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Jeppy

Week 2 and they increased my insulin

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Jeppy

I feel good, except for the blurred vision. My numbers are down and they still increased my insulin. That's "OK", I'll still follow the doctor's orders. I guess I am still in the adjustment period eh?

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Bountyman
How often do they adjust the insulin?

 

Insulin adjustments with a basal insulin are usually adjusted every 2 to 3 days. Bolus insulins are adjusted accordingly.

 

Is it dependant on the log I turn in?

 

The log is your reference point to how your body is using the amount of insulin you're giving it.

 

Does everybody use a log?

 

I think it would be safe to say everyone who posts on this forum uses some type log.

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aggie168

I am on a pump and I still fine tune my basel dosage as necessary.

 

My bolus insulin is base on my carbohydrate consumption. Hence it change by the meal each day and it is not a fix number of unit per day. :)

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Subby
I feel good, except for the blurred vision. My numbers are down and they still increased my insulin. That's "OK", I'll still follow the doctor's orders. I guess I am still in the adjustment period eh?

 

Hi Jeppy. What kind of insulin are you taking? Do you have anything else you are doing for your diabetes?

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Jeppy

I use Novolog 70/30 mix 3 times using a flex pen a day at meal times and I take 5mg of glyburide in pill form with every meal. I walk alot at work and like to work in the yard. I went from 220 lbs to 146 lbs in 3 months.

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Subby

Good work! What kind of blood sugar readings are you getting these days? The usual points of interest are fasting (on waking), before meals and 2 hours after meals. Do you have any of those you could share?

 

You are on an unusual regimen for a type 1.5. Mix is not commonly used these days, and is usually twice a day. It is rather more brittle than using a separate long (basal) and fast (bolus) insulin, as everyone needs different amounts of each.

 

And Glyburide isn't a common pill for a type 1.5 to use. It works by forcing the pancreas to produce more insulin, which is suspected to make it run down faster. One idea behind using insulin to maintain control, is to let the pancreas relax a bit, which may give you much longer where you are getting internal support to help you with your external injections and maintain control easier, for longer.

 

I'm not saying you should change, but it's good to be aware of these things and that there may be alternatives if you want.

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aggie168

Hello Jeppy, do you take a fix dosage of Novolog 70/30 at meal time? I second Subby that you should not use any of the "G" drug to push your pancreas any further. There is no reason to burn it out any faster. :)

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Jeppy

What kind of blood sugar readings are you getting these days?

 

Between 70 and 290

 

The usual points of interest are fasting (on waking), before meals and 2 hours after meals. Do you have any of those you could share?

 

No soda and lots of veggies and fruit. Moderate meat and little bread, butter and potatoes and pasta.

 

You are on an unusual regimen for a type 1.5. Mix is not commonly used these days, and is usually twice a day. It is rather more brittle than using a separate long (basal) and fast (bolus) insulin, as everyone needs different amounts of each. (The Doctor said I was an unuasual case. I still have plenty to learn as well. The family doctor gave me the glyburide in pill and the endocrinologist gave me the Novolg and told me to use both.) When first tested during a normal yearly physical I had a 731 BSC and they freaked out and told me to leave work and go to the ER or their office immeidately. I went to office and the fun began.

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Subby

OK, now you say you are taking Novolog. That's not mix, there's a huge difference between them. Which are you taking? Not asking to be annoying... it's beneficial for you to be clear on this, too. :) If Novolog, are you taking a long acting insulin once or twice a day, as well?

 

It's good to let us know a little about your diet, but I was (badly) trying to ask if you had specific bg readings to share. Eg, the last 3 fasting tests. Or what you got before lunch. etc. Again, it's helpful to get really specific. What a range of 70 - 290 says is that you need to start working out when you are getting the highs, and determine what is causing them.

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Jeppy

I did say Novolog in my response the first time, can't get any clearer than that. The Novolog 70/30 is a mix of quick action and long action insulin, according to the doctor. I was taking it twice a day and now I am taking it three times a day and stated that previously as well.

 

I walk at least three miles a day.

 

I am new to this whole thing and do not understand half the stuff you said.

 

Thanks for the advice Subby,

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jenb

You might find that you can control those wide swings better with two separate insulins instead of the mix. Getting your background (long-acting) insulin sorted out first will pave the way for setting appropriate doses of rapid acting. Many of us use Lantus or Levemir as basal insulin and Novolog or Humalog (or Apidra) to cover meals and do corrections. I really don't see how one gets adequate control without being able to adjust the basal and bolus insulins separately since they have such different purposes. I'd encourage you, Jeppy, to talk to your doctor about this.

 

I'll seem like a one trick pony to those who have read my posts over the last couple of years but....Get the books Think Like a Pancreas by Gary Scheiner and Using Insulin by John Walsh. These are really informative books that explain in easily understood terms how insulin works and how to get the most out of your treatment.

 

Best of luck! It's a lot to take in, isn't it?

 

Jen

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Jeppy

Thanks jenb. For someone like me, I need the easy terms and education of diabetes. 2 weeks into it and I still don't have a clue of all the meds and what they do. I just trust the doctor right now. Until I found this website and noe I have more questions for the doctor.

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Todd G.

Hi Jeppy,

Read this forum in detail, including the type 1&2 sections. Everything applies to you. You NEED to understand Subby's question, trust me. You'll be the one adjusting your dosage forever, so it's up to you to understand your situation and options. You can't, IMO, just leave it up to the Dr.

 

And, if you're wondering where the 290 BG reading is coming from, look to the fruit. Generally, fruit is a no no for diabetics. You need to get a meter, or use the one you already have, to test before and after each meal, and in the morning at waking and before bed. Do this daily for a month and you'll have a better understanding of what is being asked of you and where you need to go from here.

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Subby
I did say Novolog in my response the first time, can't get any clearer than that.

 

Novolog without the "mix" bit is just the short acting part, and is commonly used three times a day. It it very widely used.

 

So, if you drop the "mix" off the end of the Novolog mix and talking about 3 times, it gets very unclear unfortunately. Because it sounds like you are on a very common, very different course of insulin than the one you are on.

 

I walk at least three miles a day.

 

I am new to this whole thing and do not understand half the stuff you said.

 

You are more than welcome to ask specific questions. That's how we learn.

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aggie168

Call me slow. I am confuse now. Novolog and Novolog 70/30 is two different kind of insulin. So which one are you actually taking? It makes a very big different on how other forum member may answer your questions. :)

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Jeppy

I get it. I am on Novolog 70/30. I guess I was taking a short cut and should not have with just saying Novolog. Sorry about that. I take it three time a day the settings are 10 before breakfast and 5 before lunch and then 10 before dinner. I do eat fruit, but will stop that.

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jenb

Jeppy - I just want to say that you should not feel bad about being confused, overwhelmed, and just plain frustrated. Every one of us was where you are at some point. There are new terms and new concepts to learn, and a lot of testing to be done. After a couple of months you will feel as though you've had a graduate level course in your own physiology! And you will have adjusted to your new normal.

 

I'm really glad you've joined us. As you can see, there are many kind, concerned and generous people here. Some are quite forthright, others a little more gentle. In the end, everyone wants to help and has great first-hand experience to share. Keep posting and asking questions - someone once told me that you might have to ask the same question 999 times before the thousandth explanation finally makes sense. Diabetes is kind of like that.

 

Jen

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Subby
I get it. I am on Novolog 70/30. I guess I was taking a short cut and should not have with just saying Novolog. Sorry about that. I take it three time a day the settings are 10 before breakfast and 5 before lunch and then 10 before dinner. I do eat fruit, but will stop that.

 

No need to be sorry - and no criticism was implied at any stage. It's just like talking about different car models named similarly and getting clear on what is what so we all know what is being talked about, nothing personal at all. Usually people use the word "mix" for any mix, the reason I'm saying that is not to say you have done wrong or tell you what to do but that that is a term people will instantly know what you are talking about.

 

As for eating fruit, the most important thing is to keep an eye on what your blood sugars do after eating fruit, and work on how you dose for your food. The only way to do that is to be testing through the day, to some degree.

 

Different people take different approaches to diet, and you should have a good long think about what foods are in and out, and how they react to your body. There are different overall approaches (like going very low carb) and different personal reactions to individual foods (bananas might be a problem for one, not for another). As a type 1.5, it is likely you are making up a lack of internal insulin. Just be careful not to get too caught up in some T2 low carb discussions, where they are dealing with an excess of insulin inside (different, and unhealthy).

 

Working out what foods spike you and what do not, is a primary goal of controlling the condition. It means some more blood sugar testing through the day to identify those foods and keep an eye on things, which I recommend you do. That may be a little contrary to your doctor's approach, who's use of mix suggests a more blanket, less refined approach to insulin use. What can I say, I'm for people being involved with their control, or at least being aware that it's a viable option to think about. Keep asking questions, the mist clears away that way.

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ColePit09

I'm not a docotor but the problem is you're using the Mix 70/30...that's not good enough it sounds like. I was on the 70/30 and it did almost nothing for my BG. I am now on the Novolog fast acting the "30" in your mix insulin. You probably need to take different inuslins Basal and Bolus. Just to give you an idea. If you eat a 80 carb meal on the mix plan and you give your self 10 units you're only giving yourself 3 units of fast acting insuling to cover 80g of carbs. At a minimum you'd need 6 units of Bolus if you have the standard 1:15 carb ratio. Unless you're super sensitive that won't be enough. 80g of carbs for me I need 13 units of Bolus. Plus the 7 units of long acting well is long acting and may not peak soon enough to have an effect on the BG thus you have a high BG for hours before you really get any relief. The purpose of taking them separately is so that you can adjust to the meals you eat, and adjust your basal depending on your individual needs. Giving yourself a fix dose doesn't work in the real world because the body is complex machine that adjusts constantly. I would ask my ENDO to really look at using the sliding scale insulin injection to begin with. You're gonna have to get use to using needles I'm afraid.

 

Testing is also important. I know I test 5-6 times a day to make sure I stay well within my target range. They have free meters out there, call up your insurance and get them to help pay for the strips too!

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Jeppy

Just had a episode of 49 BG. I drank a soda and ate something. I just tested myself after 10 minutes of eating and drinking the soda. How long should I wait to get an accurate reading?

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jenb

Hi. It's usually good to check your blood sugar about 20 to 30 minutes after correcting a low. I'm sure that 49 felt pretty awful. Are you feeling better now? One thing that's hard to do in the beginning is avoid panic at a low. Your body is telling you to feed it carbs, carbs, carbs. But you really don't need that many to get you back into your target range. At first you'll have to exert a lot of mental will to eat just what you need. You may find that keeping glucose tablets handy will help avoid overtreating the low. I usually start with one 4-gram glucose tab. That's enough to increase my blood sugar between 24 and 36 point - almost always enough to get me into the happy 70 to 90 range. If, after about 30 minutes, I'm still a little low I eat a strawberry or small slice of apple and I'm good to go.

 

Jen

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Jeppy

Hi Jen,

 

Great advice. Seems my biggest problem hours are when I am at work. I have good snacks too. I am starting to think stress is a huge factor here to. My job as a FBO General Manager (Aviation) puts a lot of stress on me during the day. I work at home after the day is over and it seems to be more relaxed. I eat Almonds quite a bit too. I creadted my own log to monitor my ups and downs as well. It includes the meals and snacks i eat throughout th day. I am taking that to the doctors during my next visit. Thanks again, all of you are comforting and very resourceful.

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