[Lea]

Hello all!
This is my first post, although I have been visiting the forum for a few months now and have gained much valuable info. I would love to have some feedback on my current situation. Sorry in advance if this gets lengthy.

I have had Type 1 diabetes for 24 years now. I have been pondering the idea of switching to the insulin pump for some time now, but have mixed feelings about it, so have decided to give lantus/novolog MDI combination a try first. Anything has to be an improvement over the NPH/Regular combo I have been on for the past 24 years---very antiquated, I know and I am just ready for a different way of life. After my doctor's appt. today I have also come to the conclusion that I need a new doctor, but right now I am forced to work with my current M.D. with these insulin changes, which brings me to my questions/need for input.

At MY insistence, my M.D. wrote me scrips for Lantus and novolog today. He wants to keep Regular in my regimen, so I agreed to this. He insists that with having diabetes for 24 years there is no way for me to do just Lantus and Novolog. I really don't think that this is necessarily true, but got tired of arguing with him about this, so agreed to use a combination of regular(1/3) and novolog (2/3) as bolus at mealtimes. I have just begun to figure out the whole carb counting thing (my idea, not his), but do not have a ratio yet.

My biggest question right now is where do most people typically start out with their Lantus dose? I feel like he has given my way too low a starting dose and am really concerned about where my blood sugars are at. I read in several different places (including the drug literature that comes from the maufacturer) that when switching to Lantus from NPH, the starting point is recommended to be 20% less than your total daily dose of NPH. My total daily dose of NPH is usually around(not less than) 25 units, thus a starting point for me would be 20 units of Lantus at bedtime. However, he told me to take 10 units tonight and call him Tuesday eve with the past 36 hours of blood sugars. My blood sugars have skyrocketed and I cannot seem to get them down ( thus awake and typing this at 3:30 am!!).

I took the Regular/Novolg (3u R and 8u Novo) combo at 6:15p.m before dinner (BS was 141 at this time, so I gave one more unit of Novo than he had recommended). Had a severe insulin reaction at 8:15p.m. ( BS was 27)--WAY overcorrected with OJ. Was still only 58 at 9:15. Was concerned about taking the lantus before bedtime, so ate a bowl of cereal and drank a little milk. At 10:15, I was 169. At 11:30 I was up to 263--I gave 2 shots at this time 10u Lantus and 2 uR and tried to go to sleep. Dozed off, woke up to check at 1:15, and I was 362; gave 4 u Novolog and laid back down. Got up at 2:30 and I was 283. Got out of bed and decided to watch TV/browse forum and at 3:20 I was 306. I am ready to scream! Looking for feedback! By the way, my total daily dose of insulin was close to 60 units of R/NPH and my last A1C ( one month ago was 6.8, far from ideal,but part of the reason I am changing things) Any and all feedback is appreciated. Thanks in advance!

Lea