Supposed to Start Insulin tomorrow..Scared out of my Mind

[Holly In RI]

I am scared of the unknown I guess...side effects, going too low, etc....

I am quite happy being on metformin, but am going to switch to insulin b/c we are trying to get pregnant..

But I am scared out of my mind...there is so much I do not know to begin with, and add this to the mix, and I feel like I am knocking my head into the wall:(

Any side effects? How many different kinds of insulin are there? Myu transcription from the doctor said it will be B I D


Also, I have started seeing an endochronologist, so should I stop seeing my regular doctor who was originally treating me? Should I just as my endo about that? My appt tomorow is at the endo office, with the nurse educator.:(

[duck]

Ask your endo AND your regular doc...If you are seeing an OB because you are planning to get pregnant, then definately continue to see them.

Which type of insulin is on the script? There are a number of varieties, and I have stopped trying to guess what kinds doctors prescribe for people in different circumstances, but my thinking is in your circumstance, it is either Lantus or Novolog/Humalog...

[Funnygrl]

Insulin isn't as scary as people make it sound. BID means you'll be taking it twice a day. That means they're probably starting you on N and R or some premix, which isn't what I would do, but might work for you as you are currently well controlled on Metformin, and just need a little help keeping things in control. Some doctors prefer to use N and R during pregnancy because it's category B, as oppose to the analogs that fall in category C. Pretty much any insulin is safe for pregnancy though, and Lantus or Levemir, with Novolog, Humalog, or Apidra generally provide better control (but at the cost of 4+ injections a day, as oppose to 2). However, like I mentioned, you may not have to work so hard at better control.

Insulin has pretty much no side effects except going low, unless you're allergic, which is extremely rare. Maybe a little redness where you took the shot. The needles are tiny and hurt less than testing your blood sugar.

There's a lot of different types of insulin.
There are flat action basal insulins:
Lantus, generally lasting 24
Levemir, which lasts 12-24 hours

There's rapid acting bolus insulins, these peak in 15 minutes and last about 3-4 hours:
Apidra
Novolog
Humalog

There's N, which is intermediate and peaks in 6-8 hours and lasts for about 12.

There's R, which is a slower acting bolus insulin, which peaks around a half hour and lasts about 6.

Finally, there's the premixes, Novolin and Humulin 70/30, Humalog 50/50, Humalog 75/25, and 70/30.

In terms of lows, they might happen, but aren't likely to happen badly since you are well controlled on Metformin, it means you have natural insulin to "buffer" what you inject. It gives you a safety cushion. Take your meter with you, take sugary stuff with you, and test when you get symptoms. If you're below 75, eat 15 grams of simple sugars, and test again in 20 minutes or so to make sure you go up. If you are going below 55 or getting more than 2-3 a week, call your doctor- you probably need less insulin.

It might be a good idea to see a endo during your pregnancy. There's "reproductive endocrinologists" also. I imagine they have you seeing a high risk obgyn?

Take a deep breath, and good luck!

[Holly In RI]

I am not seeing a high risk ob/gyn as of yet...

I am not pregnant, just trying right now...


I do not even have a prescription for it yet...I am told I will get it when I go there tomorrow. I assume I will not be taking my metformin tomorrow then? I usually take ti with my breakfast around 8:30, but my appt is at 9, so I will be fasting till then probably b/c I wont have time to eat before I go there anyways..

Does Insulin help you to lose weight also? The endo said he would restart the metformin regime again after a pregnancy. I much rather have just a pill to take.

I am sure I will be back on here tomorrow to update, and probably ask 5 million questions also. I am still so unsure about all that is going it, it just stinks. I am still newly diagnosed (december( and my regular doctor (not obgyn) never really gave me any info at all..wanted me to go on a pill for cholesterol and one for preventing kidney problems. I elected not to take them after reading the side effects, etc and when I met with the endo, my blood test results came back fine, without using those meds. I am willing to eat right and exercise, but I also feel like I want to eat a box of girl scout cookies at some times too!!! uuuuughhh

[gettingby]

Holly, being on insulin is not that bad. We will be here to help you through this. Ask all questions you may have.
Hang in there and good luck in getting pregnant.:)

[Funnygrl]

Insulin doesn't help you lose weight. Often the opposite.

The pill for the kidnies- is that an ACE inhibitor? Does the name end in "pril?"

If so, you need to come off that soon. Those are well known to cause birth defects. You can go on an ARB instead.

[Holly In RI]

I did not go on the kidney medication. I did not like the side effects and the possiblity of birth defects, so I decided against taking it. Also, it has to do with controlling high blood pressure, which I do not have.

[kgm0612]

Good luck Holly! Which endo do you see in the group?

I wish I had logged on last night to read your post. I would have suggested you ask for an insulin pen because I think you'd be more comfortable with that.

As you know, I'm a type 1 pumper but I also take Metformin. My endo (Dr Ortiz) says studies show it helps to maintain a consistant weight and it has worked for me thus far.

Karen

[Holly In RI]

Hi Karen!

I am seeing Dr. Krauss. I met with the nurse educator today though. I am on a mixed insulin--humalog and humalin.

The biggest problem is that my co pay is 35.00 for each bottle. Plys 5.00 for the syringes. I am taking 20 units before breakfast and 10 units before dinner. It is not that bad actually injecting myself, but I am SCARED TO DEATH I am not going to eat dinner or breakfast quick enough and go low,a nd pass out! We go out to dinner or breakfast sometimes, so do you just do it in the bathroom at the restaurant after you order or something? The nurse helped me with my meter (my BIGGEST FEAR). and she also gave me a meal plan. It was so nice to talk to her, and she was so helpful and nice.

[Funnygrl]

I used to inject right at the table.

[Cyborg]

It is not that bad actually injecting myself, but I am SCARED TO DEATH I am not going to eat dinner or breakfast quick enough and go low, and pass out!

As long as your dosing is correct and you take your injections right before you eat, you don't need to worry...

[Holly In RI]

how long should the bottle of insulin last? its 100 units for every ML? Ther are 18 ML...

so is that 1800 units?

I am trying to figure if I should ask my doctor to change it b/c of the high co pay, or if ti wil be ideally lasting more than 30 days?

[ladytaz]

Hi Holly, I just started on insulin almost 2 months ago ... I don't know if they are interchangeable, but I take the Walmart brand ReliOn insulins, which is actually Novolin ... I take 70/30 (20u 30 min before breakfast and 20u before supper) and then I take Novolin R on a sliding scale when above 160. These are $19.99 a vial, and you can ONLY get them at WalMart. But I'd ask the doc if they're interchangeable, and that could save you $15.00 a bottle if you even have to full out pay for them yourself, and may be even cheaper if your insurance does cover them! ;) Check into it! Can't hurt to ask!

With my 70/30 taking 40u daily, my 100ml vial lasts me about 3 weeks.

OH and you can get the ReliOn needles too, they're around $13 for a box of 100, and I usually use a needle twice (saves $$!! - as I don't have insurance). I'd also suggest you get the 30 (or 31) gauge 5/16 in. needles. Lord, I have some of the BD 1/2 inch needles they gave me with my 'starter' kit and decided to try one yesterday and OMG I thought it was gonna go right thru me! LOL It looks SO much longer! I have NO probs with the shorter, 5/16 inch ones! I'll just stick with those hee hee ;)

It really isn't that bad stickin yerself, and unless you hit a nerve or something (happens occasionally), you don't even feel it!! Honestly, pokin your finger hurts way more!! ;) Only thing I have found is that someitmes it does burn a little a few minutes after I've given myself a shot. But nothing bad at all! ;)

Good Luck hun!

[Funnygrl]

how long should the bottle of insulin last? its 100 units for every ML? Ther are 18 ML...

so is that 1800 units?

I am trying to figure if I should ask my doctor to change it b/c of the high co pay, or if it will be ideally lasting more than 30 days?
18 mls would be 1800 units, but I'm trying to figure out how you got 18mls of insulin...

Yes, it should last more than 30 days. And honestly, the only cheaper option would be N and R (which sucks). I'm assuming the Humulin you use is N. Walmart sells Novolin N for $20. You can also reuse the syringes to save money.

Edit: I should read, Melissa beat me here.

[kgm0612]

Holly..........I'm glad you met with the nurse educator and I really hope you can overcome some of your fears. I was terrified when I first started taking shots, but after awhile, it became second nature and the fear disappeared.

You have a terrific endo. Dr Krauss is very well known in RI. That's one reason my endo (Dr Ortiz) gave up his private practice to join that group.

I'm willing to meet with you if you need any help. PM me if you don't still have my email and I'll respond back to you.

Hang in there, Holly. I know you'll do great!

Karen

[Holly In RI]

day 2 of insulin, and I really don;t ahve much of a problem doing it. I do feel a little bit of a burn sometims after doing it. Is it normal to be bruised? Now, pricking my finger for the testing, I have a major problem with. I bit the bullet and did it today, and could not even get enough blood to test on the strip. What am I doing wrong? I just started crying this morning b/c I tried 2 different fingers,a nd not enough blood either time, and it HURT. Theres got to be an easier way:(

[Holly In RI]

We like to go out to dinner, and sometimes breakfast.

How do you do the testing then? Tonight, I went into the bathroom to do it, but I missed eating my salad, because by the time I got back out, dinne was almost there. Any tips or tricks? can I measure it out beforehand and just go in the bathroom and give myself the shot? I do not feel comfortable lifiting up my shirt and giving it to myself at the table:(

[tanyatype1]

Hi Holly! Try testing your blood from your forearm or palm of your hand. (at the base of your thumb) I never test my fingers because it HURTS! :) Don't forget that you can adjust the depth on the tester. As for taking the insulin, I'd wait until my food actually showed up at the table before I'd give myself the insulin.

[notme]

Did you test before you used insulin Holly???

I use the side of my fingers. If you use the middle of your fingers it can hurt a bit. Thumbs are ok too, I tried it after I saw KGM do it. I still don't use it much.

As for meals and shots, I just used any bare skin available. You will get more comfortable with it over time. Not a big deal. Actually, after you have done it for awhile, you will have it done in about six seconds flat. No need to miss your salad even if you feel the need to go to the bathroom to shoot.

[Holly In RI]

Did you test before you used insulin Holly???

I use the side of my fingers. If you use the middle of your fingers it can hurt a bit. Thumbs are ok too, I tried it after I saw KGM do it. I still don't use it much.

As for meals and shots, I just used any bare skin available. You will get more comfortable with it over time. Not a big deal. Actually, after you have done it for awhile, you will have it done in about six seconds flat. No need to miss your salad even if you feel the need to go to the bathroom to shoot.

honestly, no I did not test before going on insulin, because I am scared to death of doing it. My finger would hurt when the doctor did it at the office. WHen i tried this morning, I had to close my eyes even. If the darn thing did not make that awful clicking sound, i think I might be better...

I think maybe once it gets warmer, and i am wearing capris, I will be able to shoot it in my legs, so that might make things easier.

Is there any kind of cosmetic bag or anything that you use to keep all your gear in? I ahve a large coach pocketbook, but would rather have it all together in one thing, you know?

[notme]

I use a pump Holly so most of my supplies are on me. I do use the meter bag for my flash meter, but that just fits right in my purse.

[JediSkipdogg]

Holly...one point of advice....NEVER give insulin without testing first. If you are scared to death of going low from the insulin if you don't test before giving it you can go extremely low.

[Holly In RI]

thanks for the advice.

I am working hard on testing. I am supposed to test 4 tiimes a day, but I only give insulin 2 times a day. In speaking with the nurse, she did not seem overly concerned with my not testing. But, I am trying to do it. I even have a few co-workers helping me, as they have either had gestational diabetes or has a son with diabetes. I am confident I will be testing fine within the next day or 2. It just really hurts me to test, there has got to be an easier way for me. As I typoe this, the finger I pricked at 630 this morning, is still stinging.

[lilituc]

If testing is that much of a problem, you can get a different lancing device. What kind are you using now? Have you tried the BD 33 gauge lancets? If cost is an issue, you could ask your doctor or nurse if they have samples available.

As for getting enough blood, just "milk" the fingertip before you lance. It's better to do it before rather than after because otherwise the sample could be a little off.

[slipperyelm]

Holly, go through the "Monitoring" section of the website and you can pick up some tips about finger-pricking. To get enough blood, I do best to warm my hands under hot water and to milk the finger toward the spot where I will prick it before I do so. This gets the blood to the area, just ready to come out.

To reduce pain, I find that it helps if I not only prick toward the side of the finger, but away from the finger tip end, closer to where the first knuckle fold line is. At least in the bottom half of that first section of the finger. That gives a balance between being less painful, and being "juicy" enough to give me a drop of blood.

Also try another brand of lancet device if you do not like the noise it makes. They all make some little noise, but there is no sense in being taunted by a noise that makes you nervous.

I imagine there will be times when you want to test after exercise. Let me give you this encouragement: When I have had cardiovascular excercise enough to get just a bit of a tired feeling, it does not hurt at all to test within about 30 minutes. It is like magic! No pain at all! It makes me really believe in endorphins, the natural pain killers that are stimulated by exercise. A low level of non-cardiovascular exercise does not have this benefit.

Are you squeezing real hard to get enough blood out? That might be why your finger continues to hurt for so long. It actually could be less painful in that respect if you use a deeper setting on the lancet. A deeper setting will give more blood a chance to be reached so you don't have to squeeze so much. Less squeezing can make a less painful finger afterward.

Oh, after 14 years, I still close my eyes at the moment I launch that lancet! :o

[Cyborg]

I've also found that the type of lancer makes a difference in the amount of sting. Personally, I prefer the Accu-Check Softclix Plus.