Re: Re: insulin, testing

[Guest guest]

Sky,

I'm not good with math at all myself. But you can get friends to help you with

it, friends in particular who are A) diabetic and onliners. You might be

surprised as to the willingness and generous hearts of folks to help us

math-challenged individuals. I've had a great deal of help from my friends in

the above categories, ongoing and past, for both carb-counting math and for

insulin math.

And in turn, you might be able to help your friends with something that they are

not too hot at. Pass It On.

:>)

Bron

[Guest guest]

Sky, I went on insulin weeks after an a1c of 5.8. A lot happened in those 6

weeks, but it was in partnership with my CDE/NP that I did. She wrote the

prescription for a humalog pen for me to deal with spikes. Several weeks later,

going from 8 mg of 4 mg of avandia, she gave me my first vial of lantus. An

August a1c of 6.4 told me that I had made the right decision - though I know it

looks like I didn't.

I wanted off the glucatrol xl which was pushing my pancreas to greater and

greater lengths to keep up with me and forced me into a routine that made me

nuts starting in about May. The first 6 months of my diagnosis I did everything

" right " but I was so stressed and emotionally out of control that I couldn't

keep it up.

I had shoulder surgery in May and wanted to avoid a train wreck - exercise

became difficult (I'm a swimmer, mostly) - and I was dealing with some very big

issues with my psychiatrist. I thought I might have an infection or something

else going on that would drive up BG, but other than a recent diagnosis of

migraines (gee, I needed something else to deal with???) which could play havoc

with BG, no infections have been found.

Now, with blood taken yesterday for my 3 month check up, I feel certain that

my a1c will be up again to 6.8 or so. But, I'm trending downward again, and

the BG is starting to behave better. Plus I'm thinking it's time for me to try

Ultralente to deal with what seems like insurmountable insulin resistance

variability in a 24 hour period that lantus can't deal with effectively.

So, while the CDE/NP is the one who started with me on the insulin, my doctor

is fully on board. And my doctor is not a Endo, though the practice has an

endo as one of the tree doctors. I'm driving this train, and my Dr. and CDE/NP

are cheif engineer and conductor - but I'm in charge - at least mostly... LOL

My CDE/NP allowed as how it could be that the treatment I got starting last

November gave my pancreas a bit of a break from the overload of glucose

floating around and I had a bit of a honeymoon. I therefore was able to attain

pretty good control pretty quickly, but that all started changing in about May

when

the stress of surgery and emotional distress kicked in and my body went

haywire and so did BG.

You might not need insulin, per se, but there are many reasons to go to it.

Arm yourself iwth knowlege and the reasons why you might like something (not

necessarily insulin) to deal with meals.

Doctors often see using no meds or fewer meds as a virtue and they push that

attitude on their patients without giving due consideration to the patient's

needs and desires. Sure, I " d like to be on fewer medications, but I need them

right now, and maybe forever. That's ok too.

I'm also always wary of the attitude on the part of doctors that says that

overweight people should just lose weight and stop bothering me since they

surely don't care about anything if they don't at least lose weight. My first

doc

last year was like that. I fired him.

Stacey

[Guest guest]

At 02:05 PM 11/5/04, Anne Kim wrote:

>If you are getting that low of numbers without insulin, though, you are

>going to have a

>really hard time convincing your doctor to give you insulin. They usually

>only do that

>when someone can't control it by oral meds. There are other theories

>however. Dr.

>Bernstein, for instance believes in putting someone on insulin immediately

>to give

>their pancreas a rest.

>

>I honestly think you would be better off with the really fast acting oral

>med for those

>occasional times you are eating out for the time being.

Has anyone here managed to convince a stubborn doctor to do this when their

numbers were almost okay but they wanted to eat " normally " once in awhile?

If so, what is the technique? I'm afraid my inclination to tell such a doc

to put it where the sun don't shine wouldn't work too well (Miss Tact I'm

not).

I'm going to miss thanksgiving as it is...I could go to a friends but

there'll be potatoes and gravy and dressing and cranberry sauce and pumpkin

pie and I'm not sure I wouldn't cave in and have some (or a lot) of all of

it. Since it's so close it's not likely I'd find a new endo and convince

him/her of anything in that short a time.

sky

[Guest guest]

At 03:49 PM 11/5/04, staceypmartin@... wrote:

>Sky, I went on insulin weeks after an a1c of 5.8. A lot happened in those 6

>weeks, but it was in partnership with my CDE/NP that I did. She wrote the

>prescription for a humalog pen for me to deal with spikes. Several weeks

>later,

>going from 8 mg of 4 mg of avandia, she gave me my first vial of lantus. An

>August a1c of 6.4 told me that I had made the right decision - though I

>know it

>looks like I didn't.

(big snip)

>You might not need insulin, per se, but there are many reasons to go to it.

>Arm yourself iwth knowlege and the reasons why you might like something (not

>necessarily insulin) to deal with meals.

>

>Doctors often see using no meds or fewer meds as a virtue and they push that

>attitude on their patients without giving due consideration to the patient's

>needs and desires. Sure, I " d like to be on fewer medications, but I need them

>right now, and maybe forever. That's ok too.

>

>I'm also always wary of the attitude on the part of doctors that says that

>overweight people should just lose weight and stop bothering me since they

>surely don't care about anything if they don't at least lose weight. My

>first doc

>last year was like that. I fired him.

Thanks, , for that information. To be truthful it makes my stomach

feel a bit upset just *thinking* about dealing with a doctor or NP that

isn't cooperative. We'll see what happens on Nov 18th (such a long time to

wait).

sky

[Guest guest]

Hi Sky, I've certainly tried to convince my doctor, and I think I'm

getting to him, finally. He just can't get it, that the pills do NOT

work without constant attention to diet and exercise, except that I have

to take a week off the exercise every 6-8 weeks so I can lose a pound.

I don't want to get lazy about d & e, because I don't want to have to use

a lot of insulin, but I MUST get relief from the side effects of the

drugs and the continuing bgs that are just too high. So my plan is,

this next time I go in for the blood tests, to just tell him that I'm

going to do it on my own with OTC insulin unless he agrees to help me

with it. Good question about syringes and pens tho - need a

prescription for that???? I'll talk to the pharmacy guy first. I'm

already thinking about pecan pie for Xmas, even tho I know that much

sugar is going to make me sick.

Carol

[Guest guest]

I think you do need a prescription for the insulin pens but that's only

because the insulin that comes in the pens requires a prescription.

There are a few [old] insulins which don't require prescriptions: NPH,

regular, and Ultralente, which I use. All the new ones, such as Lantus,

Humalog and NovaLog require prescriptions. But as far as I know, you

can't use them in pens.

Vicki, LADA type 1 diagnosed 1997, UL and Humalog insulin and lotsa

testing, no complications.

Re: Re: insulin, testing

>

> At 12:26 AM 11/6/04, whimsy2 wrote:

>

>>In Oregon you don't need a prescription for syringes. But it's

>>different in every state.

>>

>>If you do start insulin, I would strongly recommend the BD extra fine

>>short needles.

>

> I've noticed that you can buy them online. I went looking yesterday.

> There

> were lots of different needle gauges, sizes, and syringe sizes, too,

> and I

> wanted to ask what was good. This is assuming I don't get any help

> from

> doctors and decide to do it on my own. I've also heard folks mention

> insulin pens but don't see any of those for sale. I'm under the

> impression,

> based on just the little bit of looking that I did, that they differ

> according to the name brand of the insulin you're using?

>

> So many questions.

>

> I'll have to check with my pharmacy to see if syringes require a

> prescription here.

>

>

> sky

>

> Type 2 diabetes dx'd 9/04. Low carb diet.

> Finds any excuse not to exercise.

>

[Guest guest]

Sky, looking at your tagline " find any excuse not to exercise " ....I used

to feel that way too. But exercise is such an important part of diabetes

management that I got over it.

One thing that helped me is getting books on tape from the library. I

only listen to it while I'm taking my daily walk, so if it's a really

good book I may exercise extra just to listen to the book!

It also breaks the boredom of doing mallwalks, smile.

Vicki

Re: Re: insulin, testing

>

> At 12:26 AM 11/6/04, whimsy2 wrote:

>

>>In Oregon you don't need a prescription for syringes. But it's

>>different in every state.

>>

>>If you do start insulin, I would strongly recommend the BD extra fine

>>short needles.

>

> I've noticed that you can buy them online. I went looking yesterday.

> There

> were lots of different needle gauges, sizes, and syringe sizes, too,

> and I

> wanted to ask what was good. This is assuming I don't get any help

> from

> doctors and decide to do it on my own. I've also heard folks mention

> insulin pens but don't see any of those for sale. I'm under the

> impression,

> based on just the little bit of looking that I did, that they differ

> according to the name brand of the insulin you're using?

>

> So many questions.

>

> I'll have to check with my pharmacy to see if syringes require a

> prescription here.

>

>

> sky

>

> Type 2 diabetes dx'd 9/04. Low carb diet.

> Finds any excuse not to exercise.

[Guest guest]

At 12:20 PM 11/6/04, whimsy2 wrote:

>I think you do need a prescription for the insulin pens but that's only

>because the insulin that comes in the pens requires a prescription.

>

>There are a few [old] insulins which don't require prescriptions: NPH,

>regular, and Ultralente, which I use. All the new ones, such as Lantus,

>Humalog and NovaLog require prescriptions. But as far as I know, you

>can't use them in pens.

You use Humalog, right? I think I remember you mentioning it. What are the

differences between the newer and the old insulins?

sky

[Guest guest]

At 12:22 PM 11/6/04, whimsy2 wrote:

>Sky, looking at your tagline " find any excuse not to exercise " ....I used

>to feel that way too. But exercise is such an important part of diabetes

>management that I got over it.

>

>One thing that helped me is getting books on tape from the library. I

>only listen to it while I'm taking my daily walk, so if it's a really

>good book I may exercise extra just to listen to the book!

>

>It also breaks the boredom of doing mallwalks, smile.

I started out walking. Then I got sick with that food poisoning, then it

was wet and cold. Now it's dark at the time of day when I'd normally walk.

Once I get involved with the computer or my art then it's hard to want to

go outside and do much. There are no malls within any sort of easy drive

and I'm not sure the few malls I know of (maybe 12-15 miles distant) in Ann

Arbor are open for mall walkers or not. As for music or books to listen to,

I like to hear what's around me when walking (this from back in the days

when I walked all of the time). Mark wanting to hear to my old martial arts

self-protection training.

I have heard that resistance exercises, like weight-lifting, are of more

benefit to those with diabetes, especially those with lots of gut fat (I'm

apple-shaped). I hate weights. Hate 'em, hate 'em, hate 'em.

sky

[Guest guest]

Oh, that's too bad about no mall near you. How 'bout your nearest

supermarket or box store such as Walmart? Though people might look

askance at someone just walking/not shopping, it's not against the law,

smile.

I also prefer to neighborhood walk. But my walk time is 7 a.m. and I'm

not about to walk in the dark. So I do neighborhood walk in the

spring/summer/fall but mallwalk in the winter.

Vicki

Re: Re: insulin, testing

>

> At 12:22 PM 11/6/04, whimsy2 wrote:

>

>>Sky, looking at your tagline " find any excuse not to exercise " ....I

>>used

>>to feel that way too. But exercise is such an important part of

>>diabetes

>>management that I got over it.

>>

>>One thing that helped me is getting books on tape from the library. I

>>only listen to it while I'm taking my daily walk, so if it's a really

>>good book I may exercise extra just to listen to the book!

>>

>>It also breaks the boredom of doing mallwalks, smile.

>

> I started out walking. Then I got sick with that food poisoning, then

> it

> was wet and cold. Now it's dark at the time of day when I'd normally

> walk.

> Once I get involved with the computer or my art then it's hard to want

> to

> go outside and do much. There are no malls within any sort of easy

> drive

> and I'm not sure the few malls I know of (maybe 12-15 miles distant)

> in Ann

> Arbor are open for mall walkers or not. As for music or books to

> listen to,

> I like to hear what's around me when walking (this from back in the

> days

> when I walked all of the time). Mark wanting to hear to my old martial

> arts

> self-protection training.

>

> I have heard that resistance exercises, like weight-lifting, are of

> more

> benefit to those with diabetes, especially those with lots of gut fat

> (I'm

> apple-shaped). I hate weights. Hate 'em, hate 'em, hate 'em.

>

> sky

[Guest guest]

The older insulins such as regular and NPH have irregular peaks and

require that you keep to a strict schedule to meet those peaks. Even so,

lots of people experience lows with these insulins. And they force you

to eat whether or not you're hungry or ready for a meal.

The newer, fast acting insulins such as Humalog and NovoLog you take

immediately -- well, 15 minutes -- before you eat. And you can eat

whenever you want. Or not. And they're out of your system within 3-4

hours, unlike regular or NPH.

You could go to the Lilly website and they have graphs showing insulin

action for the different insulins except for Lantus 'cause that's made

by Aventis. -- but Lantus, like Ultralente, is basically for basal, i.e.

background insulin.

Vicki

Re: Re: insulin, testing

>

> At 12:20 PM 11/6/04, whimsy2 wrote:

>

>>I think you do need a prescription for the insulin pens but that's

>>only

>>because the insulin that comes in the pens requires a prescription.

>>

>>There are a few [old] insulins which don't require prescriptions:

>>NPH,

>>regular, and Ultralente, which I use. All the new ones, such as

>>Lantus,

>>Humalog and NovaLog require prescriptions. But as far as I know, you

>>can't use them in pens.

>

> You use Humalog, right? I think I remember you mentioning it. What are

> the

> differences between the newer and the old insulins?

>

> sky

>

[Guest guest]

At 12:57 PM 11/6/04, whimsy2 wrote:

>Oh, that's too bad about no mall near you. How 'bout your nearest

>supermarket or box store such as Walmart? Though people might look

>askance at someone just walking/not shopping, it's not against the law,

>smile.

Saline is a small town. The Walmart is further than the malls I know of,

There is no big store in this town. Markets are normal-sized and the aisles

are, if not narrow, with enough shoppers and displays that just walking

there for 90 minutes would be odd. I could go to the local Sam's Club, I

suppose. That's " only " 10 miles.

Neighborhood walking is the easiest because there it is, right outside of

your door. No need to get in the car and drive anywhere.

sky

[Guest guest]

At 01:02 PM 11/6/04, whimsy2 wrote:

>The older insulins such as regular and NPH have irregular peaks and

>require that you keep to a strict schedule to meet those peaks. Even so,

>lots of people experience lows with these insulins. And they force you

>to eat whether or not you're hungry or ready for a meal.

>

>The newer, fast acting insulins such as Humalog and NovoLog you take

>immediately -- well, 15 minutes -- before you eat. And you can eat

>whenever you want. Or not. And they're out of your system within 3-4

>hours, unlike regular or NPH.

So it sounds as if I'd really have to convince someone to give me a

prescription if I wanted to try one of the fast-acting ones. I will mention

this to the NP when I visit on the 18th, but my hopes aren't high. I have a

feeling I'll have to stick to low carb and not much eating out (if any) for

awhile.

Heck, I have to lug food along just to visit my closest friend. I go to her

house every Tuesday and Wednesday to help her pack orders from her catalog

and website sales, so stay overnight rather than make the drive back home

after dark. She barely manages to shop well for herself and her mother, let

alone think of getting anything I might be able to eat. Domestic she is

not, nor is her mom (the nut don't fall far from the tree, as they say). So

a trip there entails getting some food prepared in advance plus some cheese

and deli meat and anything else I might want to nosh on. Well, I could go

on, but I guess it's just me griping and not really about anything much.

sky

[Guest guest]

Yup, I agree...neighborhood walking is more convenient and generally

more interesting too. Can you change your walk time?

Vicki, trying to get Sky to exercise (smile)

Re: Re: insulin, testing

>

> At 12:57 PM 11/6/04, whimsy2 wrote:

>

>>Oh, that's too bad about no mall near you. How 'bout your nearest

>>supermarket or box store such as Walmart? Though people might look

>>askance at someone just walking/not shopping, it's not against the

>>law,

>>smile.

>

> Saline is a small town. The Walmart is further than the malls I know

> of,

> There is no big store in this town. Markets are normal-sized and the

> aisles

> are, if not narrow, with enough shoppers and displays that just

> walking

> there for 90 minutes would be odd. I could go to the local Sam's Club,

> I

> suppose. That's " only " 10 miles.

>

> Neighborhood walking is the easiest because there it is, right outside

> of

> your door. No need to get in the car and drive anywhere.

>

> sky

>

[Guest guest]

I'll walk with you. Where do you live?

Connie

It would

> be nice to find someone else who walked and who walked about my speed.

>

> sky

[Guest guest]

At 08:00 PM 11/6/04, Connie wrote:

>I'll walk with you. Where do you live?

Saline, Michigan.

sky

[Guest guest]

But you were doing drugs, just not the illegal kind. <lol>

Les

-----Original Message-----

When I was able to work, I tested at my desk. If I am at a restaurant I go into

the bathroom and test. I do the same at my daughter's school when I am

volunteering (I go into the teacher's bathroom, not the children's). I even shot

up once at an outdoor festival. I was so nervous. It was my first time and I was

afraid the police would think I was doing drugs! LOL

Anne

[Guest guest]

I already sorta replied to this earlier in regards to testing, but I want to

talk about

taking food with me. It IS hard to plan ahead and think about where I am going

and when

I am going to be back. It is especially hard since I rely on public

transportation and

the smallest trip usually takes 1.5 hours there and back again, meaning I am

often gone

for 3-6 hours for even the smallest trip. Just today, I had to leave the house

an hour

prior to a meeting to go a distance that would take me 5 minutes if I were

driving.

When I calculated the time to come home, it would have taken me 1.5 hours! Thank

goodness, someone offered me a ride home.

The point I am making is that I often have to think about whether I need to take

food

with me. It's not part of what we used to do so it takes a bit of time to become

second

nature, but it will happen. Now I just think: leaving at 11am home at 2... hmmmm

maybe

I'd better make myself something to take along, like a peanut butter sandwich or

an

apple and little thing of plain peanut butter to put on it, or potted cheese

(spreadable cheese). I don't like to take something big because I don't like to

carry a

lot of bags... ha!

Hope this helps,

Anne

--- Sky wrote:

> At 04:34 PM 11/6/04, whimsy2 wrote:

>

> >Yup, I agree...neighborhood walking is more convenient and generally

> >more interesting too. Can you change your walk time?

> >Vicki, trying to get Sky to exercise (smile)

>

> If someone would come by and flog me, maybe... 8-)

>

> Seems so much nowadays is also tied into things like " if I go to get

> groceries now, just an hour before I should test, I'll have to do it there "

> or " if I leave now for such-and-such I'll probably have to find something

> to eat " . Of course I suppose the world won't end if I miss a BG test since

> I *don't* take insulin (and my diet stays pretty much the same). It would

> be nice to find someone else who walked and who walked about my speed.

>

> sky

>

>

__________________________________________________

[Guest guest]

Okay, that's going to be a bit of a stretch. <grin> I live in Federal Way,

Washington.

Connie

>

> At 08:00 PM 11/6/04, Connie wrote:

>

>>I'll walk with you. Where do you live?

>

> Saline, Michigan.

>

> sky

[Guest guest]

>All the new ones, such as Lantus, Humalog and NovaLog require

>prescriptions. But as far as I know, you can't use them in pens.

Prescriptions, yes . . . and Humalog and Novolog both come in pens. I've

never used Humalog in a pen as my HMO considers them too expensive and

unnecessary. I used to be able to get pen/cartridges for Regular with a

special request if I wanted a few for travel. I found it wasn't worth the

effort and, after so many years, I'm much handier with a vial/syringe.

Humalog:

http://www.lillydiabetes.com/using_insulin/what_types_of_insulin.jsp?reqNavId=3.\

3

Novolog:

http://www.novolog.com/?MenuID=30

Sandy

T1 - 1979

[Guest guest]

Sandy, how do you handle insulin using syringe when you eat out? I find

the pens invaluable for eating out -- I can give the shot quickly and

discretely at the table with the pen but I'd imagine filling a syringe

would be a lot more conspicuous. Do you do it at the table? I don't

consider going to the bathroom to give a shot a viable alternative,

while the food gets cold.

Vicki

Re: Re: insulin, testing

>

>

>>All the new ones, such as Lantus, Humalog and NovaLog require

>>prescriptions. But as far as I know, you can't use them in pens.

>

> Prescriptions, yes . . . and Humalog and Novolog both come in pens.

> I've

> never used Humalog in a pen as my HMO considers them too expensive and

> unnecessary. I used to be able to get pen/cartridges for Regular with

> a

> special request if I wanted a few for travel. I found it wasn't worth

> the

> effort and, after so many years, I'm much handier with a vial/syringe.

>

> Humalog:

>

http://www.lillydiabetes.com/using_insulin/what_types_of_insulin.jsp?reqNavId=3.\

3

>

>

> Novolog:

> http://www.novolog.com/?MenuID=30

>

>

> Sandy

> T1 - 1979

>

[Guest guest]

Humalog and Novalog are available in Pens or vials. I am using Humalog

in a pen. IMHO, the only way to go.

> There are a few [old] insulins which don't require prescriptions: NPH,

> regular, and Ultralente, which I use. All the new ones, such as Lantus,

> Humalog and NovaLog require prescriptions. But as far as I know, you

> can't use them in pens.

>

Maurer

Type II diabetic since 1987

Insulin dependent Type II since 9/04

(currently Lantus, Humalog, and Metformin XR)

[Guest guest]

I assume you mean the disposable, " big fat " Humalog pens?

Vicki

Re: Re: insulin, testing

>

> Humalog and Novalog are available in Pens or vials. I am using Humalog

> in a pen. IMHO, the only way to go.

>

>

>

>> There are a few [old] insulins which don't require prescriptions:

>> NPH,

>> regular, and Ultralente, which I use. All the new ones, such as

>> Lantus,

>> Humalog and NovaLog require prescriptions. But as far as I know, you

>> can't use them in pens.

>>

>

> Maurer

> Type II diabetic since 1987

> Insulin dependent Type II since 9/04

> (currently Lantus, Humalog, and Metformin XR)

[Guest guest]

I use insulin and have no prescription right now. I just buy the Humalog and

syringes and needles at our friendly Walgreen's right here in Altamonte Springs.

Thus far, you can still get a big (50 ct.) package of syringes, though the

pharmacist says someone (some IGNERNT someone, as we say in the South)is

lobbying for a restrictive law that prevents one from getting more than say,

five at a time.

Been there, done that, in NY state you can only get...get this!...*three*

syringes at a time! However, dh and I figured out a way around that; just go to

several pharmacies and buy the packet. You can get many more than three that

way. Of course, it's rather a pain to have to do it, but necessity, etc....

:>)

Bron

Type II in Florida

[Guest guest]

At 02:58 PM 11/9/04, Bron Gibson wrote:

>I use insulin and have no prescription right now. I just buy the Humalog

>and syringes and needles at our friendly Walgreen's right here in

>Altamonte Springs.

Whoa. I thought Humalog was one of those that NEEDED a prescription! Isn't

that the fast-acting new kind?

Oh and may I ask, lest I sound totally ignorant if I ask out loug about it,

how is that pronounced? Is is HUMalog or HOOMalog or something else altogether?

sky

(who needs to keep written notes on all the info in the emails so she can

remember what she has info on and what not)