I definately see your points and have suspected they were trained in the “good old fashioned ways” for a long time. I’m actually not as rigid about eating as it might have come across as I can pretty much eat when I want considering I don’t skip a meal or feel myself start to get low. I don’t know why the glucose or straight sugar products don’t seem to stay with me but they just don’t during that lunch time. I also don’t think it’s an adjustment issue as those tend to make me higher than I prefer. The fact is, I made it work for the company, myself and the receptionist, but in the end they told me that’s why they were ending the job with no reason besides the fact that I wasn’t there to help her at 12:00 when we had all previously agreed (all as in the receptionist, my boss, the entire HR team) that I could relieve her and eat whenever I wanted, granted she didn’t have a meeting which I would NEVER question. There were also other questionable things done in the mix here but I don’t want to get too deeply into those. IE sexual harassment, the girl taking the insulin out of the fridge that day, because they aren’t directly relevant to the on paper reason they gave for firing me. I feel like unless somethings in writing it’s probably not worth delving too deeply into, but that’s just my thoughts.
Believe me I would love to disclose the name of the organization but due to the nature of the industry I worked for, I feel it unethical for me to do so. I’m definately researching further legal information.The ADA and the EEOC has been extremely helpful thus far.
You can take insulin vials in and out of the fridge and put them back after reaching room temperature… it is not a problem.
I agree that with modern insulins if they are properly adjusted there is no reason a person using them would have to eat at the same time every day. As others have mentioned, the way to determine if they are properly adjusted is to skip a meal and see what happens. This is called basal testing, it is standard practice…
So does everyone’s endos now days has them skip meals to test if their rates are good? Mine must be extremely old fashioned I suppose. They’ve always told me since I was 6 that could cause me to end up in the hospital. In all of the 25 years I’ve been diagnosed I’ve never heard of that, read about it or heard of any of my diabetic friends doing it. I suppose that probably because we all have the same endo. I will say one thing, if that was ever presented to me to try they might have to put me in a straight jacket. If anyone messes with my meals I usually turn into a wild boar.
I’ve tried to skip a meal one time at night before and I lasted until about 3:00 a.m. before a low. My endo told me to eat peanut butter before bed. Another one of my friends even further south than me also eats a sooon of peanut butter before bed every night. I could be wrong here but it seems to me like the region of your location depends on if they are willing to “starve you out” to do the basil testing practice that everyone mentions.
What you are describing sounds like how we used to eat on a rigid schedule, using the older NPH, Lente, and Regular insulin. With the newer insulin and pumps, there are more options to vary schedules and eating times, to accommodate flexible schedules.
The book Think Like a Pancreas or Sugar surfing describe more up to date ways of using insulin.
What is a newer insulin you’re referring to?
So just so we’re clear, you can go to bed without eating any supper and not get low? I use that example because that’s the longest time span you can easily use to skip.
Sam19, if you don’t mind me asking what is the lowest basal rate of all of your basal settings that you have set? The reason I ask is because some time ago I saw that you were on a thread where people were discussing really low basil rates. Mine is pretty low but I’m just wondering if it’s safe to go any lower at this point.
Also little side note here, I had my own mini fridge in my office.
I have “Think Like a Pancreas” I’ve only gotten to the first two chapters but I’m really excited about the others. I didn’t mean to exclude you MM1 from the lowest basil setting question I had. I’ve seen the other fellow on a previous low basil settings post is why I directed it to him but now I’m curious if mine might actually be higher than I thought. There seem to be a lot of low carbers here in this tudiabetes community.
The right amount of basal for you is the amount that keeps your BG relatively flat. Basal testing is when you intentionally skip meals for portions of the day, and confirm if your basal is correct by frequent BG testing or use of CGMS. There are many books and websites that provide specific details for testing different portions of the day, rather than a 24 hour fast.
I think you mentioned you are using pump/pod. Has your medical team helped you to manage your own settings, or do they do it for you ?
Humalog, Novolog and Aprida are the current fast acting insulin typically used in pumps to provide both basal and bolus. If not using pump, then Lantus, levemir, tresiba are commonly used for basal.
I use humalog in an Omnipod but I basically calculated all of my settings on my own. My peaditrician when I first got a pump as a child gave me a good template and I’ve just worked off that as I’ve aged. I think my lowest basal setting during any time period of the day is 0.6 per hour. I take less now then I did as a child but I’m sure some people that do this “fasting” take less than that amount? Just a guess, I’ve had to basically just use my instincts to survive through most of it.
I will say I had one awesome diabetes specialist help me along the way before he left his practice, but no endrocronoligist I’ve met has given me any solid setting advice to use ever. Like I said I’m sure this is a costal issue since I live in the south.
My basal ranges from .425 to .550 throughout the day. I also use alternate patterns on days I am more or less active, with total daily basal ranging from 11.4-12.7
On any day I can vary the time of my meals without going high or low, because my basal is set to what is right for me. Others may have much higher rates, even if same size/weight. Weight is often used to determine a starting point, and then adjust for each individual. For women, it is common for significantly different rates during hormonal changes, due to insulin resistance.
Great to hear you are reading TLAP. The author also has website with lots of great info, including detailed instructions on basal testing.
He’s quite intillegent and funny which makes for a beneficial and enjoyable read. I’ll definately check that website out.
Bravo, this looks exceptionally personalized. I can’t wait to delve into it more.
I don’t use a pump, I use tresiba 1x daily for basal. I skip meals numerous times a week…
Yes it’s pretty standard process to do basal testing by skipping a meal. If your basal is driving you into lows if you don’t eat, it’s means it’s too much…
It sounds like your doctor is giving extremely old school advice from back before current generation insulins. “Think like a pancreas” is a good book that talks about how to get basal set just right to prevent lows, so is “pumping insulin” (also “using insulin” by the same author)
I use around 20u of basal a day (from a 1x daily injection) if it was pumped instead it would translate to about .85u/ hour generally (if you believe that all insulins are created equally— which I really don’t)
(Sorry if some of that had already been said I only log on with a cell phone and have very poor data service so it’s very hard to follow along in longer threads sometimes)
So that’s relatively close to mine give or take. I know when I was a child I would take 1 plus units an hour but since I’ve become an adult I take less. I honestly didn’t know if there were many type ones my age that take less so I appreciate the ball park numbers from folks who are also in good control or striving for better control as we all seem to be here.
It’s not a negative thing… making a small sacrifice of skipping a meal once in a great while is a tiny sacrifice to make in order to ensure ones basal is set correctly, the freedom that comes with that is immeasurable