**** this, I just want to kill myself.

[Psycho Penguin]

My blood sugar was 378, really ****ing high, so I took 40 units of novalog then ate 2 pieces of whole wheat toast just in case.

I test it 2 hours later and It says HI. Then I test it an hour later and 478!

WHAT THE ****. WHY THE **** DOES IT ALWAYS GO UP EVEN AFTER I TAKE INSULIN?

This is not ****ing fair. I don't care any more. I am trying my hardest and my body just does not want to help me.

[Stuboy]

is you insulin good? did you try a new cartridge/vial?

i have the same problem, although not on the same scale, where i take a correction shot and it goes up... it's confusing, but give it time and it will come back down again...

What insulin/s are you on? Is your basal level right?

we need some more information about your insulin regimen before we can really start to help you discover what's happening.

Diabetes can be a rocky road with lots of unexplained results, but we always get through it in the end...

[xMenace]

Eating carbs is no good when you are that high. You're throwing gas onto a fire. If you are worried it's too much, set alarms to test every hour or two for up to eight hours.

Where are you injecting? For highs like this I shoot into my triceps then do some light weights or cals for 10 minutes to improve the absorption.

There's areas on my body that just won't absorb insulin. I've learned the hard way to avoid them!

[Psycho Penguin]

I inject the insulin into my stomach. I heard novalog works best there and I have trouble injecting in other areas.

I take Novalog on a sliding scale.

I did not think taking 40 units of Novalog and then eating 2 slices of toast would make it go up 100 points. I was told never to take insulin without eating because I could go into a coma.

[Olidus]

How are you managing your diabetes now?
Are you carb counting? If so what is your I:C (Insulin:Carb)ratio?
I have to agree with xMenace - eating / taking carbs when you are already high is not a way to treat it. Take your insulin monitor / test. Eating something like bread when you are high - even though you have taken insulin will cause a teeter-totter affect I would assume.

How are you feeling? Could you be getting sick? Cold or flu? This I know will cause high BGs.

You should never take insulin without eating if your BGs are already under control. In this cause you need to get your BGs under control.

[pandeia]

yea i agree with the other members, eating with insulin on a high won't drop your numbers much. it'd be better basaling for the high then testing again and again a few hours later :D

[Erin]

I did not think taking 40 units of Novalog and then eating 2 slices of toast would make it go up 100 points. I was told never to take insulin without eating because I could go into a coma.

Can I ask what kind of doctor you see for your diabetes care? This sounds like the advice of a GP. You will get better care from an endocrinologist. I also reccomend seeing a diabetes educator to get you off on the right foot.

Why did you choose 40 units? Do you have a correction ratio sorted out? Or did you just pick a number because you knew you needed some insulin. 40 units is a whole lot of insulin to correct a high. Unless you are very insulin resistant you would probably come crashing down with that much. I know people are different, and I'm pretty sensitve to insulin, but I'd probably take 7 or 8 units of insulin to treat the same number.

That said, you took that amount and went UP! I don't think two slices of toast (about 15 grams of carbs each?) would make you go up that much.

It sounds like 1, your insulin might have gone bad. Try opening a new vial.

And 2, you might need to talk to your doctor about taking some other medications in addition to insulin to make you less insulin resistant. Also I find that walking really increases my insulin absorption, I might even end up low if i take a walk after my correction shot.

[Psycho Penguin]

Thanks for the advice, everyone. I picked 40 units because it seemed like a good number to drop such a high blood sugar count. Usually I take 20 if it's 200 or so so I figured doubling it would work. I feel kinda dizzy and low now so I will check again now. I really don't have a god**** clue what I am doing sometimes. One doctor tells me one thing and another tells me something else and so on. It's all so confusing and I hate it :( I'm really sorry for the rants but I am crying over here becase I just don't understand what's going on and I am losing it..

[mageerobin]

The only times I have done anything like this is after a huge meal. I have found out over the years that I digest very slowly and sometimes after going out to eat (like at Olive Gardens and having a big bowl of pasta whatever) my BG's continue to spike all night even with me taking 2 or 3 correction boluses. I'm not usually in range again until the next midmorning reading.

[Erin]

One doctor tells me one thing and another tells me something else and so on. It's all so confusing and I hate it :( I'm really sorry for the rants but I am crying over here becase I just don't understand what's going on and I am losing it..

Diabetes is a huge learning curve. One of the first things to learn is who NOT to listen to. This includes, (in my case) grandmother, cousins, most MD's except for the one in charge of my diabetes care, the dentist, friends, co-workers, eye doctors. Everybody thinks they know best. Medical Doctors who don't specialize in treating diabetes are often working on dated information that is obselete. Don't listen to them. Find a good endo, and listen to him or her... most of the time.

[mageerobin]

I left my desk for 10 minuets and somehow poseted this message twice.

?????????????????????????????

[Psycho Penguin]

Diabetes is a huge learning curve. One of the first things to learn is who NOT to listen to. This includes, (in my case) grandmother, cousins, most MD's except for the one in charge of my diabetes care, the dentist, friends, co-workers, eye doctors. Everybody thinks they know best. Medical Doctors who don't specialize in treating diabetes are often working on dated information that is obselete. Don't listen to them. Find a good endo, and listen to him or her... most of the time.

Thank you. I have been listening to my PCP who is a great guy but I don't think he knows what he is talking about. I will set up an appointment with my endo now.

Just tested again, 66. What the ****. Well that explains why I feel like a complete ******* these last few hours. Sorry everyone :( I really am a nice guy usually, lol

[d_k_moon]

I was told never to take insulin without eating because I could go into a coma.

Under normal conditions, one shouldn't take Novolog without eating immediately afterwards as it could cause a person to go hypoglycemic.

[Psycho Penguin]

So if my meter says HI it's ok to take insulin without eating?

[Erin]

So if my meter says HI it's ok to take insulin without eating?


We're not allowed to give medical advice, only share our experiences.

When my blood sugar is over 200 I take SMALL amounts of insulin to bring it down. I have a correction ratio (you should have your endo work yours out with you) of 1:40 I take 1 unit of insulin for every 40 mg/dl i want to lower my blood sugar. There is no eating involved.

[Psycho Penguin]

Fair enough. Thank you guys so much for the advice and listening to me. I really feel like a complete *** now. Hopefully I'll get my sugar under control and I can sleep. I don't even mind 150 right now. I just want to feel normal.

[soso]

Hi PP
Get a hold of 'Think like a Pancreas" by Gary Scheiner... good stuff for a newbie on Insulin...

Sorry you had such a rotten experience and hope you get some help from your Dr's soon...
You don't sound like an *** you just sound like someone who hasn't been told the stuff they need to know.. I would have been just like you, if I had to jump in at the deep end...so would most people... glad you are OK and keep asking questions...

[ericm31]

Fair enough. Thank you guys so much for the advice and listening to me. I really feel like a complete *** now. Hopefully I'll get my sugar under control and I can sleep. I don't even mind 150 right now. I just want to feel normal.


Please don't feel bad, it's easy to get angery and frustrated when your gluclose levels are high, it tends to make most people grumpy, and we all understand.

Good luck. :cool:

[SueM]

There is one thing that puzzles me............ You have not mentioned a basal insulin.
Are you just injecting novolog? If so then that 100% of your problems.

[notme]

Erin is correct. Doing a correction depends on how insulin sensitive you are and what type of exercise you will be doing (working) while you are taking it.

Diabetes makes you take into account many things. You can't just double a dose and hope it works. I know rationally, it seems right, but your dealing with an irrational disease.

The problem with high blood sugar (especially the 400's) is you can give yourself a whopping dose of insulin and then you find yourself too low. By eating food to correct the low, you run your numbers back up and the roller coaster begins. High blood sugar requires a bit of finesse to make corrections and some calculations that will get your numbers down, without dropping you like a rock.

Call your doctor and ask for some Diabetes Education classes. Your frustrated (rightfully so) and I think some classes can help. You really need someone to work with you closely to help you get off on the right foot.

Frustration and Diabetes is a bad mix.

[mortis505]

PP dont sweat the small stuff mate. We ALL get frustrated when things are out of whack and that can cause your BG levels to go even higher. Take a deep breath, relax, and get your BG stabilized.

[DeusXM]

Ok, let's clarify something here.

Insulin, on its own won't make you go into a coma. Insulin simply reduces your blood sugar.

In someone with a normal BG (say, 90, for argument's sake), if they take X units of insulin, it'll make their BG drop by X mg/dl.

Now for the sake of keeping things really simple, let's say in this person, 1u of insulin makes them drop by 10 mg/dl. And they're at 90mg/dl and take 10u of insulin. That means theoretically their BG should drop by 100mg/dl. Which means they won't be doing very well and will have to eat in order to raise their BG to counteract the effect of the insulin.

Now let's say the person is at 400mg/dl and take 10u of insulin. Their BG will drop by 100 to 300. That isn't coma territory at all.

If your BG is high, generally you should take insulin and not eat, in order for the insulin to bring your BG down to normal levels.

(Disclaimer: Be careful when doing this, you need to know what you're doing.)

Now to complicate things. As your BG gets higher, you become more insulin resistant. When you're at 90mg/dl, 1u of insulin might make you drop by 10. When you're at 400, it might only make you drop by 5. I'm simplifying here - the numbers I'm using are arbitrary.

I think this is what happened with you, and when you combine this with the extra food you ate, you have very high insulin resistance, which means you'd need more insulin to bring you back to normal.

You would also need to wait 3 hours to have the full effect - you could still be high after one hour and yet still drop low after 3 hours.

Also, stress makes you more insulin resistant as well.

Ok, so you've had a tough day. I know, it's hard. And everyone makes mistakes. You haven't had diabetes for long, so don't beat yourself up over it. The odd high blood sugar reading doesn't mean anything in the long-term.

[d_k_moon]

Ok, let's clarify something here.

Insulin, on its own won't make you go into a coma. Insulin simply reduces your blood sugar.




Yes, let's clarify something here. Too much insulin can cause hypoglycemia. In the extreme, a extremely hypoglycemic person can pass out, fall into a coma, and die.

[Stuboy]

geez lets not scare this person with the unlikely event of him dropping into a coma and dieing... He really doesn't need that now.

Sure, it's possible. but it's also extremely unlikely.

Diabetes can be complicated at first, but over time you will learn that the scary scenario's are unlikely to happen if you look after yourself... esp. after you've been educated on how to treat your diabetes. Then you start to relax and get less stressed which only helps the situation because as already mentioned here, stress = high blood sugars.

You've already made a good step by joining the forums and asking questions. Although it's not a substitute for real medical advice, the advice here is based on real diabetics experiences and their (our) massive knowledge base is one of the best on the net.

[johgn]

Don't beat yourself up, it takes a ton of learning to get things squared away.

[Psycho Penguin]

Thanks for the suppport everyone :) My insurance doesn't cover Lantus because "they don't think I need it" (translation: it's expensive) and therefore I've had to go without it for a while

[Olidus]

Thanks for the suppport everyone :) My insurance doesn't cover Lantus because "they don't think I need it" (translation: it's expensive) and therefore I've had to go without it for a while

Something is not right there at all.
If you have been DX'd with Type 1 - then you need a basal.
Lantus, or Levemir as a couple populars for example.

If your insurance company does not cover cause they think you don't need it. Then you need a new insurance company as a diabetics basal is very important to maintain good control.

[TenderVittleS]

You NEED a basal, no doubt about it!!! I'd pay full price until I could find a new job with insurance.

[Psycho Penguin]

Ok I'll make sure to buy some tomorrow then, I didn't even realize that could be the problem. I'm a complete goof!

And I just found out that it DOES cover lantus but I need my doctor to fax a letter to the office explaining why I need it.. so there is hope yet.

[BlueSky]

My blood sugar was 378, really ****ing high, so I took 40 units of novalog then ate 2 pieces of whole wheat toast just in case.

I test it 2 hours later and It says HI. Then I test it an hour later and 478!

WHAT THE ****. WHY THE **** DOES IT ALWAYS GO UP EVEN AFTER I TAKE INSULIN?

This is not ****ing fair. I don't care any more. I am trying my hardest and my body just does not want to help me.
The advice doctors/CDEs give is for when blood glucose is in a "relevant" range. All those rules go out the windo when blood glucose goes over about 250 (with me anyway). Be aware that we lost insulin sensitivity as blood glucose goes up. It means that, as the BG level rises, ever larger amounts of insulin are needed to bring it down again. Eating carbs at a time like this makes the insulin resistance much worse.

I think if I had done what you did I would most probably have got a similar result. As John says, injecting into muscle helps because absorption is much quicker. I find that insulin works in half the time when used in this way. Exercise also improves absorption, and it improves insulin sensitivity at the same time.

[Erin]

Thanks for the suppport everyone :) My insurance doesn't cover Lantus because "they don't think I need it" (translation: it's expensive) and therefore I've had to go without it for a while

Get a new doctor get a new doctor get a new doctor get a new doctor.

Any doctor worth their weight in *insert something really cheap because I'm too flabberghasted to speak* would NEVER send a type 1 away without a basal insulin or insulin pump.

Get a new doctor get a new doctor get a new doctor get a new doctor get a new doctor.

[sable_032592]

my insurance (governmental) didn't cover lantus either, unless there was a request by my doctor explaining the request for this medication to them... i was lucky enough to still have some humulin N with me until the lantus was accepted, but it took over 3 weeks for it to go thru, mainly because my doc was on vacation the week after he prescribed it... yeesh...

it can take a while for your body to adjust to insulin that isn't part of your body, like biosynthetic, i have less highs with rDNA insulin (humalog, lantus) but when i switched to lantus last month, i started getting lows more often than before, even with just 10 of humalog instead of my usual 30... i thought it was strange but it hasn't happened again lately so stick with the program and you'll get there...

one thing about diabetes, you have to stay with it or you'll die, it's not like you can skip or miss medication and not suffer any ill effects of it, in the end, you'll pay... not trying to scare anyone here, just saying, diabetes isn't like most other diseases, this one is a control freak, so either you control it or it controls you...

good luck with your new med...

[David_S]

wow.. 40 units is a lot to me.. but I eat moderate carbs and I take 2 units of novolog at dinner and 1 unit over 150 for every 10.. so for me.. if I had a reading of 378 at dinner I would have taken my 2 units plus 22 more for a total of 24 units. However.. in two years I have never needed more then 4 units at dinner.. usually just the 2. But this is the advice of my endo.. not a GP.. I would see an endo and get your plan to fix highs straightened out wiht expret advice. MY GP could not meet my needs for diabetes tx.

[Psycho Penguin]

Yeah I don't understand why my insurance covers medicine I don't really need but when it comes to LANTUS, a medicine I probably should be taking and completely forgot about because it's been months, they give me a hard time about it.

I do have a lantus pen actually that my former PCP gave me but I need to get needles for it..

[Psycho Penguin]

I have been prescribed 20 units before meals. I started at 32 units before meals. Maybe because I am still new to diabetes, or because I had it for 18 months before being officially diagnosed?

[BlueSky]

I have been prescribed 20 units before meals. I started at 32 units before meals. ...
That is a very high dosage for a recently diagnosed T1. And you need to use so much because you aren't using a basal. This is what is making your blood sugar so unpredictable. Because of a lack of basal, blood sugar goes high, and you need large amounts of rapid acting insulin to compensate. If insurance won't pay for Lantus, get NPH. It may not be as good as Lantus, but it works. And it is very cheap. :D

[Stuboy]

18 months undiagnosed type 1? wow i thought i had it rough with 3 months... i was on deaths door!

If Lantus is too expensive, try levemir.

once you're basals are under control you will want to think about working out your insulin to carb ratio... then you can completely scrap the idea of 20units before meals... because you take 20units for a salad... you're not gonna feel very well at all afterwards!!!

Counting carbs and injecting the correct amount of insulin for the amount of carbs you eat is very important if you want to gain good control!

[Erin]

I do have a lantus pen actually that my former PCP gave me but I need to get needles for it..


Well then my former rant of "get a new doctor" isn't really applicable. Your doc DID give you a basal insulin. WHY haven't you gotten the needles for it? You're really not taking care of yourself, the doctor must have told you to take lantus if he GAVE you a pen! I hope you at least kept the pen in the refrigerator. Get the needles for that pen. Call your doc and ask him to remind you how many units to take. Watch out for lows, because you'll need less rapid acting insulin when you have the basal working. Then get your doctor to write a letter of medical necessity to the insurance company so the lantus will be covered.

You're going to notice a huge difference in how you feel.

[sugardumplin]

I do have a lantus pen actually that my former PCP gave me but I need to get needles for it..

You can get needles for it over the counter I think. It was cheaper for me to buy needles directly from the pharmacy rather than run it through my insurance. Check with your pharmacy.

[type1db]

same here about the needles. I just pay for it with cash. I get the cheap Walgreens brand.

[Scarlett]

One big plus that I do for highs (and I've had my share) is to drink a LOT of water to flush out the sugar from my system. Seems to work pretty good. I take 1 unit for every 40 points I want to reduce my BSL. Always count from 100 as your normal BSL . You can always take a bit more insulin in an hour or so. I always go slow on the insulin because there may be some working in the bloodstream too. The worst thing is riding that roller coaster. It messes us up more than anything else.

[mazea]

When you start taking basal insulin you will feel a lot better and your blood sugar levels will come under control. So get that basal insulin!

I reduced my dose of Lantus to almost nothing for a few weeks when I was first diagnosed. I did this because I had a severe reaction to Lantus and since changed to a better basal insulin. When I wasn't taking much basal insulin, my blood sugar levels were all place, my brain wasn't getting the energy it needed because sugar wasn't stored by my brain, I went a bit depressed and confused and had to take huge doses of short acting insulin to compensate. As soon as I started taking the basal insulin again my blood sugar levels stabilised and I felt better emotionally. That basal insulin is really important.

HBAc1: 18 in May 2008
HBAc1: 5.6 in August 2008

[Gary_W]

Go and buy 'Using Insulin' by John Walsh or 'Think like a pancreas'.

Putting in insulin using guesswork alone is never wise. Whilst you clearly need basal insulin, you'll make this whole thing work a lot better if you throw some effort at undertanding the theory behind a basal / bolus regime. You need to be given a ballpark starting dose for the Lantus (which the doc should work out based on your weight) and then you can tweak from there.

There are reasonable, logical ways to work out how much insulin to give yourself. Learning them makes life so much more pleasant. Sure, diabetes will still do strange things and bite you with odd numbers here and there but most people can get things pretty good if they understand the basics. The odd numbers that you can't explain should be the exception, not the norm.

For many people with T1, the difference between diabetes being an inconvenience and it being an uncontrolled nightmare is education. I was ill for years due to ignorance and I'm by no means unique.

Good luck

[notme]

No...... you weren't unique Gary. I also learned to live feeling sick all of the time. It takes time and effort and a lot of reading, but it is something that we can all accomplish. I just wish I didn't have to..... ;)

[Psycho Penguin]

I got the needles over the counter today. I didn't know they could be purchased over the counter.

Yes I am an idiot. :( Thanks for the help, everyone. I'd be lost without you guys.

[notme]

Glad you got what you needed PP. Hopefully, you will be feeling better soon! Eeesh....it's been a long week for you.

[Psycho Penguin]

Thanks! More like a long year :(

[Olidus]

Thanks! More like a long year :(
I can't believe you have been DX'd as a Type 1 since Feb of this year and have not been taking a basal. How have your BGs been? What are you last A1Cs like?

A couple people have suggested a couple books, I can speak of Think Like A Pancreas as it was suggested to me by the great people of this forum and I can tell you that you can learn alot from that book.

[Psycho Penguin]

I was on a basal but like I said my insurance doesn't cover lantus because it's a "non formulary medication" or something.

[Psycho Penguin]

Also my BGs suck and my last AIC was a 10.9 even though I watch my diet a lot and exercise well. I knew it wasn't totally my fault.

[David_S]

Your endo can call and get it covered as it is necessary... wow I can't get over the trouble you are getting with a prescription.

[Psycho Penguin]

I have free Florida insurance for poor people.. so I can't complain too much, but yeah, their policy on this REALLY bothers me.

My endo has to fax in a form and then it has to be approved. My endo is a lazy person.

[parrotletzoo]

if you don't have the money to buy think like a pancreas, much of the same information is available at The Diabetes Mall, your source for the latest in diabetes information, technology, and resources, plus diabetes books, test strips, and products at discount. (http://www.diabetesnet.com)


Even though the site is "the diabetes mall" and the description on the url looks like an ad it has a ton gf good info on using insulin, mdi, and on pumping.

[BlueSky]

I have free Florida insurance for poor people.. so I can't complain too much, but yeah, their policy on this REALLY bothers me.

My endo has to fax in a form and then it has to be approved. My endo is a lazy person.
I get the sense that you are looking for reasons not to use a basal insulin. If there are problems with the endo and/or insurance as far as Lantus is concerned, use NPH. It costs half as much as Lantus, and you don't even need a prescription. So there is really no excuse :o .

[Psycho Penguin]

parrot: Thank you, that's been very helpful :)

BlueSky: That's a very.. weird assumption there. I had no idea what NPH even is, for one.

My diabetes experience has basically been "you have diabetes. watch your carbs and take this medicine your insurance won't approve. good luck." and I am here to, you know, learn stuff.

[Olidus]

PP,

Amazon.com: Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin: Gary Scheiner, Barry Goldstein: Books (http://www.amazon.com/Think-Like-Pancreas-Practical-Managing/dp/1569244367)
Try and pick it up - if you have a Diabetes education center in your area - give them a call.
Whoever told you "you have diabetes. watch your carbs and take this medicine your insurance won't approve. good luck." Clearly does not know enough about diabetes to send you on your way with that fram of mind.

[squidsdc]

parrot: Thank you, that's been very helpful :)

BlueSky: That's a very.. weird assumption there. I had no idea what NPH even is, for one.

My diabetes experience has basically been "you have diabetes. watch your carbs and take this medicine your insurance won't approve. good luck." and I am here to, you know, learn stuff.
Psycho--you are on the right path now. Wanting to learn is the first step to control. Don't forget there's this little thing called "denial" that can present itself when newly diagnosed!:T
The more info you gain, the more info will change. New developments and such. NPH used to be one of the standard long acting insulins; however this was before Lantus came around, which is truly long acting. NPH has to be taken more often and has definite peak times, which is why it is not as advisable as trying to regulate with Lantus. When I was diagnosed I was fortunate enough to have parents who needed to learn, and there wasn't much out there back then to learn. I immediately went to a session at the Diabetes Education Center in MN, and then away to a diabetic summer camp. These things set me on a path to always want to know what was going on in my body and not be passive. As I got older, I learned to question the doctors on the why things are being done, so I could understand even better.

Now I"ve been pumping for 3 years, and I feel I need to re -learn again. I just bought "Pumping Insulin" but I'm not much of a reader so I'm struggling with getting through the first chapter. I wonder if any of these books, like "Think Like a Pancreas" or "Pumping Insuln" are available as a book on tape? That would certainly help for those of us who are averse to the printed page. (And I"m not suggesting that you are, but if you are, then I completely understand)

[Erin]

I was on a basal but like I said my insurance doesn't cover lantus because it's a "non formulary medication" or something.

To be on a basal you actually have to take the medicine. What basal insulin were you on? It sounds to me like you were supposed to be taking lantus, but you weren't. were you taking something else we don't know about?

Novolog is a rapid acting "bolus" insulin. Unless you have a pump, when you can get tiny amounts of novolog administered continuously, you need to take a long acting "basal" insulin like Lantus, Levimer, etc. You can also use older "intermediate" insulins like NPH in this role, but you don't necesarily treat it like a basal, because it has a peak. But it does the long acting insulin job, keeping your numbers relatively stable between meals.

It sounds like you've given up on getting Lantus. I really don't think you will have a problem getting it once your doctor has done the paperwork. Advocate for yourself. You have options. You can call your insurance and speak to them about what insulins are covered, and get your doctor to write a script for one of them, OR you can call your doctor and have him fax the letter to the insurance company, OR you can talk to him about using a cheaper long acting insulin like NPH.

IMHO I think the best course of action is having the doctor write the letter... but that is not the only option open to you. Do some investigating and find a way to get yourself the medicine that you need to survive.

[Psycho Penguin]

I was on lantus in the hospital when I visited every time and took it before I got insurance. I can't afford it any longer and it's expensive. :( But I'll see what I can do, I have these pens for now.

[SueM]

I was on lantus in the hospital when I visited every time and took it before I got insurance. I can't afford it any longer and it's expensive. :( But I'll see what I can do, I have these pens for now.

OK lets put it another way............. You have 2 choices live or die.
You need a basal insulin to keep you alive end of story.
Your ins does cover you for basal insulin end of story. Be it Lantus/Levemir/NPH. So go and sort it.
The complications you are working so hard to get will not go away once you have them, and the death is a slow painful one.
Sorry if I sound hard/mean but hopefuly it will give you a kick in the right direction to sort yourself out.

[CaptCrashIdaho]

When I manifested I was pissed. I mean other than peeing and drinking up a storm I had no other harsh symptoms. It's a shocking/upsetting thing.

Key thing is you can't let it own you--you have to own it. Diabetes has a management plan for us: slow painful death. Manage it or it will manage you. (Oh look, tons of catch phrases!--but they're true)

I remember when I told my Mom and Dad and they were relieved I would live but frightened for my quality of life. Call your Endo, tell him to get off his butt and send in your insurance forms. Call your case manager or agent or the office and make sure he did. If he didn't, call him back and kick him again.

OWN IT. If you do you're gonna be fine. Sounds like your initial shock is wearing off, now use your anger to wrestle Diabetes to the floor with that syringe and make it do what you want.

[Gary_W]

Insurance or not, basal insulin is something you need to afford; you simply cannot make a go of managing this condition without it. BlueSky's comment on NPH does make sense. Lantus is just one of several basal insulins on the market and it happens to be the most expensive one. It suits many people in terms of its effects, others don't get on with it so well.

Let's put it this way. Lantus has been on the market for <10 years. People have been injecting basal insulins for many years before this. Some of these basal insulins are available today, and whilst they may not be as predictable as Lantus they will at least work. If it's a choice between NPH that you can aford and Lantus that you can't then NPH looks pretty attractive.

[d_k_moon]

I just googled the Florida Medicaid formulary, and both Lantus and Levemir are on the list.

[Aero750]

My blood sugar was 378, really ****ing high, so I took 40 units of novalog then ate 2 pieces of whole wheat toast just in case.

I test it 2 hours later and It says HI. Then I test it an hour later and 478!

WHAT THE ****. WHY THE **** DOES IT ALWAYS GO UP EVEN AFTER I TAKE INSULIN?

This is not ****ing fair. I don't care any more. I am trying my hardest and my body just does not want to help me.
Yes, Diabetes can be an extremely frustrating disease and a real beast to control BUT you can handle it. I agree totally with Erin: you have to get a good endo who treats diabetics with the most modern treatment regimen. The higher your BG, the more insulin resistance you encounter. I use a sliding scale BG correction amount e.g. if my BG is between 125 - 180, I use 1 unit/40 mg/dl BG; for 180 - 250, I use 1 unit/30; and so on. But of course you need the ratios that are customized for you. I've been a T1 diabetic for 37 years and as the years progressed, I felt that my Diabetes became uncontrolable! I could eat the same food with same insulin dosage the same time of day but with varying BGs after 4 hours. THE SOLUTION: Since 2/2005, I've been using Dr. Richard K. Bernstein's regimen - I've truly had the best control in 37 years! Under my endo's supervision, I follow the book Dr. Bernstein's Diabetes Solution. Even if you don't follow his low carb regimen (and i highly recommend it, it not as bad as it sounds), the book will answer almost every question that you would have about Diabetes - check it out.

Just to repeat - first get a good endochrinologist. If you don't have your basal and bolus calculations correct, it can be very dangerous.

Hang in there - it gets better through knowledge.

[Psycho Penguin]

I just googled the Florida Medicaid formulary, and both Lantus and Levemir are on the list.


I'm on Palm Beach County Health Care District, not Medicaid. Thanks for trying to help thiugh, it's appreciated. I'll figure out a way yet, I hope it's as simple as talking to my endo and getting her to understand. I would hope she would if it's as serious as I am reading here!

Thanks for the help everyone, these pens should last me a few weeks at least :) If I don't get the insurance thing settled, I will ask my endo about NPH (which my insurance SHOULD cover and again I know it's not much at wal mart if it doesn't) and get myself on a plan.

I am feeling a lot better these last couple of days with the lantus in me. I can't believe I forgot about lantus. I am such an idiot, heh.

[nicole]

I have this problem alot too.
But only I don't eat anything. I take my insulin in my stomach which seems to work the best for me. But like you say my blood is sky high maybe and hour later.

I'm on Humalog...sliding scale...yes I am. Have you talked to your doctor about it?

[lilituc]

Even though the site is "the diabetes mall" and the description on the url looks like an ad it has a ton gf good info on using insulin, mdi, and on pumping.

Diabetes Mall is John Walsh's site.

[CarrieScott]

:afraid:
i'm so sad to read this post. i can understand your frustration, though i know that doesn't make it any easier for you to go through it.

stick it out, and work closely with Doctors and Diabetes support groups.
:flowers:

[Psycho Penguin]

Well my endo is on vacation until Oct. 16th so I bought some NPH at Wal Mart and am just winging it until I can discuss a plan with her. I feel a lot better lately :)

[domsko67]

some of the info I'm picking up from reading these posts is brilliant.

I think we can evidently all relate to the frustration aspect but there are some great nuggets of practical advice in there. I'm going to get a hold of that Bernstein book and push for an appointment with an endocrinologist.

Ten minutes ago I didn't even know what an endocrinologist did lol :T

[Eddy]

Lots of good advice here. In addition to what others have said, I'd like to "me too" on a few things.


So if my meter says HI it's ok to take insulin without eating?


Ipso facto, yes. A "HI" means that your blood sugar has gotten waaay too high, which is due to insufficient insulin. Your body needs more in the bloodstream. Personally, I correct if I even hit 120.

The reason I said "ipso facto", and stressed "in the bloodstream", is because you could have lots of so-called "insulin on board" that you injected, but has not yet kicked in. Be careful not to overdose.

When I was a couple months into the diabetes game, I didn't know that hyperglycemia slowed insulin activity in me. And my ratios were wrong. And I didn't know how much walking affected me. Bottom line: I went from 220-ish to "LO", when I previously had never been below the 40s. That scared the you-know-what out of me to the point where I ran my BG about 20 mg/dL higher for a month.


I really feel like a complete *** now.


Don't. That's a value judgment that, I would argue, likely is based on a faulty premise.


Hopefully I'll get my sugar under control and I can sleep. I don't even mind 150 right now. I just want to feel normal.


My condolences and empathy.


My insurance doesn't cover Lantus because "they don't think I need it" (translation: it's expensive) and therefore I've had to go without it for a while

Not cool. IDDM, you need Lantus or Levemir... unless you want to get creative. As others have mentioned, you can use the cheaper-but-peakier NPH in a pinch.

In me, NPH only lasts six hours. I usually do 3x NPH shots during the day for my cheaper-and-more-flexible-than-Levemir daytime basal. If I'm working a lot, and not sleeping more than a few hours at a stretch, I'll do 5x/day NPH (every 4h:48m apart) for my basal -- no Levemir or Lantus at all.

However, for those who have insurance, I'd argue that being unable to get a full night's sleep so that one's insurance company can save $70/mo is an unreasonable expectation on their part... that they are failing to provide the accepted, standard level of medical coverage.


I got the needles over the counter today. I didn't know they could be purchased over the counter.


Laws and degree of hassle vary widely.

[mazea]

My diabetes endocrinologist told me something that I thought of after your post. When your blood sugar levels are really high, the insulin resistance is higher so it takes more insulin to bring it down. Maybe try next time not to eat the carbs when your correcting. I try to test my blood sugar level if I think I need to eat carbs during a correction.

Also when I didn't take a long acting insulin for a week once to see if my foot improved, my numbers do tended to jump all over the place. I would think a long acting insulin is a critical part of diabetes treatment.

I correct with small amounts of insulin. Very small, and then check 2 hours later and give myself another small amount of insulin if I am not coming down. But I also know that 1 unit of insulin brings me down by 2 points and 2g carbs brings me up 1 point.

Your doing great pycho penguin. Just learning is all and it's a big topic.

[Psycho Penguin]

I'm doing a lot better lately with the control after realizing about the long lasting insulin problem. I am still not doing terrific, but I am barely seeing highs any more and have learned it's ok to correct them.

(BTW, does anyone think Lantus can cause nerve pain?)

[sprzepiora]

I am glad to hear you are doing better. I haven't heard about nerve pain, but I have noticed that after taking my Lantus I get very anxious and want to tense my muscles. I am ignoring it because it goes away after a few minutes and I will be starting on the pump on Jan 9th 2009.

[Eddy]

I don't know about the nerve pain. However, for a variety of reasons, I prefer Levemir over Lantus. It's nice to have choices. :)

[Psycho Penguin]

I definitely had a problem with nerve pain and leg twitches when I was on Lantus. I am on 70/30 now (yeah, yeah, I know), and while my control isn't as super and I have to work harder at it, I don't have much nerve pains and leg twitches.

[Eddy]

Far be it from me to criticize 70/30. As per above, I now usually run straight NPH during the day -- 3x shots/day -- and Levemir by night. It's all about finding what works...

[mazea]

I had quite a bad case of inflammatory neuropathy, that was diagnosed by the neurologist, when I was taking Lantus. The feet swelled up so much the toes together and became paralysed and the neuropathy was so bad I couldn't walk for 3 months. So YES Lantus can cause nerve pain for some people. I changed to Levemir and the problem went away.

[Psycho Penguin]

I didn't think I was going crazy.. I guess different insulin effects people in different ways.