Hi guys. I know nothing about HTML or any of that other stuff so I hope this doesn’t look like gibberish on the page. I recently participated in a sort of “round table” discussion with a couple of other veterans, while we were hanging out at the pharmacy waiting for our numbers to be called. Both these guys were older than I am and both were combat vets. I told them I was dosing on Levimir morning and night, and was supposed to shoot Novolog right before meals (which I rarely do because I rarely sit down and eat a meal. I just tend to graze on small bites all day.) They both told me the exact same thing. They said the levimir was basically ineffective, and that if I really wanted to bring down my A1C and feel better the thing to do was keep my meter on me at all times, and check my sugar throughout the course of each day. If it’s high they told me, shoot some Novolog even if you’re not going to eat. When I asked how many units, they told me, - “You’ll get a feel for it.” Both of them were adamant that this was the path to a lower A1C. One of the gentlemen was very angry because wherever he was receiving his care before, his health team had no problem with him doing that. Then he moves here to Las Vegas and made the mistake of telling what he had been doing. He’s actually still on the syringe and his clinical pharmacist has cut down how many vials he gets now, so he’ll run out if he tries to continue. Has anybody out there heard of this before, or tried it and can offer some insight. I googled Novolog and it actually isn’t as prone to drop you into hypoglycemia as some other insulin’s, and I always carry glucose tabs everywhere I go, so why not give it a try?? Your thoughts?
In theory I suppose it would work but just doesn’t make a lot of practical sense in my case to take for example 1 unit of novolog every hour all day and night… or 2 units every 2 hours etc. instead of just taking 24u of basal insulin (IMO there are better options than levemir) 1x daily…
I think the data you may have found about novolog potentially causing less hypoglycemia are probably based on the assumption that it’s being used correctly… and not like this. What you’re basically proposing here is simulating pump therapy by trickling in rapid acting as basal as needed, except without any of the benefits or automation of the pump. Seems like a losing strategy to me.
Not sure if you are referencing to the pattern @Sam19 thinks or just want to correct high bs with novolog without eating anything (which basically everyone does).
i agree with sam that taking 1 unit every hour (like with a pump, but by hand) is quite a hassle and i would not know how you’d do in the night.
but if you are high and wanna correct that bs that is another story
I’m interpreting your post as a request whether we think correcting high blood glucose levels with a rapid acting insulin like Novolog, is a good idea. I heartily endorse making correction boluses with an insulin like Novolog. You need to do this, however, from a well-informed position.
A person needs to be aware of and fluent in determining insulin on board (IOB) , duration of insulin action (DIA), and how much 1 unit of insulin will drop your blood sugar level (also known as insulin sensitivity factor or ISF). Correcting, if ignorant of these ideas, is asking for trouble.
Insulin corrections are a fundamental tool when dosing insulin. It’s not an exotic or advanced technique but you do need to understand the concepts I listed, like IOB.
No pharmacist or doctor should withhold insulin from a person with diabetes that needs it. Maybe you need a heart-to-heart discussion with your doctor. If you need to study up on the concepts I cited, please do. There are many books, like Think Like A Pancreas by Scheiner, that lay it all out in a way that’s easy to understand . You will feel better.
I interpreted it as a question as to whether he should stop taking levemir and -only- do novolog corrections throughout the day…
If he actually is asking if he should be doing corrections with novolog as needed even if it’s not right before eating, (in addition to his meal bolus and his 2x daily levemir) I agree with Terry— it is very important to do so as needed
I’m a little unclear about what the intended question really was. (And the fact that different people heard it differently would seem to reinforce that.)
However. If the question is, should the OP stop taking basal insulin, then the answer is absolutely not. CERTAINLY not absent a heart-to-heart talk with his/her medical team.
If the question is, should one use fast acting insulin to knock down highs, then as @swisschocolate says, that’s standard procedure.
Now, then . . .
Perhaps this is out of context, but based on what was posted, this should be making lights flash and bells ring, loudly. I won’t use the m-word but that doc’s behavior sounds awful close to crossing the line, based just on what is posted here.
If the question is: should I stop levemir - then, imho the vets’ opinion on levemir is totally uninformed against plenty of research available. Levemir provides you with a basal level for insulin that is critical to your overall balance.
If the question is: should I do Novolog corrections during the day as needed, based on a BG (blood glucose) measurement, and considering carefully the insulin on deck, my answer would be - absolutely, that is exactly what it is there for, on top of pre-meal bolus dosing.
I suggest you talk to your endo and see if you can schedule a training class or two. In the training classes you will learn how to estimate correction doses. We took all the training that was available (something like 8 or 10 classes), and the difference in our understanding and skills was enormous. Yet still not enough:-)
If you’re looking to connect with other people with diabetes, check out the monthly ADEMS support group at the West Charleston Library and the diabetes coaches and training classes offered by St Rose Hospital.
Thanks Lainey!