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Re: Switching insulins

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Have you only been using one vial of the Humilog and Ultralente? You could

have a bad vial of one or both of them. Other than that, assuming Mike

hasn't suffered any emotionally severe change or stress lately, or been

under the influence of an infection of some kind, I'd get the endo

involved. This is why he gets the big bucks.

At 09:17 PM 5/8/00 -0700, you wrote:

>Does it take the body awhile to become accustomed to a new type of insulin?

>After switching from Humilin R and N to Humilog and Ultralente, Mike's BGs

>have been running high most of the time. Sunday was typical, with readings

>at 7 a.m., noon, 8 p.m. and midnight of 209, 205, 217 and 129.

>

>I don't think his diet is at fault. Today his BG was 121 at noon. He took

>six units of Humilog as per the endo's schedule and ate a moderate helping

>of salad with ranch dressing. No afternoon snack. At 8 o'clock tonight, the

>BG was 262.

>

>He has new medications, too, because of the kidney problem worsening. Where

>should we start looking for an explanation of the high BGs, and what do we

>do about it?

>

>Cass

>

>

>

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Cass wrote:

<< After switching from Humilin R and N to Humilog and Ultralente, Mike's

BGs

have been running high most of the time ... Today his BG was 121 at noon. He

took six units of Humilog ... and ate a moderate helping of salad with ranch

dressing. No afternoon snack. At 8 o'clock tonight, the BG was 262. >>

Cass, I hope others in the group will chime in, because I don't know much

about insulin. But my guess is that Mike needs more UltraLente (background

insulin).

Susie

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> Cass, I hope others in the group will chime in, because I don't know much

> about insulin. But my guess is that Mike needs more UltraLente (background

> insulin).

In my experience with Ultralente, it did about " a hill of beans of

difference " ... nothing. It seemed I was injecting massive amounts to no real

benefit. I discussed this with my DE, who said that for an active type 1, it

wouldn't really be much of a benefit (my dr. also had some reservations about

the benefits of ultralente for me).

Right now I take H with meals and H and N at bedtime. I think the H at bedtime

is unique to my situation... whenever the endo or DE review my file, they always

seem surprised that I need this.

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Cass, I was reading your message again (I've been a bit out of the loop here...

lots of email to catch up on). It sounds like Mike's condition is very complex,

and my suggestion is that if something isn't working, call the doctor. You

wouldn't want to compromise the kidneys any more than necessary.

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McErlean wrote:

<< ... Right now I take H with meals and H and N at bedtime. I think the H

at bedtime

is unique to my situation... whenever the endo or DE review my file, they

always

seem surprised that I need this. >>

I'm surprised too, . I was told H and R are only to cover meals. You

are an insulin-resistant type 1 - yes?

Susie

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Hi ,

When you say you ahve H and N at bedtime am I wrong in guessing that you

mean both a fast acting and a slow acting insulin. If so I have never

heard of this before. Would you eat a snack after you're fast acting ?

Sorry if I've completely misunderstood this.

Bye

PS Sorry to hear about your hypo - hope things are settling down now.

Re: Switching insulins

> Cass, I hope others in the group will chime in, because I don't know much

> about insulin. But my guess is that Mike needs more UltraLente (background

> insulin).

In my experience with Ultralente, it did about " a hill of beans of

difference " ... nothing. It seemed I was injecting massive amounts to no real

benefit. I discussed this with my DE, who said that for an active type 1, it

wouldn't really be much of a benefit (my dr. also had some reservations

about

the benefits of ultralente for me).

Right now I take H with meals and H and N at bedtime. I think the H at

bedtime

is unique to my situation... whenever the endo or DE review my file, they

always

seem surprised that I need this.

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Public website for Diabetes International:

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wrote to :

<< When you say you ahve H and N at bedtime am I wrong in guessing that you

mean both a fast acting and a slow acting insulin. If so I have never

heard of this before. Would you eat a snack after you're fast acting ?

Sorry if I've completely misunderstood this. >>

is using a fast-acting insulin (Humalog) and a medium-acting insulin

(N) at bedtime. Here is the URL of a chart of insulin actions ...

http://www.diabetesdigest.com/dd_insulin4.htm

Ron Sebol says to use R and/or H only to cover food (Humalog for

carbohydrates; R for protein). 's regimen means she wakes up each

morning with little insulin coverage, and that she is at risk for hypos

45-90 minutes after her nightly shots. I would think her liver is getting

quite a workout from this combo.

Susie

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I should have added that the night when had the worst hypo was a night

she chose to match a bedtime shot of Humalog with a before-bed serving of

cottage cheese, which contains only 5-6 grams of carbohydrates per cup. So

her body treated that item pretty much like it wasn't there. As I see it,

the Humalog was the problem, but she cut back instead on her nighttime N,

and she hypoed again (although less dangerously) the following night.

I am surprised 's doctors are not warning her about the danger of using

Humalog before bed to pull her numbers down, instead of to cover

carbohydrate intake - i.e., to keep her numbers from climbing following

meals.

Susie

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