Which insulin to choose?

[smidge]

Hi guys!

I have a weird form of diabetes that seems to mean I produce adequate background insulin, but the signal doesn't go from my brain to my pancreas to produce the insulin after eating. (if the signal got there, my pancreas would probably respond OK). So, I have a couple of questions:

1. Anyone know what this type of diabetes might be? (I know it's a long shot :lol
2. Anyone know any tests to diagnose it? (My consultant says it doesn't matter what it is, we just need to treat it).
3. I am on Insuman basal (5 units, 45 mins before tea) and that keeps things under control as long as i don't eat more than about 10g carb at a time - more than that and i'll be in double figures for a few hours. I have been given leaflets about Humalog, Novorapid and Aspidra(?). The theory is that my basal insulin is intact and so I need to stop the basal and use a rapid one with my food. However, I am very sensitive to insulin and tiny amounts have a drastic affect (as does carb in the other direction!) So, does anyone have any experience of these types of insulin or can give me any comparison or ways I might choose which to try? I am back at the hospital on 4 March to see the nurse and choose which one to try.

Any thoughts would be appreciated

Thanks

Smidge

 

[ewan]

I would think any of the mentoned short/fast acting ones would be what you need, could check their 'quickness in acting' and their length of acting as this will inform your decision.

and carb count, adjusting insulin to suite, by testing, testing and more testing, perhaps a lot is trial and error with the insulin you choose, in of course discussion with a professional.

stay on this forum, cuase its brill and in the short time i have been using it, it (the peeps on it) have taught me loads!!!!!

good luck and take care

 

[smidge]

Thanks, Ewan. It just sometimes feels like it's all a big trial and error experiment and I'm expected to make decisions without the rules! I just wish they'd diagnose me properly and then prescribe me something that would work At the moment I'm 'diabetes type unknown' and I have to choose between three insulins I'd never heard of!

Smidge

 

[ewan]

this might be so wrong, so be warned!!!!!!

I perhaps would not worry about type, perhaps asume your type 1, (as you need insulin)

test blood

do fasting ie first thing in am without eating, if its normal ie 4.00 - say6-7, then you may not need long acting as you say, if you eat and the sugar rises then you can treat with a bit (measured units) of the fast acting you choose.

there is a guide to how much insulin is needed for how many carbs you eat, but people are different so it is a guide, you unfortunatley can omly learn by trial

if you dont need long acting insulin, thats a major bonus so only need fast acting when you eat, should learn to adjust fast acting dose prior to eating, test blood prior to eating, if its higher than normal take this into account then plus the carbs your about to eat, calculate dose and JAB, then 2 hours after eating check levels agin and the result should guide you when you eat the same again.

hope that makes some kind of sense and is not patronising, its ment in good will,

I am not a DB professional, your clinic nurse, consultant, GP should help officially, though try not to worry re exact diagnosis, its your blood sugars and there treatment to bring them to normal limits that really matter (in my opinion)

best wishes

 

[phoenix]

Smidge, if basal is intact I can see why insuman basal isn't much help. I posted a profile for that insulin here.
viewtopic.php?f=15&t=18161&p=165128&hilit=insuman#p165128
It's onset is far too slow to effect your meal in time even if taken 45 min in advance.
The rapid insulins work very quickly, the onset of action is 5-15 min, the peak action is at 1-2 hours and they last for 3-5 hours. It does vary between people. Some people seem to think that apidra is marginally faster and lasts for a shorter time.(and it is licensed for use after a meal which suggests this might be true)

 

[Snodger]

how fascinating that you have that unusual insulin profile.

I found this: http://www.deo.ucsf.edu/types-of-diabet ... table.html
...not that it really helps because it doesn't explain them but at least you have some names of different unusual types of diabetes which perhaps you/your doc can look up in more depth?


(also, totally unrelated, but I found it while I was looking: vinegar makes you more sensitive to insulin. http://care.diabetesjournals.org/content/27/1/281.long. Right then. Big plate of fish and chips covered in vinegar for me!)

 

[smidge]

Thanks for the advice and information everyone. Having looked at it all, I'm leaning towards trying Apidra as it seems to be especially rapid and clears quickly, so maybe less risk of Hypo? (I don't really snack after tea, so don't need it to last too long after food). At the moment, my fasting levels without insulin would be around 8, although this is totally dependant on the levels when I go to bed. So if my BG is around 9 when I go to bed it will be around 7.5 or 8 in the morning. By taking 5 units of insuman basal before my tea, it can be around 8 when I go to bed and between 4.5 and 5.5 in the morning. But it can spike very high after food and only reduce very slowly (3 to 4 hours). The theory we're testing is that if I reduce my after food BGs by using a rapid-acting insulin, will my BGs be low enough in the morning without any basal insulin - the consultant believes this might be the case. I guess i'll just have to try and see. I'll let you know how I get on after I've been to the hospital next week.

how fascinating that you have that unusual insulin profile.

I think I'd rather have a less fascinating profile :lol:

Thanks guys

Smidge