used to do 200-300 after meals

regularly. Okay ... you were on sulfs for 15 months. That could have been

long enough to do in your pancreas - but you apparently still have some

functioning beta cells.

<< ... I think at that time I put a question to the group as to which was

better...more Glucophage or more insulin...and I don't remember the answer.

Obviously I decided to stick with the " more Glucophage " though my insulin

needs have increased slightly since then. >>

I am wondering if you might want to do some Glucophage in the morning only,

and increase your insulin according to whatever carbs-to-insulin ratio works

for you - using H to cover meals. I know how important tight control is to

you. And yet your social life is just as important to you. And I am thinking

that you might have the most freedom, in combination with the best control,

combining Glucophage as an assist during the day, plus H for meals - and

ease off overnight. Somehow, we need to give you the level of control you

are comfortable with, and yet not have you pass to the other side overnight.

Vicki, thank you for putting all that material together. I figure your

pancreas is getting pretty iffy, and you will want to baby it all you can.

We have been playing with the notion in the low-carbing diabetics' group

that type 2's could approximate the output of their pancreas and space the

shots out and sort of " give the pancreas a rest " by injecting the needed

amounts of insulin.

How does that idea sound to you? Paice and Ron Sebol and Gretchen

Becker and others over there have really been batting this idea around. You

could pick through the archives there for the past few weeks and really put

some good thinking together and mull the idea over.

<< Incidentally, with my increased dose of NPH at bedtime for the last two

weeks

I haven't had a fasting BG above 125, most of them between 105 and 115, a

few

lower, a few higher. . This is success! >>

There has been so much fretting and fiddling in the groups with that morning

reading! Some people feed it before bed; some quit eating after 6 pm; etc.

Sometimes I think it is just an individual thing that is very resistant to

change. What is uppermost in my mind is that you don't experience more of

these *dangerous* overnight lows! Nothing else matters if we lose you, girl!

<< In answer to your last question, Susie, the only way I think I could get

by

on diet and Glucophage alone would be to do Bernstein STRICTLY -- and I

don't

think I have enough discipline for this. :-( ...I love eating out too

much.

And the insulin allows me to do this. >>

I believe in the insulin, Vicki. I just didn't have a clear picture of your

diabetes experience up to now. I agree ... if you can't live with a program,

it's useless.

Susie