Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and diabetic > > complications are rare in diabetics with an A1C reading > > of 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of insulin > > reactions? If my blood sugar is, say, 8 two hours after a meal, at the > > next > > meal it will usually be between 5 and 6. If it were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target two > > hours > > after meals ... Humalog continues to work for three or four hours after > > it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist in > > 1992, > > so there are better tools today than there were then. When I was first > > diagnosed in 1991 I took Regular and NPH for the first five or six years, > > and the Humalog and Lantus combination has given me a lot more control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve > > it more I will go from there. I only know one person (type 1) who had an > > A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for about two > > months now so anticipate things to get much better still over the next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and diabetic > > complications are rare in diabetics with an A1C reading > > of 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of insulin > > reactions? If my blood sugar is, say, 8 two hours after a meal, at the > > next > > meal it will usually be between 5 and 6. If it were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target two > > hours > > after meals ... Humalog continues to work for three or four hours after > > it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist in > > 1992, > > so there are better tools today than there were then. When I was first > > diagnosed in 1991 I took Regular and NPH for the first five or six years, > > and the Humalog and Lantus combination has given me a lot more control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve > > it more I will go from there. I only know one person (type 1) who had an > > A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for about two > > months now so anticipate things to get much better still over the next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and diabetic > > complications are rare in diabetics with an A1C reading > > of 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of insulin > > reactions? If my blood sugar is, say, 8 two hours after a meal, at the > > next > > meal it will usually be between 5 and 6. If it were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target two > > hours > > after meals ... Humalog continues to work for three or four hours after > > it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist in > > 1992, > > so there are better tools today than there were then. When I was first > > diagnosed in 1991 I took Regular and NPH for the first five or six years, > > and the Humalog and Lantus combination has given me a lot more control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve > > it more I will go from there. I only know one person (type 1) who had an > > A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for about two > > months now so anticipate things to get much better still over the next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 I agree with you that a lot of factors affect the diabetic. While it is very true the factors you mentioned can have a tremendous effect on the diabetic, I still like to stick to bhe basics of medications, diet and activity level, which probably accounts for more than 90% of the diabetic's blood sugar level most of the dtime. Re: Normal range >> >> >> > Hi Harry, >> > >> > " If you have a two hour post prandial target of between 5.0 and 5.5 > moles, >> > and you also maintain it, your bs will run at 5.5 or lower, and >> > diabetic >> > complications are rare in diabetics with an A1C reading >> > of 5.5 and lower. " >> > >> > Wouldn't this low a target two hours after meals cause lots of insulin >> > reactions? If my blood sugar is, say, 8 two hours after a meal, at the >> > next >> > meal it will usually be between 5 and 6. If it were 5, it would be > between >> > 2 >> > and 3 by the next meal, which is way too low. Is this drop not supposed > to >> > happen? I thought that was the reasoning behind the 7 to 9 target two >> > hours >> > after meals ... Humalog continues to work for three or four hours after >> > it's >> > injected, even though it peaks at about two hours, so I assumed the >> > drop >> > was >> > normal. If a drop like this isn't supposed to happen two hours after a >> > meal, >> > would the culprit be Humalog or Lantus, or a combination of both? >> > >> > I may also be wrong here, but in the DCCT (Diabetes Control and >> > Complications Trial) that was published in 1992, they found that below > an >> > HbA1c level of about 6.5% there was no significant reduction in the > risks >> > for diabetes complications. Granted Humalog and Lantus didn't exist in >> > 1992, >> > so there are better tools today than there were then. When I was first >> > diagnosed in 1991 I took Regular and NPH for the first five or six > years, >> > and the Humalog and Lantus combination has given me a lot more control > and >> > a >> > lot more flexibility than I had back then. (Ironically, back then my > A1c's >> > ran consistently around 6.5% compared to the past few years when it's > ran >> > consistently around 9%!) >> > >> > At this point my goal is to get an A1c below 6.5% and then if I can >> > improve >> > it more I will go from there. I only know one person (type 1) who had >> > an >> > A1c >> > of 5% and she said she had way too many insulin reactions, so now hers > is >> > around 5.5% I believe. I suppose anything closer to normal can't be a > bad >> > thing if it doesn't have negative effects (such as hypos). >> > >> > Anyway thanks for the encouragement. I've been working at it for about > two >> > months now so anticipate things to get much better still over the next > few >> > months. I'm finding this list very informative so far. >> > >> > Jen >> > >> > >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 I agree with you that a lot of factors affect the diabetic. While it is very true the factors you mentioned can have a tremendous effect on the diabetic, I still like to stick to bhe basics of medications, diet and activity level, which probably accounts for more than 90% of the diabetic's blood sugar level most of the dtime. Re: Normal range >> >> >> > Hi Harry, >> > >> > " If you have a two hour post prandial target of between 5.0 and 5.5 > moles, >> > and you also maintain it, your bs will run at 5.5 or lower, and >> > diabetic >> > complications are rare in diabetics with an A1C reading >> > of 5.5 and lower. " >> > >> > Wouldn't this low a target two hours after meals cause lots of insulin >> > reactions? If my blood sugar is, say, 8 two hours after a meal, at the >> > next >> > meal it will usually be between 5 and 6. If it were 5, it would be > between >> > 2 >> > and 3 by the next meal, which is way too low. Is this drop not supposed > to >> > happen? I thought that was the reasoning behind the 7 to 9 target two >> > hours >> > after meals ... Humalog continues to work for three or four hours after >> > it's >> > injected, even though it peaks at about two hours, so I assumed the >> > drop >> > was >> > normal. If a drop like this isn't supposed to happen two hours after a >> > meal, >> > would the culprit be Humalog or Lantus, or a combination of both? >> > >> > I may also be wrong here, but in the DCCT (Diabetes Control and >> > Complications Trial) that was published in 1992, they found that below > an >> > HbA1c level of about 6.5% there was no significant reduction in the > risks >> > for diabetes complications. Granted Humalog and Lantus didn't exist in >> > 1992, >> > so there are better tools today than there were then. When I was first >> > diagnosed in 1991 I took Regular and NPH for the first five or six > years, >> > and the Humalog and Lantus combination has given me a lot more control > and >> > a >> > lot more flexibility than I had back then. (Ironically, back then my > A1c's >> > ran consistently around 6.5% compared to the past few years when it's > ran >> > consistently around 9%!) >> > >> > At this point my goal is to get an A1c below 6.5% and then if I can >> > improve >> > it more I will go from there. I only know one person (type 1) who had >> > an >> > A1c >> > of 5% and she said she had way too many insulin reactions, so now hers > is >> > around 5.5% I believe. I suppose anything closer to normal can't be a > bad >> > thing if it doesn't have negative effects (such as hypos). >> > >> > Anyway thanks for the encouragement. I've been working at it for about > two >> > months now so anticipate things to get much better still over the next > few >> > months. I'm finding this list very informative so far. >> > >> > Jen >> > >> > >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 There are many facators that affect diabetes. I have come up with an achronym that affects the management of diabetes. DREAM is the achronym, which means: diet, routine, exercise, attitude and medication. Most all management comes under one of those titles. I figure that diabetes does not have to be a nightmare-but can be a dream come true if you get all these things under control Re: Normal range If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and diabetic > > complications are rare in diabetics with an A1C reading > > of 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of insulin > > reactions? If my blood sugar is, say, 8 two hours after a meal, at the > > next > > meal it will usually be between 5 and 6. If it were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target two > > hours > > after meals ... Humalog continues to work for three or four hours after > > it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist in > > 1992, > > so there are better tools today than there were then. When I was first > > diagnosed in 1991 I took Regular and NPH for the first five or six years, > > and the Humalog and Lantus combination has given me a lot more control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve > > it more I will go from there. I only know one person (type 1) who had an > > A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for about two > > months now so anticipate things to get much better still over the next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 There are many facators that affect diabetes. I have come up with an achronym that affects the management of diabetes. DREAM is the achronym, which means: diet, routine, exercise, attitude and medication. Most all management comes under one of those titles. I figure that diabetes does not have to be a nightmare-but can be a dream come true if you get all these things under control Re: Normal range If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and diabetic > > complications are rare in diabetics with an A1C reading > > of 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of insulin > > reactions? If my blood sugar is, say, 8 two hours after a meal, at the > > next > > meal it will usually be between 5 and 6. If it were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target two > > hours > > after meals ... Humalog continues to work for three or four hours after > > it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist in > > 1992, > > so there are better tools today than there were then. When I was first > > diagnosed in 1991 I took Regular and NPH for the first five or six years, > > and the Humalog and Lantus combination has given me a lot more control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve > > it more I will go from there. I only know one person (type 1) who had an > > A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for about two > > months now so anticipate things to get much better still over the next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 There are many facators that affect diabetes. I have come up with an achronym that affects the management of diabetes. DREAM is the achronym, which means: diet, routine, exercise, attitude and medication. Most all management comes under one of those titles. I figure that diabetes does not have to be a nightmare-but can be a dream come true if you get all these things under control Re: Normal range If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and diabetic > > complications are rare in diabetics with an A1C reading > > of 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of insulin > > reactions? If my blood sugar is, say, 8 two hours after a meal, at the > > next > > meal it will usually be between 5 and 6. If it were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target two > > hours > > after meals ... Humalog continues to work for three or four hours after > > it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist in > > 1992, > > so there are better tools today than there were then. When I was first > > diagnosed in 1991 I took Regular and NPH for the first five or six years, > > and the Humalog and Lantus combination has given me a lot more control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve > > it more I will go from there. I only know one person (type 1) who had an > > A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for about two > > months now so anticipate things to get much better still over the next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 My dose of Lantus at night drops my bs by 40 or more points for my fasting bs in the morning. This would probably be the case if I had a bedtime bs of 99, and this would put me into a hypo reaction. In mole measurements we are talking about a drop of more than 2.0 moles during the night while I sleep. I prefer to be conservative when it comes to things like medications and diet and exercise. When it comes to dosing Lantus at night, I would recommend doing it with the bs at the top of the normal range and preferrably slightly above the normal range, say a bs mole reading of 7.0-7.5. In the beginning of dosing Lantus I would even recommend a bs reading of 8.0 or 8.5 moles at night when dosing Lantus, then in the morning take a fasting bs level to see how many points drop the dose of Lantus caused during the night while I slept. Since I have a high insulin resistance level, I prefer to have low carb consumption and dose Humalog accordingly. Insulin is not a good hormone to keep flooding the body with. It can cause the CRP to be elevated indicating inflamation in the veins and arteries, so I like to keep the insulin levels as low as I can. I eat just about anything I can, but definitely avoid high carb foods. I am a carb counter, so my diet is composed of those items that make up a low carb diet of my choosing. Re: Normal range > My bedtime snack now is actually smaller than the one I ate when I was > on NPH. I do think my Lantus will end up at a lower dose than I am > taking now. I'm just glad I'm not having anymore hypos in the middle > of the night. Luckily I always wake up for them, but waking up at 2.1 > or so isn't fun. My morning readings were also all over the place with > NPH with no rhyme nor reason to them. When I was on NPH I also went > low a lot if I tried skipping a snack or eating a late meal, so > overall the past month with Lantus has been a lot more stable even if > it's not the correct dose yet. When I switched from Regular to Humalog > in 1996 or '97 the same thing happened with weird readings for the > first month or two until the dose was right. As long as I am not > having serious lows I'm going to cut back slowly a unit or two every > couple of days so I can find exactly what a good dose is. > > With Lantus is the ultimate goal to be able to go to bed at say 5.4 > and wake up with something like 5.5, without a snack? Some people I > know eat bedtime snacks and some do not, my doctor said that I should > for at least the first while until I know exactly how it affects me > overnight. > > Are you on a low-carb diet? Do you take insulin (Humalog/NovoLog) at > meals when they are so few carbs? 15g carbs for me is usually > considered a snack, and I take 1 unit of Humalog to cover those if I > eat a snack like that. Most of my meals are 30-50g carbs, depending on > what I eat, and some are more if I eat out. > > Jen > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 My dose of Lantus at night drops my bs by 40 or more points for my fasting bs in the morning. This would probably be the case if I had a bedtime bs of 99, and this would put me into a hypo reaction. In mole measurements we are talking about a drop of more than 2.0 moles during the night while I sleep. I prefer to be conservative when it comes to things like medications and diet and exercise. When it comes to dosing Lantus at night, I would recommend doing it with the bs at the top of the normal range and preferrably slightly above the normal range, say a bs mole reading of 7.0-7.5. In the beginning of dosing Lantus I would even recommend a bs reading of 8.0 or 8.5 moles at night when dosing Lantus, then in the morning take a fasting bs level to see how many points drop the dose of Lantus caused during the night while I slept. Since I have a high insulin resistance level, I prefer to have low carb consumption and dose Humalog accordingly. Insulin is not a good hormone to keep flooding the body with. It can cause the CRP to be elevated indicating inflamation in the veins and arteries, so I like to keep the insulin levels as low as I can. I eat just about anything I can, but definitely avoid high carb foods. I am a carb counter, so my diet is composed of those items that make up a low carb diet of my choosing. Re: Normal range > My bedtime snack now is actually smaller than the one I ate when I was > on NPH. I do think my Lantus will end up at a lower dose than I am > taking now. I'm just glad I'm not having anymore hypos in the middle > of the night. Luckily I always wake up for them, but waking up at 2.1 > or so isn't fun. My morning readings were also all over the place with > NPH with no rhyme nor reason to them. When I was on NPH I also went > low a lot if I tried skipping a snack or eating a late meal, so > overall the past month with Lantus has been a lot more stable even if > it's not the correct dose yet. When I switched from Regular to Humalog > in 1996 or '97 the same thing happened with weird readings for the > first month or two until the dose was right. As long as I am not > having serious lows I'm going to cut back slowly a unit or two every > couple of days so I can find exactly what a good dose is. > > With Lantus is the ultimate goal to be able to go to bed at say 5.4 > and wake up with something like 5.5, without a snack? Some people I > know eat bedtime snacks and some do not, my doctor said that I should > for at least the first while until I know exactly how it affects me > overnight. > > Are you on a low-carb diet? Do you take insulin (Humalog/NovoLog) at > meals when they are so few carbs? 15g carbs for me is usually > considered a snack, and I take 1 unit of Humalog to cover those if I > eat a snack like that. Most of my meals are 30-50g carbs, depending on > what I eat, and some are more if I eat out. > > Jen > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 My dose of Lantus at night drops my bs by 40 or more points for my fasting bs in the morning. This would probably be the case if I had a bedtime bs of 99, and this would put me into a hypo reaction. In mole measurements we are talking about a drop of more than 2.0 moles during the night while I sleep. I prefer to be conservative when it comes to things like medications and diet and exercise. When it comes to dosing Lantus at night, I would recommend doing it with the bs at the top of the normal range and preferrably slightly above the normal range, say a bs mole reading of 7.0-7.5. In the beginning of dosing Lantus I would even recommend a bs reading of 8.0 or 8.5 moles at night when dosing Lantus, then in the morning take a fasting bs level to see how many points drop the dose of Lantus caused during the night while I slept. Since I have a high insulin resistance level, I prefer to have low carb consumption and dose Humalog accordingly. Insulin is not a good hormone to keep flooding the body with. It can cause the CRP to be elevated indicating inflamation in the veins and arteries, so I like to keep the insulin levels as low as I can. I eat just about anything I can, but definitely avoid high carb foods. I am a carb counter, so my diet is composed of those items that make up a low carb diet of my choosing. Re: Normal range > My bedtime snack now is actually smaller than the one I ate when I was > on NPH. I do think my Lantus will end up at a lower dose than I am > taking now. I'm just glad I'm not having anymore hypos in the middle > of the night. Luckily I always wake up for them, but waking up at 2.1 > or so isn't fun. My morning readings were also all over the place with > NPH with no rhyme nor reason to them. When I was on NPH I also went > low a lot if I tried skipping a snack or eating a late meal, so > overall the past month with Lantus has been a lot more stable even if > it's not the correct dose yet. When I switched from Regular to Humalog > in 1996 or '97 the same thing happened with weird readings for the > first month or two until the dose was right. As long as I am not > having serious lows I'm going to cut back slowly a unit or two every > couple of days so I can find exactly what a good dose is. > > With Lantus is the ultimate goal to be able to go to bed at say 5.4 > and wake up with something like 5.5, without a snack? Some people I > know eat bedtime snacks and some do not, my doctor said that I should > for at least the first while until I know exactly how it affects me > overnight. > > Are you on a low-carb diet? Do you take insulin (Humalog/NovoLog) at > meals when they are so few carbs? 15g carbs for me is usually > considered a snack, and I take 1 unit of Humalog to cover those if I > eat a snack like that. Most of my meals are 30-50g carbs, depending on > what I eat, and some are more if I eat out. > > Jen > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Hello, Mike Are you a type 2 or one of the rare type 1 diabetics who become type 1 when older? (that does occasionally happen.) Re: Normal range Harry: What you say makes sense. I have only one bone to pick with you -- that of your hoping people can stay " Type 2 " and not become insulin-dependent. As I've said on another list, what's the matter with being insulin-dependent? Almost every Type 2 I know who has switched from oral meds to insulin says he/she feels a thousand times better now that he/she is on insulin. I wouldn't know in that I am that rarity of Type 2's -- one who had a normal fasting glucose and A1C level last summer (not even pre-diabetic) (2004) and landed in the hospital with HHNS in March. NO oral meds for me; I was placed immediately on insulin and, like all the others I know, feel a thousand times better than I did in February. Mike Freeman > In August of 2003 I came back to this list serve after several years of > absence. I came back because I was desperate. My A1C was 9.2, and I felt > like I was dieing. My doctor was ignorant about the treatment of diabetics, > since four months before August I had an A1C of 7.2, but he said I was doing > okay, and I just took his word for it. That was a big mistake. The folks > here got me on the right path, and I have stayed on it pretty much since > August of 2003, and in a four month span of time I brought that 9.2 down to > less than 6.0. Most type 2 diabetics in the past usually become insulin > dependent in 10 to 15 years after being initially diagnosed as being a type > 2 diabetic. In my case my pancrease finally played out after 16 years after > I was diagnosed as a type 2 diabetic. I was using the oral medication of > Diabeta or the generic name is glyburide. It is an oral medication that > stimulates the pancrease to produce insulin. Well, after 16 years of using > this oral med, the pancrease just finally played out. I do not know the > longevity of type 2 diabetics lasting with the newer oral medications like > metformin, glucotrol, starlix and the like, since they have a different > action on the body, but I hope type 2 diabetics can remain a lot longer > period of time as a type 2 diabetic rather than becoming insulin dependent, > as I am today. > > If you are a type 1 diabetic starting off at 24 units of Lantus, I would > think this is a very dangerous dose for any type 1 to start out with. One > unit of Lantus can account for any where to up to a 50 point drop in the bs > for a single unit of Lantus. For a type 1 diabetic it would be much safer, > I think, for the diabetic to start at the recommended dose of 5 units and > work upwards instead of working downwards, but the doctor is God, you know, > and we cannot doubt his word, can we? When it comes to dosing short-acting > insulin like Humalog and Novalog, it is recommended to start out for a type > 1 diabetic at a dose of 1 unit per 15 grams of carbs consumed and work > upward to the proper dose, but only the doctor knows for sure <grin>. > Re: Normal range > > >> Hi Harry, >> >> Right now I take 21 units of Lantus at night, but as I said that will >> probably go down to 19 or 20 soon if my blood sugar keeps dropping >> overnight. I just started on Lantus about a month ago so am still >> fine-tuning the dose. When I started on Lantus my endocrinologist gave me >> 24 >> units because he said that's what he'd give a newly-diagnosed diabetic and >> there was no formula he knew of for transitioning from NPH to Lantus, so >> he >> said to just keep decreasing it until we've found what I need. >> >> Overall my TDD (total daily dose, short- and long-acting together) of >> insulin has been decreasing dramatically as I get in control again. It's >> gone from being about 85+ units a day six months ago to being 40 units >> (and >> dropping) right now. >> >> I am curious, if you are type 2 and take insulin, does that mean your beta >> cells are no longer able to produce it? Does it make you >> insulin-dependent, >> like a type 1? >> >> Jen >> >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Hello, Mike Are you a type 2 or one of the rare type 1 diabetics who become type 1 when older? (that does occasionally happen.) Re: Normal range Harry: What you say makes sense. I have only one bone to pick with you -- that of your hoping people can stay " Type 2 " and not become insulin-dependent. As I've said on another list, what's the matter with being insulin-dependent? Almost every Type 2 I know who has switched from oral meds to insulin says he/she feels a thousand times better now that he/she is on insulin. I wouldn't know in that I am that rarity of Type 2's -- one who had a normal fasting glucose and A1C level last summer (not even pre-diabetic) (2004) and landed in the hospital with HHNS in March. NO oral meds for me; I was placed immediately on insulin and, like all the others I know, feel a thousand times better than I did in February. Mike Freeman > In August of 2003 I came back to this list serve after several years of > absence. I came back because I was desperate. My A1C was 9.2, and I felt > like I was dieing. My doctor was ignorant about the treatment of diabetics, > since four months before August I had an A1C of 7.2, but he said I was doing > okay, and I just took his word for it. That was a big mistake. The folks > here got me on the right path, and I have stayed on it pretty much since > August of 2003, and in a four month span of time I brought that 9.2 down to > less than 6.0. Most type 2 diabetics in the past usually become insulin > dependent in 10 to 15 years after being initially diagnosed as being a type > 2 diabetic. In my case my pancrease finally played out after 16 years after > I was diagnosed as a type 2 diabetic. I was using the oral medication of > Diabeta or the generic name is glyburide. It is an oral medication that > stimulates the pancrease to produce insulin. Well, after 16 years of using > this oral med, the pancrease just finally played out. I do not know the > longevity of type 2 diabetics lasting with the newer oral medications like > metformin, glucotrol, starlix and the like, since they have a different > action on the body, but I hope type 2 diabetics can remain a lot longer > period of time as a type 2 diabetic rather than becoming insulin dependent, > as I am today. > > If you are a type 1 diabetic starting off at 24 units of Lantus, I would > think this is a very dangerous dose for any type 1 to start out with. One > unit of Lantus can account for any where to up to a 50 point drop in the bs > for a single unit of Lantus. For a type 1 diabetic it would be much safer, > I think, for the diabetic to start at the recommended dose of 5 units and > work upwards instead of working downwards, but the doctor is God, you know, > and we cannot doubt his word, can we? When it comes to dosing short-acting > insulin like Humalog and Novalog, it is recommended to start out for a type > 1 diabetic at a dose of 1 unit per 15 grams of carbs consumed and work > upward to the proper dose, but only the doctor knows for sure <grin>. > Re: Normal range > > >> Hi Harry, >> >> Right now I take 21 units of Lantus at night, but as I said that will >> probably go down to 19 or 20 soon if my blood sugar keeps dropping >> overnight. I just started on Lantus about a month ago so am still >> fine-tuning the dose. When I started on Lantus my endocrinologist gave me >> 24 >> units because he said that's what he'd give a newly-diagnosed diabetic and >> there was no formula he knew of for transitioning from NPH to Lantus, so >> he >> said to just keep decreasing it until we've found what I need. >> >> Overall my TDD (total daily dose, short- and long-acting together) of >> insulin has been decreasing dramatically as I get in control again. It's >> gone from being about 85+ units a day six months ago to being 40 units >> (and >> dropping) right now. >> >> I am curious, if you are type 2 and take insulin, does that mean your beta >> cells are no longer able to produce it? Does it make you >> insulin-dependent, >> like a type 1? >> >> Jen >> >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Hi Pat and Aussie , In keeping with this thought, Crystal has had a truly awful time the past couple of days with her sugar readings. They have gone through the roof. The problem, I believe, is a stomach virus which has left her not wanting to be very far from a facility. (well, on the bright side, she has not wanted to do a lot of shopping) Anyway, when you mentioned " other factors " you were so correct. Although Crystal has done a good job of counting those carburetors some things were simply out of her control. Additionally, the hormones were entering their usual monthly visit and this also has an effect on her sugar reading. By testing the readings we were able to determine what actually needed to happen rather than guessing at it. Pat, I like the " DREAM " acronym. Cy, the Ancient Okie... Re: Normal range If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and > > diabetic complications are rare in diabetics with an A1C reading of > > 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of > > insulin reactions? If my blood sugar is, say, 8 two hours after a > > meal, at the next meal it will usually be between 5 and 6. If it > > were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not > > supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target > > two hours after meals ... Humalog continues to work for three or > > four hours after it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that > > below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist > > in 1992, so there are better tools today than there were then. When > > I was first diagnosed in 1991 I took Regular and NPH for the first > > five or six years, > > and the Humalog and Lantus combination has given me a lot more > > control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when > > it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve it more I will go from there. I only know one person (type > > 1) who had an A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be > > a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for > > about two > > months now so anticipate things to get much better still over the > > next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Hi Pat and Aussie , In keeping with this thought, Crystal has had a truly awful time the past couple of days with her sugar readings. They have gone through the roof. The problem, I believe, is a stomach virus which has left her not wanting to be very far from a facility. (well, on the bright side, she has not wanted to do a lot of shopping) Anyway, when you mentioned " other factors " you were so correct. Although Crystal has done a good job of counting those carburetors some things were simply out of her control. Additionally, the hormones were entering their usual monthly visit and this also has an effect on her sugar reading. By testing the readings we were able to determine what actually needed to happen rather than guessing at it. Pat, I like the " DREAM " acronym. Cy, the Ancient Okie... Re: Normal range If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and > > diabetic complications are rare in diabetics with an A1C reading of > > 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of > > insulin reactions? If my blood sugar is, say, 8 two hours after a > > meal, at the next meal it will usually be between 5 and 6. If it > > were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not > > supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target > > two hours after meals ... Humalog continues to work for three or > > four hours after it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that > > below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist > > in 1992, so there are better tools today than there were then. When > > I was first diagnosed in 1991 I took Regular and NPH for the first > > five or six years, > > and the Humalog and Lantus combination has given me a lot more > > control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when > > it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve it more I will go from there. I only know one person (type > > 1) who had an A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be > > a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for > > about two > > months now so anticipate things to get much better still over the > > next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Hi Pat and Aussie , In keeping with this thought, Crystal has had a truly awful time the past couple of days with her sugar readings. They have gone through the roof. The problem, I believe, is a stomach virus which has left her not wanting to be very far from a facility. (well, on the bright side, she has not wanted to do a lot of shopping) Anyway, when you mentioned " other factors " you were so correct. Although Crystal has done a good job of counting those carburetors some things were simply out of her control. Additionally, the hormones were entering their usual monthly visit and this also has an effect on her sugar reading. By testing the readings we were able to determine what actually needed to happen rather than guessing at it. Pat, I like the " DREAM " acronym. Cy, the Ancient Okie... Re: Normal range If only it was easy as taking the correct amount of insulin, watching what you eat and doing exercise. There are so many other factors than those three I've listed above that can effect your blood sugar levels. Infection, stress, depression, ones attitude towards there diabetes, other health problems, coeliac for example, hormones, home life and so on. from down under from down under Re: Normal range > > > > Hi Harry, > > > > " If you have a two hour post prandial target of between 5.0 and 5.5 moles, > > and you also maintain it, your bs will run at 5.5 or lower, and > > diabetic complications are rare in diabetics with an A1C reading of > > 5.5 and lower. " > > > > Wouldn't this low a target two hours after meals cause lots of > > insulin reactions? If my blood sugar is, say, 8 two hours after a > > meal, at the next meal it will usually be between 5 and 6. If it > > were 5, it would be between > > 2 > > and 3 by the next meal, which is way too low. Is this drop not > > supposed to > > happen? I thought that was the reasoning behind the 7 to 9 target > > two hours after meals ... Humalog continues to work for three or > > four hours after it's > > injected, even though it peaks at about two hours, so I assumed the drop > > was > > normal. If a drop like this isn't supposed to happen two hours after a > > meal, > > would the culprit be Humalog or Lantus, or a combination of both? > > > > I may also be wrong here, but in the DCCT (Diabetes Control and > > Complications Trial) that was published in 1992, they found that > > below an > > HbA1c level of about 6.5% there was no significant reduction in the risks > > for diabetes complications. Granted Humalog and Lantus didn't exist > > in 1992, so there are better tools today than there were then. When > > I was first diagnosed in 1991 I took Regular and NPH for the first > > five or six years, > > and the Humalog and Lantus combination has given me a lot more > > control and > > a > > lot more flexibility than I had back then. (Ironically, back then my A1c's > > ran consistently around 6.5% compared to the past few years when > > it's ran > > consistently around 9%!) > > > > At this point my goal is to get an A1c below 6.5% and then if I can > > improve it more I will go from there. I only know one person (type > > 1) who had an A1c > > of 5% and she said she had way too many insulin reactions, so now hers is > > around 5.5% I believe. I suppose anything closer to normal can't be > > a bad > > thing if it doesn't have negative effects (such as hypos). > > > > Anyway thanks for the encouragement. I've been working at it for > > about two > > months now so anticipate things to get much better still over the > > next few > > months. I'm finding this list very informative so far. > > > > Jen > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 If it makes any sense, I'm not absolutely certain. I have plenty of the risk factors for Type 2, i.e., high blood pressure, elevated LDL cholesterol, a BMI beyond 25 or 27 and a bit extra adipos fat (although I don't have the tremendous beer gut increasingly seen these days). And the fact that I didn't go into ketoacidosis until just before my crisis in March would indicate Type 2. On the other hand, tests indicated that I was normal last summer and my system just went kerblooey this spring. That would indicate late onset Type 1. I've never put the question directly to my medical team as it didn't seem all that relevant except for academic interest in that, as Harry says, I wouldn't have been placed on insulin permanently unless my pancreas had given up the ghost, effectively putting me in the same class as a Type 1. I suppose that were I a brave, foolish man, I could stop insulin and if I went into DKA almost immediately, I could say with some conclusiveness that I was a late-onset Type 1. But even that might be all that definitive. Besides, I'm not that brave/foolish! (grin) So I'm either late onset Type 1 or a somewhat anomalous Type 2 in that one usually doesn't see total collapse of the system with a Type 2 as apparently happened with me. Believe me; it was disconcerting, to say the least. Incidentally, my cholesterol, BP and triglycerides are well in the normal range; my BP was 120/70 the other day. clear as mud, huh? Mike > Hello, Mike > Are you a type 2 or one of the rare type 1 diabetics who become type 1 when > older? (that does occasionally happen.) > > Re: Normal range > > Harry: > > What you say makes sense. I have only one bone to pick with you -- that > of your hoping people can stay " Type 2 " and not become > insulin-dependent. > > As I've said on another list, what's the matter with being > insulin-dependent? Almost every Type 2 I know who has switched from oral > meds to insulin says he/she feels a thousand times better now that > he/she is on insulin. I wouldn't know in that I am that rarity of Type > 2's -- one who had a normal fasting glucose and A1C level last summer > (not even pre-diabetic) (2004) and landed in the hospital with HHNS in > March. NO oral meds for me; I was placed immediately on insulin and, > like all the others I know, feel a thousand times better than I did in > February. > > Mike Freeman > > > >> In August of 2003 I came back to this list serve after several years of >> absence. I came back because I was desperate. My A1C was 9.2, and I felt >> like I was dieing. My doctor was ignorant about the treatment of > diabetics, >> since four months before August I had an A1C of 7.2, but he said I was > doing >> okay, and I just took his word for it. That was a big mistake. The folks >> here got me on the right path, and I have stayed on it pretty much since >> August of 2003, and in a four month span of time I brought that 9.2 down > to >> less than 6.0. Most type 2 diabetics in the past usually become insulin >> dependent in 10 to 15 years after being initially diagnosed as being a > type >> 2 diabetic. In my case my pancrease finally played out after 16 years > after >> I was diagnosed as a type 2 diabetic. I was using the oral medication of >> Diabeta or the generic name is glyburide. It is an oral medication that >> stimulates the pancrease to produce insulin. Well, after 16 years of > using >> this oral med, the pancrease just finally played out. I do not know the >> longevity of type 2 diabetics lasting with the newer oral medications like >> metformin, glucotrol, starlix and the like, since they have a different >> action on the body, but I hope type 2 diabetics can remain a lot longer >> period of time as a type 2 diabetic rather than becoming insulin > dependent, >> as I am today. >> >> If you are a type 1 diabetic starting off at 24 units of Lantus, I would >> think this is a very dangerous dose for any type 1 to start out with. One >> unit of Lantus can account for any where to up to a 50 point drop in the > bs >> for a single unit of Lantus. For a type 1 diabetic it would be much > safer, >> I think, for the diabetic to start at the recommended dose of 5 units and >> work upwards instead of working downwards, but the doctor is God, you > know, >> and we cannot doubt his word, can we? When it comes to dosing > short-acting >> insulin like Humalog and Novalog, it is recommended to start out for a > type >> 1 diabetic at a dose of 1 unit per 15 grams of carbs consumed and work >> upward to the proper dose, but only the doctor knows for sure <grin>. >> Re: Normal range >> >> >>> Hi Harry, >>> >>> Right now I take 21 units of Lantus at night, but as I said that will >>> probably go down to 19 or 20 soon if my blood sugar keeps dropping >>> overnight. I just started on Lantus about a month ago so am still >>> fine-tuning the dose. When I started on Lantus my endocrinologist gave me >>> 24 >>> units because he said that's what he'd give a newly-diagnosed diabetic > and >>> there was no formula he knew of for transitioning from NPH to Lantus, so >>> he >>> said to just keep decreasing it until we've found what I need. >>> >>> Overall my TDD (total daily dose, short- and long-acting together) of >>> insulin has been decreasing dramatically as I get in control again. It's >>> gone from being about 85+ units a day six months ago to being 40 units >>> (and >>> dropping) right now. >>> >>> I am curious, if you are type 2 and take insulin, does that mean your > beta >>> cells are no longer able to produce it? Does it make you >>> insulin-dependent, >>> like a type 1? >>> >>> Jen >>> >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 If it makes any sense, I'm not absolutely certain. I have plenty of the risk factors for Type 2, i.e., high blood pressure, elevated LDL cholesterol, a BMI beyond 25 or 27 and a bit extra adipos fat (although I don't have the tremendous beer gut increasingly seen these days). And the fact that I didn't go into ketoacidosis until just before my crisis in March would indicate Type 2. On the other hand, tests indicated that I was normal last summer and my system just went kerblooey this spring. That would indicate late onset Type 1. I've never put the question directly to my medical team as it didn't seem all that relevant except for academic interest in that, as Harry says, I wouldn't have been placed on insulin permanently unless my pancreas had given up the ghost, effectively putting me in the same class as a Type 1. I suppose that were I a brave, foolish man, I could stop insulin and if I went into DKA almost immediately, I could say with some conclusiveness that I was a late-onset Type 1. But even that might be all that definitive. Besides, I'm not that brave/foolish! (grin) So I'm either late onset Type 1 or a somewhat anomalous Type 2 in that one usually doesn't see total collapse of the system with a Type 2 as apparently happened with me. Believe me; it was disconcerting, to say the least. Incidentally, my cholesterol, BP and triglycerides are well in the normal range; my BP was 120/70 the other day. clear as mud, huh? Mike > Hello, Mike > Are you a type 2 or one of the rare type 1 diabetics who become type 1 when > older? (that does occasionally happen.) > > Re: Normal range > > Harry: > > What you say makes sense. I have only one bone to pick with you -- that > of your hoping people can stay " Type 2 " and not become > insulin-dependent. > > As I've said on another list, what's the matter with being > insulin-dependent? Almost every Type 2 I know who has switched from oral > meds to insulin says he/she feels a thousand times better now that > he/she is on insulin. I wouldn't know in that I am that rarity of Type > 2's -- one who had a normal fasting glucose and A1C level last summer > (not even pre-diabetic) (2004) and landed in the hospital with HHNS in > March. NO oral meds for me; I was placed immediately on insulin and, > like all the others I know, feel a thousand times better than I did in > February. > > Mike Freeman > > > >> In August of 2003 I came back to this list serve after several years of >> absence. I came back because I was desperate. My A1C was 9.2, and I felt >> like I was dieing. My doctor was ignorant about the treatment of > diabetics, >> since four months before August I had an A1C of 7.2, but he said I was > doing >> okay, and I just took his word for it. That was a big mistake. The folks >> here got me on the right path, and I have stayed on it pretty much since >> August of 2003, and in a four month span of time I brought that 9.2 down > to >> less than 6.0. Most type 2 diabetics in the past usually become insulin >> dependent in 10 to 15 years after being initially diagnosed as being a > type >> 2 diabetic. In my case my pancrease finally played out after 16 years > after >> I was diagnosed as a type 2 diabetic. I was using the oral medication of >> Diabeta or the generic name is glyburide. It is an oral medication that >> stimulates the pancrease to produce insulin. Well, after 16 years of > using >> this oral med, the pancrease just finally played out. I do not know the >> longevity of type 2 diabetics lasting with the newer oral medications like >> metformin, glucotrol, starlix and the like, since they have a different >> action on the body, but I hope type 2 diabetics can remain a lot longer >> period of time as a type 2 diabetic rather than becoming insulin > dependent, >> as I am today. >> >> If you are a type 1 diabetic starting off at 24 units of Lantus, I would >> think this is a very dangerous dose for any type 1 to start out with. One >> unit of Lantus can account for any where to up to a 50 point drop in the > bs >> for a single unit of Lantus. For a type 1 diabetic it would be much > safer, >> I think, for the diabetic to start at the recommended dose of 5 units and >> work upwards instead of working downwards, but the doctor is God, you > know, >> and we cannot doubt his word, can we? When it comes to dosing > short-acting >> insulin like Humalog and Novalog, it is recommended to start out for a > type >> 1 diabetic at a dose of 1 unit per 15 grams of carbs consumed and work >> upward to the proper dose, but only the doctor knows for sure <grin>. >> Re: Normal range >> >> >>> Hi Harry, >>> >>> Right now I take 21 units of Lantus at night, but as I said that will >>> probably go down to 19 or 20 soon if my blood sugar keeps dropping >>> overnight. I just started on Lantus about a month ago so am still >>> fine-tuning the dose. When I started on Lantus my endocrinologist gave me >>> 24 >>> units because he said that's what he'd give a newly-diagnosed diabetic > and >>> there was no formula he knew of for transitioning from NPH to Lantus, so >>> he >>> said to just keep decreasing it until we've found what I need. >>> >>> Overall my TDD (total daily dose, short- and long-acting together) of >>> insulin has been decreasing dramatically as I get in control again. It's >>> gone from being about 85+ units a day six months ago to being 40 units >>> (and >>> dropping) right now. >>> >>> I am curious, if you are type 2 and take insulin, does that mean your > beta >>> cells are no longer able to produce it? Does it make you >>> insulin-dependent, >>> like a type 1? >>> >>> Jen >>> >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 If it makes any sense, I'm not absolutely certain. I have plenty of the risk factors for Type 2, i.e., high blood pressure, elevated LDL cholesterol, a BMI beyond 25 or 27 and a bit extra adipos fat (although I don't have the tremendous beer gut increasingly seen these days). And the fact that I didn't go into ketoacidosis until just before my crisis in March would indicate Type 2. On the other hand, tests indicated that I was normal last summer and my system just went kerblooey this spring. That would indicate late onset Type 1. I've never put the question directly to my medical team as it didn't seem all that relevant except for academic interest in that, as Harry says, I wouldn't have been placed on insulin permanently unless my pancreas had given up the ghost, effectively putting me in the same class as a Type 1. I suppose that were I a brave, foolish man, I could stop insulin and if I went into DKA almost immediately, I could say with some conclusiveness that I was a late-onset Type 1. But even that might be all that definitive. Besides, I'm not that brave/foolish! (grin) So I'm either late onset Type 1 or a somewhat anomalous Type 2 in that one usually doesn't see total collapse of the system with a Type 2 as apparently happened with me. Believe me; it was disconcerting, to say the least. Incidentally, my cholesterol, BP and triglycerides are well in the normal range; my BP was 120/70 the other day. clear as mud, huh? Mike > Hello, Mike > Are you a type 2 or one of the rare type 1 diabetics who become type 1 when > older? (that does occasionally happen.) > > Re: Normal range > > Harry: > > What you say makes sense. I have only one bone to pick with you -- that > of your hoping people can stay " Type 2 " and not become > insulin-dependent. > > As I've said on another list, what's the matter with being > insulin-dependent? Almost every Type 2 I know who has switched from oral > meds to insulin says he/she feels a thousand times better now that > he/she is on insulin. I wouldn't know in that I am that rarity of Type > 2's -- one who had a normal fasting glucose and A1C level last summer > (not even pre-diabetic) (2004) and landed in the hospital with HHNS in > March. NO oral meds for me; I was placed immediately on insulin and, > like all the others I know, feel a thousand times better than I did in > February. > > Mike Freeman > > > >> In August of 2003 I came back to this list serve after several years of >> absence. I came back because I was desperate. My A1C was 9.2, and I felt >> like I was dieing. My doctor was ignorant about the treatment of > diabetics, >> since four months before August I had an A1C of 7.2, but he said I was > doing >> okay, and I just took his word for it. That was a big mistake. The folks >> here got me on the right path, and I have stayed on it pretty much since >> August of 2003, and in a four month span of time I brought that 9.2 down > to >> less than 6.0. Most type 2 diabetics in the past usually become insulin >> dependent in 10 to 15 years after being initially diagnosed as being a > type >> 2 diabetic. In my case my pancrease finally played out after 16 years > after >> I was diagnosed as a type 2 diabetic. I was using the oral medication of >> Diabeta or the generic name is glyburide. It is an oral medication that >> stimulates the pancrease to produce insulin. Well, after 16 years of > using >> this oral med, the pancrease just finally played out. I do not know the >> longevity of type 2 diabetics lasting with the newer oral medications like >> metformin, glucotrol, starlix and the like, since they have a different >> action on the body, but I hope type 2 diabetics can remain a lot longer >> period of time as a type 2 diabetic rather than becoming insulin > dependent, >> as I am today. >> >> If you are a type 1 diabetic starting off at 24 units of Lantus, I would >> think this is a very dangerous dose for any type 1 to start out with. One >> unit of Lantus can account for any where to up to a 50 point drop in the > bs >> for a single unit of Lantus. For a type 1 diabetic it would be much > safer, >> I think, for the diabetic to start at the recommended dose of 5 units and >> work upwards instead of working downwards, but the doctor is God, you > know, >> and we cannot doubt his word, can we? When it comes to dosing > short-acting >> insulin like Humalog and Novalog, it is recommended to start out for a > type >> 1 diabetic at a dose of 1 unit per 15 grams of carbs consumed and work >> upward to the proper dose, but only the doctor knows for sure <grin>. >> Re: Normal range >> >> >>> Hi Harry, >>> >>> Right now I take 21 units of Lantus at night, but as I said that will >>> probably go down to 19 or 20 soon if my blood sugar keeps dropping >>> overnight. I just started on Lantus about a month ago so am still >>> fine-tuning the dose. When I started on Lantus my endocrinologist gave me >>> 24 >>> units because he said that's what he'd give a newly-diagnosed diabetic > and >>> there was no formula he knew of for transitioning from NPH to Lantus, so >>> he >>> said to just keep decreasing it until we've found what I need. >>> >>> Overall my TDD (total daily dose, short- and long-acting together) of >>> insulin has been decreasing dramatically as I get in control again. It's >>> gone from being about 85+ units a day six months ago to being 40 units >>> (and >>> dropping) right now. >>> >>> I am curious, if you are type 2 and take insulin, does that mean your > beta >>> cells are no longer able to produce it? Does it make you >>> insulin-dependent, >>> like a type 1? >>> >>> Jen >>> >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Yup; an illness definitely can send blood glucose readings into the stratosphere! Mike > Hi Pat and Aussie , > In keeping with this thought, Crystal has had a truly awful time the > past couple of days with her sugar readings. > They have gone through the roof. > The problem, I believe, is a stomach virus which has left her not > wanting to be very far from a facility. (well, on the bright side, she > has not wanted to do a lot of shopping) > Anyway, when you mentioned " other factors " you were so correct. > Although Crystal has done a good job of counting those carburetors some > things were simply out of her control. Additionally, the hormones were > entering their usual monthly visit and this also has an effect on her > sugar reading. > By testing the readings we were able to determine what actually needed > to happen rather than guessing at it. > Pat, I like the " DREAM " acronym. > Cy, the Ancient Okie... > > Re: Normal range > > If only it was easy as taking the correct amount of insulin, watching > what > you eat and doing exercise. There are so many other factors than > those > three I've listed above that can effect your blood sugar levels. > > Infection, stress, depression, ones attitude towards there diabetes, > other health problems, coeliac for example, hormones, home life and so > on. > > > from down under > > > from down under > > > Re: Normal range >> >> >>> Hi Harry, >>> >>> " If you have a two hour post prandial target of between 5.0 and 5.5 > moles, >>> and you also maintain it, your bs will run at 5.5 or lower, and >>> diabetic complications are rare in diabetics with an A1C reading of > >>> 5.5 and lower. " >>> >>> Wouldn't this low a target two hours after meals cause lots of >>> insulin reactions? If my blood sugar is, say, 8 two hours after a >>> meal, at the next meal it will usually be between 5 and 6. If it >>> were 5, it would be > between >>> 2 >>> and 3 by the next meal, which is way too low. Is this drop not >>> supposed > to >>> happen? I thought that was the reasoning behind the 7 to 9 target >>> two hours after meals ... Humalog continues to work for three or >>> four hours after it's >>> injected, even though it peaks at about two hours, so I assumed the > drop >>> was >>> normal. If a drop like this isn't supposed to happen two hours after > a >>> meal, >>> would the culprit be Humalog or Lantus, or a combination of both? >>> >>> I may also be wrong here, but in the DCCT (Diabetes Control and >>> Complications Trial) that was published in 1992, they found that >>> below > an >>> HbA1c level of about 6.5% there was no significant reduction in the > risks >>> for diabetes complications. Granted Humalog and Lantus didn't exist >>> in 1992, so there are better tools today than there were then. When >>> I was first diagnosed in 1991 I took Regular and NPH for the first >>> five or six > years, >>> and the Humalog and Lantus combination has given me a lot more >>> control > and >>> a >>> lot more flexibility than I had back then. (Ironically, back then my > A1c's >>> ran consistently around 6.5% compared to the past few years when >>> it's > ran >>> consistently around 9%!) >>> >>> At this point my goal is to get an A1c below 6.5% and then if I can >>> improve it more I will go from there. I only know one person (type >>> 1) who had an A1c >>> of 5% and she said she had way too many insulin reactions, so now > hers > is >>> around 5.5% I believe. I suppose anything closer to normal can't be >>> a > bad >>> thing if it doesn't have negative effects (such as hypos). >>> >>> Anyway thanks for the encouragement. I've been working at it for >>> about > two >>> months now so anticipate things to get much better still over the >>> next > few >>> months. I'm finding this list very informative so far. >>> >>> Jen >>> >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Yup; an illness definitely can send blood glucose readings into the stratosphere! Mike > Hi Pat and Aussie , > In keeping with this thought, Crystal has had a truly awful time the > past couple of days with her sugar readings. > They have gone through the roof. > The problem, I believe, is a stomach virus which has left her not > wanting to be very far from a facility. (well, on the bright side, she > has not wanted to do a lot of shopping) > Anyway, when you mentioned " other factors " you were so correct. > Although Crystal has done a good job of counting those carburetors some > things were simply out of her control. Additionally, the hormones were > entering their usual monthly visit and this also has an effect on her > sugar reading. > By testing the readings we were able to determine what actually needed > to happen rather than guessing at it. > Pat, I like the " DREAM " acronym. > Cy, the Ancient Okie... > > Re: Normal range > > If only it was easy as taking the correct amount of insulin, watching > what > you eat and doing exercise. There are so many other factors than > those > three I've listed above that can effect your blood sugar levels. > > Infection, stress, depression, ones attitude towards there diabetes, > other health problems, coeliac for example, hormones, home life and so > on. > > > from down under > > > from down under > > > Re: Normal range >> >> >>> Hi Harry, >>> >>> " If you have a two hour post prandial target of between 5.0 and 5.5 > moles, >>> and you also maintain it, your bs will run at 5.5 or lower, and >>> diabetic complications are rare in diabetics with an A1C reading of > >>> 5.5 and lower. " >>> >>> Wouldn't this low a target two hours after meals cause lots of >>> insulin reactions? If my blood sugar is, say, 8 two hours after a >>> meal, at the next meal it will usually be between 5 and 6. If it >>> were 5, it would be > between >>> 2 >>> and 3 by the next meal, which is way too low. Is this drop not >>> supposed > to >>> happen? I thought that was the reasoning behind the 7 to 9 target >>> two hours after meals ... Humalog continues to work for three or >>> four hours after it's >>> injected, even though it peaks at about two hours, so I assumed the > drop >>> was >>> normal. If a drop like this isn't supposed to happen two hours after > a >>> meal, >>> would the culprit be Humalog or Lantus, or a combination of both? >>> >>> I may also be wrong here, but in the DCCT (Diabetes Control and >>> Complications Trial) that was published in 1992, they found that >>> below > an >>> HbA1c level of about 6.5% there was no significant reduction in the > risks >>> for diabetes complications. Granted Humalog and Lantus didn't exist >>> in 1992, so there are better tools today than there were then. When >>> I was first diagnosed in 1991 I took Regular and NPH for the first >>> five or six > years, >>> and the Humalog and Lantus combination has given me a lot more >>> control > and >>> a >>> lot more flexibility than I had back then. (Ironically, back then my > A1c's >>> ran consistently around 6.5% compared to the past few years when >>> it's > ran >>> consistently around 9%!) >>> >>> At this point my goal is to get an A1c below 6.5% and then if I can >>> improve it more I will go from there. I only know one person (type >>> 1) who had an A1c >>> of 5% and she said she had way too many insulin reactions, so now > hers > is >>> around 5.5% I believe. I suppose anything closer to normal can't be >>> a > bad >>> thing if it doesn't have negative effects (such as hypos). >>> >>> Anyway thanks for the encouragement. I've been working at it for >>> about > two >>> months now so anticipate things to get much better still over the >>> next > few >>> months. I'm finding this list very informative so far. >>> >>> Jen >>> >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 120/70 is a good bp. You could always ask the doctor or the hospital to send you the test results, so you would have a hard copy of it. Then you would know for sure if they did a C-peptide test on you or not. With all those risk factors you mention, you would be an excellent candidate to consider a life long user of niacin, which can help with all of those factors. Especially, if some one has had heart trouble and is not taking niacin daily for the rest of their life, I would consider it bad advice not to do so. Re: Normal range >>> >>> >>>> Hi Harry, >>>> >>>> Right now I take 21 units of Lantus at night, but as I said that will >>>> probably go down to 19 or 20 soon if my blood sugar keeps dropping >>>> overnight. I just started on Lantus about a month ago so am still >>>> fine-tuning the dose. When I started on Lantus my endocrinologist gave >>>> me >>>> 24 >>>> units because he said that's what he'd give a newly-diagnosed diabetic >> and >>>> there was no formula he knew of for transitioning from NPH to Lantus, >>>> so >>>> he >>>> said to just keep decreasing it until we've found what I need. >>>> >>>> Overall my TDD (total daily dose, short- and long-acting together) of >>>> insulin has been decreasing dramatically as I get in control again. >>>> It's >>>> gone from being about 85+ units a day six months ago to being 40 units >>>> (and >>>> dropping) right now. >>>> >>>> I am curious, if you are type 2 and take insulin, does that mean your >> beta >>>> cells are no longer able to produce it? Does it make you >>>> insulin-dependent, >>>> like a type 1? >>>> >>>> Jen >>>> >>>> >>>> >>>> >>>> >>>> >>>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 120/70 is a good bp. You could always ask the doctor or the hospital to send you the test results, so you would have a hard copy of it. Then you would know for sure if they did a C-peptide test on you or not. With all those risk factors you mention, you would be an excellent candidate to consider a life long user of niacin, which can help with all of those factors. Especially, if some one has had heart trouble and is not taking niacin daily for the rest of their life, I would consider it bad advice not to do so. Re: Normal range >>> >>> >>>> Hi Harry, >>>> >>>> Right now I take 21 units of Lantus at night, but as I said that will >>>> probably go down to 19 or 20 soon if my blood sugar keeps dropping >>>> overnight. I just started on Lantus about a month ago so am still >>>> fine-tuning the dose. When I started on Lantus my endocrinologist gave >>>> me >>>> 24 >>>> units because he said that's what he'd give a newly-diagnosed diabetic >> and >>>> there was no formula he knew of for transitioning from NPH to Lantus, >>>> so >>>> he >>>> said to just keep decreasing it until we've found what I need. >>>> >>>> Overall my TDD (total daily dose, short- and long-acting together) of >>>> insulin has been decreasing dramatically as I get in control again. >>>> It's >>>> gone from being about 85+ units a day six months ago to being 40 units >>>> (and >>>> dropping) right now. >>>> >>>> I am curious, if you are type 2 and take insulin, does that mean your >> beta >>>> cells are no longer able to produce it? Does it make you >>>> insulin-dependent, >>>> like a type 1? >>>> >>>> Jen >>>> >>>> >>>> >>>> >>>> >>>> >>>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Just to see what would happen I decreased my Lantus last night to 20 units instead of 21. I went to bed at 7.4 and woke up at 11.9, which surprised me because I haven't woken up that high in over two weeks. Mind you this was with my same 12g snack that I've had every night. I'm going to watch things today and if I'm high throughout the day I may put the Lantus back to 21 since I do drop overnight but don't end up high or really low, either. I think this is going to take some trial and error to figure out the right dose. I think it will end up being either what I have right now (21 units) or else a few units less. I just need to make sure I only change one variable at a time so I know what is causing what. My doctor's often told me I should try to be at the high end of my target at night as well. In fact when I was on NPH I used to give a unit or two less if I was under 5 to make sure I didn't go low when it peaked. I'm not sure that would work with Lantus because it lasts for the whole day, not just overnight. Anyhow now I am just thinking aloud so will end this. Just thought you'd be interested in what happened. Jen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2005 Report Share Posted June 3, 2005 Just to see what would happen I decreased my Lantus last night to 20 units instead of 21. I went to bed at 7.4 and woke up at 11.9, which surprised me because I haven't woken up that high in over two weeks. Mind you this was with my same 12g snack that I've had every night. I'm going to watch things today and if I'm high throughout the day I may put the Lantus back to 21 since I do drop overnight but don't end up high or really low, either. I think this is going to take some trial and error to figure out the right dose. I think it will end up being either what I have right now (21 units) or else a few units less. I just need to make sure I only change one variable at a time so I know what is causing what. My doctor's often told me I should try to be at the high end of my target at night as well. In fact when I was on NPH I used to give a unit or two less if I was under 5 to make sure I didn't go low when it peaked. I'm not sure that would work with Lantus because it lasts for the whole day, not just overnight. Anyhow now I am just thinking aloud so will end this. Just thought you'd be interested in what happened. Jen Quote Link to comment Share on other sites More sharing options...
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