Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 In a message dated 10/5/04 2:37:27 PM Eastern Daylight Time, whimsy2@... writes: >Type 2 diabetics produce insulin; it's just not being utilized >appropriately or properly. Type 2 is a disease of insulin resistance. >As a result of many different factors, but largely because of poor BG >control, eventually diet and exercise or diet, exercise and pills do not >control BGs any longer so insulin becomes necessary. This makes one a >type 2 on insulin, not a type 1 diabetic. >>>>>>>>>>>>>>>>>>>> While type 2 and type 1 do occur for different reasons, a type 2 can reach a point where no insulin is being produced, and, further, a type 1 can become insulin resistant. Further, there are other things at work besides poor BG control. Type 2s most likely also have something at work that makes their pancreas not keep up with demand and they suffer beta cell burnout - not always as a result of poor BG control, but also from age and some genetic issues that have to do with how the pancreas works. >I'm always pleased when people start using Ultralente because it really >does work well and is a lot cheaper than Lantus. They both cost me $20 in a co-pay. >However, for maximum >results, it needs to be taken twice a day at 12-hour intervals. This isn't true for all people. Some do quite well on one injection per day. >The >best time to take it is 8 a.m. and 8 p.m. If you're only taking it once >a day (like Lantus) you're not likely to get good results. Maybe, maybe not. Some people do better at other times, and some do fine with once a day. In theory, UL is effective for up to and even a little more than 24 hours, as stated in the drug information. Unlike Lantus, you have to allow for the peak of UL that will occur about 10 hours after injection. Not as high a peak as NPH, but a peak just the same. >If you're interested >in learning more about proper insulin dosing, I can refer you to Ron >Sebol, who runs another diabetic list called DSM (Diabetes Self >Management) and who is an expert on insulin dosing and how to gain >excellent control. >>>>>>>>> As a former member of that list, I have to chime in that Ron's methods were over 100 % wrong for me and the amount of insulin I need. I am using a little more than double what his results said was the right amount. YMMV, of course. Stacey Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 Sandy...your doctor is either inadvertently or purposely misleading you. Or maybe he just doesn't know better. A type 2 diabetic doesn't become type 1 just because insulin is needed. The difference between type 1 and 2 is this: Type 1 is autoimmune induced. The pancreas of a type 1 diabetic isn't producing beta cells, which produce/carry insulin throughout the body because the autoimmune system has destroyed that mechanism, therefore the type 1 diabetic must take insulin to replace that which isn't being made naturally. (And if I have this wrong I'm sure someone will let me know, smile.) Type 2 diabetics produce insulin; it's just not being utilized appropriately or properly. Type 2 is a disease of insulin resistance. As a result of many different factors, but largely because of poor BG control, eventually diet and exercise or diet, exercise and pills do not control BGs any longer so insulin becomes necessary. This makes one a type 2 on insulin, not a type 1 diabetic. I'm always pleased when people start using Ultralente because it really does work well and is a lot cheaper than Lantus. However, for maximum results, it needs to be taken twice a day at 12-hour intervals. The best time to take it is 8 a.m. and 8 p.m. If you're only taking it once a day (like Lantus) you're not likely to get good results. Further, despite what you may have been told about " gently rolling the bottle, " it is CRITICAL to shake the bottle vigorously -- I do it 20 times -- in order to mix the granules evenly. Otherwise, you may get unpredictable results, not to mention a clogged needle. It is very likely also that your basal insulin needs aren't the same in the morning and in the evening. Most diabetics using UL find that their morning dose is roughly half of the evening dose. If you're interested in learning more about proper insulin dosing, I can refer you to Ron Sebol, who runs another diabetic list called DSM (Diabetes Self Management) and who is an expert on insulin dosing and how to gain excellent control. Of course, anyone who wants join-up information for the DSM list, not just Sandy, can write me offlist and I'll be happy to give it . Vicki, LADA type 1 diagnosed 1997, UL and Humalog insulin and lotsa testing, no complications. Lantus to Ultralente > > Well, I have not been on Lantus for some time now -- I had > an awful allergic reaction, and I finally got in to see my > endo, and he has now put me on Ultralente. Meanwhile, > though I watched my carbs, my blood sugar has been rising, > even though I walk every day. My doctor said he thinks I'm > " becoming a Type 1. " He also said he hopes I'm just allergic > to Lantus, not all types of insulin. Me too. He put me on > Ultralente, as he said it's closest to Lantus, so we'll > see... hopefully, it will work as well as Lantus did, > without the allergic reaction. I'll continue to do low carb > and walk on a regular basis, so hopefully my insulin needs > won't increase. Right now, I'm take 30 units at night. > > Sandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 Sandy...your doctor is either inadvertently or purposely misleading you. Or maybe he just doesn't know better. A type 2 diabetic doesn't become type 1 just because insulin is needed. Hi Vicki, Wow... that's a little scary, as he's supposed to be the best in the area, so I hope he knows what he's doing. I doubt that he's deliberately misleading me, but maybe trying to simplify things? He's a very nice man, and to find a better doctor than he's supposed to be, I'd have to go to Chicago -- 3 hours away :-( Maybe he meant something else by what he said, but those were his exact words. The difference between type 1 and 2 is this: Type 1 is autoimmune induced. The pancreas of a type 1 diabetic isn't producing beta cells, which produce/carry insulin throughout the body because the autoimmune system has destroyed that mechanism, therefore the type 1 diabetic must take insulin to replace that which isn't being made naturally. (And if I have this wrong I'm sure someone will let me know, smile.) Type 2 diabetics produce insulin; it's just not being utilized appropriately or properly. I used to produce some insulin 5 years ago, but he told me that he doesn't think I'm producing insulin any longer. Type 2 is a disease of insulin resistance. I knew that, so I was surprised when he said that. He's an older man, so maybe he's of the school that doesn't clue his patients in to what's really going on. However, he's also the doctor who told me to read books on the Glycemic Index and Bernstein, so he's not too old fashioned. As a result of many different factors, but largely because of poor BG control, eventually diet and exercise or diet, exercise and pills do not control BGs any longer so insulin becomes necessary. This makes one a type 2 on insulin, not a type 1 diabetic. That's what I thought, but as I said, his words were very clear... next time I go in, I'll have to ask him just what he meant by that. I'm always pleased when people start using Ultralente because it really does work well and is a lot cheaper than Lantus. I hope you're right...hopefully, it will work well, and crossing my fingers, I'm hoping that I'm not allergic to this one. However, for maximum results, it needs to be taken twice a day at 12-hour intervals. There again, I asked if I should be taking it twice a day, and he said... " No... the same as you took Lantus, once a day. " The best time to take it is 8 a.m. and 8 p.m. If you're only taking it once a day (like Lantus) you're not likely to get good results. I have a feeling that right now he's just trying to make sure I'm not allergic to Ultralente, as he only prescribed 1 bottle, and my next appointment is in 4 months, so I'll obviously have to call in for more. If taking it once a day isn't working for me, I'll be calling him to change things around. Further, despite what you may have been told about " gently rolling the bottle, " it is CRITICAL to shake the bottle vigorously -- I do it 20 times -- in order to mix the granules evenly. Otherwise, you may get unpredictable results, not to mention a clogged needle. Ah... I did that :-) Glad to know I did it right, as I was worried I was going to get bubbles from shaking it as much as I did. It is very likely also that your basal insulin needs aren't the same in the morning and in the evening. Most diabetics using UL find that their morning dose is roughly half of the evening dose. If you're interested in learning more about proper insulin dosing, I can refer you to Ron Sebol, who runs another diabetic list called DSM (Diabetes Self Management) and who is an expert on insulin dosing and how to gain excellent control. Thanks, Vicki...I know Ron. Is DSM a different list or did the name just change? I think the name of his list that I was on was differerent. So, you're saying that if I'm supposed to take 30 units, I could take 20 of it at night and 10 in the morning, for better results? That shouldn't be too hard to do on my own, but I'll e-mail you off list to get the join up information for DSM. Thanks again... Sandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 , I'm responding specifically to this paragraph, which I've moved up to the top of this post for reference: << Maybe, maybe not. Some people do better at other times, and some do fine > with once a day. In theory, UL is effective for up to and even a little more > than 24 hours, as stated in the drug information. Unlike Lantus, you have to > allow for the peak of UL that will occur about 10 hours after injection. Not as > high a peak as NPH, but a peak just the same. If UL is taken twice a day, 12 hours apart there is basically no peak because of the overlap. So it really is nearly flat. I do agree with you re beta cell burnout that type 2s experience. This can be the result of using sulfonylureas and continued high BGs. However, that still doesn't turn a type 2 into a type 1. And of course, re taking UL once a day versus twice a day...the YMMV factor kicks in here. Although I've never actually heard of one shot of UL a day working well, I 'spose it could for some. I'm glad to hear you've found the right insulin dosing, , no matter how you got there. Vicki Re: Lantus to Ultralente > > In a message dated 10/5/04 2:37:27 PM Eastern Daylight Time, whimsy2@... > writes: > > >Type 2 diabetics produce insulin; it's just not being utilized > >appropriately or properly. Type 2 is a disease of insulin resistance. > >As a result of many different factors, but largely because of poor BG > >control, eventually diet and exercise or diet, exercise and pills do not > >control BGs any longer so insulin becomes necessary. This makes one a > >type 2 on insulin, not a type 1 diabetic. > >>>>>>>>>>>>>>>>>>>> > > While type 2 and type 1 do occur for different reasons, a type 2 can reach a > point where no insulin is being produced, and, further, a type 1 can become > insulin resistant. Further, there are other things at work besides poor BG > control. Type 2s most likely also have something at work that makes their > pancreas not keep up with demand and they suffer beta cell burnout - not always as a > result of poor BG control, but also from age and some genetic issues that have > to do with how the pancreas works. > > >I'm always pleased when people start using Ultralente because it really > >does work well and is a lot cheaper than Lantus. > > They both cost me $20 in a co-pay. > > >However, for maximum > >results, it needs to be taken twice a day at 12-hour intervals. > > This isn't true for all people. Some do quite well on one injection per day. > > >The > >best time to take it is 8 a.m. and 8 p.m. If you're only taking it once > >a day (like Lantus) you're not likely to get good results. > > Maybe, maybe not. Some people do better at other times, and some do fine > with once a day. In theory, UL is effective for up to and even a little more > than 24 hours, as stated in the drug information. Unlike Lantus, you have to > allow for the peak of UL that will occur about 10 hours after injection. Not as > high a peak as NPH, but a peak just the same. > > >If you're interested > >in learning more about proper insulin dosing, I can refer you to Ron > >Sebol, who runs another diabetic list called DSM (Diabetes Self > >Management) and who is an expert on insulin dosing and how to gain > >excellent control. > >>>>>>>>> > > As a former member of that list, I have to chime in that Ron's methods were > over 100 % wrong for me and the amount of insulin I need. I am using a little > more than double what his results said was the right amount. > > YMMV, of course. > > Stacey Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 In answer to your last paragarph, Sandy...yes, Ron is the same Ron who used to be on the LC-D list. That list folded but Ron rescued the (very valuable) archives and is now the co-owner and moderator of DSM. He knows a lot about insulin dosing -- more than most doctors, IMHO - and has helped many diabetics. However, be warned, he tends to speak in paragraphs and loves to get technical. But if you need clarification, he's willing to clarify. I consider him my own personal diabetic mentor and the one who is chiefly responsible for my excellent control. But it was a long journey, smile. Lots of testing. Vicki, LADA type 1 diagnosed 1997, UL and Humalog insulin and lotsa testing, no complications. RE: Lantus to Ultralente > > > > > Sandy...your doctor is either inadvertently or purposely > misleading you. > Or maybe he just doesn't know better. A type 2 diabetic > doesn't become > type 1 just because insulin is needed. > > Hi Vicki, > Wow... that's a little scary, as he's supposed to be the > best in the area, so I hope he knows what he's doing. I > doubt that he's deliberately misleading me, but maybe trying > to simplify things? He's a very nice man, and to find a > better doctor than he's supposed to be, I'd have to go to > Chicago -- 3 hours away :-( Maybe he meant something else by > what he said, but those were his exact words. > > ... Thanks, Vicki...I know Ron. Is DSM a different list or did > the name just change? I think the name of his list that I > was on was differerent. So, you're saying that if I'm > supposed to take 30 units, I could take 20 of it at night > and 10 in the morning, for better results? That shouldn't be > too hard to do on my own, but I'll e-mail you off list to > get the join up information for DSM. Thanks again... > > Sandy > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 He knows a lot about insulin dosing -- more than most doctors, IMHO - and has helped many diabetics. However, be warned, he tends to speak in paragraphs and loves to get technical. But if you need clarification, he's willing to clarify. Vicki, I remember :-) He did clarify for me more than once. Sandy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 I take UL only once a day; just before bedtime. And I used Ron's chart, posted several years ago on world, to work that out. It was an absorption chart and is included in the archives of DSM, which used to be LC-D when it was on St. 's. Once I am past morning IR and rises, I need little UL until bedtime. Then the bedtime shot carries me thru the night and right up to noonish. Now as to becoming a type 1. LADAs, such as Vicki, can have very long honeymoon periods leading the doctors to diagnose them as 2s. Eventually, the honeymoon is over, nothing works but insulin, the C-peptide is under .5 and it is " discovered " they are really type 1s. And doctors telling you that you are cured? Unfortunately, it truly does happen; it happened to me. My doctor at the time was as close to a diabetologist as you could get here and he made a point of telling how unusual I was. That's why today I use insulin, actos and metformin. A short term cure! ;-) Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 Re your last paragraph, you didn't mean you were cured; you meant the doctor told you you were cured, right, Helen? Just wanted this to be Real Clear, smile. Vicki Re: Lantus to Ultralente > > I take UL only once a day; just before bedtime. And I used Ron's chart, > posted several years ago on world, to work that out. It was an > absorption chart and is included in the archives of DSM, which used to > be LC-D when it was on St. 's. > > Once I am past morning IR and rises, I need little UL until bedtime. > Then the bedtime shot carries me thru the night and right up to noonish. > > Now as to becoming a type 1. LADAs, such as Vicki, can have very long > honeymoon periods leading the doctors to diagnose them as 2s. > Eventually, the honeymoon is over, nothing works but insulin, the > C-peptide is under .5 and it is " discovered " they are really type 1s. > > And doctors telling you that you are cured? Unfortunately, it truly > does happen; it happened to me. My doctor at the time was as close to a > diabetologist as you could get here and he made a point of telling how > unusual I was. That's why today I use insulin, actos and metformin. > > A short term cure! ;-) > > Helen > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 Yes, Vicki, the doctor told me I was cured and most unusual. I didn't accept it then, tho I did consider that I was in remission, as I blamed the hormone shots for pushing me over the edge and I had stopped them. In the fullness of time, with my husband's illness, my bgs could no longer be controlled with diet and exercise. Helen Quote Link to comment Share on other sites More sharing options...
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