I have lived with diabetes all my life because my uncle had it at age 2…i was diagnosed in 2000 Type 1 and I try to limit my carbs, my sugars, just found out Splenda spikes my sugars. I exercise and are on humilin 75/25 before meals…my base is 12 units and does anyone know where i can find a chart to help me do the sliding scale? I take 45 units of Lantus every night. I want to get my sugars under control. They were great for years but the last 3 they have been bad. I see a nurse practioner because i have no insurance and the county (small town) doesn’t have any help. My husband is frustrated, i am devastated and lost…help please!!! Thank you!!!
I think that 75/25 is evil. I don't think you're evil but I'd wonder about your doc. It's much easier to split the short-term and long-term insulins to balance things than to take them mixed like that. I took R/N until 2008 but the modern stuff (Humalog/ Novolog and Lantus/ Levemir...) work a lot more smoothly. I haven't seen directions for making 75/25 work as they sort of preload your whole day and you have to figure out how to make them work through trial and error, finding the "sweet spots" (ha) in the day where the insulin is working and eating to the insulin. I hope that you can figure out a way to make it work for yourself but 75/25 is a tough row to hoe.
Humilog did not work…its a great rescue insulin when they get too high. I hope to that I find the magical way to do it right…thanks for commenting acidrock.
If Humalog is too fast for you, I would think you'd still have an easier time if you simply used Lantus and R. Once you get your Lantus dosing about right, you don't need another basal insulin during the day.
I'm using levemir and novolog. I have not heard of type 1 being on 75/25 before. I think you may do better on a long acting and one of the fast actings for meals. Have you always been on the mixed insulin? I was on lantus but that was making me gain weight. I think novolog is slower because I wait around 15-20 minutes to eat.
I think for the most part everyone is going to recommend that you move away from the humulin mix and to a modern insulin therapy based on a basal/bolus regime. Twenty years ago the DCCT trial conclusively found this basal/bolus regime and the accompanying improvement in control led to truly remarkable health improvements. So today, every current and competent health practitioner will advise you to move to the basal/bolus regime. It doesn't have to be more expensive, you can buy humulin NPH and Regular (R) (which are the constituents of the mix) for essentially the same cost as the mix. Walmart sells vials of each for $25. Since you are already on Lantus, you could simply start using R at meals instead of mix. If you need more basal during the day you can split your Lantus. I found good books which clearly described how to implement a basal/bolus regime. I recommend "Using Insulin" by Walsh and "Think Like a Pancreas" buy Scheiner. They may be in your local public library.
And I have to tell you, with the conventional insulin therapy using a mix you typically take a "fixed" dose at the meal always trying to eat the same amount of carbs and then try to use additional food or correction insulin to make adjustments. You don't typically use a sliding scale to calculate the dose of mix, you use a sliding scale to calculate a correction bolus.
Thanks everyone for your comments, they are really appreciated.. @Meee, yes, TYPE 1 have been on mixes and 75/25 as well as 70/30. If I use just plain Humalog I do not get the longer acting effects of 75/25. Every diabetic is different and my daughter is the same way I am, I think it is just going to take time for me to get the dosing right. And P.S. thorough research has proven that a sliding scale can be used for 75/25. We can not guarantee that everything we eat has the same amount of carbs every time. Thank you again for your help I will have to further my research..
What I think you're missing here is that sliding scale and insulin mixes are very old-school, out-dated methods for managing blood sugar in diabetics. The modality is significantly inferior to the modern split basal/bolus, carb-counting ratio-based approach.
The degree of (lack of) control, and frustration you are experiencing, is not surprising. It's pretty much de rigeur for your treatment approach.
What we're advising here is to abandon that approach and update to the modern regimen. Take a long-acting 1-2x a day to cover your basal needs. Learn to count carbs, determine your insulin:carb ratio, correction factor, and then bolus with a regular or rapid-acting insulin for meals and corrections.
All this requires testing at least 5x a day -- wakeup, 2-3 hours after each meal, before bed. Tighter control would include testing before meals too, and adding correction to the meal bolus.
Ideally, this is all done with Lantus/Levimir for the basal, Humalog/Novolog/Apidra for the bolus. However, given the expense of these insulins, the same regimen can be achieved with regular R and N humulin. Some of the timing and dosing needs to be adjusted, but the same results can be achieved.
However, even if you don't have insurance, the makers of these insulin analogs have really good "getting started" offers. For example, Novolog: "Sign up for Cornerstones4Care® to receive an instant savings card that you can use to pay no more than $25 for Novolog® and each refill for up to 2 years.* " (go to the Novolog site). Lilly has also has a great offer on their site for Humalog.
The bottom line is, to achieve your stated goals, you will have to update your treatment strategy. It will be very very difficult, if not impossible, to get there the way you're going.
One of my fellow diabetics at work is on 70/30 novalog or something like that.
I think the reason I may not have heard of that is that I'm recently diagnosed, however, as Dave said the method you're using is outdated now. Type 1 & Type 2 on insulin are recommended to use a long acting basal and a fast acting for meals. Specifically for type 1 we produce very little insulin so the basal is covering our insulin needs throughout the day and the fast acting is covering what we eat. If your basal dose is good you shouldn't need a long acting with your meals. That was why I asked if you had used both and you have only mentioned humalog a fast acting. Were you taking a basal insulin also when you took that? I'm wondering if you have tried the basal separate from fast acting before? You said your sugars are not under control so I would consider trying them separately again or for a change if you haven't. I also recommend no artificial sweeteners- splenda spikes me also, aspartame makes me ill and has been linked to cancer. Stevia is the only safe one which won't spike you. Just make sure you buy the pure raw extract with nothing added in. Products made with stevia often add in sugar alcohols which add carbs and act as a laxative causing gas and intestinal distress. I have no idea why these things are used in food, candy and medications.
I see my doctor in 2 weeks and I am going to see my Nurse Practioner in 2 weeks and see what he recommends but his collegue has suggested splitting my Lantus into 2x a day and taking the 75/25 with meals...I count my carbs, I adjust my insulin...I exercise, I take my insulin every meal, it has nothing to do with me being lax or lazy about my health. And the approach I am using is not outdated. EVERYONE is different.Just because you might take 12 units for 47g of carbs does not mean it will work for me...I have a dear friend who is Type 1 she takes 1 to 5 units each meal.. I get patient assistance through Lily Care..my insulin is free. I have better numbers with the 75/25 then with just Humalog..
Thanks Kelvin..:)
meee..I take HUmalog 75/25 at meals and Lantus at bedtime...My sugars where under control for many years but over the last 3 yrs my body has changed. my doctor has me on:
Lantus 45 units at bed
Humalog 75/25 at meals (base is 12 units depending on carbs and BG levels)
Humalog fast acting if sugars won't go below 250. ( i used to use this at meals but it did nto stay in my system long enough so we went to 75/25,,,,so this is just a rescue insulin now)
ok.. think I understand now... maybe it would be better to just try another fast acting instead of the 75/25 because the extra long acting may be messing things up? At first I was correcting sometimes with Lantus and it seemed to confuse my body.. now I only correct with fast acting and take levemir 2x per day. I don't know, obviously these are just my thoughts on what you have said. There may be another solution.
I think splitting the lantus dose and maybe switching to levemir may help. I feel better on levemir overall I think I stay more stable although I still have my flucutations.
Okay... sorry for the unwanted advice.
Thanks Meee..you may be right...:(
Dave,
I did not mean it that way. I am sorry if you took what I said the wrong way.
Yes, mixes continue to be available, and are prescribed occasionally to newly dependent diabetics.
The reason is because some people are unwilling/unable to handle the more intensive regimen involved with current state-of-the-art treatment protocols. Also, there are quite a few older patients that are set in their ways, don't want to relearn everything, so the older treatment methods with mixes, base meal boluses, and sliding scale calculations are still around and used by many.
None of that changes the FACT that there are much better ways to treat this condition, and achieve far better control, as most of us here know (given we are following these protocols).
As this site demonstrates in spades, non-diabetic BG control is not only possible today, with all the latest and greatest technology (pumps, CGMs, insulin analogs) it's actually pretty straightforward and uncomplicated.
I take action any time my BG goes over 110. I rarely exceed 140-150 postprandial. Anything over 200 would set off the incoming nuclear missle klaxons for me.
This is to be contrasted with routine BG's in the 300s before I got on the wagon with modern treatment protocols.
yw :) well, don't worry, it's worth a try because it may work better and 3 years of not well controlled bg is too long... you need to get this under better control asap :)
Dave, you're lucky if your control is that straightforward. Mine is definitely not, as I was saying to my endo the other day... as hard as I work and careful as I am with diet etc., I can really never predict what will happen and I still have numerous fluctuations.