Glad to hear your experiment is coming along, bsc. I know you’re proceeding methodically and don’t yet have results, but hang in there. All you need is enough to show the new endo to justify your use of insulin, but on the other hand if your numbers don’t improve, that’s its own result and also indicates the need for insulin, no?
Yeah, the “stuff” factor is a bit easier for us girls. Are you a backpack kind of guy? I personally prefer backpacks to purses if I’m not needing to look pretty as they leave your hands free and the weight is well distributed.
I still can’t figure out you and Lil Mama being so actively interested in insulin and not being able to arrange it? It doesn’t make medical sense to me, although I don’t know squat about T2, it seems like it would make sense if the other, pricier meds weren’t working? Complications know no type.
Re the $$$ trail, I knew I should have gone to medical school!
I have a backpack, but if I am off to a restaurant or shopping it is not that convenient. I also need to figure out the gym. I have usually not tested, let alone needed to treat in the gym, but the day may come. At least for now, my blood sugar just skyrockets in the gym so at least for now I don’t have to worry about hypos. That may change with insulin.
I got a messenger bag @ a street vendor in NYC that is pretty useful. It won’t hold a laptop but I don’t lug my laptop anywhere anyway and it is a bit more aerodynamic than a backpack. It will hold a 6 pack though.
Thanks!
I think bsc and LiL MaMa are getting treated badly (both literally and figuratively) because their doctors are following a protocol, and can’t see past it. Also, these docs may not know much about insulin in non-obese Type 2’s.
Exogenous insulin suppresses endogenous production, and so up to the point of a person’s particular insulin requirements, will not particularly cause hypos. Of course, too much is too much, and when a hypo occurs, you know that’s the place to back off about 2 units, and you’ve arrived at the right dose.
When I first went on insulin (NPH at night), I started on 5 units, and gradually worked up to 20. That proved to be too much, and I backed down to 18. I know I had significant insulin production at the time, but did not have hypos until I reached 20.
Same thing with R during the day. If you’re going low 4 hours after meals, you know the dose is too high. If you’re peaking too high even so, then you increase the time between the injection and the first bite of food. That’s how I figured out how to use R; my doctor was of no use, other than to write prescriptions. Mind you, I never did get peaks under 180, much less under 140, but at least I wasn’t going into the 300’s.
It really irks me when I know more than the doctor!!
Those are all great suggestions. I do have a backpack that I use to carry my laptop in and I’ve used it to carry my supplies for quite some time. But it is not the sort of thing one would carry into a nice restaurant. Some of the suggestions you all have made do seem more appropriate. And as acidrock notes, you can fit a six pack into a messenger bag.
there is a marathon man who measures his bg every 20 min i think; he talks about the best meter to use when undertaking sports activities; it may help you out (?)
ps to above: for your gym work
my mother just brings her pen in a ‘hard case’ to the restaraunt, and that works for her
you could try the manufacturers of the pen for suggestions about lugging it about town
Glad to hear but not surprised that you are doing well. Today I had a pleasant surprise I asked the pharmacist if I needed a prescription from the GP to try apidra. I was worried that I would have to justify why I wanted to change. And thank God for small mercy the pharmacist said I will give you a prescription. Don’t know if it is any better but cheaper by $4 per vial.
I continue to move slowly, eating low carb and making slow changes. I decided my basal during the day was “close enough,” I got my preprandial levels before dinner down to 90. But I still need to work on my morning reading. One injection of NPH in the morning appears to be sufficient for all day. I then take another injection at 10pm when I go to bed. I’m working on that nightly injection to try to get my morning numbers down. If I could get the average of my morning readings below 110 mg/dl, I’ll be a happy camper.
It has also become apparent to me as I test more that I am going to have to bolus for at least lunch and dinner. I am taking a bolus for dinner and have done reasonably well. But lunch is still a problem. It seems clear that a any meal over 15g of carbs will leave me > 140 mg/dl at two hours.
The biggest difference is actually with exercise. Usually, I would be more than 200 mg/dl when leaving the gym. Last time I was under 100 mg/dl. A real surprise. I’m going to have to start being better prepared in case of a in the gym. I’ve not had any treatable lows (< 70 mg/dl) to date, well except for that one time early on where I bolused at the restaurant and the meal was delayed. My daughter gave me a mento, but I’m better prepared.
What were your readings before you started exercising when you had those 200s, B? If they were 300, you exercised 1 hour and they dropped to 210, that’s a pretty darn good drop. OTOH, if they started out at 125 and rose to 220, then that’s not so hot. It also makes me think that at some point, you may have gone far lower than you realized, perhaps down into the 60s, but that you rebounded relatively strongly. It’s worth investigating if you haven’t done so aleady.
If you’re still doing the NPH-R combo, keep in mind that by lunch time, your R has peaked and should be out of your system. The NPH has to handle the load and, as has been said before, NPH’s peak time is quite wide and unpredictible. While I’ve known many very thin type 1s for whom NPH has a profound peak, I wonder if the peak flattens for people who are not as thin. That may explain why you are unable to handle more than 15g of carbs at each serving. It’s also possible the 140 is a reading while your bgs are on their way down. It’s a shame you can’t get your hands on a CGMS to get a better idea of the trend of your bgs to see exactly how the insulin is working.
bsc, long term you ‘could’ be prepared with for severe hypos with a spare ‘glucagon’ injection/shot.
do any other Tu members carry these in their arsenal for severe hypos?
note these injections (single dose needles) have an expiry date.
i think its for use by a family ember freind to treat a severe hypo??
i dont know if its a big issue with T2s?
i might start a new post to get more info here?
Well, I generally started at my typical impaired fasting, 120-140 mg/dl. I wouldn’t exercise with a blood sugar of 300 mg/dl. I don’t think it is a rebound high. I am quite hypo aware and I’ve taken measurements during exercise, It think it is just a rise, probably amplified by insulin deficiency and my anaerboic exercise. You are right a 200 is all relative.
I’ve not been taking R at lunch, only at dinner. I seem to have a weak natural insulin response to small amounts of carbs. I usually rise 2-3 mg/dl per g and at a peak hence would expect to be at 130-155 for 15g carbs at lunch. Today, I messed up I had mixed veggies (with carrots) and some soup with some potato chunks. I was 153 mg/dl 2 hours after lunch, but was down to 72 mg/dl before dinner.
I just think I am going to have to move to a lunch bolus in the near future.
Hi, bsc. I’ve been watching your progress with great interest. How soon do you get to see someone who will give you prescriptions for 21st century insulins? Whatever you are doing is educational, but not as good as it ought to be… Anyway, your project is a good idea, and best of luck.
Hypos and in particular serious hypos can happen with anyone who uses insulin or a sulfonylurea and T1s and T2s are both at risk. Glucagon shots are an effective treatment of last resort. While I think they are good to have in your “arsenal,” they should be part of your “layered defense.” Your defense should work to “prevent” hypos by managing your insulin/medication regime to not place you at significant risk of hypos. Second, you should work to detect hypos early and treat them and in particular treat them at a level appropriate to restore normal levels. Glucagon is a last resort and should be used to restore safe blood sugar levels when you are unable to treat. Unfortunately, this means that the primary user of glucagon will likely not be yourself. If you are coherent enough to use a glucagon shot, you are generally able to “treat” your low.
And as to your specific question. No, I don’t have a glucagon pen yet. It requires a prescription. I realize I am at risk, but I won’t give my doctors a chance to intervene yet. When I do meet with my doctor in another two months, I will ask about a pen and I will give certain family members training.
