[Tribbles]

Originally Posted by plattb1

No other antibody testing. Should I? Would it serve any practical purpose to know?

It might be worth doing. Insurance companies tend to be easier on type 1 diabetics, probably because they have less of them. From a treatment perspective I think you are right and I doubt it makes any difference at this point.

[NewdestinyX]

PreDinner=106 (*relieved*)
Dinner= Bacon Cheeseburger no bun, Steak Fries (a few), Let/Tom, Cole Slaw, Unsw Iced Tea/Splenda
1.5hrPP=109

3.0hrPP=131
Had some Dutch Chocolate SF Turkey Hill IceCream at 9:30PM..
And 2hrPP the IceCream, now at bedtime = 148 --
This ice cream, before Lantus, for me used to be okay in that I perceived a move from 125-145 as only a minor bump up.. but with Lantus creating a solid baseline under 110 it now makes it clear that, at least late at night, it creates a full blown spike. I'm gonna try another brand.. But I can't really eat this stuff later at night it would seem. Too spikey. On days where I exercise midday I seem to be able to have it at lunch without a spike-- but not late at night.

Tomorrow's another day.

[NewdestinyX]

Day 21 on Lantus

Moved to 19 units today (Injected at 8:15AM)
FBG=121 (can't eat that ice cream before bed anymore... )
Bfast- Usual cheese omelet, sausage, Latte-but tried a new brand of Lo carb Choc Muffin (AND- there was a ripe banana in the fruit basket and my potassium is always low... LOVED bananas... None in 3 months -- Oh no -- I'm going to do it.... AAARGH.. I ate half... O please, O please -- tiny spike only...)
1.5hrPP= 184 (guess that's out.... *sigh* - or MAYBE it's the 'new' lo carb choc muffin -- this is a 'no sugar added' version -- different bakery -- Oh I HOPE it's the muffin)

It's brisk out there today -- but I have my new 'biker jumpsuit' (which is still a little funny looking on a 262lb guy..). Though I'm tryin' to MAKE IT WORK! This will be my first 6 mile bike ride in "2 weeks" because of all the rain. I am open to the fact that these higher numbers all around are also due to my lack of activity these last 2 weeks. Still have walked/jogged a couple of days when overcast.. but I'm beginning to see pretty quickly that the 'colder weather' is going to be a challenge for me with my activity program that started in the summer months of a pretty 'cool' summer for the midAtlantic region. I tend to hybernate in the winter and I JUST CAN'T this time.. I've come so far.

Has anybody experienced the need for 'more basal insulin' in a less active period of life (or lower carb for that matter)? Wonder if there's any correlation between activity and basal insulin needs....

[Subby]

Of course I am not a t2 and I don't know what difference that means here exactly. But I find that if I don't exercise at least a little at least every 2 days, my insulin does not work nearly so well, basal or bolus. I find exercise every day a better bet.

Even just a moderate 10-20 min on an exercise bike is way better than nothing, for me. Getting the heart rate up for some time, even just breaking a sweat, seem to be the important part that I can see.

[NewdestinyX]

Originally Posted by Subby

Of course I am not a t2 and I don't know what difference that means here exactly. But I find that if I don't exercise at least a little at least every 2 days, my insulin does not work nearly so well, basal or bolus. I find exercise every day a better bet.

Even just a moderate 10-20 min on an exercise bike is way better than nothing, for me. Getting the heart rate up for some time, even just breaking a sweat, seem to be the important part that I can see.

Very helpful, Subby. Thanks very much for the input. Makes total sense.

[ShottleBop]

Originally Posted by Subby

Of course I am not a t2 and I don't know what difference that means here exactly. But I find that if I don't exercise at least a little at least every 2 days, my insulin does not work nearly so well, basal or bolus. I find exercise every day a better bet.

Even just a moderate 10-20 min on an exercise bike is way better than nothing, for me. Getting the heart rate up for some time, even just breaking a sweat, seem to be the important part that I can see.

Works that way for me, too. And breaking a sweat seems to make the difference.

[NewdestinyX]

Day 21 on Lantus

Moved to 20 units today. Interesting day so far. But in this all I'm learning that my body's also trying to figure out what I'm doing. It wasn't that long ago when I thought I'd really land at 12 units or so because I was seeing all these numbers under 100 - but that's sorta stopped. Yes the rain kept me from a lot of my exercise regimen -- but my diet really hasn't changed all that much as I read over those early days. I was still, then, seeing how far I could 'push' this basal insulin and see if it would help my body round the spikes off a bit. Some days yes, others no. Here's today so far. Using my new Diabetes Pilot iPhone app to help me keep records:

9:43 AM Med-20iu Lantus
9:43 AM FBG_Glucose_115
9:55 AM Breakfast__Starbucks Egg,Chs,Saus sandwich (ate half of EngMuff), Latte
11:27 AM 1.5hrPP-BF_Glucose_164 (pretty expected - just as bad as bagels for me in am)
1:08 PM 3.0hrPP-BF_Glucose_92 (YES!! Thank you Lantus!!)
1:09 PM Pre-Lunch_Glucose_92
1:30 PM Lunch__Chik/Chs sandwich no bread, steak fries, let/tom, unsweetened tea AND 3 Keebler Fudge Stripe cookies (full sugar) for dessert -- LIVING DANGEROUSLY
3:02 PM 1.5hrPP-LU_Glucose_126 (? really?)
4:37 PM 3.0hrPP-LU_Glucose_114 (WHAT?? I can eat Fudge Stripes??? )
4:40 PM Snack_Nature Valley Granola Bar (1)

I will GLADLY give up any bagel or eng muffin product forEVER to be able to have some Dream Fields pasta and an occasional couple of FudgeStripe cookies. Of course each person's body on this forum will work differently.. As they say.. DON'T TRY THIS AT HOME.. I'm a professional.... Well -- the analogy doesn't quite fit..

And DOWN another pound today!!

[NewdestinyX]

The rest of Day 21 (11/5/09) had no spikes. Day 22 (11/6/09) I moved to 21 units of Lantus - also an unremarkable day. No spikes - pretty good control 107-141 for the day and only about 75 carbs.

At this point of my journey on Lantus - its given me a solid enough baseline under 110 than I've been able to truly do my first food testing. Everyone of us is different as I've noticed since I joined here -- so these 'conclusions' are for ME only -- on MY meds in THIS body... But here goes:

The saddest news for me is that any bread product of any kind, even whole wheat and multigrain products send me thru the roof in a spike. I've LOVED breads and rolls and bagels -- but if I want to avoid Bolus insulin or a Prandin type medication I can't eat them - at all.. Depending on the forumlation some Sugar Free muffins and cookies are spikey for me and some aren't still trying to get to the bottom of it.

The Dream Fields pastas are a 'go' for me. About a 25 point up -- but a relatively predcatable landing at about 3hrPP.

Most No Sugar added icecreams are fine for me too except not late at night.

My Lattes are a 35 point up so I have to be careful with them. More espresso and less milk seems to be better.. But if I drink regular coffee or decaf with half and half no spike to speak of -- 10 points up max..

The most joyous one to report is that I seem to have been spared giving up potatoes. Pretty much any fried potato product, hash browns, french fries are all okay with me. No long burns and only a 20-25 point up for about 2 hours and then a normal recovery. In the am they help my pancreas to turn on as they do with MCS. So if I drink my Latte 'with only' the eggs and meat -- I recover later and spike higher. Add the potatoes and the recovery is quicker and the spike non existent. So I'm grateful. Mashed potatoes don't seem to mess too badly -- and haven't tried a baked one yet. Potato chips, okay too - fried are better than baked with regard to BG levels but a-okay. Oh -- rice is also out -- spikey.

[NewdestinyX]

Been swamped last few days.. I'll update shortly.. I forgot to take my 2nd dose of Met 3 days ago.. And noticed my am number was still 104. Now I know the MET's in my system after build up -- but I decided to try dropping down to 1 dose of 500mg in the am and see if the Lantus is making up enough of the difference. I'm still pretty 'gassy' in the am on the MET, even with the extra Fiber I'm taking.. Some of the old Met symptoms have returned since I've been on Lantus.. It's harder to control the gas cramping than it was before Lantus. Don't know why.

Up to 23 units of Lantus as of today.. Still want my fasting sugars in the am under 100. I don't have as bad DP as some of you -- but I think I DO have it.. My before lunch numbers are in the hi 80's lo 90's most days now.. So I know if I push the Lantus too high the other fasting numbers in my 'less carb sensitive' time of the day could get too low.. If that's the case then I'll consider taking the Lantus at night.. That might be the best next step for me..

[NewdestinyX]

Well -- had my first hypo yesterday.. After exercise before lunch.. Got back home and heart was racing.. Thought it was just from the exercise.. But then the shakes came.. BG was 58 -- Will probably do anything in my power to 'never' feel that again... Wow.. I remember it from my youth -- as such feelings and fear of them coming started my bad eating habits.

I tried not to overreact.. 4oz of orange juice and a granola bar (grains shoot me up quick) -- in 15 minutes sugar was at 88. Did I consider it 'job well done' and eat a 'good lower carb' lunch? No.... What the heck -- it's been 4 months since I had a milkshake.... Forgettaboutit.... 175 for 3 hours.. Won't do that again... Silly me..

Also -- dropping my nighttime 500mg of Met -- won't work for now.. FBG numbers creeping up into the 115-122 range.. I need the 1000mg of Met for now -- at least at THIS level of Lantus... I suppose I could up my Lantus to help..

Anyway -- predictable numbers these last couple days too. Lantus is like a RUBBER BAND that you stretch when you eat higher carb but it rounds the top of the spike (not prevent it) and then it YANKS you back to a basal numbers by your next premeal.

It's been a pretty amazing thing for me. Thanks for everyone's input. I'll likely stop my daily logging here.

I think thinking of LANTUS like a RUBBER BAND is a great mental picture of what it can do and of what it's done for me.

23 units seems like a good place for me on 1000mg of Met split AM PM. Everyone will find their own place.. My 30 day average has moved from 135'ish to 118 in this month. And it would be even lower than 118 if I desired to eat lo carb - which I don't. So Lantus has given me the ability to eat with great freedom.

DISCLAIMER -- Most medical science shows that having a more 'peak-valley' aspect in your BG levels is less 'controlled' than a soft curve. SO moving from 90-150 back to 90 in a meal cycle every meal of the day is less controlled than 80-110-80.

But I'm satisfied with my eating regimen now and I continue to lose weight - so - I will likely ask my doc for some bolus insulin or Prandin to help me get that softer curve at the level of carbs I wish to eat. Exercise is the KEY.. I have not gained a single pound on Lantus. I believe that's teh case because I've kept up my exercise.

If you don't want to eat less than 50g of carbs a day. A Basal insulin can help you get BG control along with Metformin. That's what my journey has showed me. You will have to live with some spikes though if you don't want to use basal insulin or a pancreas stimulator like Prandin, Starlix and I think 'Gliburide' is one too. Using as many 'smart carbs' (veggies and fruits) are better than processed carbs and CAN be less carby. YMMV... as always.

[PatrickR]

A few thoughts:

The pancreas stimulators (sulfonylureas like Gliburide) are widely considered by some to lead to beta cell burnout by further stressing the pancreas, leading to shorter times to complete insulin dependence. In my own case, I stopped the Gliburide and switched to a bolus of Novolog.

Yes, it is more complicated. You have to get a feel for how each type of carb will affect you, and how that can change. Also how the bolus works over time in your body. Even thought Novolog is supposedly rapid acting, FOR ME it starts after about an hour. In fact, If I correctly bolus an hour before eating, I don't spike at all - my readings are flat.

I've seen several reports that suggest your basal/bolus ratio should be about 1:1. I don't know how true that is - I'd be thinking it's pretty diet dependent. Mostly I'm a low carber, but like to have the option for going out, etc.; my ratio is a little different.

I'm about 20 u of Lantus (I go up and down a little), and only about 10 u of Novolog (this also varies, and is much more diet dependent). If I am close to zero carb, I can almost skip the Novolog.

After a year of using both, I am still tuning. I'd like to get my A1c from 6 down to 5, but also avoid hypos (had a few, nothing scary). But D is just too variable - some days I can work out and drop 60, some days I rise 20. Control is a path, not a destination.

Good job on getting things on an even keel. There's a lot to learn, and it takes some time.

Good luck!

[NewdestinyX]

Originally Posted by PatrickR

A few thoughts:

The pancreas stimulators (sulfonylureas like Gliburide) are widely considered by some to lead to beta cell burnout by further stressing the pancreas, leading to shorter times to complete insulin dependence. In my own case, I stopped the Gliburide and switched to a bolus of Novolog.

Yes, it is more complicated. You have to get a feel for how each type of carb will affect you, and how that can change. Also how the bolus works over time in your body. Even thought Novolog is supposedly rapid acting, FOR ME it starts after about an hour. In fact, If I correctly bolus an hour before eating, I don't spike at all - my readings are flat.

I've seen several reports that suggest your basal/bolus ratio should be about 1:1. I don't know how true that is - I'd be thinking it's pretty diet dependent. Mostly I'm a low carber, but like to have the option for going out, etc.; my ratio is a little different.

I'm about 20 u of Lantus (I go up and down a little), and only about 10 u of Novolog (this also varies, and is much more diet dependent). If I am close to zero carb, I can almost skip the Novolog.

After a year of using both, I am still tuning. I'd like to get my A1c from 6 down to 5, but also avoid hypos (had a few, nothing scary). But D is just too variable - some days I can work out and drop 60, some days I rise 20. Control is a path, not a destination.

Good job on getting things on an even keel. There's a lot to learn, and it takes some time.

Good luck!

Super helpful post, Patrick. Thanks for taking the time to share your journey. I too am thinking that I don't want to pound my pancreas any more.. My doc is old school and doesn't like any of the drugs that ask more of the pacreas. I too am thinking of the 'Novalog as needed' approach that I see several of you use successfully. I was also wondering how you time your injection of the fast acting. I know how to calculate my I:C ratio now.. But was wondering about effectiveness in terms of timing. I'm ready for the journey. It's still my goal to get off insulin all together - but I have another 9 months or so to get rid of this remaining 70 lbs I have to lose. And I want better control in the mean time without super lo carbing. I have not gained any weight and am still losing on the Lantus so I'm pretty sure I know the secret of not gaining weight with insulin and it's exactly as I suspected --- exercise and more exercise. Then the glucose goes into your muscles as energy and isn't stored. Some people on the board here refer to insulin in ONLY its role as a fat storage hormone - but that's only half the story.

Thanks again!

[NewdestinyX]

After the one month marker I find I'm leveled out and controlled at 24 units of Lantus.

FBG and Premeal readings (if I don't BLOW IT with something too carby) are consistently between 88-102'ish. 2hrPP numbers are consistently between 105-130 max - unless I go above 25 carbs per meal. Even then I top out at 150.. which I don't want to do often and has been made clear here -- Lantus and other basal insulins don't prevent spikes -- but they DO round the TOPS of the spikes. That's been clearly shown by my journey.

I will get my Dr. to prescribe some Novalog or Humalog Bolus (fast acting) Insulin to have on hand for the holidays. I don't want to go nuts -- but I also don't want to be too restricted.

Thanks for everyone's input here. As many of you know -- I will never very low carb for lifestyle choice reasons. But it's good to know that, for others of you that would prefer to moderate your carb intake but not 'kill it' - that you too can get well controlled BG levels - using a little insulin. 24 units -- is "a little" and I can tell you I've never even felt 'one needle prick' from the shot I take each am... The finger sticks for monitoring I feel way more. And even they're okay.. I have also not gained a pound on it either. I'm still losing - a little more slowly these days -- but the colder weather has also limited my outdoor exercise program. I'm switching to a gym membership for winter. I need to stay active. If I slow down -- I WILL gain weight.. That won't be the insulin's fault. It will be mine for slowing down the exercise. Insulin is ONLY a fat storage hormone WHEN the body's inactive. If you're active the insulin then acts as a converter of glucose in the blood into energy for the body to use.

Oh and now that I'm on an insulin product I only test in my fingers except for Fasting levels where I use my knee to check. At one time I used only my knee. But with the possibility of a hypo on an insulin product I use my fingers most of the time.

Actually I can tell my blood glucose level by the way I feel most of the time..

Thanks again all!!