Carb counting has failed... also I have questions!

Rach79

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It is like any insulin I had ..... works great for a week or two then becomes very erratic in it's functioning. My carb counting was introduced recently and started to look ok but unfortunately now it isn't working again. Also I always feel ****... and don't sleep ... is this because of my blood sugars going up and down? If my legs stay on and I could feel normal one day a week for a start... then I can hope for better things. However at the moment my foot is numb and I have no energy at all. I had two hypos last night again, I had two hyper attacks today meaning I'm lethargic as hell at work... nothing new... just wish it would change :| I get frustrated when times get like this, as they have been better, but only for short spells. Anyway I have some more questions... which include the one above in the hope someone can give me some advice. I've asked to be referred to the diabetic clinic but I need to be sure of what to ask for and what to discuss when I go:-

Does anyone here think I could be allergic to GM human insulin? Need to get to the bottom of this so I can start living a normal life. Also did I hear somebody was on an insulin pump with animal insulin? I can't remember who it was on this forum but if they read this can they hold their hand up and wave it at me thanks :)

Also has anyone switched from injections to pump? If so have you found this good or bad or is there any advice you can give me about this? Are you able to be flexible and have last minute snacks and adjust your insulin?...

Another question... sometimes when I inject it hurts like hell and spurts out blood in my arms or legs? Is this normal or has anyone else experienced this (I'm on Novafine needles number 6 with Novapen) ... it doesn't happen daily but just occasionally but I hate it when it does.

Thanks people....... Rachael x
 

jopar

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rache I'm not sure where to start?

I notice that you use lantus, there are a lot of people who have found this to sting when injecting and have found swapping to levimer helps has this has different perservitives and a slightly different PH balance...

As to the bleeding, I used to get this when I used a noraml syring to inject, as you can hit one of the small veins with in the fat layer you are injecting to.. Sometimes a change in needle sizes can make a differnce... I would ask your nurse if you can try a 5mm, and several of the larger ones, and perhaps change the manufacturer as there is a slight difference to how each tool there needles..

Carb counting and pump

Well I changed from injections to the insulin pump and yes it was the best thing I ever did... It was a steep learning curve, not so much in the basic starting the pump running, inserting the canulars this part was pretty easy, and within days I stopped taking notice of it...

The steep learing curve was learning a new way of delivering your insulin, basic basal and bolus is pretty easy to get off the ground, but it can take a while to sort out basal rates per hour, and creating different basal profiles for different needs, I have four set up on mine, one is relax home day, the housework then 2 profiles set for work.. I flick from one to the other, to match what I'm doing... And can change it at any point as I decided what to do throughout the day..

Bolus most pumps come with 3 types of bolus, a standad which is like injection, a square wave/extend wave, which delivers the bolus over a choosen set period of time, and a multiwave bolus that delivers a intinal dose of insulin, then delivers the rest over a choosen period of time... And then you have the Tempoary Basal Rate (TBR) which you can use to turn the basal rate up or down by percenages, for a choosen period of time.. Using the effectivily can take timeto sort out what is best for what situation..

I would say in your case you would properly benefit from the insulin pump, as some of your probles could be that the insulin pen isn't capable of delivering a fine enough dose of insulin, so sending you high as not enough, or causing a hypo because it's a tad bit too much.. (my problem) or your problems could be that you are one of those diabetics that will constantly have changing needs, and with this you have the tools to react quite quickly to changing needs as they crop up rather than dealing with the insulin or carbs that you injected or eaten...

Hope this helps

P.S Yes there was a member on the forum that use animal insulin in there pump, but sadly they have now left the forum... But I do know that they have immence difficulty in getting funding for this... A major battle that they adventully one, with gritted determination indeed... Most would have given up long before..

I would suggest if you decide the pump could be a option for you, then approach your consultant with using a human insulin first and if you are sucessfull, seeing how you go with this
 

Trinkwasser

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Over time I've met not a few people who had problems principally with Lantus. Some improved on Levemir and some didn't and regained control and hypo awareness on animal insulins. Some just improved their control on pork or beef L and stay with it for that reason, but it can be VERY hard to convince anyone to trial it.

Likewise for pumping, most people use either Humalog or Novolog (I don't actually think I know anyone who pumps Apidra) which does away with any problems caused by the basal. Again mostly people who have problems with one seem to do better on the other.

Again the difficulty is convincing people that you aren't making this up! Just because something is relatively rare doesn;t mean it is nonexistent
 

Rach79

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Thanks Jopar and Twinkwasser! I have an appointment Wednesday and I'm asking for the pump but also mentioning animal insulin to see what is or what could be available. I've been told where I am they can get funding for the pump so that is a good sign.

The other day I got so fed up because I've got (and still have) pins and needles in my big toe (now spread to toes and a bit of my foot on one side). I'm hoping I can obtain controlled blood sugars very soon. It seems that the pump might indeed be the way forward! :)

Anyway I've had a busy day so off to bed now.

Thanks again,

night, Rachael :)
 

lilibet

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Rachel

If I recall correctly, you are not long diagnosed, yes?
If so, you might find the insulin wonky because you are in honeymoon period and your pancreas is erratic and it is frustrating as hell when you try your best and no two days are the same! If not then, it might just be a need to change the insulin?

I had lots of funny sensations post dx and too was looking at whether insulin was to blame. My bg came under control quickly and my 2nd a1c was great but IMHO if its not 'text' book then they wont entertain your thoughts. I had pins and needles and toe pain (like shoes were too tight) and I still get this if bg goes up and down too quickly but they dispute neuropathic pain for someone not long dx.
Hypos leave me feeling terrible and anywhere near double figures will have me wanting to lie down in the street and sleep. However, tell and Endo this and they will assume you are neurotic because only 'prolonged' hypers cause probs. Yeah, right!

I still dont really feel normal at times but am just hoping to sit it out and fingers crossed that over time it all goes away. Its not good being so aware of your body all the time!

Just another thought re the pump, I think to qualify you need to have difficulty controlling bg, exhaust other avenues and have a poor A1c though this may change from area to area.
 

iHs

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Hi Rach

I don't know whether animal insulin or a pump will sort out your problems or not but before you go for a pump you will most likely be asked to try another bolus insulin first such as Humalog or Apidra as every possible road will need to be gone down as a way of helping you improve your control before pump therapy is considered. You will might also be asked to change basal insulins to see if that helps.

There are a few peeps on this forum who use Apidra and get good control. There are also some who use it in a pump too. I joined the Insulin Pump UK site some time ago and found out loads of info about using pumps so I suggest that you join as well and just sit on the fence for a while before making any decisions.
 

Trinkwasser

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Rach79 said:
Thanks Jopar and Twinkwasser! I have an appointment Wednesday and I'm asking for the pump but also mentioning animal insulin to see what is or what could be available. I've been told where I am they can get funding for the pump so that is a good sign.
night, Rachael :)

IMO go for it! Not everyone is that lucky.

It will take some getting used to and some people never do and go back to basal/bolus. But even then you will LEARN a lot about their ratios etc. which will help. If your problem is specific to Lantus and you aren't having problems with your bolus insulin then that sorts it. Currently I think the usual choices are between Humalog Novolog and Apidra which all have slightly different characteristics.
 

Rach79

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Hi everyone thank you very much for your advice! Well I went for my appointment this morning and explained my situation. The nurse was very helpful and said she understood my problems. She said I would benefit immensely from the pump. However since last time I am now on a waiting list for the pump and funding may not be available. Last time I went there was funding available but now there isn't - I'm truly gutted!! We also discussed animal insulin and other forms of insulin - however after much discussion her analysis was that they are all very similar to each other. I have also tried a wide range of insulins already. Also she says I am doing everything I can to get good sugar levels however I'm not succeeding so therefore she is going to push for funding for this pump. I have to wait a few months but I said to her I don't know if I'm capable of doing that mentally. I just hope that there is light at the end of this tunnel otherwise I'm going to go in sane.

BTW lillibet to qualify for the pump 1) a diabetic has to be trying to obtain good HB1Ac levels however if they don't manage i.e. if their averages are too high then they qualify or 2) if they have very frequent and disabling hypos where no matter what they have tried with multiple injections if they don't succeed then they would qualify also. These are the NICE guidelines and I fall into the latter category and also I get a lot of hypers so my average is good but for all the bad reasons if you get me. Also I've been diabetic for a while now - 13 years so I'm really concerned that if I don't get my sugars in check soon it will be too late. I've got to try not to aim too low at the moment to see how I go and to look at various insulin pumps to see if I want them. However without the necessary funding I feel like there isn't much point. I'll just have to wait and see hey?!
 

Trinkwasser

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That is a total bummer. Maybe the local MP was using the pump to empty his swimming pool?

I didn't tell you this, because it is fraught with danger and complexity, but I've heard of people pseudo-pumping by using no basal and several injections per day of bolus or R, just to get a feel for how their ratios change during the day. This should only be done with medical or other supervision in case you get it drastically wrong.