Please Help - New Insulin User Concerns and Question

[Korban]

Hello all, this is my first post here. I have been lurking for sometime now and am struck by the fact that you all don’t seem to duke it out on every post like some forums. :) Great information, experience and hope here – what a nice concept seeing as how life in general can be trying enough. I am a third way through Bernstein’s latest edition and it is my first exposure to a diabetes publication. I obtained a copy because of the name of your forum. I am a new un-informed insulin (Lantus) user.

Over the past 8 months or so my blood sugars have continued to increase as I have gained weight (or maybe just gotten older). I was taking glipizide and metformin, rarely measuring blood sugar – I figured the 150’s or so I was getting back then were pretty close to 100 and therefore must be okay – move forward 8 or so months and 20 odd more pounds – A recent a1c showed > 10% and my bg has lately been running 240 – 285 (or 330!) with the same meds. Knowing that carbs = glucose from Atkins I started <20 g carb per day and bg went down 100 points within 6 days. I then met with my internist 2 weeks ago and he put me on 20 units of Lantus (in the evening). I can control the blood sugar reasonably well as I have been eating about 15 – 18 grams net carbs per day. I am testing bg a lot now and it seems to go up about 4+ units for ever g carb.

I “splurged” for the first time last night and ate a meal with 20 g carbs and my blood sugar went up 85 points and was slow to come down over the next few hours. I don’t believe that I can do 6-12-12 without bg going way up. I think I may need a fast acting insulin on top of the Lantus but I am only inferring this from Bernstein as I have only very limited experience. I am now back to 15 g net carb per day but have no where close to the control that Bernstein suggests. I have started daily exercise and that does help bring my numbers down pretty quickly. I am about 55 lbs overweight (obese with BMI of 32).

Is it time for me to harass my Doctor or find another one?… he doesn’t seem to be too clued in on LC diets and their benefits. I hope this is the correct forum. Any experience that you might share would be appreciated.

In spite of my “splurge” the lower bg’s have made a great impact on improving my mood and energy level and I am committed to staying with this. I just don’t know what to do to get the numbers down other than jump on my exercise bike each time as this does help some.

Thank you and have a nice day,

[RobLL]

Dr. Bernstein has a suggested procedure for discovering what your basal needs for insulin are, using a fasting procedure. You might find that helpful in adjusting your Lantus dosage.

[Cajunboy47]

I have no experience with insulin, but when I was on glipizide, at that time, I couldn't keep my BG under 200 and often it 300, and then there were all those hypos... So, I can understand mood swings and low energy.


I went my own direction, eating all natural foods, herbs, vitamins, minerals and amino acids. My weight has been slow coming off from the very beginning.

I want to lose weight, but being diabetic controlling my BG has been my priority. The weight will eventually come off of me.

Exercise is very important in getting control. If you're able to walk, bike or whatever, don't ignore it.

Take insulin if you must to get your BG down. It is a way, but not the only way to get control of BG. The key thing is to do what many of us do. Experiment, monitor and never give up. Through constant attention and adjusting, you'll get on top of it....

I don't remember my highest A1C test, but I remember a 12, then 9, 8, 7, 6 and I've been under 6 for a year or so now. My last three tests were 5.9, 5.8, and recently 5.6.... The funny part is I know I could have done better. So don't be hard on yourself, there are many things you can do on your own to get it right one day and probably sooner than you think..

Ron

[Charran]

Korban...First off, welcome to the forum! :wave: It is indeed a wonderful place to share experiences and gain valuable information. Reading and keeping yourself informed is so very important to managing your own health. I don't have any experience with insulin ( except while being pregnant and I doubt that would help you much :lol: ) Is it time for me to harass my Doctor or find another one?… he doesn’t seem to be too clued in on LC diets and their benefits. It is so common around here to read about people with doctors that don't support the LC lifestyle for diabetics. I was lucky enough to find one who keeps saying that the results speak for themselves and encourages me to just keep doing what I'm doing. I guess it's up to you though. If you think you'd do better with support from an MD, then by all means find one. If yours isn't too vocal about it and you like him otherwise, then just stick with it. I do hope you find the "key" to managing your health in the most advantageous way possible. It's all such a matter of trial and error and even then when you think you finally have it all worked out, nature throws you a curveball. Come back often, ask questions....I'm sure there is someone around who will be able to answer! I wish you all the best! :)

[Korban]

Thanks for the comments. I titrated myself down from 24 units to 20 units because in the middle of the night when I awoke on two different nights I had readings of 52 and 50... I had no symptoms, perhaps because I have to take beta blockers for a heart condition. Twenty seems to be a good point although I think it might be best (doh-not sure) to break up the Lantus into evening and morning doses. I have recently heard that other people do this. Bernstein says that Lantus at night only lasts about 8-9 hours whereas taken in the morning, it should last like 18 hours. If he is correct, then I don't have much residual Lantus in the evenings, when my bg spiked. He also says that Lantus is "not intended to prevent the blood sugar rise after eating." (pg 270 - 2007 edition). Hopefully exercise and losing weight will help me here. My next appointment with my internist is in 4 months - seems a bit long per Bernstein.

I am getting into exercising and am up to 20 mins on a recumbant bike now - up from 8 a couple weeks ago. I can usually only walk for about 12 - 14 mins before my upper legs cramp up. The bike has been great.

Kind Regards,

[dancinbr]

Welcome Korban,

What is so great about this forum is people are here to help each other and share their experience.

If you have a Doctor that supports whatever you are doing as long as you get results and is willing to run the tests and write the Rx's that you request without a hassle, then stick with him.

My Doctor is terrific. Anytime I come into the office and discuss my situation with him, he fully supports whatever I want to do. He does take the time to listen to me and also comments on what I am doing.

Recently, I requested that I add basal insulin, Levemir Flexpen, which is essentially the same as Lantus, and he was all for it.

I have found that I need 35 units of basal insuling to bring my range down to 85's and peaks after 1 hour of eating LC around 120-130. When I have a higher carb meal my peaks will still get up to 150-180 area.

Thus, I am thinking about adding Novolog, or Humalog or perhaps even the Regular insulin to my regimen.

I also take 2000mg of Metformin ER, 1000 in the am and 1000 in the PM.

I take other supplements as well that are supposed to help the T2 or T1 diabetic maintain better control and health.

I am T2.

I also take Niacin. This is something I recently added as well to see if it wil raise my HDL in my Cholesterol. I already have good cholesterol but there are concerns about my LDL being over 100 now that I am diabetic. I refused to take a stating. I tried it for two weeks forget about it. I also read that it can wreak havoc.

So, the key point here is you must be in charge of your disease. You must learn as you are doing. You must try different thing. You must find what works for you.

Always come to this forum and ask and read and converse with people.

There are so many experiences here to gain knowledge from.

CajunBoy has been a huge help to me. However, I don't have the same success as he does with natural approach. So I went meds.

Lottadata is a huge help for all of us.

See her website here>>> http://www.phlaunt.com/diabetes/14046621.php

Also, poke around in her website for all kinds of information on diabetes that she has collected over the years from her experience and her dialogue with pharma companies, manufactureres, etc.,

See here >>> http://www.phlaunt.com/diabetes/sp2index.php

I am happy you have found Dr. Bernstein. I use what he has to say as a guide.

If I drop weight and stick to 6-12-12 I am sure I would bring and keep my BG levels down in the "safe" range.

I thank you since you have now reminded me to go back and do more reading in his book since I have recently added Insuling to my regimen.

Welcome,

Ralph