Minor changes, major results

Since I stopped just doing what I was told and started being an active participant in my D management a bunch of really good things have happened. I switched endos and have seen the new endo twice first time my A1C was 6.4 this time 5.8 and she was perfectly happy with the number because she could see from the Dexcom that it was not a "bad" 5.8 combining many highs and many lows, but a "good" 5.8 representative of consistent blood sugars. In December I stopped taking Humalog before meals and started taking Apidra. What would seem to most medical professionals as an insignificant change because they are taught all fast acting insulins are the same, was for me a huge step on the path to better control. Humalog for me hung around for 5 hours and created some really bad hypos hours after a meal, Apidra is done and gone in a little over 2 hours and does not cause the post meal lows. It's also a lot easier to correct a bolus miscalculation without stacking. The only downside for me as an MDIer was the similarity between the Apidra pens and the Lantus pens since they are both Sanofi Aventis products and use the same exact solostar pen shape. I stupidly mixed it up one night and ended up taking 14 units of Apidra thinking it was Lantus. That was not a fun night. I decided to approach this problem logically. I could switch back to syringe and vial for basal or I could just change basal to another type. Since I like the convenience of pens I decided to switch from Lantus to Levemir. Naturally I read every thread on here about switching. There were of course the usual horror stories, lantus didn't work, levemir didn't work, etc. But for me after an initial small increase in dose I am really loving how "even" and peakless levemir is. Yet again, the medical professionals would say both basals are peakless, 24 hour insulins but we all know that is pharma hype. Lantus would peak and send me low about 3 hours after taking it. With the Dexcom I could see the drop literally every single day at 9:30 am and 11:30 pm and hindsight being 20/20 I now realize that was the lantus, not my I:C ratios at breakfast or dinner. I swam a mile yesterday afternoon, followed that up with 2 1/2 hours of social mixed doubles tennis and my blood sugar stayed constant with some help from skittles and some Sobe water. I started swimming for exercise and find time to fit in an hour in the pool most days. I am tracking my swim to China 1 mile at a time, so far I have managed 33 miles. I'll get there eventually I have no doubt it's only 6981 miles but I am 0.47 % of the way there.

hmmm that is what my endo said when I asked about trying a different insulin, now I will demand it :)

clare, congrats on your huge success! more than anything you should feel so good about yourself for listening to your body and making educated decisions that work for you! as you suggest medical professionals sometimes do not understand the subtleties in everything and that cookie cutter prescriptions/medical care do not best serve their patients. when jacob was on MDI we gave novolog vrs lantus what a guilt trip for me, but jacob got to eat alot, can you picture it come honey one more candy bar ( it was just after halloween!). anyways keep up the good work. feels good when you own it, good luck getting to china!! amy

Thanks Karen my new endo listened when I told her I wanted an insulin with a shorter tail than humalog and suggested apidra. Although she had not had much experience with it, she took me to the back room at the clinic where they keep all the salesman samples and handed me a couple of free pens. "Let me know what you think" is what she said, and a week later I told her I wanted a new prescription. But I think all doctors and CDE's are told that fast acting insulins are the same and basal insulins are the same when in actual fact they can be vastly different from one D to the next. I read a lot here before I even considered changing so at least I could approach my endo as an educated consumer and give her the reasons I felt a switch would be appropriate.
Thanks Amy, I'm one mile closer to China after my swim today. I'm glad I'm not the only one who has overdosed on fast acting. But I'm sure Jacob was happy for the extra candy bar. I don't even remember exactly what I had but I am sure it had something to do with caramel and gelato.
Yahooo indeed Shawnmarie. I went shopping for bathing suits yesterday and what was in the past an odious task was can I say it ? fun this time. Got 2 new suits which are beautiful and a whole lot smaller.

Amazing progress, Clare! It is so important to find the insulins that will fit to your individual needs. Congrats and big applause!

Thanks Holger, it's amazing how very little I had learned about myself after 37 years with D, but the amount of information and experience here has certainly changed that for me. It is a lot more productive to go to a doctor's appointment with a plan and be able to explain to them why you are asking for a certain insulin or why you have stopped taking a drug, like statins. Endos in general are more likely to listen if you come across as knowlegeable and if your results back up what you say. While life with D is always a work in progress, it is gratifying to see the hard work pay off both in how I feel and in how I look as well.

Bravo! The swim to China seems a goal you'll easily reach. :-)

I would not say you have learned little. Perhaps you have just arranged yourself with the tools you had. I did that too and have used Regular and NPH for a long time. The switch after 20 years to the modern analog insulins has been life changing for me. Just recently and out of curiosity I switched to Lantus (two shots per day). To my surprise this worked even better than Levemir - which is a basal insulin I highly recommend.

I am not on insulin, so I'm not sure about all of the terminology. What is a dexcom? I would love to be at 5.8. I'm at 6.5 but after reading your post I am questioning whether my 6.5 is even ok.

Hi Babs,
The Dexcom is a continuous glucose monitor or CGM it gives me a reading of my blood sugar every 5 minutes which helps me avoid lows and highs and helps me keep my blood sugar in a relatively normal range. The ADA recommends an A1C of 7.0 or less and the AACE (American Assoc. of Clinical Endocrinologists) recommends an A1C of 6.5 or less provided hypoglycemia is not an issue. An A1C of 6.5% represents an average blood sugar of 140 which is just a bit higher than I want to be, but it is a constant battle.