Who's On Insulin??

[Blaine]

I start next week. Aside from the obvious PITA, what's the drill? I can't help but think that a shot has to be better than all those oral chemicals I've been taking ( about 9 a day)...... Getting old is interesting

[20cows]

I have managed to avoid that by losing the 150 pounds. I lost the weight because I was diagnosed a diabetic.

All you gotta do is quit eating (oh, yeah, it's easy -not).

[Rimfire McNutjob]

I'm on it. Used to be on Lantus (twice a day) and Humalog (U-100 pen three times a day). Now I take Humilin (U-500) twice a day instead of those two others. I also take 2000mg of Metformin daily.

Are you going on a fast acting type like Humalog or a slow acting like Lantus? Or perhaps a 70/30 mix?

You have to be careful and measure your glucose and snack. You'll crash if you take a fast acting and forget to take a shot of juice or have a snack bar right after or right before. I've been on insulin for about 10 years and I get stupid and crash maybe once or twice a year. It happens when you get distracted ... like from being married and having kids.

[Blaine]

I'm on it. Used to be on Lantus (twice a day) and Humalog (U-100 pen three times a day). Now I take Humilin (U-500) twice a day instead of those two others. I also take 2000mg of Metformin daily.

Are you going on a fast acting type like Humalog or a slow acting like Lantus? Or perhaps a 70/30 mix?

You have to be careful and measure your glucose and snack. You'll crash if you take a fast acting and forget to take a shot of juice or have a snack bar right after or right before. I've been on insulin for about 10 years and I get stupid and crash maybe once or twice a year. It happens when you get distracted ... like from being married and having kids.

I have no idea....I'll find out next week...I didn't even know that there was more than one kind of shot

[CEMENTHEAD]

I'm really lucky that my Eye Doctor caught my diabetes. I was headed for a crash myself. When they caught it, my sugar was over 400, A1C was 9.6, now it's @ 6.3. Luckily I've been able to shed 30 lbs. It's just diet and exercise for now. I'd like to keep it that way. Good luck with it. It's hard, but you have to do it. Thanks, Tom

[gary rice]

im sorry you guys have to be on that stuff. my wife is type 11 and on the needle for 3 years now, lost a ton of weight but that didnt stop it. ive tried all kinds of natural stuff on her but it doesnt help either. a month ago we tried hydrogen peroxide 35% food grade which has cured many but the stuff made her sick to her stomach. do any of you suffer the night time leg cramps and if so have you tried anything that helps? keeps her up all night sometimes.

[KirbyAUS]

I'm a type 2 as well.
Been on Insulin for years.

I currently use Lantus once (slow acting) and Novorapid three times (fast).
My insulin comes in disposable pens which you dial up the amount required.
You just screw on a new needle every shot.

I test three times a day before meals using a blood glucose meter.
A quick drop of blood on a test strip with a result in five seconds. Then the injection.
Most needles are very fine (28 guage) and you hardly feel them.
It's something you just have to do and you soon get used to it.

Kirby.

[Blaine]

im sorry you guys have to be on that stuff. my wife is type 11 and on the needle for 3 years now, lost a ton of weight but that didnt stop it. ive tried all kinds of natural stuff on her but it doesnt help either. a month ago we tried hydrogen peroxide 35% food grade which has cured many but the stuff made her sick to her stomach. do any of you suffer the night time leg cramps and if so have you tried anything that helps? keeps her up all night sometimes.

A banana a day helps many, including me, with the leg cramps....it's the potassium, I think.

[AJMD429]

These days most people say the finger-sticking for testing sugars is more bothersome than the insulin shots.

I've had patients who really take the bull by the horns and eat right and exercise get back off the insulins.

Make sure your doctor checks to be sure your testosterone level isn't low and causing sugar problems, too. Lots of doctors don't bother to check that unless the guy complains of ED, and yet it sure screws up your lipids and insulin response. May be similar things turning up now with regard to Vitamin D levels. Make sure you don't have sleep apnea, too.

And don't rely on regular 'cholesterol' tests without seeing if your 'particle count' verifies your LDL level; I've seen patients who had "great cholesterol" according to their cardiologist or internist or family doctor, with an LDL of 45 or 50 (corresponds to an estimated particle count of 450-500, which is well under the 1,000 'safe zone') - yet I'd check their actual particle count and find out it was over 3,000. THAT person would have been the next 'surprise' heart attack. Sometimes it's good news, though - one guy who was being pressured to take more medicines due to a 'high' LDL of 165 actually only had a particle count of 300 or so. His other doctors didn't believe me until I did a high-res carotid ultrasound and there was no plaque and no endothelial thickening, even; a cardiolyte stress test also was normal, and he's still doing well some ten years after all that, without medication. Another "3,000" patient went off her cholesterol medication because her specialist said that LDL of 45 was 'perfect' and had had a heart attack and a stroke within the next two years. Might have happened anyway, but probably not that soon.

The LipoProfile test is $81 vs the 'normal' lipid panel which runs around $55, but the insurance typically doesn't pay for it. Get the LipoProfile test - http://www.lipoprofile.com/patients.cfm?scid1=12

And remember that all the good 'reasons' in the world that you can't eat right ('Doc, you don't understand how hard it is to give up my hash browns') or exercise ('I just don't have the time') or take the right medications ('That stuff costs me $25 a month, and that stuff my insurance likes is only $4!') or get the right tests ('My insurance doesn't cover that, so I can't do it') - all those legitimately good reasons - have about as much effect on the outcome as a really good reason you didn't put on the parachute before jumping out of the plane.

Good luck; approach it like you would keeping a prized car or motorcycle, or even a home (your body is your home, actually...) in good shape, and apply that kind of effort (and money ), and you just may do really well. Our system is increasingly encouraging mediocrity and 'token effort' care for all patients except those who really make it a point to seek the best. Doctors are far more likely these days to make extra money by rationing your care than by ordering extra tests or better medications. Even the 'quality indicators' are generally established by insurance companies, in response to their own profits and vendor pressures, so we can really 'shine' if we do the cookbook thing. Just watch how different the care is when it is the family member of a physician, and you'll see what's what! Thanks Saint Obama-the-Anointed, as well as the RINO socialist wannabes who preceded him, for that one...

Oh yeah, and 'your mileage may vary, consult your own physician, etc. etc...'

[/practicing medicine on a levergun forum mode OFF... ]

[Chris83716]

I'm a type 1 diabetic on Novalog and Lantus. I can highly recommend using a "pen" over the old style syringe. I would also recommend using the thinnest needle you can get into your hide. I use a BD ultra 31g 5/16" needle 4 times a day. If I'm paying attention when I inject myself it is painless. Also spend the money to buy the thin lancets for drawing blood. It hurts way less.

Have you taken a diabetic management course yet? Take the class even if your insurance wont cover it. Some of it might be stuff you already know but the review wont kill you. If nothing more it will confirm that your asking the right questions of your Doctor and get you started on the right track.

My wife got a book from the American Diabetes Association called "A field guide to type 1 Diabetes" well worth the $15.

Insulin is easy after the first couple of weeks. Just pay attention and always have a snack handy. You will screw up If you start feeling funny test you blood sugar. This is not rocket science but does take some planning and attention to detail.

Feel free to PM me if you have questions.

Chris

[Rusty]

Blaine, Chris is right, make sure you take the classes offered in your area. My wife is type II and is an RN, but you'd be surprised at how many people don't know what they have or what it all means. I work with a guy who just takes the oral meds because the Doc tells him to. You might try www.dlife.com and see what you can find out on your own.

Happy Trails and God Bless,

[Doc Hudson]

do any of you suffer the night time leg cramps and if so have you tried anything that helps? keeps her up all night sometimes.

A banana a day helps many, including me, with the leg cramps....it's the potassium, I think.[/quote]

My Mom eats at least one banana a day, drinks orange juice, and even takes potassium tablets, it doesn't phase her leg cramps.

But you are 100% right about lack of potassium being the culprit.

[Pete44ru]

[Who's On Insulin ? What's the drill?]

Monitoring your blood sugar morning/noon/night, and adjusting the insulin dosage(s) to keep the blood glucose level(s) within the prescribed norms that your Doctor or Nutritionist should have given you.

I have friends who have haphazzardly eaten whatever they wanted, then used insulin to bury their sins - until one's kidney(s) failed and he also then had to go on dialysis every-other day, until he was fortunate enough to win a kidney transplant.

Please do not fall into that trap.



[I have managed to avoid that by losing the 150 pounds.]
[I lost the weight because I was diagnosed a diabetic.]

+1 - I've been a Type 2 diabetic, on pills/etc, since 1989 - but was told by my primary care Doc last Easter, that it was time for me to go on insulin, aka "the NEEDLE"

Soooooo - I axed da Doc "******* I lost weight/exercised, could I avoid da needle ? "

The Doc gave me 90 days, and scheduled out a retesting.

I changed my eating habits (HARD) , with smaller food portions (portion control), making SURE to eat four SMALL meals/day, and low carbs - plus, I hit the treadmill daily, followed by calesthentics.

So far, I've only dropped 60lbs - but I'm now fitting into clothing I haven't worn for years, AND my blood sugar tests daily just below the low mean for diabetes.

In fact, for the last 30 days, my blood sugar's been so low, that I've been able to stop my diabetes medication.

We'll see - no wine, before it's time.

.

[Blaine]

I could stand to lose 50 pounds....70 would be ideal.

[Rimfire McNutjob]

I could stand to lose 50 pounds....70 would be ideal.

Yeah, me too.

Some superfluous info ...

1) Don't get a meter that requires a finger stick. Get one for use in Alternate Site Testing ... your forearm. I believe the FreeStyle meter was the first to allow this type of testing. It's FAR less irritating to pop your forearm with a lancet than the side of a finger. I've been using the FreeStyle meter since they came out and they work well. The only downside is that many new meters have the calibration information for the strips encoded on the strips themselves. The older FreeStyle do not and so you have to enter a new calibration profile code when you get a new bottle of strips. On the plus side, the FreeStyle strips have a capillary channel on either side of the strip instead of one in the middle. The tube on the strip will sometimes not work or be malformed and you'll have to use a new strip but since the FreeStyle strips have two entry points, you can just touch the other side of the strip to the droplet if one side fails. Anyway, any meter that allows for Alternate Site Testing is good.

2) If you are getting a fast acting insulin that you are supposed to take before each meal, you'll probably want to measure three times a day (before each meal) as well. Most insurance will only pay for strips to measure twice a day ... unless the doctor specifically marks a scrip for the strips as needing to test three times a day. If you're on a slow acting insulin or you only take one or two shots a day, two tests is fine.

3) If you're getting a pen delivered insulin, as Chris83716 mentioned above, try and get the needles that snap on instead of twist on. Your pharmacists probably won't know the difference so it's something you'll have to try and figure out yourself. But it's pretty convenient compared to the twist-on's. The inside of the needle still has threads, but they are pliable and allow you to just push the needle over the end of the pen and then snug it up with a 1/2 twist to finish. When I first hit upon these after the pharmacy ran out of my normal order I thought it was a miracle invention.

4) If you're on a fast acting insulin, you will, at some point ... crash. Testing more often helps but everyone get's distracted from time to time and takes their shot with the intention of eating right away. Then they get busy and have to do something or other and before you know it ... you're down about 70mg/dl on your sugars. When I hit 70, I start to shiver and sweat beads up on my scalp and forearms. It's probably a different level for different people ... but it's right at 70 for me. You need to have some GlucoTabs handy or a Sprite or 7-UP or orange juice, etc. I remember the first time I screwed up and dropped that low ... I thought I was getting the flu. It felt the same and hit me hard and fast. Then about 5 minutes later it dawned on me (hey, I'm slow) ... I needed to test my sugars. I didn't have my stuff with me so I made it to a vending machine and downed 1/2 a can of coke. It took about 10 minutes to bring me back up and stop the symptoms.

I have ultra low Testosterone as AJMD429 mentions and it definitely affects my ability to utilize the insulin. For some reason my pituitary doesn't make enough FSH and thus I end up with a testosterone level in the 50's instead of the minimum of 200 or more. I used to take Testosterone Cypionate shots but I haven't lately ... need to go see the Urologist to get going on those again. Now there's an unpleasant shot to have to give yourself. A 21 gauge needle (fat) about 1-1/2 inches long plunged into your tricep muscle to inject something as thick as motor oil ... it takes about 60 seconds just to push it through the needle it's so thick. I do NOT miss that stuff. On the upside though, you've got the testosterone level of a 16 year old for about 5 days before it drops back into the normal range.

Anyway, let us know how it turns out.

[Blaine]

The way VA works, and it's perfectly fine with me, is that they start out with the cheaper treatments and work their way up to the super good stuff if the old stuff don't work. Yes, the testosterone level has to be really low I'll mention this in case there is a chance the oral stuff would work if THAT was better I'd be tickled to death with "the level" of a 40 year old

[O.S.O.K.]

What percent of the population has type II diabetes? I've been tested as part of a normal checkup - doc actually thought I might have high sugar levels but it turned out that I was throwing the test by taking my vitamins in the morning - which included magnesium tabs (which are mostly sugar... doh!). But I'm about 40 pounds overweight and so I'm sure he was suspicious that I might be susceptible.

I need to shed these pounds... diet and excersize - make that read "no beer" and excersize....

[jeepnik]

I'm really lucky that my Eye Doctor caught my diabetes. I was headed for a crash myself. When they caught it, my sugar was over 400, A1C was 9.6, now it's @ 6.3. Luckily I've been able to shed 30 lbs. It's just diet and exercise for now. I'd like to keep it that way. Good luck with it. It's hard, but you have to do it. Thanks, Tom

Eye doc found mine, as well. After weeks of test from a nerologist (go figure) the eye doc finally came up with right off the bat. Sometimes I wonder what ever happened to the good ole GP. Those guys knew their patients (not to mention the entire family) and spotted stuff like that from accross the room.

[AJMD429]

Rimfire McNutjob, if you lived in Indianapolis, I'd pay you to come counsel my patients - that was great info and a classic example of the details we 'clinicians' don't know but other patients can share. Thanks!

On the testosterone, there IS a gel that you apply daily (smoother blood levels, no needle) yourself, and although it is more expensive than the shots, the insurances are beginning to cover it due to the reduced cost of less office visits. There are also implanted pellets that go in your behind and last three months, but if you ARE skinny, they are uncomfortable. Oral forms tried so far are not stable and won't work.

On 'finding' type two diabetics (type ones usually find us... ), here's my take on the sequence of events, chronologically, that you see and the doctor can/should use as hints to do more testing...

1. Your family history
2. Your weight going up or tired more often
3. A woman's cycle not right or body hair changes, or a man's bedroom difficulties starting
4. LDL-P more than 15x the LDL-C (lipoprofile test)
5. HDL dropping
6. Triglycerides rising
7. Trig/HDL ratio over 3.5 to 4
8. Insulin level (fasting) over ten and rising
9. ONE hour glucose test over 200
10. A1C over 6.5
11. TWO hour glucose test over 200
12. Fasting glucose over 125

The farther down the list, the more specific the clue. Going from number 3 to 12 may take a decade or more, or happen quickly, and they don't always happen in that order, but that's the general sequence I see on average. The problem is, the only "official" tests to diagnose diabetes are # 11 and # 12, and # 10 will be "official" shortly. Typically, doctors may not think about the earlier items representing diabetes, until they see #12 appear, which is the LAST one for many people.

Moral of the story - if you don't actively seek the screening and so forth, you may be diabetic, or very close, by the time it's "discovered" - and by then you may have nerve, kidney, heart, eye, and even brain damage! If you can get "discovered" up near issues # 3 or # 4 - you may have a ten year 'head start' on treatment, and MAY NEVER EVEN BECOME DIABETIC if the doc starts you on all the appropriate treatment (diet, non-insulin medication, and exercise).

[BigSky56]

Gary Rice, theres a OTC medicine for leg cramps works in 30 seconds or so made by Hylands called Leg Cramps with Quinine pop a couple in your mouth they dissolve immediately you dont need to chase them with water when I ride all day I get them and at night also stuff sure works about 5-6$ for 100 tablets. danny

[morgan in nm]

I take both Novilin Type R and N. I don't use a pen as the VA won't give me one. Its not bad after the first few days but you will get sick at first from it so keep candy on hand.