[Duncan Ferguson]

I am currently receiving treatment for water-logging in my right eye using Avastin injections. I have had two and will receive the third this week. What I want to ask is whether anyone else undergoing this treatment has experienced difficulty with their BG control? I read a post by Mich in 2006 referring to some difficulty he had experienced and I would really like to know if this problem is more widespread than my opthalmologist or diabetologist are prepared to believe. This is a relatively new procedure in UK.
Duncan

[xMenace]

Originally Posted by Duncan Ferguson

I am currently receiving treatment for water-logging in my right eye using Avastin injections. I have had two and will receive the third this week. What I want to ask is whether anyone else undergoing this treatment has experienced difficulty with their BG control? I read a post by Mich in 2006 referring to some difficulty he had experienced and I would really like to know if this problem is more widespread than my opthalmologist or diabetologist are prepared to believe. This is a relatively new procedure in UK.
Duncan

Welcome Duncan (or just Dunc? as seems to be the Canadian custom)

Do you mean BG control associated with the shot or BG control in general? Of course BG control by diabetics is the root cause of this evil.

I've not yet been able to obtain any avastin, but I'd sure like to know the answer to whether it causes BG control difficulty.

By water-logging do you mean edema (swelling)? How long have you been diabetic?

[Mich]

I suspect my blood sugar jump after the Avastin was caused by the stress. I was scared to death, but it actually went pretty quickly. I guess I was disproportionately scared.

You might want to google Avastin Retinal Detachment just to be informed on the issue. As you may or may not know, I had three retinal detachments, the first a few days after the Avastin injection. I'm not saying it did or it didn't, but I wish I'd known first.

Mich

[Duncan Ferguson]

Originally Posted by xMenace

Welcome Duncan (or just Dunc? as seems to be the Canadian custom)

Do you mean BG control associated with the shot or BG control in general? Of course BG control by diabetics is the root cause of this evil.

I've not yet been able to obtain any avastin, but I'd sure like to know the answer to whether it causes BG control difficulty.

By water-logging do you mean edema (swelling)? How long have you been diabetic?

Michael,
I was referring to my long term BG control - that is for the four week period after the injection of Avastin. By water logging, I mean oedema, which just so happens was caused by a cataract operation that was the one in 100 that failed!
I have just spoken to my diabetic consultant and she has suggested applying sick day rules (an increase of 20% in insulin doses) for the period after the treatment. Seems sensible, but it would be nice to have known of this side effect before they attacked my eye with a needle!
Take care,
Duncan (not Dunc, although many years ago Drunken Duncan!)

[Duncan Ferguson]

Originally Posted by Mich

I suspect my blood sugar jump after the Avastin was caused by the stress. I was scared to death, but it actually went pretty quickly. I guess I was disproportionately scared.

You might want to google Avastin Retinal Detachment just to be informed on the issue. As you may or may not know, I had three retinal detachments, the first a few days after the Avastin injection. I'm not saying it did or it didn't, but I wish I'd known first.

Mich

Mich,
My symptoms were more long term than a quick BG jump from stress - in fact they lasted about 4 weeks, which is the life span of the drug and why they repeat the treatment every 4 - 5 weeks. I am being put on a pump this weekend, so I may be back asking for advice!
Duncan

[xMenace]

Originally Posted by Duncan Ferguson

Mich,
My symptoms were more long term than a quick BG jump from stress - in fact they lasted about 4 weeks, which is the life span of the drug and why they repeat the treatment every 4 - 5 weeks. I am being put on a pump this weekend, so I may be back asking for advice!
Duncan

Please stick around. It's the reason I'm doing so well. We'll get you into basal testing, meal profiling, and all kinds of mean and nasty stuff!

[Duncan Ferguson]

Originally Posted by xMenace

Please stick around. It's the reason I'm doing so well. We'll get you into basal testing, meal profiling, and all kinds of mean and nasty stuff!

John,
I have been on the pump for about 10 days now. Its been a bit of a mixed bag with plenty of daytime hypos every time I do some activity and as a farmer that is difficult to avoid. This has even caused a couple of night-time hypos (the reason I was given the pump was to avoid these!) on the rebound. I realise that it is a learning curve -at present it looks fairly flat!
Duncan

[xMenace]

Originally Posted by Duncan Ferguson

John,
I have been on the pump for about 10 days now. Its been a bit of a mixed bag with plenty of daytime hypos every time I do some activity and as a farmer that is difficult to avoid. This has even caused a couple of night-time hypos (the reason I was given the pump was to avoid these!) on the rebound. I realise that it is a learning curve -at present it looks fairly flat!
Duncan

Sounds like your key is learning to adjust for those heavy work days. I have little advice there.

[Mich]

Hi Duncan,

It sounds to me like you may need to set yourself up with two different basals. One for the heavy physical work days and one for lighter work days.

If you are having several lows in one day, and especially at night, you probably have your basal set too high. If your basal is correct, you should be able to start with a good nmber and not go any lower because of what you are doing. Basal is just "operating insulin" and you may need a lighter dose per hour if you are lifting, digging, carrying, etc. Also, you will need a small test kit, lots of glucose tabs and a couple of granola bars or even a sugar sweetened drink nearby!

Yay for farmers! We all benefit by what you do.
Wishing you and your new "pocket pancreas" a quick adjustment.

Mich

[HelenM]

I agree with Mich about cutting your basal rates.

I also had quite a few hypos at night when I started because I started on far too high a rate (based on my lantus doseage). I took 16 units of basal on lantus, I'm now using between 9 and 11 units of Apidra for basal depending on activity levels during the day. On heavy activity days I also reduce the bolus with dinner.

If you have regular days where you know that you will be doing heavy activity all day then it might be a good idea to set up a pattern of basal rates for those days.

If some days are more unpredictable then you'll need to experiment to find temporary basal rates that work for you . Its best to try and anticipate any 'extra' activity and make changes to basal rate in advance (I often don't and sometimes still go low because of the residual insulin).


I have found that for heavy gardening such as digging, pushing the mower up and down a hilly field or for running I need a surprisingly small amount :a temp basal of 30%,which for me is only 0.1 units per hour. If its a very hot day I've found that even a relatively gentle activity requires a reduction.