What insulin should I use

MCS · #1 (**permalink**) 11-20-2009, 09:19 PM

Going to see the doc tuesday. I am thinking I should hold off the supps for awhile, let things kinda settle down a bit.

So what I will propose to him is wrting me a script for insulin just so I can regain some better control quicker. Been near 140-150 all week.

Any ideas

They had me on a main line of glucose directly into my caroitid artery, attached with that was some slow acting insulin. So to say the least everything is kinda of out of whack

Josselyn · #2 (**permalink**) 11-20-2009, 09:47 PM

My MD , when asked, said she would suggest Lantus if I/we decided to put me on insulin temporarily to give my pancreas a break. Unsure if this helps.

Glad you're back and essentially okay.

ramon · #3 (**permalink**) 11-20-2009, 11:20 PM

This doesn't seem to high, ask him about Januvia cause its supposed to stop you from sliding to low as well. Anyway try what he says and if you don't like the results after a couple months try something else.

dbaratta · #4 (**permalink**) 11-21-2009, 05:45 AM

Quote:

Originally Posted by MCS

So what I will propose to him is wrting me a script for insulin just so I can regain some better control quicker. Been near 140-150 all week.

Any ideas

You have a great A1C, why not just try metformin first? I didn't see that in your list of meds? 140-150 is not horrible, my doc would not have started me on Lantus with those numbers......but if he wants you on insulin Lantus is supposed to be the best one. Not real sure about that.

dbaratta · #5 (**permalink**) 11-21-2009, 05:46 AM

Quote:

Originally Posted by ramon

This doesn't seem to high, ask him about Januvia cause its supposed to stop you from sliding to low as well. Anyway try what he says and if you don't like the results after a couple months try something else.

Oh yeah! I was doing great on met and januvia until my insurance would not pay for the januvia anymore. Enter Insulin. ugh! Stupid insurance co.

foxl · #6 (**permalink**) 11-21-2009, 07:20 AM

On diagnosis they used insulin on me for 2 days, then put me on Actoplusmet and Glimepiride, at discharge. Glimepiride can cause lows ... but it quickly got me down, at one pill, then 1/2 pill, per day. Took it in the morning so I would be up if I went low. I did.

But yeah, I agree, 140- 150 is not that high -- I was about that high with FLU.

MCS · #7 (**permalink**) 11-21-2009, 07:24 AM

Went 165 last night for no reason, woke up at 145. Can't seem to get a handle on this.

Quote:

Originally Posted by foxl

On diagnosis they used insulin on me for 2 days, then put me on Actoplusmet and Glimepiride, at discharge. Glimepiride can cause lows ... but it quickly got me down, at one pill, then 1/2 pill, per day. Took it in the morning so I would be up if I went low. I did.

But yeah, I agree, 140- 150 is not that high -- I was about that high with FLU.

foxl · #8 (**permalink**) 11-21-2009, 07:28 AM

As a research asst in a lab, I learned that even general anesthetic has a tremendous effect on adrenal release of cortisol/cortisone. And of course that affects gluconeogenesis.

Marty, you have been through a lot -- including maxing out your adrenals. I know for day-to-day control that is not what you want for yourself, but, be PATIENT.

Took me over a MONTH to bring my fastings down after flu and a sinus infection!

Subby · #9 (**permalink**) 11-21-2009, 08:25 AM

Quote:

Originally Posted by MCS

Going to see the doc tuesday. I am thinking I should hold off the supps for awhile, let things kinda settle down a bit.

So what I will propose to him is wrting me a script for insulin just so I can regain some better control quicker. Been near 140-150 all week.

Any ideas

They had me on a main line of glucose directly into my caroitid artery, attached with that was some slow acting insulin. So to say the least everything is kinda of out of whack

Answering to the question in your title, and assuming you are talking long acting or basal, there are two alternatives with clear benefits, being Lantus and Levemir. Lantus is longer acting for most and more even. Levemir less so, but of the same generation of insulins. I far prefer Levemir for myself. Why? Less side effects for me, and the curviness actually helps me match to my curvy needs.

So if your basal needs are relatively even, Lantus would seem an obvious choice. if that's not so great for any reason, Levemir is a good alternative to try, probably definitely needing 2 doses through the day. Beyond that, long acting insulin options are older and generally, shorter in their action and trickier to deal with.

MCS · #10 (**permalink**) 11-21-2009, 12:16 PM

Thanks Subby, I was thinking towards the Lantus, from what I have read.

I believe it was the glucose drip in the ICU that maxed out my pancreas

Quote:

Originally Posted by Subby

Answering to the question in your title, and assuming you are talking long acting or basal, there are two alternatives with clear benefits, being Lantus and Levemir. Lantus is longer acting for most and more even. Levemir less so, but of the same generation of insulins. I far prefer Levemir for myself. Why? Less side effects for me, and the curviness actually helps me match to my curvy needs.

So if your basal needs are relatively even, Lantus would seem an obvious choice. if that's not so great for any reason, Levemir is a good alternative to try, probably definitely needing 2 doses through the day. Beyond that, long acting insulin options are older and generally, shorter in their action and trickier to deal with.