New to Lispro (Humalog)

[RobLL]

Doctor gave me an Rx for Lispro two weeks ago. Don't know why it took so long for one to agree. (actually my last doctor would but he just got nabbed in a SW State for identity theft!!!! and he was a nice guy) I digress, anyway...

I had terrible results, a really hard time staying below 100. While toying with the idea that I could have got another bad batch, or that I am resistant to Lispro those really are not good first guesses.

So here is my #1 suspicion. On my very low carb diet, by the time the food turns to amino acids/glucose in my blood stream, the Lispro is long gone, and so my BGs go up. It is likely/possible that I metabolize Lispro faster than other insulins.

I liked Lispro because allegedly you can take it when you start to eat. I have gone back to Regular for bolus injections. Lispro now is only to lower my infrequent spikes. Any suggestions on Lispro insulin timing to make it work for boluses?

[v-effect]

I find that for a truly low carb meal I use my pump to spread the bolus over anything from 1 hours (cauliflower rice and a hot dog, for example) to 6 hours (steak and low carb mozzarella stix). You could try apidra or novolog, other fast acting insulin. I personally find the action of all of these to be the same-- others see differences. When I was on shots, I would often combine the two - take a little lispro right away for minimal carbs, then wait an hour and take some Regular for the protein. (All of this said, I bet from a T1 perspective that your postprandial numbers look great- I mean I simply cannot be under 130 after a meal . ) All of this leads to another question- what is the correct insulin to protein ratio. I cannot yet answer that.

V.

[RobLL]

Interesting. So if I forget the take the regular, take an appr. amount of Lispro, and then an hour later Regular. That should work, or if I only have Lispro with me, take it in two injections.

res protein. Dr Bernstein and others have suggested the 58% of excess protein will be converted to glucose. This of course somewhat begs the question, what is excess? I assume most of my insulin is to cope with my protein consumption. I actually use an ideosyncratic system, I eat very low carbs, and almost always the same amount at meals. I eat two meals a day and bolus for them plus something extra for exercise (any kind for any amount of time up to two hours always spikes me if I don't bolus for it) My basal is enough for my smallish snacks.