Re: Sandy's questions [was: Tired and sleepy

[Guest guest]

> When you say use Humalog for meals. Do you check before a meal

> and inject according to bs?

**Yes, you should check before meals as a matter of course, but you actually

dose with Humalog according to the number of carbs you are planning to eat.

Getting the dose right is a matter of testing frequently too, as well as

keeping good notes. I don't eat carbs for breakfast, so no H. I dose one

unit of H for every 20 g. of carb for lunch, because I'm very active in the

afternoon. I dose 1 unit of H for every 15g of carb for dinner. This is

what works for me. We can be very different. The starting Humalog dosage

suggestion is one unit for every 15g of carb.

> I am having some lows but am so proud that it

> never gets much above 100 that I am afraid to not take everything that I

been

> taking..

**Sandy, if you're having lows and your A1c is 6.5 (still a bit high), then

you're having spikes as well. I'd suggest that you test more frequently

until you can stop the highs, and the lows should take care of themselves

between lower carb way of eating and a change to fast acting insulin

(Humalog) before your meals. The spikes and consequent lows are hard on

your body and could be part of why you're feeling so lethargic. Try testing

upon rising, before and after every meal, before exercise and bedtime and

write it all down, along with what you eat and exercise program. THe

resulting journal will be invaluable in your quest to find what works for

your particular diabetic body, plus it might help your doc better assess the

situation.

> He did tell me I might want to try stopping the Glocovance and just

> do the Avandia. I go back the 21st. I want to have a list of questions

> ready. There is so much to learn and I feel like I am teaching him.

**I've also read that there is a warning about not taking Avandia and

insulin, something about increased risk of heart disease. You really need

to check on this. And maybe find an endocrinologist that knows more about

diabetes that your current doc. His information sounds very inaccurate,

which can impact your body and your health. Take charge. He works for you,

not the other way around.

> I have

> learned so much from this list. I want to learn to do this the right way.

I

> think I was out of control for so long the doesn't really trust me to be

able

> to do this on my own. My reading before the 6.5 was 9.1.

> Sorry this is so long. I just have so many questions. Sandy

**No problem, Sandy. It's what we're here for. You might want to copy

pertinent answers to your questions into a Word document or something

similar, so you can edit it and print it out for your doc. Family practice

docs are notoriously under-knowledgable about diabetes. Keep great notes

and he will learn to trust you. Plus I guarantee he has many, many patients

who are noncompliant, just like you used to be. It's hard for these docs,

when no one seems to care. It's up to you to care, to do the work, to find

out what works, to test frequently and keep good notes <smile>.

Keep up the good work!

Barb