I haven't been on shots for almost a year, i've only known i was type 1 diabetic for a year and a half.
I've been wondering about a few things, if you have anything to help me that'd be great! :)
-I went back to shots becasue i had a VERY difficult time controling and maintaining my blood sugar levels. They have been much better since the shots (Why???) but i still run a little higher and i haven't had ANY lows...have any idea why?
- I've been doing all my shots on my stomach, any other places that work and don't hurt as much?
- If you are on shots, what insulins do you use? I take Lantus once a day and Novolog evertime i eat/correct. And, how much do you injuct a day?
I use Levemir 12 units, and for my meal or correct I use Apidra 4 or 5 units before meal ( I count my carbs). One year ago I was under Lantus (8 units) and every day I used to have a big low in the night, and a big low in the afternoon. I injected Levemir in my thighs and Apidra on my stomach/abdomen. I never used a pump. Now I can control my blood sugar levels because I control what I eat (carbs counting) and how many units of insulin I need. Courage! I don’t understand why you stop pump? People who use pumps seem happy to use them and have good control. These days I’m going low after meal because I’m sure I only need 10 or 11 units of Levemir, but with these numbers I have high blood sugar when I wake up. When did you inject your Lantus? I choose 7 in the morning when I wake up.
I am on Levemir 11 units and for meals/correction I am on Novorapid same as Brigitte I carb count that helps me figure out how much insulin to take for that meal.
I use my thighs a lot,its a brilliant place for me hardly feel any pain and do move around a lot.Hardly use my stomach as it hurts and get marks after.
Goodluck and get in touch if you need any help.xxx
Yes, I understand you. I’m older than you but I’m a thin woman and yes people can show a pump! You have the chance to live in California, good weather, a dream for European. Now it’s time to have lunch in France!
I chose do do my Levemir in the morning because I am afraid to forget to inject it at night, and I go out too many time at 9 or 10 at night. And I don’t sleep too much. If you need help We are all here for you!
Im thinking that perhaps on your pump you/ your healthcare professional didn’t allow for the extra insulin sensitivity that a pump causes. If that’s the case, then having gone back to your usual doses you’d have fewer lows. I use the outside of my thigh, the top of my bum, and my stomach, but if you have a decent amount of fat on your arms you can use them too. I’m on 14 units Levemir at night, and my Novorapid varies depending on how much carbohydrate is in the foods i eat, but I have an I:C ratio of 1:10, and i’m extremely hungry most of the time. I’m about to go on a pump, hoping that it will allow me to snack more easily and bolus at restaurants etc without having to use an open needle in front of friends.
I recently went back on shots for the summer so I could spend time exercising in the pool. I use the Lantus, and Novolog just like you are using. I have found my blood sugar jumps around… high, then low. I have been having trouble keeping it consistant. Were you on a MiniMed pump? You might want to try the OmniPod. No tubing, so fast and simple to apply. Not all that tubing, priming, and it inserts itself…Good luck!
Megan,
Biggleton is right. You use less insulin via pump, so you need to look at your basal amount at 4 time periods through the day and determine if you need more.
After that is set so that you know your round the clock BG is in your target zone, then recalculate your I:carb ratio to set enough for each meal. I:C ratio may differ between meals. You’re doing GREAT to be asking these questions.
I am on shots and use humalog and it really works for me and i dont think i could find a better insulin for me . do whatever works for you is my method and belief . mine is a sliding scale so I really cant say . I dont think I will ever use a pump because it is so hard to get insurance when you are a diabetic and if you cant afford it you go with out and pray to god you dont end up in the hospital .I dont think I have ever had health insurance cause we could not afford it . Even through my husbands work is very costly and when you have to decide wheather you want to eat that week or pay your health insurance then you know it costs too much .
Hi Megan: I’ve been diabetic about 13 years now, and I have always been on shots. I take Levemir twice a day at bed (11 units) and morning (6 units). The split dose works from me. I take Humalog on sliding scale before meals. I tend to watch what I eat so I do not have to take big shots of Humalog. Of course, the higher the carbs, the more Humalog. I inject in my stomach, thighs, butt and upper arms. Shots, for the most part, work for me. With diabetes, I find you have to constantly adapt and make it work the best you can, because we are thrown a lot of curves each day. I know the pump is a wonderful technology and works for a lot of people, but a pump would never be for me. The insulin pens are a good choice for me so I am glad for that option. Good luck! Peter
I am on shots with Novolog and Levemir. I am not a big fan of Lantus because there is quite a likelyhood that one shot will not cover 24 hours. I also dislike that this one shot regime is just too static for an active lifestyle. Many Lantus users have an incredibly high dosage to cover the whole day and this often leads to lows - especially at night. With a two shot regime on Levemir you can react to heavy physical activity by decreasing the night dosage for example. This also gives you the right mindset to always think about the right basal dosage - very important for times of being ill. This is truely an advantage because I am convinced that a good basal coverage is the fundament for good control. Without good basal coverage you will need many corrections with the danger of overcorrections for example. Please do not believe the claims that Levemir is a one shot insulin like Lantus. This is just a claim that is valid because the higher the dosage the longer the coverage. With two shots of Levemir you will be on the safe side and will reach 24 hour coverage for sure. With my endo I can try different basal insulins to find out my individual reaction to it. This is something I recommend to you too. Just be experimental and seek a medical team that will support your search for improvements.
Most likely reason to be better on shots is that it tends to average out your available insulin - there is always some insulin floating around in you. If you are not properly tuned for the pump (which I gather takes a lot of effort) then shots that average out the insulin can work well. In addition you probably have honeymoon insulin helping round out your insulin needs since you have had T1 for only a year and a half. And you are young and a student, so your days are probably radically different one day to the next (exercise, food intake, food timing) so averaging may work well for you. That said, most people who have pumps (I do not) seem to like them a lot and think they improve their control, so I would recommend putting it in a drawer and keeping it for future use.
I agree that shots in the stomach can be a bit more painful (although I inject there when I’m in public like on an airplane) and I don’t have enough fat on my thigh or arms to be comfortable with that; my preference is my upper buttocks which I find pain free; here’s a diagram of all these recommended sites LINK HERE.
I use Lantus, but I split my dose; half in the morning and half at dinner - about 12 hours apart. I found that Lantus didn’t last a full 24 hours for me - I found my BG rising even with no food as I got close to the 24 hour time - so splitting the dose gets me more much consistent coverage throughout the day. But if it works the full 24 hours for you there is no reason to add the complexity of splitting the dose. I use Humalog for bolus; I tried Novolog and thought that was good too but didn’t see a big difference.
Keep up the good work; and keep trying to learn more about your diabetes. After 35 years of T1 I find there is still a lot for me to learn.
Hey Megan - I was like you using a pump - except I wasn’t having any probs with BG’s - I just wanted a bit of a break. I may go back to the pump - but I am still paying for it until 2011 - so might as well get some use out of it - but at the same time - I don’t miss being wired up to it. I do find tho’ with being back on injections that I “think” more about diabetes. With the pump, if it’s working correctly, I found I thought less like a diabetic for some reason. Do any of you other pumpers feel the same way I’m wondering?
I use Levemir twice a day - I was using Lantus - but had too many low’s at night and waking up - so decided to try Levemir as some people (Brigitte) said they had less lows. So far it’s working. It’s taken a few months to get my basal settings right, but then today - I woke up to BG of 11 / 198 - which isn’t normal for me - so who knows what is happening there (and no - it’s not time of the month ).
I found that after using the settings my doctor told me to use when I went back to injections, that I am now almost using the same amount of insulin that I did with my insulin pump, except use 2 insulins instead of one. Between my 2 injections of Levemir - I’m averaging about 14 units a day - tho’ today I gave more in the morning due to high. Hopefully that doesn’t backfire on me later, and I have lows, just means I will not have to inject as much with NovoRapid (Novolog). I average about 10 units a day of NovoRapid. I’m finding now with my basal rate sorted out (took over 2 months of … patience) I do not have to use the NovoRapid for correcting my BG, except I did today of course.
Hope this helps. Hang in there, it can be abit of a head banging experience at times with diabetes. Trust me, I’ve been dealing with this for 43 years
I use my bum, legs for my Levemir - and my stomach/arms for my NovoRapid. I also use 32 gauge pen needles. What do you use, regular syringe? I hate using those because they aren’t as fine - or maybe they are now.
I’m on 10-12 units of Lantus and 5-7 units of Novolog before meals. I’ve never tried Levemir and my new endo hasn’t said anything about it since he’s been trying to get me to go on the pump.
I was, indeed, having a terrible time on higher doses of Lantus to cover 24 hours. 2 smaller doses of Lantus screwed with my exercise plan though. I would always go low during my evening gym sessions regardless of my Lantus dose. I have since lowered my one evening Lantus dose and I make sure I get into the gym in the afternoon before dinner and before my evening Novolog dose.
So far, so good. I can adjust my dinner time Novolog according to my BG and I usually can get coverage all the way up until my evening Lantus. I’m waiting for my Dexcom to check my overnight BG but I’ve had more consistent early AM spot checks, less nightime hypos and a more stable fasting since going back to 1 Lantus shot and regular early evening work-outs.
I realize this doesn’t follow your advice and I wouldn’t recommend my program either. But I’m very active and work-out regularly and, barring a switch to Levemir instead of the pump, it’s what I’ve found works best for me.
Hopefully, I can apply what I’ve learned when I go over to the pump.
First of all congrats on making the switch - must be tough to decide that since everyone is always saying pumps are better, but clearly it wasn’t better for you!
We did shots for 10 months before switching to the pump, and we used Lantus 1x daily and Humalog for meals & cx… the Humalog had to be diluted though because my son was so little, he only took like 0.3 units at a time. That’s the main reason we switched to a pump - diluted insulin sucks at maintaining BG control (anything under 250 was considered OK!). Eric didn’t seem to mind the butt, thigh, or stomach shots, objected a little to shots in the calves, but boy did he hate having them in the underside of his arms so we didn’t go there. One trick you might try if you have thin or sensitive skin (or very little body fat) is, pinch the skin up and slide the needle in at a 45 degree angle rather than a 90 degree angle - as long as you’re under the skin sufficiently that the insulin gets where it needs to go, that might help you to avoid hitting muscle or nerve fibers (and that’s what really hurts).
Second of all, you may be running higher and having no lows because you aren’t getting enough basal insulin, or you could also be in a growth spurt (growth hormone makes you insulin resistant) so that you need more insulin than you’re currently getting. Or, your carb to insulin ratios could need tweaking. Or, all of the above. Do you keep tabs on all your insulin usage each day? It’s good to do that because keeping your ratio of basal insulin (Lantus) to bolus insulin (Novolog) at the proper level is going to help keep your BG stable. If you log your insulin and carb intake each day then, maybe on the weekend, you calculate your daily and weekly averages of total insulin (Lantus + Novolog) and figure out what percentage is Lantus and what percentage is Novolog, it will give you a sense of whether the ratio of one to the other is correct. My son’s CDE tells me that at least 40% Lantus to 60% Novolog is necessary for stable BG, and closer to 50/50 is even better, but talk to your CDE about what the Lantus-to-Novolog ratio should be for you - they should be able to tell you what someone your age, height, and weight ought to be using on average for basal insulin so you can use that as a target. It may be that you had trouble on the pump because you didn’t have your settings placed right, and plus you’re still growing so the settings keep changing as you grow, which is annoying as all hell (I have a 3-year-old on a pump and it’s crazy-making sometimes, the setting change every time I turn around!).
I am type 2 (don’t hold it against me) I am on Lantus (38 units) at bedtime and Novolog 3 or 4 units per meal. I do no carbs so I shoot to adjust before I eat accordig to my BG before the meal. I shoot to adjust down to 100. My last A1C was 5.5
Hate to be a spoilsport and a “Mom”, but did you know that not getting enough sleep can affect your insulin sensitivity (makes you mildly insulin resistant)? If you aren’t getting a full 8 or 9 hours, that could very well explain your highs… I’m just sayin’… Even ONE NIGHT of insufficient sleep is enough to have that effect. Think about it, next time you want to stay up late.
Hi, Megan. I totally understand your choice of shots over the pump, too! I feel the same way. I do a lot of shots every day and have to move around the injection site. I recently split my Lantus into a morning dose and an evening dose (per my doc, of course), and I take Humalog at every meal and boosters throughout the day as necessary. Like several others on this thread, I try to count carbs to know how much fast acting to take. Shot sites I like – thighs (just to the outside on either leg, farther from my knee rather than near it), triceps area, stomach (least favorite). But from the sounds of all these messages, it’s really about trying different places to see what works best for you!
Good luck!!
Hi Megan,
I hated shots, and love the pump, but really you have to do what works for you! I hope you find the best method to make your diabetes in its best control!
On MDI you will always need additional carbs to cover heavy physical activity. The basal rate should be picked in a way that covers normal activity. To have a dosage that needs the additional activity like you have choosen is to restrictive. It will structure your day in a way that takes away any flexibility. There will always be days where the activity is not possible. On these days you risk higher numbers. Why not setting the basal right and then you figure out how much to eat as a preparation. For example I will eat glucose tabs and drink juice for my 1 hour workout if necessary. After a while you will know exactly how much carbs you will need and how fast they need to be. This is also helpful on the pump because the reduction of the basal rate must for most users happen one hour before the activity. Otherwise the insulin on board will drag you down as the basal insulin on MDI does.
I’m still having to cover physical activity with additional carbs. That hasn’t changed. It feels like the afternoon is a strange middle area where a single Lantus dose is tailing off, maybe, but still on board. Even if I don’t work out, which is rare, I just have to eat dinner a couple of hours earlier.
I know it’s strange and I know I need more flexibility but that’s why I want to get off MDI and onto a pump rather than screwing around with Lantus or Levemir.
