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dkyle

Starting Bolus insulin and feeling pretty overwhelmed

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dkyle

All,

I was Diagnosed as a type 2 in 2007, got under control and off all meds in a couple of months but have gone back and forth between a1c or 6 and 8.5 a few times now.

 

I started taking Lantus last spring ( i did not want to take the actos my Dr suggested ) so we settled on Basal therapy, i also take 2000mg Met each day

 

I have been doing very poorly with my control for 4 - 5 months and finally went to see my dr and I am back to 8.5 and starting Bolus Insulin. On one hand I think this will be good for me as I have been trying to cover post meal spikes with Basal and Thus going Quite low at times and not covering the spikes very well either

I have been using as much as 200 units of Lantus per day and can see PP BGs of 200 or more ( I have gone as low as 62 )

 

Basically I feel I am totaly out of control right now and it seems like I have little or no natural insulin response to anything i eat - Very frustrating!

 

I am working out most every day ( weights, walking, eliptical, Bike ) and that has helped improve my IR, but i honestly can not predict how high any given meal will take me. I might have a couple of days or reasonable numbers but then i am off to the peaks again.

I had a c-peptide and GAD test a couple of years ago and they cam back normal, but it seems like this is awfull quick to have lost all my Beta cell function, yet that seems like the neighborhood I am in

 

Any thoughts or any help for someone starting Bolus for life??

 

It looks like I will be on Humalog, but I have to go to the Diabetes educator first, which is tomorrow

 

Don

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Bountyman

Hold on there, Don, don't go another further. You can't use a basal insulin as a bolus insulin. I know, sounds like a good idea...but it isn't fast enough, you end up stacking it and when your system's finished with the food feed...all that stuff you been stackin' comes back with a vengence.

 

If you're reading this before class...take notes when you get there. If you've already gone to class...whatcha' learn?

 

And what the heck are you eating that warrants all this extra insulin?

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aggie168

Hello Don, using a basel insulin to cover meal is never going to work. The "tail spin" low BG that you are getting is the insulin working after you already digested all your food (carbs). If diet, exercise and oral meds are not helping anymore, basel+bolus insulin is the way to go. It is the natural way to replace what your body can not produce enough on its own. How it happen to your body is old news. Look forward. For myself, I wish my doctor have introduce me to insulin early on. :)

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dkyle
Hold on there, Don, don't go another further. You can't use a basal insulin as a bolus insulin. I know, sounds like a good idea...but it isn't fast enough, you end up stacking it and when your system's finished with the food feed...all that stuff you been stackin' comes back with a vengence.

 

If you're reading this before class...take notes when you get there. If you've already gone to class...whatcha' learn?

 

And what the heck are you eating that warrants all this extra insulin?

 

Let me Clarify:

What i was trying to communicate is that I end up taking more lantus than i would like because i need enough in my system to cover the PP highs. I am not injecting before each meal like you would with a bolus

 

I eat about 200G of carbs a day, The reason for so much insulin is......... it takes that much???? Like i said my lowest reading is 62, and i have less than 10 readings in the last 3 months that are under 90 ( and a whole bunch that are over 200 )

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Subby

Not sure there is much to prepare for in terms of generally, you will hopefully have found that shots are no big deal in terms of doing them day to day. You would have gotten used to shots with the Lantus, it's just more of the same. There are various things to keep in mind but the nurse should cover it, like taking your bolus in a separate body area to your basal. I recommend you learn how to carb count and use an insulin to carb ratio, also a correction factor. These need to be nutted out, hopefully with a health professional, but not all are savvy to this. There are also books to guide you through that method of using bolus insulin. What is particularly good about it, is you can easily change what you eat as you wish, whether adjusting your diet overall, or at the time, and still get a suitable dose. On set doses you get stuck eating the same amounts of carbs day in and day out.

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foxl

I actually got bolus insulin, by pointing out to my Endo that I was trying to cover carbs with basal ... it does not work and you can end up with nighttime hypos.

 

If you read Think Like a Pancreas, it outlines segmented basal testing; your basal regimen should keep you flat 24 hr per day, without any carb input. Then you use bolus to cover carbs.

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groovydb

My endo told me I would probably have to move on to bolus very shortly. I have been doing o.k. with Lantus and Metformin for quite a while now. I had assumed when I started to bolus, I wouldn't have to use the Lantus anymore, but, that seems to be wrong??? Good grief, I am not looking forward to my next endo appt now....

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