Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 Yep, that's definitely hypo unawareness. Here's the good news: I've been told that it improves after a while of good BG control and no hypos. Don't know how long it takes...I haven't gotten to that point yet. You know, if your endo is telling Carey to take a set dose of Humalog per meal no matter what he eats, I don't see how he can avoid hypos. After all, we don't eat the same thing every meal...we don't start out at the same baseline...and there's good old day-to-day variability. I really don't understand why doctors think it WOULD work with a set dose of Humalog...yet I know a lot of docs do it that way. Carb to dose equivalent is really the only way to go, IMHO. BTW, here's the url for the new list I mentioned before... Subscription is by sending email to: glucolow-subscribe@... >> Vicki In a message dated 01-01-17 11:46:42 EST, you write: << he 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 17, 2001 Report Share Posted January 17, 2001 Re hypo for Carey; What insulin to carb ratio do you use?? Do you dose for protein? If it is not too personal, what is Carey's weight. Just curious what food would need 15 units of Humalog to cover it. I am still a novice at this. n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 So that sounds to me like the doc told Carey to take a standard dose, am I correct? And he's a type 1? (Or is he a type 2?) No wonder he's going hypo! I rarely take more than 5 units of H per meal based on carbs. But those large numbers of insulin indicate to me that he's insulin resistant, which is a characteristic of type 2. Please clarify. From what I've heard, the pump may solve this problem...but I think you still have to calculate the dose. Vicki In a message dated 01-01-17 17:51:32 EST, you write: << 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... >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 In a message dated 01-01-17 19:09:49 EST, you write: << Just curious what food would need 15 units of Humalog to cover it. >> That's just what I was wondering too, n. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 In a message dated 01/17/2001 8:53:57 PM Eastern Standard Time, whimsy2@... writes: << In a message dated 01-01-17 19:09:49 EST, you write: << Just curious what food would need 15 units of Humalog to cover it. >> >> This isn't right, IMHO. In my pre lc days, my endo had me injecting 5-8 units of H for breakfast and lunch and 10 for dinner, that was before I developed a carb/insulin ratio of course. Are you sure DR didn't mean 15 a day, all 3 meals and snacks? You need to clarify this. carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 In a message dated 01/17/2001 9:06:29 PM Eastern Standard Time, gardner_donna@... writes: << 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? >> what happens to a lot of people on mixes is they have extreme highs and lows, ask if he can inject separate insulins, not a mix. with a mix if you don't eat at very specific times, he will go low, but too high later after insulin has worn off. carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 He is taking a set dose twice a day. One with dinner and one with breakfast. He is eating a set amount of carbs in his meals/snacks. We didn't have a problem with his insulin dose until he went back to work. Before then it was fine, but now he is getting more exercise at work. He is also exercising every evening, but he seems to be OK in the evening. Could you please send me the URL? > In a message dated 01-01-17 11:46:42 EST, you write: > > << That is when the rapid acting insulin in the Humalog hits it's peak. >> > > Is Carey matching carbs to insulin? Or is he just taking a set dose? The > first way is much more accurate, Donna, and once you get the correct carb to > dose ratio, hypos don't happen as often. There's a new list going now with > an expert in this area, name of Ron, who's helped me out immensely in this > area. If you have time for still another list, I'd strongly suggest you join. > I've mentioned the URL a few times and I'll post it again if you want. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 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... > > Yep, that's definitely hypo unawareness. Here's the good news: I've been > told that it improves after a while of good BG control and no hypos. Don't > know how long it takes...I haven't gotten to that point yet. > > You know, if your endo is telling Carey to take a set dose of Humalog per > meal no matter what he eats, I don't see how he can avoid hypos. After all, > we don't eat the same thing every meal...we don't start out at the same > baseline...and there's good old day-to-day variability. I really don't > understand why doctors think it WOULD work with a set dose of Humalog...yet I > know a lot of docs do it that way. Carb to dose equivalent is really the > only way to go, IMHO. > > BTW, here's the url for the new list I mentioned before... > > Subscription is by sending email to: glucolow-subscribe@t... > >> > Vicki > > In a message dated 01-01-17 11:46:42 EST, you write: > > << he 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 17, 2001 Report Share Posted January 17, 2001 Re:dosing Okay. We went through that " call me and I'll decide for you " routine with the doctors for four months when my 11 year old son was diagnosed (Type I). Then we dumped those docs for Dr. Bernstein who believes in educating you as much as possible as soon as possible. I don't know if you have read it, but if not, please, please read Dr. Bernstein's Diabetes Solution. You won't be surprised thatyour husband is getting ypos. A 140 pound person, according to Bernstein will experience a 5 point rise for each gram of carb. Also, a unit of insulin will probably lower that person 60 points. This is just an estimate. If you are taking 15 units of insulin it will lower your sugar about 900 points. Divide that by 5 (1 gram raises 5 points) and you will need to eat 900/5 or 180 carbs at that meal to cover the insulin. That is, of course, without any adjustment for protein. Approximate numbers of course. Anyway, I am not a physician (dr in drmarion is for Ph.D. in psychology). So good luck. n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 In a message dated 01-01-17 21:06:15 EST, you write: << 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? >> What is the 75/25 a mix of? What percentage is the 75, Humalog? and what's the other kind of insulin? I'm a type 1 and I take straight Humalog before meals based on carb count of meal and I rarely take more than 4 units straight Humalog (meal carbs rarely above 25). The numbers Carey is taking seems to me to be way too high and would certainly explain his hypos. Did his endo say anything at all about how he calculated the necessary dose? What is he basing it on? You know, diabetes is (or should be) a largely self managed disease. Sounds like Carey's just taking the doctor's word for it. I think maybe a little investigation is in order. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 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. Right now we are still pretty clueless...Carey was just diagnosed December 1st in the ER. We were actually seeing a doctor who had diagnosed him as a type 2 in February 2000. Then, in November he started getting sick and she had him on pills for 2 weeks. After the ER visit, she still wasn't convinced he was a 1. So I took him to an endo and he confirmed the diagnosis in mid to late December by an antibody test. Oh...Carey is 42 years old, 5'10 " and 170-175 pounds. The doctor wants him to stay at this weight. He was down to 142 pounds when he was sick. > Re hypo for Carey; > > What insulin to carb ratio do you use?? Do you dose for protein? If it is > not too personal, what is Carey's weight. Just curious what food would need > 15 units of Humalog to cover it. I am still a novice at this. > > n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 I am not sure I understand your message. About being sick and needing 180 carbs. Those of us following a low carb or somewhat low carb diet as low as 30 grams of carb A DAY (not a meal). My son eats somewhat more because he is growing; however, he is restricted to low and moderately low glycemic carbs. So I wasn't suggesting that your husband eat 180 carbs. What I was saying was that 15 Humalog is a large dose of insulin for low carbers and it would require a massive dose of carbs to go with it. I hope this clarifies. n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 In a message dated 01-01-17 22:28:47 EST, you write: << Do you think 15 (75/25) at breakfast and 15 (75/25) at dinner is more than a type 1 would use? >> Yes, Donna, I do. Again, what is the doctor basing this on? Does Carey eat the same thing every morning for breakfast? Lunch? Dinner? Because unless he does, how could the same dose be correct? Have you read Dr. Bernstein's Diabetes Solutions yet? Or checked out his website? (Link is on our web page, URL at bottom of page). Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 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? > So that sounds to me like the doc told Carey to take a standard dose, am I > correct? And he's a type 1? (Or is he a type 2?) No wonder he's going hypo! > I rarely take more than 5 units of H per meal based on carbs. But those > large numbers of insulin indicate to me that he's insulin resistant, which is > a characteristic of type 2. Please clarify. > > From what I've heard, the pump may solve this problem...but I think you still > have to calculate the dose. Vicki > > In a message dated 01-01-17 17:51:32 EST, you write: > > << > 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... > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 The 15 (75/25) is at breakfast and covers breakfast, mid-morning snack, lunch, and late afternoon snack. The dinner dosage (which was 18) looks like it needs to be changed also. Also, when Carey was first put on the insulin his sugar was very high and he had a cold and an upper respiratory infection. He was also laying in bed not doing much of anything because he felt awful. > In a message dated 01/17/2001 8:53:57 PM Eastern Standard Time, > whimsy2@a... writes: > > << In a message dated 01-01-17 19:09:49 EST, you write: > > << Just curious what food would need 15 units of Humalog to cover it. >> > >> > > This isn't right, IMHO. In my pre lc days, my endo had me injecting 5-8 units > of H for breakfast and lunch and 10 for dinner, that was before I developed a > carb/insulin ratio of course. > Are you sure DR didn't mean 15 a day, all 3 meals and snacks? You need to > clarify this. > carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 Do you think 15 (75/25) at breakfast and 15 (75/25) at dinner is more than a type 1 would use? In diabetes_integroups, astrocarly@a... wrote: > In a message dated 01/17/2001 9:06:29 PM Eastern Standard Time, > gardner_donna@m... writes: > > << 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? > >> > > what happens to a lot of people on mixes is they have extreme highs and lows, > ask if he can inject separate insulins, not a mix. > with a mix if you don't eat at very specific times, he will go low, but too > high later after insulin has worn off. > carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 Yikes! 180 carbs? I guess he needed that before cause he was sick? > Re:dosing > > Okay. We went through that " call me and I'll decide for you " routine with the doctors for four months when my 11 year old son was diagnosed (Type I). Then we dumped those docs for Dr. Bernstein who believes in educating you as much as possible as soon as possible. > > I don't know if you have read it, but if not, please, please read Dr. Bernstein's Diabetes Solution. > > You won't be surprised thatyour husband is getting ypos. > A 140 pound person, according to Bernstein will experience a 5 point rise for each gram of carb. Also, a unit of insulin will probably lower that person 60 points. This is just an estimate. If you are taking 15 units of insulin it will lower your sugar about 900 points. Divide that by 5 (1 gram raises 5 points) and you will need to eat 900/5 or 180 carbs at that meal to cover the insulin. That is, of course, without any adjustment for protein. Approximate numbers of course. > > Anyway, I am not a physician (dr in drmarion is for Ph.D. in psychology). So good luck. > > n Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 17, 2001 Report Share Posted January 17, 2001 The pamphlet says, " Humalog Mix 75/25 is a mixture of insulin lispro solution, a rapid-acting blood glucose-lowering agent and insulin lispro protamine suspension, an intermediate-acting blood glucose- lowering agent. " > In a message dated 01-01-17 21:06:15 EST, you write: > > << > 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? > >> > What is the 75/25 a mix of? What percentage is the 75, Humalog? and what's > the other kind of insulin? I'm a type 1 and I take straight Humalog before > meals based on carb count of meal and I rarely take more than 4 units > straight Humalog (meal carbs rarely above 25). The numbers Carey is taking > seems to me to be way too high and would certainly explain his hypos. Did > his endo say anything at all about how he calculated the necessary dose? What > is he basing it on? > > You know, diabetes is (or should be) a largely self managed disease. Sounds > like Carey's just taking the doctor's word for it. I think maybe a little > investigation is in order. > > Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2001 Report Share Posted January 18, 2001 Carol wrote to Donna Gardner: << what happens to a lot of people on mixes is they have extreme highs and lows, ask if he can inject separate insulins, not a mix. with a mix if you don't eat at very specific times, he will go low, but too high later after insulin has worn off. >> I also would feel relieved if you and Carey looked into using straight Humalog with each meal, estimating his carb intake and injecting accordingly (often the ratio is 1 Unit per 15 grams carbs, or maybe 1 Unit per 10 grams carbs), and using a background insulin as well. 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. Its' actually 75% medium acting. There is quite a bit of difference. Barb -------- http://www.RainbowFarm.com Equine photography http://www.RainbowFarm.com/photos.html Quote Link to comment Share on other sites More sharing options...
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