Insulin Dosages Are Confusing

[gabby]

I have had really bad reactions to ALL the oral drugs for my type 2 diabetes so the doctor says the only thing left is insulin injections. The problem is they are so confusing I'm afraid of them. How do you know which is better or how much and how often to take? With pills you just take them once or twice a day and forget about it but with insulin you could kill yourself with too much or too little.

I have hep c so almost all meds affect my liver, does insulin do that as well? What are the side effects? Also what about the cost? I have no insurance and only my SS check every month to live on and manage my medical expenses. I am 2 years away from Medicare and doctor visits and lab work is very expensive. Is the " pens " more or less expensive than syringes and needles? Can anyone give me a ballpark figure on the monthly cost. I'm only paying $8.00 a month at Walmart for my glipizide so I know it must be much more expensive than that.

Does anyone have any suggestions for me to ask my doctor about?

Sorry this has been so long but I really do appreciate this forum even if I am only a lurker. I have learned a lot from reading it everyday.

[owlyn]

Can't really help you on the cost issue, except to say that there are assistance plans provided by the pharmaceutical companies. You can definitely investigate that. I prefer pens because they are more convenient. You still need needle tips for them, so I suspect the overall cost is about the same.

Now, regarding taking insulin. There is nothing to be afraid of except taking too much. Too much will kill you now - too little will kill you years from now, but you'll have that starightened out long before it's a problem. Your doctor will suggest a starting point in terms of how much to take and when. After that, you test, test, test, and monitor how many carbs you are eating. After a few weeks, you will have a pretty good idea how many carbs it takes to raise your BG X number of points, and how much insuklin to take to account for it. In my case, 15 grams of carbs = 30 BG points = 1 unit fast acting insulin.

Regarding which insulin to use- you will need two types- a slow acting to mimic the low level of insulin your pancreas would issue during the day (called basal dose), and a fast acting to take with meals (called a bolus dose). There are sevral kinds of each. The mopst popular combiantion today seems to be:

Slow (or long) acting: Lantus or Levemir
Fast acting: Humalog or Novolog

You take the long acting once or twice a day, and the fast acting as needed with meals or if your BG goes out of whack because the price of tea in China has risen.

Many doctors like to start out new insulin users on something else- A long acting called NPH with one of the rapids, or a 70/30 combination of Humalog/NPH because it's less confusing- or so it would seem. The common advice and wisom is to avoid this combination. It's harder to control, and NPH has some odd characteristics that make it uneven in it's action.