[Ella1]

I see now, from what I read above, I understood that Lantus implies multiple injections. That's why I was surprised.

But when injecting NPH or any other basal insulins, we still need to inject short-acting insulin for food.

So on NPH, we have 2 injections of NPH (basal) plus 3-4 injections of short-acting insulins (for food) like Humalog or Novorapid, Humulin or Actrapid. So, we get in total about 6 injections a day. On Lantus, which is injected only once, we get the same 3-4 jabs of short insulin, and it already gives us 5 in total.

[rzrbks]

Ella1

I see now, from what I read above, I understood that Lantus implies multiple injections. That's why I was surprised.

(as they say in Maine) ayeah. = yes

If you're on Lantus (long acting insulin) then you're also, probably, going to be on a rapid acting insulin as well

[Ella1]

Are there basal (long-acting) insulins on which you don't need additional shots for food? How else can we compensate for the bg after-food spikes... Sorry, I'm just trying to understand.

I found that the multiple shots are important if you want to have a freedom in what you eat and have a good BG control - some sort of having a cake and eating it. That is if one doesn't mind injections of course

[DeusXM]

No, you can't take basal insulin and then not have bolus shots. You can have mixed insulins, a combination of basal and bolus (like Mixtard) but these kill off flexibility.

Basically, in a person without diabetes, the pancreas slowly releases insulin throughout the day so that the body can always have fuel for itself. This constant release is what's mimiced by the basal insulins like Lantus or isophanes.

When you eat, your body detects the increase in blood sugar, and so the pancreas releases a burst of more insulin to deal with the food you've just taken. This is mimiced by the bolus insulin, like Humalog.

Therefore it's impossible to treat T1 with just basal insulin because you're not helping your body to do what someone without diabetes can.

I get the impression you've been rather confused by Lantus, that you seemed to think you just take one jab a day and then that's it, it deals with everything. The reason why Lantus is special though, is quite different. As you probably know, insulins have a peak action period. With bolus insulins this is usually after about 15 minutes or so and lasts for up to an hour. Basal insulins like isophane also have a peak, typically after 3 hours and up to 5 or six afterwards.

The problem is, since isophane peaks, this means towards the end of the 24 hour period between isophane injections, it's not really doing anything which means you can have higher blood sugars for a few hours before your next isophane jab. Lantus is special because it doesn't peak; it works at a constant rate. This means Lantus is brilliant for control because it mimics more closely the action of a non-diabetic pancreas than anything else. Unfortunately, a small minority of people have also had significant side-effects with Lantus.

So, to recap, if you are taking a basal insulin, you will also need multiple shots of a bolus one, for every time you eat.

[Ella1]

I think we both misunderstood each other. That's exactly what I was trying to say earlier.

When I was talking about just one injection of Lantus a day, I meant Lantus on its own. Of course on top of that you need to inject insulin for food, because it's impossible to use basal insulin to compensate postprandial BG spikes.

So I guess when you were talking about increasing the number of injections when switching to Lantus you were comparing it to premixed insulins... Because with Lantus you do decrease number of injections of basal insulin only, i.e. instead of 2 only 1 injection of basal insulin, and the rest bolus injections stay the same. That's what I meant sorry if I was a bit misleading

[dpav]

II know I am late on this one but I read about the dry skin condition. I also have a dry skin problem too. My dermatologist gave me a moisturizer that helps very much. Lyca Hydren. Also one called Utter Cream and Zimms Crams Cream. They all work real well. I have to use the first one all over my body or I can open up with a soar.
I also do 10 to 12 tests per day. My fingers also hurt and I am moving my sights all over to make it easier. I have calluses on every finger and when I use the creams it reduces the Calluses and I can then reuse those finger sights. I hope all is working out well for you. Just an FYI note
Don

[shamsul]

Hi LauRa Lu,

It's been about a week since your first post. How's it been so far? Has any of the advice/tips worked for you?

Regards,
Shamsul

[LauRa Lu]

Originally posted by shamsul
Hi LauRa Lu,

It's been about a week since your first post. How's it been so far? Has any of the advice/tips worked for you?

Regards,
Shamsul

Hi, things have got a little better, my fingers don't seem to hurt as much...well hardly at all really now. I've been using the sides of my fingers more so than i was before and also using just the same one or two fingers for a day seems to help.

As for the hypo's in the night that DeusXM sugested i might be having, i think i am! a couple of times i've woken up in the night feeling a little funny, most nights i dont wake up until the morning but do feel awful with a really bad head when i do. I'm not sure how to stop this really because i'm eating well in the evening and b4 bed...if i eat any more i'd be really high.

[lgvincent]

I get up around 2:00 or 3:00 each morning to check my blood sugar. It's no fun but it does help me take care of potential problems with low blood sugar before my NPH peaks.

As far as the bruising from insulin injections is concerned, I used to have major problems with it but started using a sharper (30 gauge) and shorter needle. I did use the 1/2 inch needle but find I don't bruise as much using the 3/8 inch needle.

[lgvincent]

My mistake, looks like the needles I'm using are 5/16 inches (8 mm) long. Oh, dopey me!

[shamsul]

Dear LauRa Lu,

I knew you could do it. Practice makes perfect.

Cheers,
Shamsul