Guest guest Posted January 16, 2001 Report Share Posted January 16, 2001 The endo has adjusted Carey's morning insulin dose. Since returning to work he was starting to have hypos early in the morning (2 hrs after breakfast). That is when the rapid acting insulin in the Humalog hits it's peak. He was actually getting down into the 30s before having a reaction and one day he was at 29! He always keeps a snacks, a small kiddie apple juice, and glucose tablets with him at work. Luckily, he didn't have any problem with physically being able to get food. For his first month back at work, he has another person working with him at all times in case something like that happens. I also call him about 2-3 times a day on his cell phone...especially in the morning when he may be low...which I am sure he appreciates! ;-) He is testing a lot right now...probably 8-10 times a day. I was with him one day when he tested in the 30s and you couldn't tell. He tested his sugar and was surprised how low it was...then he tested again because he couldn't believe it. He is usually getting the shakes and sweating in the 30s. Re: Hypo Unawareness In a message dated 01-01-16 22:18:42 EST, you write: << We (Carey & I) have a question about hypo unawareness. What is the definition, exactly? Does it include someone who would get down to say 20s or 30s before they have a reaction or is it just when someone has no indication at all that it is coming on and they just pass out? >> Hi, Donna..I have hypo unawareness (also have hyper unawareness)...I can go as low as mid 40s without feeling any different than I usually do...or can go up as high as 275 feeling the same, which is generally energetic. Sometimes within a two-hour period. That's why I test up to ten times a day. Considering the fact that anything under 65 is considered a hypo, that qualifies. At low 40s I start to feel spacy and sweaty. I've never gone below 38 (that I know of). I always carry glucose tabs with me and have them stashed around the house in various places too. Doesn't happen very often now, thank goodness, just now and then. Vicki eGroups Sponsor Public website for Diabetes International: http://www.msteri.com/diabetes-info/diabetes_int Post message: diabetes_integroups Subscribe: diabetes_int-subscribeegroups Unsubscribe: diabetes_int-unsubscribeegroups List owner: diabetes_int-owneregroups URL: /group/diabetes_int <br clear=all><hr>Get your FREE download of MSN Explorer at <a href= " http://explorer.msn.com " >http://explorer.msn.com</a><br></p> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 16, 2001 Report Share Posted January 16, 2001 In a message dated 01-01-16 22:18:42 EST, you write: << We (Carey & I) have a question about hypo unawareness. What is the definition, exactly? Does it include someone who would get down to say 20s or 30s before they have a reaction or is it just when someone has no indication at all that it is coming on and they just pass out? >> Hi, Donna..I have hypo unawareness (also have hyper unawareness)...I can go as low as mid 40s without feeling any different than I usually do...or can go up as high as 275 feeling the same, which is generally energetic. Sometimes within a two-hour period. That's why I test up to ten times a day. Considering the fact that anything under 65 is considered a hypo, that qualifies. At low 40s I start to feel spacy and sweaty. I've never gone below 38 (that I know of). I always carry glucose tabs with me and have them stashed around the house in various places too. Doesn't happen very often now, thank goodness, just now and then. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 16, 2001 Report Share Posted January 16, 2001 In a message dated 01/17/2001 12:47:52 AM Eastern Standard Time, whimsy2@... writes: << Doesn't happen very often now, thank goodness, just now and then. Vicki >> I do have awareness, now more than I used to, I'm lucky. As I said before I had to increase my U due to my skin wound infections, but Endo says she doubts beta cells return after an illness or infection so she expects I'll need the high doses of insulin from now on, although, who knows, could change, but I doubt it. but anyway, I forgot to account for decrease in my IR, so of course my H needs would decrease with U increase. Sure enough, I took my H for my food this afternoon, and I was feeling very shaky 4 hours later, very unusual for me, its always been 2 hours tops for a H peak. I tested at 70, so when I start feeling a low, that means its on the way down, so I popped 2 glucose tabs and it was up to 110 30 min later, then I ate as usual. My x was 20, but now its 30 for Humalog, big difference, plus now I have to allow for 4 hours, not 2. carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 16, 2001 Report Share Posted January 16, 2001 This will get posted twice...I should have posted right on e- groups...my stuff is not posting AGAIN. We (Carey & I) have a question about hypo unawareness. What is the definition, exactly? Does it include someone who would get down to say 20s or 30s before they have a reaction or is it just when someone has no indication at all that it is coming on and they just pass out? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 Carol- How much insulin are you taking in a day (total)? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 The endo has adjusted Carey's morning insulin dose. Since returning to work he was starting to have hypos early in the morning (2 hrs after breakfast). That is when the rapid acting insulin in the Humalog hits it's peak. He was actually getting down into the 30s before having a reaction and one day he was at 29! He always keeps a snacks, a small kiddie apple juice, and glucose tablets with him at work. Luckily, he didn't have any problem with physically being able to get food. For his first month back at work, he has another person working with him at all times in case something like that happens. I also call him about 2-3 times a day on his cell phone...especially in the morning when he may be low...which I am sure he appreciates! ;-) He is testing a lot right now...probably 8-10 times a day. I was with him one day when he tested in the 30s and you couldn't tell. He tested his sugar and was surprised how low it was...then he tested again because he couldn't believe it. He is usually getting the shakes and sweating in the 30s. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2001 Report Share Posted January 18, 2001 Donna Gardner wrote: << We (Carey & I) have a question about hypo unawareness ... Does it include someone who would get down to say 20 or 30 before they have a reaction or is it just when someone has no indication at all that it is coming on and they just pass out? >> Both of those, Donna. It seems to arise from a person experiencing too many hypos. At first, the body panics and shouts MAYDAY MAYDAY to get your attention, but eventually, it just shrugs: " Oh, just another one of those things. " That's a truly dangerous situation. If we are a type 2 in poor control, we can *feel* hypo-y at or above 100, but we're not actually in trouble physically. However, as we gain better control, we don't experience hypos until the numbers dip lower. If we see a 65, we should immediately treat it, whether or not we feel hypo-y. (And if it's just before bedtime, we'll want to treat even higher numbers, like 75 or more.) Generally, the people who must worry are those on insulin and on sulfonylureas. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2001 Report Share Posted January 18, 2001 Donna Gardner wrote: << Carey was taking 22 units of humalog with breakfast and 18 at dinner. Today he took 18 with breakfast (doctor's dose) and still had a hypo (33) at about 9:00-9:30. He called the doctor and now his breakfast dose is down to 15. We have someone from Diesentronic coming tomorrow to show Carey the pump. Hopefully, that should provide him with some better control... >> Donna, I've been away and I'm confused. How many grams of carbs is Carey eating a day? That's a LOT of Humalog! He may not need the pump - just help with adjusting his insulins and food intake. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2001 Report Share Posted January 18, 2001 Donna Gardner wrote: << We are not using any insulin to carb ratio. We are just going by the diet the dietician gave us and the endo set the insulin dosage. >> If you don't already have " Dr. Bernstein's Diabetes Solution, " I hope you'll get it ASAP. Meanwhile, Ron Sebol's meticulous suggestions for tight control would be a great help for you both. You really will want to count Carey's carbs and inject accordingly at each meal (not just twice a day). And since he is a type 1, he will need a good background insulin such as UltraLente, injected once or twice a day. I'll bet anything the dietitian placed Carey on a *high*-carb diet, which makes control that much more difficult. It's what Dr. Bernstein calls the Law of Small Numbers ... match small amounts of insulin to small amounts of carbohydrates. That way, being the fallible humans we all are, if you are off by 30%, the consequences won't be so devastating. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2001 Report Share Posted January 18, 2001 Donna Gardner wrote: << Let me clarify...this is a 75/25 Humalog mix pen. He is a type 1...his antibody test came back positive. Is this a lot of insulin? >> Yes it's a lot of insulin. Thanks for clarifying. That 75/25 mix is 75% insulin lispro protamine suspension and 25% insulin lispro injection (rDNA origin). Its peak is 1-1/2 to 2-1/2 hours after injection, with a long tail. It is mostly out of the system in 14-16 hours. This 75/25 mix is much different from regular Humalog because its peak kicks in a bit slower, lasts a bit longer, and it has a really long tail. Carey would not want to inject 75/25 at each meal, unless he used very small amounts. The tails would overlap. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2001 Report Share Posted January 18, 2001 Donna Gardner asked: << Do you think 15 (75/25) at breakfast and 15 (75/25) at dinner is more than a type 1 would use? >> There's often a time lag on posts, Donna, so things have a way of cascading. I think what confused folks is we assumed Carey was using straight Humalog and not 75/25. Straight Humalog is mostly out of the system in 4, and certainly 5 hours, whereas 75/25 is not out of the system entirely until 22 hours (although mostly out in 14-16 hours). Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2001 Report Share Posted January 19, 2001 > The 25% is the fast-acting. 75% is long-acting. I had to check out which > was which so I could get control with it. > > Wow, you're kidding! ~~ LOL, all this time I thought it was the other way around ) D. Quote Link to comment Share on other sites More sharing options...
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