My fingers can't take it any more!

[LauRa Lu]

Hi, I'm testing my blood sugar around 5 to 6 times a day, but my fingers are becoming a complete reck! Sometimes by the end of the day they all ache so much that it's really hard to do a test before bed... :(

I have to test this many times because i've only been diabetic for about 6 weeks and i'm not used to what makes my sugar go up and what causes it to go low.

Does every one else have tingly bruised fingers or am i just sensitive or something?! I do only have little fingers and sometimes it's hard to get any blood out at all. :o :(

[Shalyndria]

Hey Laura.

I test my BG's on average about 10 times a day and have small fingers as well. I have never had any problems with pain and although I occasionally find it hard to draw blood from certain fingers, a deeper depth on my lancet usually does the trick.

Are you using the sides of your fingers? What type of meter/lancet device are you using? And which lancets?

Shy

[rzrbks]

Hi, I'm testing my blood sugar around 5 to 6 times a day, but my fingers are becoming a complete reck! Sometimes by the end of the day they all ache so much that it's really hard to do a test before bed...


Does every one else have tingly bruised fingers or am i just sensitive or something?! I do only have little fingers and sometimes it's hard to get any blood out at all.

1. Are you changing the depth settings on your lancet device?

2. LauRa Lu, you really ought to be alternating fingers with each check. Start with Index, then move to "finger" finger, then to number 3, then to Pinky.

Are you using the sides of your fingers?

Don't forget to move around to different sites on each finger too.

Don't know about other folks on here, but my CDE showed us to squeeze a small bit too. You might also run your hand under warm water--I know the warm water really helps when it's cold--if nothing else, be sure to massage your finger before you jab it too.

[Harold]

tingly bruised fingers

Sounds like your using the pads. Like Shy asked try the sides, but not too close to the nails. There are fewer nerves there and it gives you two places on each finger to test.

[Belinda]

warming the fingers is very helpful but I generally rub them on my jeans not in warm water due to the fact that I have very dry hands and cracked skin if I am not too careful(help if I didn't think that I needed to use all the hot water when taking a shower LOL. I also use my forearms at times too.

[zookeeper671]

Oh man did I suffer from bruised, red and polka dotted fingers when I was first dx'd 4 months ago. Think I even posted about it asking the same thing. lol

What I learned was to use the sides of my fingers (as mentioned earlier), and to alternate fingers (as mentioned earlier, too). I had such sore fingers for about 2 months, but it's not at all a problem anymore. I can use one finger per day, sometimes for two days in a row, same side, without pain, before having to switch to the other side or switch fingers.

It just takes some time for your fingers to get used to being attacked. ;) Try using the smallest setting on your lancing device (if you don't have any trouble getting blood), and using the smallest gauge lancets available (33g) if you're not already.

Best wishes,
Angie

P.S. Looking down at my fingers I notice only itty-bitty little specks, and when I press on the specks there is no pain at all.

[LauRa Lu]

:( But i do use all my fingers, use both sides of each one, warm my hands with warm water and prick on the sides.. :(

Im using a 'Medisense' lancing device, i tried a different one but i prefer this one, the other one didnt seem to be any good on any setting and i could never get any blood out.

The one i use has 5 settings, when i was in hospital at the begining and the nurses would test for me, they went from setting one and ended up always using 5 because it seemed no blood was even in my fingers! :rolleyes: (there was really of course.)

I use setting two now because i'm better at getting my stuborn blood to escape! But my fingers just hurt... :(

I'm going to try and test just 3 or 4 times today and see if it helps them get a bit beter. :p

Another problem thats only just developing and really getting me down, is my injection. at first it didn't hurt but now it seems to hurt every time. I try to change where i do it like in my belly and tops of my legs, but it keeps hurting every time now! :( i almost cant do it in my legs at all anymore coz no matter where i try it hurts...i know im not going near any muscle so its not that! i dont have much fat on my legs as i'm qiute tiny but i'm not sure what difference that makes..?

I also had a little bruise yesterday on my stomach from my morning injection, is this normal to get bruising now and again?

AAAAAAAHHH! so many questions! :confused:

The pain i get from the needle isnt really the sharp little prick ( :p ) that goes in initialaly, it actually hurts and is very uncomfortable as its in and as im injecting....i dont know why because its been fine up until now!

sorry for so many ????? :)

Laura x x

[DeusXM]

Bruising is 'normal' but not really a good thing. It happens when you spike a blood vessel rather than fat. The bruise you get usually looks absolutely brilliant, all huge and purple and speckly before going a delightful shade of yellowy brown!

Don't worry about it too much, it does happen from time to time.

As for injection technique:

Basics: Make sure you're injecting vertically, none of this approaching at an angle because you might get the blunt side of the needle hitting first.

Change your needle regularly. A new needle is sharper, more lubricated, and less likely to hurt.

When injecting, make sure you pinch up any available fat, but don't pinch so much that you can feel yourself pulling up muscle, or you'll jab the muscle and that'll hurt a bit.

Try injecting in other place. I know it's fairly inconvenient, but if you can, try injecting in your arse cheeks. Typically it's where you've got the most fat, and the least nerve endings, so hopefully it should hurt less.

In my experience you may want to restrict the amount of injections you do in your stomach. They tend to get absorbed more quickly, and also there can be some unpleasant side effects. I'm by no means a fat person, but there's actually a visible band across my stomach where I used to inject frequently of tougher skin and a deposit of fat, which effectively ruins my six pack.

As for testing, have a look at http://diabetes.about.com/cs/glucosemonitoring/a/painless_meters.htm. It talks about some companies who make alternative-site testing kits that you use on less sensitive parts of your body like your inside lower arm etc. You may want to consider them.

Good luck with the injections and testings. It sounds to me like you're in that really nasty stage where you've just been diagnosed and the reality is just beginning to sink in. Unfortunately most of us go through that bit, and it's not fun at all, but I PROMISE you, this will get better. It may take a while, but the first few months are probably the hardest for all of us. It's not fair, you and I didn't ask for all this (it's now one of the reasons why I'm an atheist), but you will become a much stronger person than you ever thought possible.

I know that's not much of a comfort for you at the moment but please trust me on this.

[WiseWords]

Laura Lu,

Sounds to me like you are one of those people who has
difficulty getting blood easily. As you do more testing,
you may find that the blood flows easier!

With the lancet device on the last number, you are
really going deep, and that will make a bigger wound,
which will take longer to heal and/or be sore, as you have experienced.

Different lancet devices will probably not make
much difference, as they all do pretty much the same thing,
and have variable settings. However, different lancet
manufacturers can make a big difference. I have used some
brands that were significantly poorer, including the 10 free ones
that come with most meters. One of the worst brands, IMO,
is BD, although I have never used their lancet device.
Their lancets do not fit into the lancet device as easily as the
other brands of lancets. It may be possible that you have a
combination that is not overly compatible, if not with the device,
than certainly with your fingers. Try a different brand of lancets.

I have found that the Monolet lancets, (and Monoject Syringes),
from Sherwood Medical, are far superior to the BD products.
Don't know if they are available in the UK.

I don't think you will have much luck with the arm testing,
and it is not as accurate as with your finger-tips. Some people
have complained of dots or bruises on their arms that did not
heal quickly. You may be one of those.

Another suggestion, aside from a different brand of lancets,
is to shake your arm vigorously in a downward motion,
and then, squeeze the lower part of the finger that you plan to
stab before you prick it. That will push the blood to the finger-tip.

Although most people use the side of their fingers,
I find it more difficult to get blood from the sides of
my fingers. I use the front, padded part. There is actually
more blood there, and that was the part used by
labs years ago, when they occasionally took blood from
a finger-tip in glass pipettes, (about 5-7 miniature glass tubes),
instead of from the arm. It was less traumatic for very small
children, or adults with poor veins in the arm.
The reason they tell you not to do it on the front, padded
part of the finger-tip, is that before it has healed sufficiently,
it may be sensitive, but it will get toughened up, and you
may find it easier to get blood from that part.
:(

[LauRa Lu]

Originally posted by DeusXM
my six pack.


:p ;) in the uk, similar age, single?

:p :p :p :p


Originally posted by wiseWords
It was less traumatic for very small
children, or adults with poor veins in the arm.


Or for wimps like me who hate it in it in the arm sooooo....much!

:D



Thanx for the replys guys, I'm going to try using the sides of my fingers better than i do at the moment...i think i'm doing it kind of in between the pad and side so i'll move it down a little bit.


:) WIll it be a silly idea to practice putting my injection in and out a few times with out actually injecting? It really hurts when i do it vertically?! it hurts how ever i seem to do it. I might try and get some smaller needles to see if that helps, im currently using 8mm ones maybe 6mmm would be better... :)

[DeusXM]

in the uk, similar age, single?

Lol well when I'm home from uni I do live in Gloucester!

I wouldn't really recommend sticking needles into yourself repeatedly since you've just end up with a load of holes in your body but I guess it might be a sort of confidence booster - still wouldn't recommend it though.

You can get smaller needles (5mm is the next size down I think) and since

i dont have much fat on my legs as i'm quite tiny

it might be worth looking into. Have a word with your care team.

[WiseWords]

Syringes & Shots

I wouldn't say that bruising is normal, although
it does happen on occasion.
If it is happening frequently, or it hurts every time you
inject, then you are injecting too frequently in the same
general area. Sometimes, people find a good spot, and
then overuse it until it is no longer good.

You shouldn't inject closer than ½inch from the previous
spot, but I never go that close. Why would you?
If you use the left thigh, then next time, use the right thigh.
Divide your leg into sections, so that you have a pattern
which is not repeated frequently. Same for other areas.

If you are not using your arms, you can do that.
If you want to pinch the skin, lean against a doorway,
although pinching the skin is not absolutely necessary.
Some people do better by not pinching it, or spreading it
apart with the fingers. Different techniques to accomplish
the same objective. Some people will find that one way
hurts less, and others prefer the other way.

If you can reach behind, you also have part of that area.
Between your thighs, arms, stomach, & posterior,
with proper rotation on each area, there is no reason to
be experiencing pain or bruises on a frequent basis.

Some people prefer not to rotate site location because
the insulin is absorbed more efficiently from the stomach
than from the extremities. Location usage varies with the
individual, and can be compensated for, with a slight change
in dosage or diet, if need be. I try to use my arms or thighs on
days when I anticipate getting more exercise.

You can also reach the back of you arms or back of other parts,
if you teach your fiancé to give you an injection.
If he hasn't learned how, he might as well, since
he will be around for a long period of time.
It will also help if he ever needs to give you a shot of
Glucagon, if you are passed out from a low BG.

Let him practice on an orange or lemon with a
syringe or pen filled with water, before he practices on
you with the real thing.

As you are using the pre-mixed insulin, which I detest,
are you using the pens only, or do you have syringes
and a vial of insulin? With syringes, you have more
choices of needle length and gage. I suspect that you need
one of the lengths that is slightly shorter than the
standard ½inch size, along with a 31 gage needle.
Pens are also available in those sizes.
As your's are measured in mm, try a shorter length.
You may find that you have a little more control over the
injection with a syringe.
I would not advise any extra practicing. It is really unnecessary.

You will probably also need one of the fast-acting insulins,
by itself, either in a pen or a vial & syringe, to cover
individual meals or unexpected high blood sugars.

Also, read up on and be prepared for low blood sugars.
Always have some form of carbohydrate, such as candy or juice,
readily available. Know how you feel when you have a low BG.
When in doubt, test.
;)

[oktokie]

I am not sure if changing the lancets would help her.
Here is my father's case. He used to have this lancet supplied with LIFESCAN glucose tester. He did not like it because it's needle was huge. So, he changed his lancet to something else. I don't remember which had much smaller needle. When I say small needle, I am not refering to the length of the meter. I am refering to a diameter of the needle.
I hope that your lancet isn't like what my father had. Monster needle!

oktokie

[LauRa Lu]

Originally posted by DeusXM
Lol well when I'm home from uni I do live in Gloucester!



Cool where abouts in gloucester..? my entire family (not me tho) lives there, i'm there loads. :p I live between hereford and abergaveny(ignore spelling:p )



I've only ever had the one bruise and it was only about 2cm across. I just wasnt sure if it was ok, could have been a blood clot for all i knew...but then i always think the worst!
:p

[DeusXM]

Well, without wanting to publicise my address all over the internet....when I'm back in Gloucester I live in Abbeymead.

And I feel sorry for your family, having to live in Gloucester. It's a hole and I'm glad I'm at uni somewhere else :)

As for bruising, WiseWords is right, it's not 'normal' but it does happen, for the reasons they suggested. The worst is when you forget where you've got a bruise and you're injecting through your clothes and you manage to hit the bruise with the needle. That f***ing hurts...

[LauRa Lu]

I know a couple of people that inject thru there jeans and stuff, i havent tried that yet it doesnt sound too hygeinic to me. if i'm out i tend to just do it in my belly, perhaps one day i'll be brave enough to do it thru my trousers but i doubt it! :)

As for gloucester it is a dump (alltho not all of it) and thats why i dont live there! Abbymead is where familly live...small word huh!

[DeusXM]

Wouldn't jab through your jeans if I were you - denim's a bit thick and would blunt the needle very quickly and make for a nice painful injection.

T-shirts work pretty well but you've always got the risk of bleeding. A blood-stained T-shirt always seems to worry other people :)

[shamsul]

Hi Laura,

Sorry to hear about your problem. Rest assured, I feel that it helps to complain. We all need help at some point or other.

Medisense has an interactive demo. I don't know whether you've seen it. It does try to show, among others, how to get that precious drop of blood.

If you haven't seen it, you can find it at www.medisense.com, click on the graphic and then you can go directly to the "Getting a blood sample" link.

There's something else that I do, which I find helps very much. I wind a rubber band around my finger, once or twice, to force the blood into the first joint of my finger (even though the Medisense guide says not to squeeze the finger). Start around the middle of the second joint and wind up to the first. This causes the joint to get slightly numb and, since the skin is slightly stretched because of all the blood in it, I can use my lancing device at the #1 setting (I've never gone higher than #2 - I use #2 on cold mornings). How hard you press the lancing device on the finger as you press the trigger is matter of testing.

I've been a diabetic since 1997 and it has taken quite a lot of pricking to get here and, personally, I think I've got it down to an art to the extent that most of the time I don't even feel the prick, it draws just enough blood for the test and the puncture closes up very quickly.

Since you test very often, I would also suggest that you make a mental note of where exactly on the side of your fingers that you prick because you don't want the points on which you prick to be too close to one another. They need to heal.

FYI I use my Medisense lancing device with the Lifescan Ultrasoft lancets (they fit just nice). I find that Medisense's lancets cause some kind of vibration (like if you snap a rubber band on your skin) as it pricks my skin which I can feel and that causes some amount of discomfort. I also dislike the new Medisense lancets because the protective cover can get me confused about whether it has been used or not (i.e. at times when I feel it is not safe to dispose of the lancets, I put it back into the case and dispose of it later).

I haven't read all the posts in this thread, but, just in case no one has said this, you shouldn't use a lancet more than once. They become dull and this makes it more painful.

Finally, the pain that you feel that stays for the rest of the day (or even longer) is IMHO the result of the lancet going in too deep (which of course differs from person to person). With experience you should be able to get this right. You should aim to get the lancet in as little as possible but the balancing act is in getting just enough blood for the test. (FYI I've even tried not screwing the cap in tightly - with the depth set at #1 - or trying at the imaginary 1 and a half, hoping to get that little less depth).

Good luck. I hope you get over this problem and can get on to concentrating on BG control instead of getting frustrated and having to live with the pain.

Regards,
Shamsul

p/s: If you looking for a good book to learn about diabetes, I've found that Diabetes For Dummies by Dr. Alan Rubin is extremely easy to follow and understand. Check it out at http://www.dummies.com/WileyCDA/DummiesTitle/productCd-076455154X.html

[LauRa Lu]

thanx for that reply it was a real help, especially the link to how to test.

I have no idea about keytones! :eek: :( How do i test for that? i dont have a tester that does it like on that site? If my bg is ok does that mean keytones will be too, or could the keytones be too high even if my bg is normal?? :(

[LauRa Lu]

ok im gonna add this question to this post as i dont wanna hog the whole forums! :rolleyes:

Since ive been diabetic i seem to have a really bad headache nearly everyday! :rolleyes: could this be something to do with my diabetes or do u thikn its likely to be something else? :confused:

My bg is usually between 4 and 8 and hardly ever really high or low.

[DeusXM]

Ketones: something you really don't want. If your bg is well controlled then it's unlikely you'll have them, providing you are eating a sensible diet which includes some carbohydrate.

You can check for ketones with Ketostix, available on prescription from your doctor. To test for ketones, you have to dip them in your urine (icky, I know) and then watch to see if they change colour - bit like litmus paper really.

Ketones are bad for a number of reasons. Firstly, they're evidence that your body is unable to process sugar and is therefore resorting to burning up fat and muscle - your body's literally eating itself to death. Ketones are also a sign that your blood is now rather acidic, which also isn't good.

Most people wake up with a very small amount of ketones since you haven't eaten since the previous night, but it's nothing to worry about. Ketones only become a problem if they're very high, or you have them for a long time, more than a few weeks or so.

Usually you won't need to check for ketones, but a good rule of thumb is to check whenever you have very high blood sugar (over 15mmol/l), or when you are ill.

As for your headaches....it could quite easily be caused by something else but it's worth first just ruling out diabetes. With your headaches, do you wake up with them or do they just appear later in the day?

If you're waking up with headaches, that's usually a sign that you've had a hypo during the night which you've slept through. When this happens your liver releases sugar into your blood to make sure you don't have any major problems, but the side-effect of this is a rather bad headache (not unlike a hangover), and usually, but not always, high blood sugar the next morning. To see if this is likely, wake up and do a blood test somewhere between 1 and 3 in the morning (typically when your bg is at it's lowest). If you're getting low readings then, then you're probably having sleep hypos. Best way to prevent that is to eat a carbohydrate-based snack like toast (or Pot Noodle if you're me :)) or reduce your insulin intake.

If they're happening during the day it might be worth doing a blood test when you get a headache just to see what your sugars are doing. Since you're newly diagnosed, it may be that because your body has been used to elevated BG, you have hypos 'earlier' than the rest of us at the moment. When I was first diagnosed I'd have a hypo whenever I went below 5, but now it's more of a case of 3.5 before I notice. Sometimes I still don't notice which is rather scary - my lowest every reading has been 2.1mmol/l (38mg/dl).

In any case, if you are having severe headaches then you should see your GP, since there are a whole variety of things that can cause bad headaches, and you shouldn't have to put up with them.

[LauRa Lu]

the lowest my bg has ever been was 1.5mmol/ (felt very scarey!), the evening i came out of hospital. i dont tend to go lower than 4 and i'm usually always ok when im 4. today i did fall to 3.5 and i certainly noticed! but that was because i hadn't had enough breakfast.

i usually wake up around 7 in the morning and test then, my bg is usually around 6-8 depending on what i'd had for supper. so do u think i should test in the night tonight, because it is in the morning that my headaches are bad..?

[DeusXM]

Give it a try because at least then it'll either confirm or rule out the night hypo idea.

As a thought....you're not on Lantus insulin are you?

[LauRa Lu]

nope i'm not.

There's alot of talk about it on here, i've never heard of it b4..whats it like?

[rzrbks]

There's alot of talk about it on here, i've never heard of it b4..whats it like?

for most of us, it's wonderful at keeping an even B/G reading, it's a synthetic that's supposed to last for 24 hours--like any other medicine, it just depends on how your body reacts to it--

Deus has a good thread up about how there are people who have had problems with Lantus--it's important to know whether or not you're a person who has trouble with Lantus

[Ella1]

Originally posted by LauRa Lu
nope i'm not.

There's alot of talk about it on here, i've never heard of it b4..whats it like?

Laura, we also didn't have any idea about Lantus, and had a nightmare with controling BS on Insulatard. The dawn phenomenon every morning didn't help either. We read about it on the internet and my boyfriend said to his doctor during one of those checks that he would like to try it. He got prescription without any problems. I guess, it depends on your doctor. But you still can tell him that you want to try it. I understand that sometimes it's so difficult to fit in all your concerns into a 15 min consultation. :( But I figured one thing that it's good to have a doctor's advise, though sometimes you need be more persistant to get it :)

Lantus hasn't got peaks, and it helps to avoid hypos, given you got your daily dose right.

[DeusXM]

Lantus is a very good insulin for bg control but it sounds at the moment that you're ok anyway. From what I can gather, I believe you're on a two-jab a day system at the moment; on Lantus, you will need around 4 jabs a day.

I wouldn't worry about going onto Lantus just yet because all this is still relatively new to you, and since you are having problems with injecting at the moment, I doubt that a 4-jab system is really ideal at the moment.

Since you seem to have pretty good control at the moment I wouldn't recommend changing your insulin system. I only asked if you were on Lantus since it is known (unofficially) to have very severe side-effects in a minority of individuals. I just wanted to rule out the (unlikely) possibility that Lantus might be causing your headaches.

Keep in mind that not all the problems you will face in your health from time to time will be related to diabetes. Too many doctors seem to think that any problems we have are purely linked to blood sugar and nothing else, which is certainly not the case. I'm just waiting for the day when (god forbid) I develop cancer or something equally horrible and my GP will be more concerned with my bg levels! If you have reasonable readings during the middle of the night, go and see your GP about your headaches since it would therefore be unlikely that they're caused by diabetes.

[shamsul]

You can also test for ketones using Medisense's Precision Xtra (in Malaysia where I am, it's called the Precision Optium). Testing for ketones requires a different strip (not unlike the BG strip) and the test process is pretty much the same: calibrate meter, put in strip, prick finger, get drop of blood ... blah ... blah ... To the best of my knowledge the Medisense Precision Xtra is the only consumer-available meter that has the ability to check for ketones, for now.

Testing for ketones is recommended only if your BG is more than 16 mmol/L (288 mg/dL) or something like that which is really high. The machine usually tells you to check ketones. The other side is of the coin it if your BG remains that high even after 2 hours you should probably go to the ER and get them to put you on a drip or something like that.

Since your BG is between 6 and 8 (which appears to be remarkably well controlled), I wouldn't worry too much about ketones. No one has told you about it so far because they probably feel that there are other areas regarding diabetes which are more relevant which you need to know for the time being. At 6 weeks, I'd recommend that you focus on getting your food/insulin balancing act (and the art of pricking your finger) off on the right foot. Then, you may not need to test too often. The rest you can learn as time goes by.

[Ella1]

Originally posted by DeusXM
; on Lantus, you will need around 4 jabs a day.


I still can't get it.. I've been on different forums with members from all over the world... I've never heard about multiple injections of Lantus.. It's considered to be the longest-acting insulin out of all the insulins. If it doesn't last all 24 hours.. then it's probably better to use some other insulin, and inject NPH or Insulatard twice. Ok, 2 injections, but 4 times!? :confused:

I'm currently on the forum where people are on the intensive insulin therapy. They always scrupulously analyse each other's routine, and trying to pin-point the problem, if there is any. The majority managed to bring their HbA1c from 9 to 5.6 and targets are 4.8 - 7mmol/l. And when I posted that Lantus can be injected twice and more times within 24 hours, they were a bit surprised.

I have a suggestion. Would it be possible to create a poll, where people vote how many times they inject Lantus. I always find polar opinions interesting. It can be something like:

How many times a day we inject Lantus?
- Once
- Twice
- 3 times
- 4 times
- I found Lantus is not for me

[DeusXM]

You inject Lantus only once a day. However, you will also need to do other injections of a bolus insulin like Humalog for every time you eat - typically another 3 injections, hence 4 in total.

Lantus is basically a replacement for NPH/Isophane.

In fairness, you actually need more injections on NPH/Isophane. Because that kind of insulin still has a peak, I've been told it's better to inject half of your total isophane dose in the morning, and the rest in the evening, thus eliminating the period where isophane is effectively doing nothing. That takes us up to 5 injections along with the bolus insulin.

I'd be astonished if you found anyone injecting Lantus more than once a day because there's simply no point.

[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