Re: Re: My menu and numbers

[Guest guest]

>Kat, you do not have to take your lantus at night, why not try it in the

morning, or even mid-afternoon?

This is an excellent idea. I will start this tomorrow.

>Novalog did not work for me; humalog does.

I thought these were pretty close to the same thing? Both fast-acting

insulins? I will ask my doc if she has a sample next time. I am tired of

buying drugs that don't work.

Thanks. Kat

[Guest guest]

>Kat, you do not have to take your lantus at night, why not try it in the

morning, or even mid-afternoon?

This is an excellent idea. I will start this tomorrow.

>Novalog did not work for me; humalog does.

I thought these were pretty close to the same thing? Both fast-acting

insulins? I will ask my doc if she has a sample next time. I am tired of

buying drugs that don't work.

Thanks. Kat

[Guest guest]

>Kat, you do not have to take your lantus at night, why not try it in the

morning, or even mid-afternoon?

This is an excellent idea. I will start this tomorrow.

>Novalog did not work for me; humalog does.

I thought these were pretty close to the same thing? Both fast-acting

insulins? I will ask my doc if she has a sample next time. I am tired of

buying drugs that don't work.

Thanks. Kat

[Guest guest]

No, I think it's sort of in a " class by itself. "

It's a longer-acting insulin. When used properly, its action is very

smooth - practically flat. This involves overlapping doses, which is

why it is best taken at 12-hour intervals.

Helen, I'm not at all good at technical explanations. Maybe you can help

me out here.

There's a website with the UL action curve on it...I'll have to search

through my archives to find it though, no time right now.

Ron Sebol is the expert on UL and is the one who taught me how to use it

properly. His expertise is available to anyone who wants it at his

list, DSM (diabetes self management). Anyone who wants the join-up

information contact me offlist.

Vicki

Re: Re: My menu and numbers

>

>

>

>

> >If you give the Lantus a fair try and it still seems to be keeping

> you

> awake, you might consider trying Ultralente as your basal. Very few

> doctors ever prescribe this -- it actually doesn't even need a

> prescription since it's an old insulin, and it's a lot cheaper than

> Lantus. It has a reputation as being unpredictable but IMHO, this is

> because most doctors don't understand how to use it to best

> advantage,

> i.e. twice a day, 12 hours apart. Also, it takes some experimentation

> to

> get the dosing correct. Very often the a.m. dose is half the p.m.

> dose.

> I get excellent basal control with it, as do quite a few others here.

> Vicki

> I'm not familiar with Ultralente. Is that like Humulin N?

>

> Kat

>

[Guest guest]

No, I think it's sort of in a " class by itself. "

It's a longer-acting insulin. When used properly, its action is very

smooth - practically flat. This involves overlapping doses, which is

why it is best taken at 12-hour intervals.

Helen, I'm not at all good at technical explanations. Maybe you can help

me out here.

There's a website with the UL action curve on it...I'll have to search

through my archives to find it though, no time right now.

Ron Sebol is the expert on UL and is the one who taught me how to use it

properly. His expertise is available to anyone who wants it at his

list, DSM (diabetes self management). Anyone who wants the join-up

information contact me offlist.

Vicki

Re: Re: My menu and numbers

>

>

>

>

> >If you give the Lantus a fair try and it still seems to be keeping

> you

> awake, you might consider trying Ultralente as your basal. Very few

> doctors ever prescribe this -- it actually doesn't even need a

> prescription since it's an old insulin, and it's a lot cheaper than

> Lantus. It has a reputation as being unpredictable but IMHO, this is

> because most doctors don't understand how to use it to best

> advantage,

> i.e. twice a day, 12 hours apart. Also, it takes some experimentation

> to

> get the dosing correct. Very often the a.m. dose is half the p.m.

> dose.

> I get excellent basal control with it, as do quite a few others here.

> Vicki

> I'm not familiar with Ultralente. Is that like Humulin N?

>

> Kat

>

[Guest guest]

No, I think it's sort of in a " class by itself. "

It's a longer-acting insulin. When used properly, its action is very

smooth - practically flat. This involves overlapping doses, which is

why it is best taken at 12-hour intervals.

Helen, I'm not at all good at technical explanations. Maybe you can help

me out here.

There's a website with the UL action curve on it...I'll have to search

through my archives to find it though, no time right now.

Ron Sebol is the expert on UL and is the one who taught me how to use it

properly. His expertise is available to anyone who wants it at his

list, DSM (diabetes self management). Anyone who wants the join-up

information contact me offlist.

Vicki

Re: Re: My menu and numbers

>

>

>

>

> >If you give the Lantus a fair try and it still seems to be keeping

> you

> awake, you might consider trying Ultralente as your basal. Very few

> doctors ever prescribe this -- it actually doesn't even need a

> prescription since it's an old insulin, and it's a lot cheaper than

> Lantus. It has a reputation as being unpredictable but IMHO, this is

> because most doctors don't understand how to use it to best

> advantage,

> i.e. twice a day, 12 hours apart. Also, it takes some experimentation

> to

> get the dosing correct. Very often the a.m. dose is half the p.m.

> dose.

> I get excellent basal control with it, as do quite a few others here.

> Vicki

> I'm not familiar with Ultralente. Is that like Humulin N?

>

> Kat

>

[Guest guest]

>I just started insulin again about a month ago - Lantus at Bedtime, Humalog

pre-meal. My Lantus at bedtime is currently 60 units, and I still don't

think it's quite enough. I may need 25 more! :o/

Bedtime bg - 127, next morning waking - 149

Bedtime bg - 95, next morning waking - 116

Bedtime bg - 99, next morning waking - 136

I've gotten my Humalog doses set very well. Lunch usually around 40 units,

dinner winds up being around 50. This is all with very low to moderate

carbs - lunch 15 - 20 and dinner 20 - 25. If I have a higher carb meal,

ie... add a baked potato (rare!!!), I need 65 - 70 units.

I think these numbers show that I have quite a bit of insulin resistance.

In the morning I will typically take 15 units of Humalog with no food, just

to get my bg down below 100.

My last Hba1c (a month ago) was 10.4 (no throwing stones!!!). Since I've

been keeping my bgs close to a hundred or slightly less, after bringing my

morning bg down, I'm sure my next Hba1c will be significantly better.

This is good to know that it could possibly take that much insulin. My doctor

never really suggested taking more Lantus after I got up to 25 units. She told

me to take 8 units of Novolog with meals and I told her I took 20 units once and

she looked at me horrified. <it didn't do anything> Do you increase your

insulin on your own, or did your doc tell you take that much? I think my doctor

is scared to death I will go low or something. And does the Humalog make you

hungry? When I take Novolog, I have an uncontrollable appetite. I hate it.

Kat

[Guest guest]

>I just started insulin again about a month ago - Lantus at Bedtime, Humalog

pre-meal. My Lantus at bedtime is currently 60 units, and I still don't

think it's quite enough. I may need 25 more! :o/

Bedtime bg - 127, next morning waking - 149

Bedtime bg - 95, next morning waking - 116

Bedtime bg - 99, next morning waking - 136

I've gotten my Humalog doses set very well. Lunch usually around 40 units,

dinner winds up being around 50. This is all with very low to moderate

carbs - lunch 15 - 20 and dinner 20 - 25. If I have a higher carb meal,

ie... add a baked potato (rare!!!), I need 65 - 70 units.

I think these numbers show that I have quite a bit of insulin resistance.

In the morning I will typically take 15 units of Humalog with no food, just

to get my bg down below 100.

My last Hba1c (a month ago) was 10.4 (no throwing stones!!!). Since I've

been keeping my bgs close to a hundred or slightly less, after bringing my

morning bg down, I'm sure my next Hba1c will be significantly better.

This is good to know that it could possibly take that much insulin. My doctor

never really suggested taking more Lantus after I got up to 25 units. She told

me to take 8 units of Novolog with meals and I told her I took 20 units once and

she looked at me horrified. <it didn't do anything> Do you increase your

insulin on your own, or did your doc tell you take that much? I think my doctor

is scared to death I will go low or something. And does the Humalog make you

hungry? When I take Novolog, I have an uncontrollable appetite. I hate it.

Kat

[Guest guest]

>I just started insulin again about a month ago - Lantus at Bedtime, Humalog

pre-meal. My Lantus at bedtime is currently 60 units, and I still don't

think it's quite enough. I may need 25 more! :o/

Bedtime bg - 127, next morning waking - 149

Bedtime bg - 95, next morning waking - 116

Bedtime bg - 99, next morning waking - 136

I've gotten my Humalog doses set very well. Lunch usually around 40 units,

dinner winds up being around 50. This is all with very low to moderate

carbs - lunch 15 - 20 and dinner 20 - 25. If I have a higher carb meal,

ie... add a baked potato (rare!!!), I need 65 - 70 units.

I think these numbers show that I have quite a bit of insulin resistance.

In the morning I will typically take 15 units of Humalog with no food, just

to get my bg down below 100.

My last Hba1c (a month ago) was 10.4 (no throwing stones!!!). Since I've

been keeping my bgs close to a hundred or slightly less, after bringing my

morning bg down, I'm sure my next Hba1c will be significantly better.

This is good to know that it could possibly take that much insulin. My doctor

never really suggested taking more Lantus after I got up to 25 units. She told

me to take 8 units of Novolog with meals and I told her I took 20 units once and

she looked at me horrified. <it didn't do anything> Do you increase your

insulin on your own, or did your doc tell you take that much? I think my doctor

is scared to death I will go low or something. And does the Humalog make you

hungry? When I take Novolog, I have an uncontrollable appetite. I hate it.

Kat

[Guest guest]

I am not the best person to ask about the action of ul, I only take it

once a day, at bedtime. UL does have a curve, but it is not as steep as

NPH. It also lasts longer in the body. You can make the action work

for you, with NPH that high curve puts too much insulin, YMMV, in the

body when it doesn't need it - such as the middle of the night.

UL's curve means I have more background insulin when my resistance is at

its highest, when the Dawn Phenomenon and morning rise are at work. The

UL mostly holds that down with the addition of a little humalog in the

AM. This is when everything is working as it should.

My three meals do not follow a morning, mid day and evening schedule.

Some days my first meal can be as late as 2PM. However, bedtime is

usually around 2AM. So that third meal is at night and when I shoot H

for it, I also add some to cover the lowering of the UL.

Rick, why not try a shot of humalog at bedtime anytime that bg is over

90? I think a unit or three will not bring you into a low. I have done

this when I am at the tail end of a vial of UL and it doesn't have quite

the same punch as a new vial does.

Helen

[Guest guest]

I am not the best person to ask about the action of ul, I only take it

once a day, at bedtime. UL does have a curve, but it is not as steep as

NPH. It also lasts longer in the body. You can make the action work

for you, with NPH that high curve puts too much insulin, YMMV, in the

body when it doesn't need it - such as the middle of the night.

UL's curve means I have more background insulin when my resistance is at

its highest, when the Dawn Phenomenon and morning rise are at work. The

UL mostly holds that down with the addition of a little humalog in the

AM. This is when everything is working as it should.

My three meals do not follow a morning, mid day and evening schedule.

Some days my first meal can be as late as 2PM. However, bedtime is

usually around 2AM. So that third meal is at night and when I shoot H

for it, I also add some to cover the lowering of the UL.

Rick, why not try a shot of humalog at bedtime anytime that bg is over

90? I think a unit or three will not bring you into a low. I have done

this when I am at the tail end of a vial of UL and it doesn't have quite

the same punch as a new vial does.

Helen

[Guest guest]

I am not the best person to ask about the action of ul, I only take it

once a day, at bedtime. UL does have a curve, but it is not as steep as

NPH. It also lasts longer in the body. You can make the action work

for you, with NPH that high curve puts too much insulin, YMMV, in the

body when it doesn't need it - such as the middle of the night.

UL's curve means I have more background insulin when my resistance is at

its highest, when the Dawn Phenomenon and morning rise are at work. The

UL mostly holds that down with the addition of a little humalog in the

AM. This is when everything is working as it should.

My three meals do not follow a morning, mid day and evening schedule.

Some days my first meal can be as late as 2PM. However, bedtime is

usually around 2AM. So that third meal is at night and when I shoot H

for it, I also add some to cover the lowering of the UL.

Rick, why not try a shot of humalog at bedtime anytime that bg is over

90? I think a unit or three will not bring you into a low. I have done

this when I am at the tail end of a vial of UL and it doesn't have quite

the same punch as a new vial does.

Helen

[Guest guest]

At 10:54 PM 4/21/2005, you wrote:

> This is good to know that it could possibly take that much insulin. My

> doctor never really suggested taking more Lantus after I got up to 25

> units. She told me to take 8 units of Novolog with meals and I told her

> I took 20 units once and she looked at me horrified. <it didn't do

> anything> Do you increase your insulin on your own, or did your doc tell

> you take that much? I think my doctor is scared to death I will go low

> or something. And does the Humalog make you hungry? When I take

> Novolog, I have an uncontrollable appetite. I hate it. Kat

Hi Kat

My doc had me start with a sliding scale on Humalog and 40 units of Lantus.

My 1st lunch meal I used 18 units of Humalog - before lunch 248, two hours

later 226 - that was with 10 carbs or less.

I decided on my own to throw out the sliding scale and try to 'match' my

doses to the # of carbs I was eating. I figured the carbs for each meal,

even looking for 'hidden' carbs. I raised my units by 2 each meal for a

couple of days in a row - no change. So I 'jumped' up to 30 units, then 35,

then 40. Each of these jumps brought me closer. I kept a close watch after

each meal to make sure I didn't go too low. I had also raised my Lantus to

60 units after about 4 days. After about 2 weeks, things were looking much

better and I faxed my doctor a copy of my numbers. I was all prepared to

have him scold me for 'going it alone' - I was also prepared to get a new

doctor if need be as I was not going to waste months of " try this for a

week or two and get back to me. " Instead of being upset, he was extremely

please with the changes in the numbers. He also agreed to raise my monthly

allotment of strips to 150 instead of 100. Since I don't ever eat

breakfast, that works for me.

I just uploaded a picture which is a screen shot of my glucose trend. It's

in the pictures section of the diabetes_int web-site. I put

it there so you can see how my aggressive attack on the high bgs resulted

in much better numbers reasonably quickly.

Rick

[Guest guest]

At 10:54 PM 4/21/2005, you wrote:

> This is good to know that it could possibly take that much insulin. My

> doctor never really suggested taking more Lantus after I got up to 25

> units. She told me to take 8 units of Novolog with meals and I told her

> I took 20 units once and she looked at me horrified. <it didn't do

> anything> Do you increase your insulin on your own, or did your doc tell

> you take that much? I think my doctor is scared to death I will go low

> or something. And does the Humalog make you hungry? When I take

> Novolog, I have an uncontrollable appetite. I hate it. Kat

Hi Kat

My doc had me start with a sliding scale on Humalog and 40 units of Lantus.

My 1st lunch meal I used 18 units of Humalog - before lunch 248, two hours

later 226 - that was with 10 carbs or less.

I decided on my own to throw out the sliding scale and try to 'match' my

doses to the # of carbs I was eating. I figured the carbs for each meal,

even looking for 'hidden' carbs. I raised my units by 2 each meal for a

couple of days in a row - no change. So I 'jumped' up to 30 units, then 35,

then 40. Each of these jumps brought me closer. I kept a close watch after

each meal to make sure I didn't go too low. I had also raised my Lantus to

60 units after about 4 days. After about 2 weeks, things were looking much

better and I faxed my doctor a copy of my numbers. I was all prepared to

have him scold me for 'going it alone' - I was also prepared to get a new

doctor if need be as I was not going to waste months of " try this for a

week or two and get back to me. " Instead of being upset, he was extremely

please with the changes in the numbers. He also agreed to raise my monthly

allotment of strips to 150 instead of 100. Since I don't ever eat

breakfast, that works for me.

I just uploaded a picture which is a screen shot of my glucose trend. It's

in the pictures section of the diabetes_int web-site. I put

it there so you can see how my aggressive attack on the high bgs resulted

in much better numbers reasonably quickly.

Rick

[Guest guest]

At 10:54 PM 4/21/2005, you wrote:

> This is good to know that it could possibly take that much insulin. My

> doctor never really suggested taking more Lantus after I got up to 25

> units. She told me to take 8 units of Novolog with meals and I told her

> I took 20 units once and she looked at me horrified. <it didn't do

> anything> Do you increase your insulin on your own, or did your doc tell

> you take that much? I think my doctor is scared to death I will go low

> or something. And does the Humalog make you hungry? When I take

> Novolog, I have an uncontrollable appetite. I hate it. Kat

Hi Kat

My doc had me start with a sliding scale on Humalog and 40 units of Lantus.

My 1st lunch meal I used 18 units of Humalog - before lunch 248, two hours

later 226 - that was with 10 carbs or less.

I decided on my own to throw out the sliding scale and try to 'match' my

doses to the # of carbs I was eating. I figured the carbs for each meal,

even looking for 'hidden' carbs. I raised my units by 2 each meal for a

couple of days in a row - no change. So I 'jumped' up to 30 units, then 35,

then 40. Each of these jumps brought me closer. I kept a close watch after

each meal to make sure I didn't go too low. I had also raised my Lantus to

60 units after about 4 days. After about 2 weeks, things were looking much

better and I faxed my doctor a copy of my numbers. I was all prepared to

have him scold me for 'going it alone' - I was also prepared to get a new

doctor if need be as I was not going to waste months of " try this for a

week or two and get back to me. " Instead of being upset, he was extremely

please with the changes in the numbers. He also agreed to raise my monthly

allotment of strips to 150 instead of 100. Since I don't ever eat

breakfast, that works for me.

I just uploaded a picture which is a screen shot of my glucose trend. It's

in the pictures section of the diabetes_int web-site. I put

it there so you can see how my aggressive attack on the high bgs resulted

in much better numbers reasonably quickly.

Rick

[Guest guest]

At 11:05 PM 4/21/2005, you wrote:

>Rick, why not try a shot of humalog at bedtime anytime that bg is over

>90? I think a unit or three will not bring you into a low. I have done

>this when I am at the tail end of a vial of UL and it doesn't have quite

>the same punch as a new vial does.

>

>Helen

Thanks for the suggestion Helen. I'll give it a try and see what happens!

Rick

[Guest guest]

Kat, I think your doctor is unreasonably afraid of hypos. Most type 2s

on insulin takes WAY more than 25 units. If you were to take a survey on

this list, asking how much Lantus the type 2s on insulin take, I bet

you'd find most of them take a LOT more than 25 units. After all, type 2

is a disease of insulin RESISTANCE.

Well, maybe we could just do an informal survey right here. Q: Of the

type 2s on this list who take Lantus, what is your dose?

Maybe you need to find another doctor, Kat.

Vicki

Re: Re: My menu and numbers

>

>

>

>

> >I just started insulin again about a month ago - Lantus at Bedtime,

> Humalog

> pre-meal. My Lantus at bedtime is currently 60 units, and I still

> don't

> think it's quite enough. I may need 25 more! :o/

>

> Bedtime bg - 127, next morning waking - 149

> Bedtime bg - 95, next morning waking - 116

> Bedtime bg - 99, next morning waking - 136

>

> I've gotten my Humalog doses set very well. Lunch usually around 40

> units,

> dinner winds up being around 50. This is all with very low to

> moderate

> carbs - lunch 15 - 20 and dinner 20 - 25. If I have a higher carb

> meal,

> ie... add a baked potato (rare!!!), I need 65 - 70 units.

>

> I think these numbers show that I have quite a bit of insulin

> resistance.

> In the morning I will typically take 15 units of Humalog with no

> food, just

> to get my bg down below 100.

>

> My last Hba1c (a month ago) was 10.4 (no throwing stones!!!). Since

> I've

> been keeping my bgs close to a hundred or slightly less, after

> bringing my

> morning bg down, I'm sure my next Hba1c will be significantly better.

>

> This is good to know that it could possibly take that much insulin.

> My doctor never really suggested taking more Lantus after I got up to

> 25 units. She told me to take 8 units of Novolog with meals and I

> told her I took 20 units once and she looked at me horrified. <it

> didn't do anything> Do you increase your insulin on your own, or did

> your doc tell you take that much? I think my doctor is scared to

> death I will go low or something. And does the Humalog make you

> hungry? When I take Novolog, I have an uncontrollable appetite. I

> hate it. Kat

>

[Guest guest]

Vicki wrote

> There's a website with the UL action curve on it...I'll have to search

> through my archives to find it though, no time right now.>

Lilly has a series of pages on insulin - this one shows the time lines for

different types of insulin.

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

3

Bea

[Guest guest]

At 10:53 PM 4/21/2005, you wrote:

>No, I think it's sort of in a " class by itself. "

>It's a longer-acting insulin. When used properly, its action is very

>smooth - practically flat. This involves overlapping doses, which is

>why it is best taken at 12-hour intervals.

>

>...

>

>There's a website with the UL action curve on it...I'll have to search

>through my archives to find it though, no time right now.

>

>...

>Vicki

Hi Vicki,

I uploaded another screen-shot - this one from Medscape - that shows

comparative insulin actions, including UL. It's in the pictures section of

the website.

Rick

[Guest guest]

Rick, are you taking any other diabetes meds? Some have had success with

taking the metformin and/or actos/avandia at night rather than in the morning or

with dinner.

I split my metformin into two doses of 1000 mg each, morning and bedtime. I

can't say I've noticed any effect whatsover with changing timing, but YMMV.

Stacey

[Guest guest]

Rick, are you taking any other diabetes meds? Some have had success with

taking the metformin and/or actos/avandia at night rather than in the morning or

with dinner.

I split my metformin into two doses of 1000 mg each, morning and bedtime. I

can't say I've noticed any effect whatsover with changing timing, but YMMV.

Stacey

[Guest guest]

Rick, are you taking any other diabetes meds? Some have had success with

taking the metformin and/or actos/avandia at night rather than in the morning or

with dinner.

I split my metformin into two doses of 1000 mg each, morning and bedtime. I

can't say I've noticed any effect whatsover with changing timing, but YMMV.

Stacey

[Guest guest]

In a message dated 4/22/05 7:48:06 AM Eastern Daylight Time,

etramsey1954@... writes:

>

>My average daily usage, pre pump was

>54 units a day. Now, it's 34 units a day. And I am

>TERRIBLY insulin resitant. I also take metformin cause

>I have PCOS. Most type 2's and I say MOST, use more

>insulin than type 1's on a daily basis.

>>>>>>>>>>>>>>

LOL - you can't be that insulin resistant if you only use 34 units a day as

your total insulin amount. That's a type 1 amount!

Stacey

[Guest guest]

In a message dated 4/22/05 7:48:06 AM Eastern Daylight Time,

etramsey1954@... writes:

>

>My average daily usage, pre pump was

>54 units a day. Now, it's 34 units a day. And I am

>TERRIBLY insulin resitant. I also take metformin cause

>I have PCOS. Most type 2's and I say MOST, use more

>insulin than type 1's on a daily basis.

>>>>>>>>>>>>>>

LOL - you can't be that insulin resistant if you only use 34 units a day as

your total insulin amount. That's a type 1 amount!

Stacey

[Guest guest]

In a message dated 4/22/05 7:48:06 AM Eastern Daylight Time,

etramsey1954@... writes:

>

>My average daily usage, pre pump was

>54 units a day. Now, it's 34 units a day. And I am

>TERRIBLY insulin resitant. I also take metformin cause

>I have PCOS. Most type 2's and I say MOST, use more

>insulin than type 1's on a daily basis.

>>>>>>>>>>>>>>

LOL - you can't be that insulin resistant if you only use 34 units a day as

your total insulin amount. That's a type 1 amount!

Stacey