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So if Insulin doesn't work...

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#1
jensw61

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What is next?

I have gone from 10 units of protophane to 100 in three weeks and it isn't making any difference. I even took 0 the other night and got the same FBSL as the day before.

Went to the GP today, who thinks there my insulin resistance is too high for any insulin (surely that can't be right?) so she is ringing an endocrinologist in Newcastle (two hours drive away) to get her opinion. She will ring me later tonight.

Maybe Byetta? Apparently it costs $200 for a 2.4ml vial (pen?). Is Byetta an insulin?

What do you think?
HBac1 8.1 Feb 09
HBac1 7.7 May 09

Lantus 142 units, Metformin 1500, Thyroxine, Coversyl, Crestor, Lipidil

cholesterol, triglycerides down - yay!

#2
AngelKitty

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Hi Jen,

What time do you inject your Protaphane insulin? (before you go to bed?) And what time do you do the first BGL reading after you've taken it? (how many hours after)

:angel: AngelKitty

Dx T1 Sept 2008
Pumping NovoRapid with Medtronic MiniMed Paradigm 722 - nicknamed Schultz

#3
jlaracuente

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Byetta is not insulin. Google it to get information.
Some points on Byetta:
--- It can make you lose weight.
--- It may make you nauseous and even throw up.
--- It may be covered by insurance.
--- It can make you very hypo when used with certain diabetic orals.

I was on Byetta for several months but stopped it because of the nausea.

#4
HuskerMychal

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Ask your Endo about Humulin R U-500. I am extremly resistant but it has done wondrs for me. I take 45 units of it 3x a day. If I was still using Novolog 70/30, my prior insulin, I would be taking 225 3x a day. 675 units a day would equate to a huge expense and alotta pokes. My cost is about $120 for 2 20 ml vials and that gets me through the month with a bit to spare for the days I am bad with the food choices. :eek:
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#5
jensw61

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Ok the Dr rang - switching to Lantus, starting tomorrow. 62 units. Will see how that goes.
HBac1 8.1 Feb 09
HBac1 7.7 May 09

Lantus 142 units, Metformin 1500, Thyroxine, Coversyl, Crestor, Lipidil

cholesterol, triglycerides down - yay!

#6
AngelKitty

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I'm not sure if you aware but Protaphane ONLY works for 8 hours it is NOT a 24 hour acting insulin like Lantus, maybe this is why it was not working for you.

:angel: AngelKitty

Dx T1 Sept 2008
Pumping NovoRapid with Medtronic MiniMed Paradigm 722 - nicknamed Schultz

#7
matingara

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Ok the Dr rang - switching to Lantus, starting tomorrow. 62 units. Will see how that goes.


Lantus is probably a good move. i am not sure what protophane is... i am not an expert about insulin.

once you get the lantus underway - i would consider asking about adding a fast acting insulin such as Novorapid (sold in Australia in pen form) to cover your meals.

i use this to counter the carbs in what i eat. my rough "rule of thumb" is 1u of novorapid for each 5g of carbs. (THIS MAY BE DIFFERENT FOR YOU).

so if a meal contains 10g of carbs (say a medium salad and some berries) - i would allow 2u of NR. if my BGL is high to start with (above 4.0 (72)) - i will also add some more rapid to try and correct at the same time.

at the moment i am at 8.9 (160) just before supper. so - as it is 1 hour before supper, i have just had 4u to cover the meal (20g of carbs) and another 5u to try and get the BGL down to about 4-5 (72-90). so - 9u in total.

some days it works well - others it works just OK.

but, i rarely have a bgl above 9.0 (162). and the majority of my bgls are between 4.0 and 7.0 (144 and 126).

:)

-- Joel.
[SIGPIC][/SIGPIC]
do not click here...
___________________________

NUMBERS
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May 2010 : A1C (home) 5.5%: Feb 2010: A1C (home): 5.2% Oct 2009: A1C: 5.7%;
Triglycerides: 53 (0.6); HDL chol: 50 (1.2); LDL chol: 19.5 (0.5); total cholesterol 87.5
Lantus before bed - 30u; Novorapid for meals (averaging 20-30u per day); Lowish carb diet

#8
jensw61

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Thanks, everyone, for your feedback. We want to get the FBSL under control then start work on the meals/daytime levels.
HBac1 8.1 Feb 09
HBac1 7.7 May 09

Lantus 142 units, Metformin 1500, Thyroxine, Coversyl, Crestor, Lipidil

cholesterol, triglycerides down - yay!

#9
fgummett

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I have to agree with Joel... sure, covering whatever you eat with sufficient insulin ought to bring your BG levels under control but it is a sure-fire recipe for increased weight (fat mass) gain... trust me, I have been there :(

A better approach may be to cut back on the type of foods which drive BG levels up in the first place...

First and foremost of these are carbohydrates... these have the most immediate effect on BG levels.

Protein will also increase BG but it is a slower and more prolonged effect; as Protein must first be digested into Amino Acids and then some of these can be converted to Glucose by the Liver... so you are less likely to see an after-meal spike with protein but still get Dawn Effect, for example.

Fat has no direct effect on BG levels other than slowing down the digestion of some carbs when eaten at the same time. Eating protein can also slow down carbohydrate digestion.

Moderate aerobic exercise -- like an 1/2 hour brisk walk most days -- can also help to reduce insulin resistance.

---

I'd also consider revising your approach in working first on Fasting BG: I am 6 years into this now, eating very low carb... I have excellent BG control through the day but my worst (relative term) BG levels are still my fasting, due to a persistent Dawn Phenomenon.

#10
lorilei

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i only have best wishes to add jen....the sorting out phase can be very frustrating..hang in there.

lori;)


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#11
GM1258

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I'm new here.
Been Type 2 for a few years now.
I'm on Metformin 2800 mg per day (upped dosage myself).
Glipizide at 40 mg a day.
Just started Lantus about a week ago at 30 units a day.
No effect.
Those receptor doors in my cells just won't open and
let the glucose in (I am resistant).
My fasting BGL is around 220.
After a meal its 300+.

The other night it was 384.
I am overweight at 270 lbs.
I cut out soda, sweets, & pasta (except whole grain).
I have neuropathy in my feet and they burn sometimes.
I walk maybe a half a mile a night and it does help.
I walked over a mile at a brisk pace and my
reading went down to 168...I was shocked.
It hasn't been that low in ages.
I don't think this Lantus is worth a ****.
I might double the dose and see what happens.
Any suggestions?...

#12
ramon

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:wavey:Hi buddy and welcome. Time for you to take control and you have come to the right place. Folks here have even rid themselves from meds with diet and exercise, I know easier said then done. Hang in here and I'm sure that you can do it too. Sure you can increase your Lantus(basal) but for now and the diet you are on you might want to consider a faster acting insulin to add with the Lantus. Take time to read the forum and ask all the questions you want and you can change this I promise you. If you go to a faster insulin like HUMULIN (BOLUS) you might get straitened out in a couple of months but should see immediate results. Low carb dieting is essential and you will find that many here have lost a lot of weight. I've lost 90lbs and I love to eat and eat good. You can do it to. Really no big deal at all.

Surviving Diabetes and Cancer Survivor.

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#13
ant hill

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Hello Jen :D,
Are you taking any Metaformin? If so how much.
Insulin is very responsive and if mistreated will have an effect dramatically!!! But this seams to be not with you. U500 is dangerous if it's used MDI it can force a low and as strong this is 5 times the U100 strength, Can you imagine getting a low from it. This will get you in a daze and stay there for a very long time.
Lantus would be a good test as the protaphane is a 24 hour insulin where I have taken as it's much like the NPH with it's peak and troughs. Try splitting the dose over 12 hour shots with half the dose and then if the dose is on the low side I woulden't bother.
Being a T2, You still have a working pancrease, With that insulin will give the pancrease a rest and also can release it's own insulin whithout you knowing so to be sure that you don't have 2 insulins working in your body and cause a low, Have some Orange Juice or something of a fast carb to revive yourself.
With Protaphane, Ensure you have the cloudy stuff well mixed!!!! then set the dose and shoot. ;) But I think Lantus would be better. :D

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Peter...





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