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diabetic too long to change

M

michellehayward

Member
hi, i have been insulin dependant for 25 years, since the age of 8. there have been many changes during my time, syringes, pens, pumps etc. i have recently been told that i need to change my way of doing things. i use the "exchanges method", 10 g of carb= 1 exch. i was taught how to manage my insulin and food this way and have been doing it ever since. my hbaic's are 10+ and have been for years. i have just started a new insulin (finally changing from pork), it seems that too much is changing at once and i am getting bogged down. does anyone have any advice?
 
Baby steps. Make a list of the changes that you are expected to make, and tick 'em off one at a time. You'll be glad you did.
 
Well modern methods of control are based upon carb counting, so you don't have to learn that. :D
What isn't clear from your post is what type of insulin you are now taking.
Are you taking one insulin such as Novomix . This is a mixed insulin and contains both long term and fast acting insulins premixed.
or are you taking 2 insulins in whats called a basal bolus regime?
ie a long lasting insulin - lantus or levimir once or twice a day (a basal insulin)
plus a rapid acting one (Novorapid, apidra,humalog) at mealtimes (bolus insulin).

The second type of regime is far more flexible (but also more to learn about)
 
thanx for your replies. i am now taking lantus (36u, am), i still take porcine hypurin (12u, 16u and 20u), my last hbaic was 12.6. the only times i have managed to get a good hbaic (eg below eight), was during pregnancy, i have 3 great kids, no time for me. i have been asked to test 4 times a day, due to no hypo awareness. i get most hypo's during the night. i get terrible rebound blood sugars after hypo's as i cant stop eating until i feel better ( normally fel hypo 1.5-2). i have mild kidney damage and slight eye trouble. i feel as if it's all at once and i am overwhelmed. when i was a teenager i wasn't warned of the dangers, now i am struggling to put things right. it seems an impossible task.
 
me again, another thought. hypo's, really scare me. i had some terrible ones when i was a kid, i was bullied for being a "druggie". my hypo's made me cry, kids thought i was weird, and i was hospitalised 3 timed due to hypo's. perhaps thats why i was happy running high for so long.
 
Hi Michelle

When I changed to Bolus/basal I started off by testing just 4 times a day but had no end of hypos as I was just following my consultants advice of 26u of Lantus at bedtime, then 5u Br, 5u Lunch and 8u Eve Meal of Humalog. On the first night of using Lantus it was a wonder that I didn't land up in A&E due to the fact that I had gone very very hypo and my other half had a job to bring me round with hypostop and lucozade. I did come round thank goodness but could have throttled my consultant. I eventually got my Lantus dose right by reducing it bit by bit and testing about 2am. Eventually I settled on 16u Lantus so a big big difference. It still didn't stop my daytime hypos so out of frustration and also peace of mind, I then started to test 6 times a day so that I could at least pick up on the times when my bg levels were dropping and eat something.

Testing 6 times a day will be the best thing that you can do for yourself. It's an education in itself as you will then be able to alter the amount of insulin you inject for the food that you eat so that you are able to keep yourself within a healthy target. If your Hba1c has been on 10 for a while it might be a mistake to make it drop very abruptly so follow the target advice given from your consultant or dsn and do it bit by bit.

There lots of threads on the forum on 'carb counting' and using 'insulin to carb ratios'. Just type in the search box at top right hand corner of the forum page. Also ask your consultant or dsn to refer you to go on a DAFNE course if they hold them.

Don't be afraid to ask questions on the forum as loads of us have had to figure out how to use insulin to carb ratios. Google - BDEC diabetes as that explains the basics.
 
I too have been type 1 for a very long time and have had many types of insulin together with carb counting. I am now taking hypurine porcine in the morning and isophane in the evenings. I never have been 100percent perfect and I have come to the conclusion that many of us have inherited conditions which can affect our blood sugars. This applies to me. Hardening of the arteries, BP and thyroid for example. We are not robots - we are all 'built' differently and most of us have different lifestyles so - we cannot always be on the dot between 5 and 7. I hope this is of some help. Make sure your food is good food not rubbish and eat sensibly- that must help too.
 
thanx again, i am glad i am not the only one. i know why i have to change insulins etc but i am happy to stay as i am. i will try testing 6 times daily and reducing the lantus. i am not a lover of human insulin so i think it may take a while. does anyone know how long i can varry on taking both human and porcine, or will i have to go completely over, thanx again
 
Some good advice by IHS.
If you get your basal right, your blood glucose levels should be stable overnight, ideally you should be able to go to bed at one level and not vary by more than a couple of mmols.
It is important though to take into account the length of time that your fast acting insulin is active for. If it is still active when you go to bed then you would need to go to bed at a higher level than if it has finished 'working'. I think your insulin has a longer period of action (6hr?) than the more modern ones but there are other people on here that can advise you better on that.
The link for the course mentioned above is here.
http://www.bdec-e-learning.com/
 
Hi Michelle

Not sure if you would get even control from using Lantus in the morning but to test its effect on yr bg levels you would need to fast from breakfast to eve meal so no eating any food for about 12hrs. Then on another day fast from eve meal to breakfast. It should hopefully keep you somewhere near your desired target level

If you look at this site http://diabeticfriend.co.uk/carb-counting/ you will find out about the 500 rule that is used by BDEC. They also use the 100 rule for figuring out correction doses. These guidelines are only a rough estimate and most people find that they do need to adjust their bolus insulin ratios for different times of the day. It's all done so that you can keep your bg levels balanced out taking account of the action the Lantus plus the porcine. The 100 rule is pretty accurate, it's just the calculations from the 500 rule that need to be varied according to the time of day.

Phoenix, Noblehead, Littlesue, CarbsRok, Kegstore and myself have all left messages on the forum about carb counting so if you click on our usernames and then look at all the messages we have left, you should be able to figure out what to do. Apologies to all the other peeps that have also left messages
 
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