Re: Winning the War with the Doc

[Guest guest]

In a message dated 01-08-28 18:32:28 EDT, you write:

<< Anyone who uses humalog and lantus I would appreciate your comments and

experiences

thanks

ressy

>>

hi, Ressy, I'm on Humalog and Lantus but I'm on a ten-minute break from work,

checking my email and no time to answer right now, I'll try to get back to

you later. My experience has been good...except the Humalog pen doesn't do

half units, which I find I need. Better is the BD pen mini, which is

re-usable and uses insulin cartridges. If you've already bought the Humalog

pens, well, use 'em up but then try to get one of the BDs. I think they're

available online if you can't find them locally. Vicki

[Guest guest]

---My husband is on the humalog and lantus. It is not good at the

moment nor has it been really good in several week. His bg's were

over 400 last night. He didn't tell me that. I had to use his meter

since I had left mine at work and his last reading came up. He had

gone to bed not a happy camper and I knew something was wrong. He

has been having headaches and bouts of nausea as well. He has been on

the humalog for a while, a couple of years I think but the lantus is

new. The endo he has now, dropped the N and added the lantus. His

numbers were in a slump before the lantus was introduced. He would

evelate in the readings after exercising, that is doing some yard

work, like pulling weeds. He can't exercise much but whatever he can

do is good. But the numbers went up. So, our dr. sent him to an

endo. She changed the meds to what they are now. However after a

couple of weeks of bad readings, she upped the humalog to take

whatever the sugar was and take the dosage to correspond with that.

It is not helping. He is taking too much insulin I think, at this

point. He has cut the carbs down. had 15 carbs for breakfast and

35 carbs for lunch. He bg went to over 200. Now he is afraid to

eat. This is nuts. He is disgusted today and I guess I can't blame

him for that at all. He is trying but nothing is working.

madge

In diabetes_int@y..., resmith315@a... wrote:

> Ok...Finally after a month of erratic numbers I got the doc to

believe me

> that I needed a little more help. I just came back from the

pharmacy with my

> humalog in a pen. I meet with the dietician tomorrow. I wrote a

very angry

> letter to his office this morning and faxed it over.

> I can only have control at less than 20 grams. I have a horrendous

dawn

> thingy and spike consistently over 200 with even 20 grams per

meal. I spent

> a horrible weekend and let him know this morning that if he was not

going to

> help then get out of the way. The nurse called me this afternoon

and left a

> curt message that the humalog was at the pharmacy. She just gave

me enough

> time to ask for it to be in pen form as it is mostly for very small

doses and

> out and about times. Anyway I will work with the dietician

tomorrow. She

> said the dose was to be one unit for 15 grams of carbs but we will

see what

> my drop test is and how resistant I am.

> I don't plan on using this alot...I can jump on the treadmill and

get my

> readings to 100 in 30 minutes of fast walking...but when you are at

the ball

> game watching your son and just eating anything that has carbs in

it causes

> headache and nausea....well life needs to be better than that and I

told him

> so in my letter.

> Anyway the dietician wants me to eat about 150 carbs a day but I

am holding

> her at bay with about 100.

> Anyone who uses humalog and lantus I would appreciate your comments

and

> experiences

> thanks

> ressy

[Guest guest]

Ressy, good girl!! WE have to stick up for ourselves. Before I get into my

insulin dosage (I really love it, btw) I will say that you may have trouble

with carbs even with the insulin, because your extreme reaction to them

(nausea, etc.) may be about something else - just a thought. Anyway, I go

by 1 unit of H for every 15 grams of carbs at night, when I'm not working

hard. During the day my ratio varies, depending on what activity is coming

up after I eat. Sometimes I eat 30 or less carbs and don't dose for it at

all, if it's breakfast or 45 or less at lunch. This all came from the usual

dose, eat, test and keep good notes <smile>. I haven't graduated to Lantus

yet and I'm not sure I will, as my am and pm dose of U are different from

each other, and my pm dose varies slightly, depending on exercise amount and

what I ate during the whole day. The recommended beginning dose for H is 1

unit per every 15 carbs, however if you're not very insulin resistant and/or

are on other meds, you might start with 1 unit per every 20 carbs, just to

be safe. Please keep glucose tabs everywhere. I find if I've overdosed my

H, I won't go low for 3 - 3 1/2 hours afterwards. I use 13 units U in the

am and 9 or 10 units of U in the pm, am careful to dose accurately for

dinner, dinner contains no high glycemic carbs, and my fasting is usually

around 90-100. I have a pretty strong morning rise too, and have found that

if my fasting is over 140 (rare) I can use 1 unit of H and be fine. For

most people 1 unit of H will reduce bs by 60 points if no food is consumed

and without the dawn rise, and I glucose tab will raise bs by 20 points.

Carbs will raise bs 3-5 points per gram of carbs, depending on glycemic

index of carbs consumed.

I'm sure this is all clear as mud, but it will become more clear as you go

along, dosing, eating, testing and keeping good notes. You will find that

your control will be much tighter with many less spikes and lows, as you get

the hang of this.

I applaud you for standing up for yourself, and reiterate that you may still

have to lower your carbs to get along with your particular body. For those

who can, I think 100 - 150 is a good amount per day.

Good luck, Ressy! and keep coming with the questions.

Barb

> Ok...Finally after a month of erratic numbers I got the doc to believe me

> that I needed a little more help. I just came back from the pharmacy with

my

> humalog in a pen. I meet with the dietician tomorrow.

[Guest guest]

>>He is taking too much insulin I think, at this

point. He has cut the carbs down. had 15 carbs for breakfast and

35 carbs for lunch. He bg went to over 200. >>

**Madge, according to his numbers, he isn't taking too much insulin, he

isn't taking enough. He should be able to dose his H, so he doesn't go

above 120-140 max after a meal. I'd suggest he talk to his doc about

increasing his Lantus or his H to carb ratio, or both. He and his doc

should be able to get his dosage to the point where his bs stays around 100

most of the time.

Barb

> ---My husband is on the humalog and lantus. It is not good at the

> moment nor has it been really good in several week. His bg's were

> over 400 last night.

[Guest guest]

--- He sees the Endo again on Sept 12. He takes humalog on a sliding

scale. It goes by the blood sugar level. e.g Blood sugar was 225

before dinner and went to 348 after dinner. He took 30 units at

dinner of the humalog to correspond to the 225. He had 45 carbs at

dinner. I am thinking he should cut back on the carbs. I didn't ask

all he ate for dinner cause he is getting grumpy! He ate before I

came home. I know he had 2 pieces of bread and meat, don't know what

else.

Madge

In diabetes_int@y..., " Rainbow Farm " <RainbowFarm@m...> wrote:

> >>He is taking too much insulin I think, at this

> point. He has cut the carbs down. had 15 carbs for breakfast and

> 35 carbs for lunch. He bg went to over 200. >>

>

> **Madge, according to his numbers, he isn't taking too much

insulin, he

> isn't taking enough. He should be able to dose his H, so he

doesn't go

> above 120-140 max after a meal. I'd suggest he talk to his doc

about

> increasing his Lantus or his H to carb ratio, or both. He and his

doc

> should be able to get his dosage to the point where his bs stays

around 100

> most of the time.

>

> Barb

>

> > ---My husband is on the humalog and lantus. It is not good at the

> > moment nor has it been really good in several week. His bg's were

> > over 400 last night.

[Guest guest]

Madge, I would strongly recommend that he ask his doc about matching H to

carbs he's planning on eating, because taking H BEFORE he eats will prevent

a spike, whereas taking H AFTER he's eaten and spiked doesn't prevent the

spikes, which is what does the damage. The ideal is to maintain control,

not deal with it after it's out of control. His numbers are very high, and

would definitely make him feel awful and be grumpy, not to mention high

numbers for long periods of time can cause a greatly increased risk of

complications.

JMHO,

Barb

> --- He sees the Endo again on Sept 12. He takes humalog on a sliding

> scale. It goes by the blood sugar level. e.g Blood sugar was 225

> before dinner and went to 348 after dinner. He took 30 units at

> dinner of the humalog to correspond to the 225.

[Guest guest]

Had my first shot at lunch today.....everyone pray for ressy

ressy

so far so good

[Guest guest]

Praying.... Be double sure to have glucose tabs handy in all areas of your

life: purse, car, house, shed, whereever, as insulin takes some time,

testing and good notes to get the hang of dosages.

Barb

> Had my first shot at lunch today.....everyone pray for ressy

> ressy

> so far so good

[Guest guest]

Prayers going up, Ressy. Please let us know how it is

going.

Sheila

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~`

Had my first shot at lunch today.....everyone pray for

ressy

ressy

so far so good

__________________________________________________

[Guest guest]

In a message dated 8/30/01 6:43:16 PM Central Daylight Time,

crnityckr@... writes:

<<

Prayers going up, Ressy. Please let us know how it is

going.

Sheila

~ >>

Things are going well. I just love this new routine. For instance this

evening I am not very hungry and will have some baked walley pike...and some

steamed green beans. None of this is high in carbs and since I am sitting

around 80 before meals I will not take anything for it. A walk this evening

with dh will put me right when I want to be. So far so good. They did

adjust my carb to insulin ratio today a tad bit downwards but as always

everything is in flux and I test and test.

ressy