Three different insulins?Cloudy insulin?Think like A pancreas book

[M80]

Hello!
I am reading the book Think like a Pancreas and in it he suggests the method (page118)using (option 5) basal in the morning,cloudy insulin (NPH) in the evening, and rapid at every meal. Does anybody do this? I am tempted to try it to get over the problem with the amount of Levemir needed to cover night some times giving me hypos at day.I have used cloudy insulin just some years back and I know it is seen as old-fashioned -but what he writes is very interesting. And it says Levemir has a slight peak after 4-10 hours, not very convenient at night is it? Seems cloudy possibly is more stable to use at night ? Anybody use this insulin? I can not remember the name of it (the one I used.)

 

[GrantGam]

Hello!
I am reading the book Think like a Pancreas and in it he suggests the method (page118)using (option 5) basal in the morning,cloudy insulin (NPH) in the evening, and rapid at every meal. Does anybody do this? I am tempted to try it to get over the problem with the amount of Levemir needed to cover night some times giving me hypos at day.I have used cloudy insulin just some years back and I know it is seen as old-fashioned -but what he writes is very interesting. And it says Levemir has a slight peak after 4-10 hours, not very convenient at night is it? Seems cloudy possibly is more stable to use at night ? Anybody use this insulin? I can not remember the name of it (the one I used.)

Think Like A Pancreas is a fantastic book It is however, only a book...

Why would you choose to mix "twice daily" with MDI "basal bolus"?

Can you kindly provide the following info:

Current HbA1c
Levemir dose
Is your Levemir dose split (2 injections per day)
What are your PM and AM readings
Have you ever used CGM or FGM?

 

[fairylights]

Before I started pumping I was using levemir in the morning, humalog for bolus and humulin I for night time 'basal' - this is a cloudy insulin which has a bit if a peak and I was using it to try and combat the horrific dawn phenomenon that I have. It was slightly better that levemir but not much.

 

[M80]

Good morning !
Thank you!Usually my hbac1 is around 7, I have my next appointment in february and it will be lower them as my Libre is really helping me to make progress.I have now landed on the dose at 9pm being 6 and a half unit, morning 3.This will decrease as I am slowly creeping my way under 10 in average.(I know it is too high but I have not despite big efforts managed before to get this down.)
I see now with the information I have learned about the dp, that I really have missed some essential information before.I am a coffee only person when I wake up.But I now know it is essential to have something,and a higher doses of novorapid than I would normally need through the day.Last night my bs was10,3 at midnight and 10,6 going up at 8 in the morning.So although too high it was incredibly stable.With this I see no need to change my insulin (if it keeps this stable) So that is great. I guess the cloudy insulin lasts shorter so the positive thing is it gets out of the system and does not peak like the lever does, sometimes if the two doses peak at the same time it can be leading to a hypo. It reads like in the book, it is hard to predict the peak in levemir?4-10 hours is hardly specific.But if it is a small peak it means nothing I guess.So far so good

 

[CarbsRok]

Think Like A Pancreas is a fantastic book It is however, only a book...

Why would you choose to mix "twice daily" with MDI "basal bolus"?

OP hasn't mentioned using a mixed insulin.

Depending on when she was diagnosed it would be insultard or Isophane I suspect. The Americans call them NPH.

 

[GrantGam]

OP hasn't mentioned using a mixed insulin.

Neither have I, read my post again.

Intermediate insulin is normally injected twice daily is it not?

EDIT - I've have just read through the "option 5" which you mentioned @M80 - and it seems more of a means to offset DP rather than anything else. Are you suffering from the effects of DP? Going by what you've said in your second post, it would seem that the issues you describe are more of a "waking rise" rather than DP? That's assuming that you were up and awake when you said your BG was rising from 10.6 at 8am.

One other thing to add, if hypos caused by "peaks" from your basal insulin are an issue then intermediate is definitely not for you. As a means to offset DP on MDI insulin therapy, its whole purpose is to "peak" to combat the sharp BG increase caused by DP. It's described fairly well on page 116 (kindle version).

 

[M80]

Hi there! It is very possible it is a waking rather than dp, will figure that out.Very steady day today until 3 when it went down under 4. Thankyou!