Re: Need for background insulin (This is what I was told)

[Guest guest]

Thanks Barb, yes indeed I do use NPH at bedtime...up to 6 units now

(gradually up from 4, increasing half a unit at a time...still not much).

Each time I increase it, my morning BG sits nicely at between 80 and 110 for

about six weeks then starts creeping up...when it gets to +125 for more than

a few days in a row I up it again. (Where will this all end??)

I asked about background because my BGs tend to peak really high an hour

after meals even properly matching carbs to H...sometimes up to +200 and I'm

a little worried about those spikes as something I read on the LC-D list

talked about PP peaks having an effect on future problems, as a matter of

fact that's what they use in England instead of A1C as indicator of future

problems. Would taking a background insulin eliminate this?

I went contra dancing last weekend and we did Irish jigs which are very

aerobic...I thought I prepared for this by not taking as much insulin at

dinner and having a very small dish of ice cream for dessert too (for the fat

to slow down the peak, doncha know)...after two very energetic (and long)

dances I thought I'd better check BG...it was 58! So I had some glucose tabs

then a cooky...sat out next two dances...checked again...it was not much

higher, certainly not enough to do more dancing, so I had another

cooky...danced only a little more, decided to quit, went home, checked BG (it

was 10 p.m. , my usual checking time) and BG was 200+! Guess those cookies

just took a little while to kick in! Messed up my weekly average too, darn

it. :-( Vicki

In a message dated 00-02-08 10:12:12 EST, you write:

<<

Vicki, I only use it at night now. 20 units of N. You are taking some a

night, aren't you? So this is probably a moot point, if your numbers are

good with the H during the day. When I was taking N in the morning, I'd go

low while digging a ditch or something, and I find the H for food is much

simpler. Actually, if I low carb during the day, I don't use the H either,

if I'm working hard. And, I've noticed (bg's this am were 72) that if I

work hard the day before, I need to use less N overnight. Usually they are

80-90, which with the dawn effect gets me through chores before breakfast.

I think I'd only worry about N or U during the day, if your H regimen isn't

working well enough. >>

[Guest guest]

Would you let me know what your research discovers about U and peaks? I'm

seriously thinking of asking my doc about trying it in addition to the H to

try to smooth things out (if this is what it does).

<Do you go low at all?

I go low all the time...but my body seems not to care unless it's below

aboutr 42, don't even notice it until then. That's why I check so often. The

only time I've ever gone noticeably low in the middle of the night have

always correlated with evenings when I've had a glass of merlot with

dinner...but not all the time, either. The daytime hypos happen usually if

my exercise is particularly vigorous. I go through a big bottle of those

glucose tablets a month! Also go low if I go out to dinner and miscalculate

the amount of carbs to insulin. (very tricky when eating out -- and I eat out

a lot!) I always check an hour after eating out meal to try to keep on top

of this. Vicki

Could you up

your match insulin to carbs ratio? >>

[Guest guest]

Vicki wrote:

>Thanks Barb, yes indeed I do use NPH at bedtime...up to 6 units now

>(gradually up from 4, increasing half a unit at a time...still not much).

>Each time I increase it, my morning BG sits nicely at between 80 and 110

for

>about six weeks then starts creeping up...when it gets to +125 for more

than

>a few days in a row I up it again. (Where will this all end??)

****Could it be that your pancreas is losing beta cells? It

seems to me that our insulin needs would perhaps increase as time goes by?

I know my nighttime is more than it was when I started. It seems to creep

up like yours. Maybe you could research a little? I'd love to know the

answer, and I'm lousy surfer.

>

>I asked about background because my BGs tend to peak really high an hour

>after meals even properly matching carbs to H...sometimes up to +200 and

I'm

>a little worried about those spikes as something I read on the LC-D list

>talked about PP peaks having an effect on future problems, as a matter of

>fact that's what they use in England instead of A1C as indicator of future

>problems. Would taking a background insulin eliminate this?

****I think it would, Vicki. When I first started on insulin, I

was taking background N in the morning, but work made me go low, and it was

easier to stop than to figure out exactly what time I could work and what

time I had to eat... I remember something about U not having peaks, and so,

not causing hypos in the night. I think it's an old LC-D post that

resurrected a couple of weeks ago? Do you go low at all? Could you up

your match insulin to carbs ratio?

>

>I went contra dancing last weekend and we did Irish jigs which are very

>aerobic...I thought I prepared for this by not taking as much insulin at

>dinner and having a very small dish of ice cream for dessert too (for the

fat

>to slow down the peak, doncha know)...after two very energetic (and long)

>dances I thought I'd better check BG...it was 58! So I had some glucose tab

s

>then a cooky...sat out next two dances...checked again...it was not much

>higher, certainly not enough to do more dancing, so I had another

>cooky...danced only a little more, decided to quit, went home, checked BG

(it

> was 10 p.m. , my usual checking time) and BG was 200+! Guess those cookies

>just took a little while to kick in! Messed up my weekly average too, darn

>it.

****The H seems to be very short lived. I wonder if you'd have

been better off taking no (or 1/2) your insulin, dancing away, then testing

afterwards and taking more if necessary. If I'm working hard, I don't take

insulin at all until supper, but I keep the carbs down too. Like you, I'm

not a rocket scientist, a mathmatician, or even a very good bookeeper, so I

really wish we could come up with something simple that we could count

on!!!!

Barb

----------

>

>In a message dated 00-02-08 10:12:12 EST, you write:

>

><<

> Vicki, I only use it at night now. 20 units of N. You are taking some a

> night, aren't you? So this is probably a moot point, if your numbers are

> good with the H during the day. When I was taking N in the morning, I'd

go

> low while digging a ditch or something, and I find the H for food is much

> simpler. Actually, if I low carb during the day, I don't use the H

either,

> if I'm working hard. And, I've noticed (bg's this am were 72) that if I

> work hard the day before, I need to use less N overnight. Usually they

are

> 80-90, which with the dawn effect gets me through chores before breakfast.

>

> I think I'd only worry about N or U during the day, if your H regimen

isn't

> working well enough. >>

>

>---------------------------

[Guest guest]

In a message dated 00-02-08 21:51:51 EST, you write:

<<

Could you up your match insulin to carbs ratio? >>

>>

Right now I'm doing 15 carbs per one unit of insulin...then I add another

unit " just for good luck " . (So the number isn't actually 1:15). Sometimes

this is right on the button, sometimes not. I like to have enuf insulin to

allow for between-meal snack, which means a little extra. (How do others do

it?) If I match carbs to insulin at meal exactly then I'm too high for

between-meal snack. I wouldn't dare have my snack without checking BG first.

If my guess is way wrong and I'm too low at snacktime then I have a

higher-carb snack. (This works for me because I'm not overweight)...if I

guessed wrong and I'm way high - and this happens sometimes -- I'll give an

additional unit or two of H (depending on how high) and check again in an

hour.

As you can see, this is a very inexact science. Thank goodness for meters --

and good insurance, which hasn't -- so far -- fussed when I go through 200+

strips per month! Vicki

[Guest guest]

In a message dated 00-02-08 21:51:51 EST, you write:

<<

Could you up

your match insulin to carbs ratio? >> >>

Oh yes, more on above...re the matter of having a little extra insulin to

allow for snack...meaning that my snacks are generally not carb free. I like

to have a piece of fruit in the afternoon and depending on the season, I can

do an orange or part of an orange or part of an apple...or a small amount of

cantalope. My morning snack is generally a half or third piece of a pastry

(my reward for exercise) with a latte...again, this works because I'm not

overweight. I weigh it out carefully on my little gram scale. One piece

generally lasts me for 2-3 days. Vicki

[Guest guest]

>this works because I'm not

overweight. I weigh it out carefully on my little gram scale. One piece

generally lasts me for 2-3 days. Vicki>

****I really am so jealous that you can eat just a little piece

at a time. Pastry for me doesn't even make it home - I gobble it in the

car! So, I don't buy it.

>Right now I'm doing 15 carbs per one unit of insulin...then I add another

unit " just for good luck " . (So the number isn't actually 1:15). Sometimes

this is right on the button, sometimes not. I like to have enuf insulin to

allow for between-meal snack, which means a little extra. (How do others do

it?) If I match carbs to insulin at meal exactly then I'm too high for...>

****Vicki, it sounds to me like you would really be well

served by a background insulin. I don't think H lasts long enough to cover

a snack as well, and the snack needs its own H. I would think with the

background insulin you could go back to the 1 to 15 ratio.

Barb

--------------

RAINBOW FARM UNLTD.

Breeding Premium Oldenburgs,

and fancy sport ponies.

http://www.rainbowfarm.com

Re: Need for background insulin (This is what I was

told)

>From: WHIMSY2@...

>

>In a message dated 00-02-08 21:51:51 EST, you write:

>

><<

> Could you up

> your match insulin to carbs ratio? >> >>

>

>Oh yes, more on above...re the matter of having a little extra insulin to

>allow for snack...meaning that my snacks are generally not carb free. I

like

>to have a piece of fruit in the afternoon and depending on the season, I

can

>do an orange or part of an orange or part of an apple...or a small amount

of

>cantalope. My morning snack is generally a half or third piece of a pastry

>(my reward for exercise) with a latte...again, this works because I'm not

>overweight. I weigh it out carefully on my little gram scale. One piece

>generally lasts me for 2-3 days. Vicki

>

>---------------------------

[Guest guest]

In a message dated 00-02-09 11:37:03 EST, you write:

<<

How do you maintain your weight while using insulin and eating snacks and

fruit and all? If I did that I would not be able to get out my front door!

Are you T1 or T2? My insulin resistance put more than 35 lbs on me in 1

month of starting insulin! And I can't get it off/ Even with low

carb...well...almost *no* carb! I am miserable! What would you suggest I do?

>>

Boy, Toni, I don't know...I'm just flopping around like the rest of you all.

I'm neither a type 1 or 2...it appears from all evidence that I'm a type 1.5,

which as you might guess, is somewhere between. I'm still not overweight -

at diagnosis I was at around 137 or so, got down to 117 with very strict low

carbing which is when I went on insulin...I'm now up to 130, which is still

not overweight but I'm getting a little concerned. (I'm 5'8 " ) Apparently

like type 1's I DON'T have insulin resistance, as evidenced by the fact that

it doesn't take much insulin to keep my numbers where they ought to be.

However, I'm getting worried about the one-hour PP peaks and I'm now thinking

about background insulin which to this point I haven't taken. The math

required sort of boggles me because as I've mentioned earlier, I'm rather

mathematically impaired. In private posts with Barb I'm trying to work it

out. I want to take a background insulin without peaks if possible so I don't

have to take that into account when figuring out how much I need. Which

means ultralente. Vicki

[Guest guest]

You do have a good insurance company. They realize that the good control now

will probably save them a lot of money down the road! Too bad the HMOs

can't see past the end of their noses! If my doctors years ago had told me

to test more and maintain good control instead of maintaining a 13.9 for

about 5 years, taking at least 3 oral meds per day at max dose of

each...then perhaps my insurance company would have save a lot too! They

just keep paying and paying and paying...with no question! I think some are

really trying to do their jobs! *hugs* Toni

Re: Need for background insulin (This is what I was

told)

> From: WHIMSY2@...

>

> In a message dated 00-02-08 21:51:51 EST, you write:

>

> <<

> Could you up your match insulin to carbs ratio? >>

> >>

> Right now I'm doing 15 carbs per one unit of insulin...then I add another

> unit " just for good luck " . (So the number isn't actually 1:15). Sometimes

> this is right on the button, sometimes not. I like to have enuf insulin to

> allow for between-meal snack, which means a little extra. (How do others

do

> it?) If I match carbs to insulin at meal exactly then I'm too high for

> between-meal snack. I wouldn't dare have my snack without checking BG

first.

> If my guess is way wrong and I'm too low at snacktime then I have a

> higher-carb snack. (This works for me because I'm not overweight)...if I

> guessed wrong and I'm way high - and this happens sometimes -- I'll give

an

> additional unit or two of H (depending on how high) and check again in an

> hour.

>

> As you can see, this is a very inexact science. Thank goodness for

meters --

> and good insurance, which hasn't -- so far -- fussed when I go through

200+

> strips per month! Vicki

>

> ---------------------------

[Guest guest]

How do you maintain your weight while using insulin and eating snacks and

fruit and all? If I did that I would not be able to get out my front door!

Are you T1 or T2? My insulin resistance put more than 35 lbs on me in 1

month of starting insulin! And I can't get it off/ Even with low

carb...well...almost *no* carb! I am miserable! What would you suggest I do?

Toni

Re: Need for background insulin (This is what I was

told)

> From: WHIMSY2@...

>

> In a message dated 00-02-08 21:51:51 EST, you write:

>

> <<

> Could you up

> your match insulin to carbs ratio? >> >>

>

> Oh yes, more on above...re the matter of having a little extra insulin to

> allow for snack...meaning that my snacks are generally not carb free. I

like

> to have a piece of fruit in the afternoon and depending on the season, I

can

> do an orange or part of an orange or part of an apple...or a small amount

of

> cantalope. My morning snack is generally a half or third piece of a

pastry

> (my reward for exercise) with a latte...again, this works because I'm not

> overweight. I weigh it out carefully on my little gram scale. One piece

> generally lasts me for 2-3 days. Vicki

>

> ---------------------------

[Guest guest]

A good insurance company can make all the difference in the world. Mine

sent me a pamphlet with guidelines for good diabetes treatment. There's a

list of tests, etc., that calls for an A1c and doctor's visit every three

months, foot exams, opthalmologist exam, and a bunch of other stuff. They

also just paid for an In Charge meter for me. In addition to regular

glucose testing, it has a different test strip that you use weekly to do a

fructosamine test. The fructosamine test is similar to an A1c except it

only covers a one-week period.

Re: Need for background insulin (This is what I was

told)

>

>

> You do have a good insurance company. They realize that the good control

now

> will probably save them a lot of money down the road! Too bad the HMOs

> can't see past the end of their noses! If my doctors years ago had told

me

> to test more and maintain good control instead of maintaining a 13.9 for

> about 5 years, taking at least 3 oral meds per day at max dose of

> each...then perhaps my insurance company would have save a lot too! They

> just keep paying and paying and paying...with no question! I think some

are

> really trying to do their jobs! *hugs* Toni