[DeusXM]

if you live out of packet food which tells you the exact carbs your about to eat thats fine but if like me you like on freshly prepared food its hard, and i found it hard to look at my plate and work it all out

Go on a DAFNE (Dose Adjustment For Normal Eating) Course. They're free and teach you how to estimate the amount of carbs on your plate and how much insulin you need. I've yet to meet a single person who hasn't found it's totally revolutionised their control and given them more freedom than they ever thought possible.

i found that the sugar wouldn't maintain itself it would always slowly drop.

Then your basal dose was too high.

i've just been put back on mixtard30, so i'm gonna see how it goes its nice that you all have your opinions but i'm sticking by my guns for now!

Let us know what your next A1C is. If it's over 7 then you'll definitely need to change your regime.

[corwin]

Great advice so far.
I want to add that as part of my job I have buisness lunches out very often and I also like to eat out at least 3-4 times a week. Obviously I don't have the exact carb count of what I'm eating. There is a lot of trial and error but soon enough you figure out specific dose for specific food, like a medium size potato needs x units of insulin etc. Many times I'm looking at a meal and I know that it's not something I ate before and I'm really not sure how much insulin I need. What I do is make an educated guess and make sure I test a lot and correct. The next time with similar food I have a better idea how to handle it.

[Ailsa]

I have a slightly different take on this to some of the others Bonnie.
I actually do think it is possible to get reasonable results on the actrapid/protophane mix. Just that, like the others, I don't think premixed insulin is the way to do it.
I used actrapid/protophane for MANY years. But always mixed it myself in the syringe. That meant I could alter the amount of actrapid if I was exercising or sitting around & also have a different ratio of the two night & morning. I don't agree with the person who said you always go up to 10 after meals. The way the peaks of the 2 insulins overlap are designed to help prevent this. I managed to achieve near normal A!cs when I was pregnant using that system.
I do have strong anti feelings about premix though. It doesn't give the flexibility required. I believe it was invented as a marketing exercise for the sellers of the stuff, & also for people (mainly T2s) who didn't like the idea of a syringe. Maybe that's an issue for you? but in the end a syringe & a pen both have a needle on the end. It's exactly the same thing.

Obviously there is a reason I am not using actrapid/protophane any more.
When I was using that I was generally getting A!cs 7.2 - 7.8. I actually don't think that is too bad but believe it is near impossible to get under 7.0 long term.
However the dissapointment for me when I switched to Lantus, was that there was no improvement. Also I was always high or hypo with the the Novorapid. In fact it was more frustrating than its predecesor.
I now realise the reason for this was that I was not told about carb ratios at the time & was still trying to work pretty much on the set carbs per meal I had been taught at an earlier era. There are some goods books on this like "Using Insulin" by John Walsh. I am now hoping to get in the 6's for my next A1c. It could be that like me, you're not getting the best help.
Have to also say, that my change of approach has made a huge difference to how I feel about my new insulin as there is now no doubt that it's all a lot easier day to day. After all A1cs are not the only thing to consider.
Hope this is constructive.

[Ailsa]

if you live out of packet food which tells you the exact carbs your about to eat thats fine but if like me you like on freshly prepared food its hard,

Forgot to mention in the previous post, the main reason I bought the "Using Insulin" book, is that it has a list of carbs as percentages. ie: bread is 50% carb, so you just weight the bread & mulitply the weight by 50% to get the carb content.
Its much better for me, as like you I'm not into packet food.

[duck]

Hi Alisa, I think the "anti-mix" people actually agree with you: We don't like the pre-mixed 70/30 blends (or is it 30/70?)--They lock you into a combination that allows zero flexibility. I personally have no issue with "mixing" fast-acting insulins with basal insulins, otherwise. As a matter of fact, short of being on a pump, that's just about the only way a Type 1 and some Type 2's can gain good control.

[Funnygrl]

Originally Posted by bonnie690

Dear Duck,

Question: what re you views on mixtard 30 insulin?

Question: do you think someone can have good control by being on a 2 a day insulin such as mixtard 30?

Question: when using the pump, do you at anytime take it off (like when you shower or sleep) or is it worn at all times?

Thanks!

1. Mixtard 30 is awful, and doesn't mimic the way the pancreas naturally produces insulin at all.

2. No, generally people can't have good control on 2 shots a day.

3. Pumps are usually taken off from showers, but need to be left on when sleeping.

[Erin]

My take on the whole thing:

The mixed insulins (whether you mix 'em yourself or get the pre-mixed stuff) are good if you want your food / exercise to be the primary variable you use to achieve good control. You take X units, and then you know what you can eat, and how active you have to be to keep your bg good. It is a good regime for people with very routine lives, who do and eat basically the same stuff all the time.

The MDI or pump route allows people to live the way they want to live and eat the way they want to eat, and adjust the insulin to keep the blood sugar in control. This is the way most of us lean. And it also allows really precise corrections for the perfectionists among us. On a mixed insulin there really isn't too much you can do to fix a mildly high number, other than wait it out. With a pump or MDI, you can make very minuscule corrections. It takes a bit longer to get a handle on, but once you figure out your basel rates and correction / food ratios, you are afforded a level of precision and flexibility that a 2 shot a day regime simply doesn't offer.

[Cyborg]

IMHO, the pump is a major step up from MDI. For me, I learned so much more about my insulin needs, my metabolism, carb ratios (how they change throughout the day), etc. after I made the move to the pump. The improvement in bg control has been incredible and the amount of insulin I'm taking now is less than half of that while on MDI.

[Tim_Roy]

Originally Posted by jeggeman31

I take mine off when I shower and get lucky with the wife.

I leave mine on for that. Since I stopped using NEEDLES, anyways. So long as we're not doing gymnastics or something, it's simply a matter of setting the pump somewhere and both parties knowing where it's at.

Anyone who has a problem with my being on the pump I tend to take as someone having a problem with me. I don't tend to keep those kinds of people around for long. Not saying anything about you and your wife, mind you.

[TAutry]

If there is a 'marvelous' part to diabetes, it is that we are all different and different management or treatment routines work for us.

I have been using Novolin 70/30 since my diagnosis in 1990. I have very good numbers. I don't starve myself, feed my insulin or exercise myself crazy. Other than my own personal peculiarities, I lead a normal life.

Many opine that the pump is the greatest device ever invented. For them, it may be. My experience has not lead me to desire a pump at this time. In the future I may consider it an option.

[Goldrun]

Once I was diagnosed I started on the 70/30 Novolog...which helped me to lower my bg levels back into the normal range...but I found I experienced lows during exercise and oftentimes at night, if I didn't compensate with enough carbs at dinner. This was frustrating, as I don't like eating right at bedtime.....or feeling like I HAVE to eat when I'm not hungry. I also travel for work and sometimes cross multiple time zones...which is NOT good when you take the pre-mixed meds...as others have said, it's not the most flexible regimen!

Since January I've been on Lantus with Novolog bolus at meals, and my only problem is underestimating my carb content at times....I'm much happier than with the pre-mixed, as I feel I have much more control rather than my meds.

good luck!