The Necessity of using Insulin

Type 1 and LADA
1

Hey everyone, hope all is good.

I have a few questions.

My regiment exist of slow acting Levimir and fast acting Novalog. However, I boosted up in my weight and I think it had something to do with the insulin. I began my own diet to lose. I am to take 14 units of Lemvir before bed but the more I get to know my carb to ratio and how this insulin works period with me, the less I may take one night per the other. I feel like the slow acting Insulin Levimir is crucial, I wont say the same of the Novalog and this is why. Yesterday, I woke up and my sugar was 133, so, throughout the day I had a piece of toast for breakfast, an atkins bar and 12 slices of very thin ham for lunch, < I was on the go. Then through out the day I had carrots, about 5 beef sticks, I love beef sticks, some more ham, maybe about 5 more slices of ham, and then two celery sticks before bed with a very small amount of peanut butter on them. No Novalog insulin throught the entire day. Today I will follow the same eating pattern except for supper, I will have green beans and salmon, possibly an apple as well. If my sugar is low by evening, I may not take the insulin before my supper. I did start out at 7 units of the Levimir but with my regular eating habits at that time, it kicked up to 14. I only used 8 units last night and woke up with the number 133, as I did the day before and this morning.

Calling the doctor and speaking to the Nurse would result in being told to eat 3 times a day with the shots more than likely to stay balanced. Well, for me this is kind of balanced, how I am eating now. I usually eat an egg, peice of toast and a very small apple in the morning, then buy lunch, one piece of bread, ham and an atkins drink. I dont snack too much in between and eat a protien and vegetable along with a small apple for supper. If I do eat between I like the atkins drinks and snacks, super low carbs but a little high in fat. The way I see it, you cant have it all so you might as well have something.

I just dont like to force myself shots just so I have to eat a circled balanced meal. The Levimir may work just fine for my eating habits, I wont know until I continue this out for a time. My carb to ratio is looking like 10 to 16 from what the doctor has measured up, I think its more like 8 to 10.

So...does anyone do it like this? I'm not a stop and eat 3 times a day person, I do it sure..but if the carbs arent there to inject a shot, then I will refrain, I'm not going to force shots if I know my sugar wont spike with the entended meal I choose to eat. Its different 3 days a week for me with my employment, I am very physical in my work. I check my sugar often. I was just wondering if anyone else does do it this way. I only want to take the insulin when its necessar and needed according to my numbers. Not sure what category to list my question in. I am type 2 but insulin dependent.

Thank you all ahead of time.
Sherri

2

Hi Sherri: It sounds like you are doing great! As long as you have the long-acting insulin on board, I think it is just fine to eat when/what you wish. I use an insulin pump, and I like the freedom to eat when and what I want.

Congratulations!

3

Hey! thank you on this Melitta.

It's a challenge, but its a lifestyle that has to be cared for or else... I am to go to a neurologist because these stent gloves for my hands no longer work after 17 years of use and its possibly time to see if surgery is due in order to correct carpal tunnel, why I cant skid through life without fun ey? bummed me out when the doc said they check by sticking needles into your hands and arms, I thought, oh JOY! more needles, AAAAAHHHHHHH!!!!!! Oh well, my hands will feel brand new when this is over...I think.

I will survive, (sigh)

4

Look up EMG and Nerve Conduction… It may look scary but, it’s not painful.

5

I think when you start with insulin, the whole idea of taking muliple shots a day is just daunting. I mean why go and take 4-5 shots a day when maybe you can just have get by with 1? And maybe for low carb meals, you don't really need any insulin. But there is a balance. I am also a T2 on insulin. I couldn't eat an apple and hope to keep my blood sugar down where I want it. I even have trouble just eating a meal with meat/seafood and green veggies. And I have had bad carpal tunnel syndrome. I had surgery. And I believe that it as at least partially a result of my higher blood sugars. So I want to keep my blood sugars tightly controlled as I expect you do as well.

But thinking that basal insulin (Levemir) will give you enough insulin to "cover" your meals is perhaps an illusion. If you raise your basal to do this, you may go hypo if you don't eat, and it may drive you to eat all the time and then when you do eat, it will do a poor job of bringing your blood sugar down.

I think you have to make a decision about this yourself based on testing your own blood sugar. I would encourage you to bring your blood sugar under tight control and there is no reason you cannot aspire to get an A1c down to 6% or even lower. These days, I eat low carb, I just accept that I need to take my injections and I am fortunate that my mealtime injections are small (as should yours be).

6

Thank you Sportster..

I'm going to to just that, I want to be fully educated on this deal before any deal goes through, not to mention run the doctor by Google to make sure he has good credibility.

7

Thank you Shawnmarie..

I'm comforted knowing others are on this wagon with me and well with all of this, I like what is revealed in here more than what I learn at the doctors, it matters. I'm sure thankful for the forums, I have learned much.

delilahjed

8

Right bsc,

I'm with you here all the way, and like you, protien and veggies for supper, well its still at 8 to 10 carbs to ratio for me, to my misfortune. Now, if I eat small amounts through the day, veggies, I remain less hungry come supper time for a full meal. Also, your right on that basil, I use 14 units in the morning for the day and dependent night fall numbers in which I am still in the trial and error part of things. So its starting to come together, slowly but surely. I am having a harder time getting the added weight off but I want to remain at 130 lb to 132 lb. I dont mind eating veggies, protein and fruit, but like you again, an apple brings on the higher numbers. I love apples. I sure hope to get that A1C to 6, I fully agree on this, I think I am heading that way.. thanks again.

jedidiah

9

The most important lesson that I have learned since coming to TuDiabetes is that basal insulin is NOT there to cover meals. It is there to cover the steady drip-drip-drip of glucose released by our liver whether we eat or not. Whatever that drip-drip-drip is for your body -- and we all have our own natural rhythm -- the basal insulin should be tweaked until it should hold you steady wherever the bolus insulin left you.

The way to figure this out is explained much better than I can in the books, "How to Think Like a Pancreas" and also in, "Using Insulin".

If I inject the correct basal insulin in the morning, then test my BG in the afternoon (four plus hours after any food or insulin injections) my blood glucose holds rock steady from there over the next four, five, six hours. If it drops more than 30 mg/dl during several hours of a fasting basal insulin test, you have too much basal on board. If it rises more than 30 mg/dl, then you have too little basal on board. If you were trapped in an elevator, if your basal is set correctly, your blood glucose should hold steady until the basal insulin wears off. That's what it's for. Not covering meals.

The reason this is so important is that if you use it to cover meals, then when you are too busy/distracted to eat, or you go to sleep and don't eat, you'll very likely drop hypo, especially during/after a physically busy day.

If you eat an egg, a piece of toast and a small apple, you should need to bolus for the toast and apple (that's what? 25-30 grams of carbs?) If you don't need to bolus for a meal with 30 grams of carbs, then you're either honeymooning (your body is still making some insulin) or else your basal is set too high -- which could drop you too low in the wee hours.

10

Hey JeanV

Well said and thank you on this. I have just finished one book and have to get some more. I read about 4 at a time and needed to finish up the one I have on the food intake so as to get it back to a friend.

When I eat an egg, toast and apple for breakfast I definately use the bolus before a meal like that. If I am going to work I will only use 2 units oppose to possibly 3 if I am not working that day and eating the same food. My work is very physical, not a sit down job. Usually by lunch its around 80's and 90's after even so eating above said meal for breakfast, so its definately time to stop and eat. I just make it a habit to stop at a certain time, check my sugar, do the bolus and eat again. However, if I am just doing toast until lunch and or some kind of raw veggies in between and I am home, I then may not do any bolus dependent what the morning number may be and if I am active at home. Well, yes I probably am still in the honeymoon stages, but..thats ok, I have to live and learn.

I cant really be dependent on a precise reading after 4 hours in the day until I get to know this insulin much better and how to exactly use it. I did start out, by the doctors prescription, 7 units in the morning and night, but..it went up to 14. I then decided, no..thats not going to happen. So, I have been eating perfectly to get this thing down to a science if you will. So its back to 8 units so far, but..I do that if and only if my sugar is hovering around 133 before bed. Well, like I said, I am learning this stuff and my body. I did have an upset one night in bed, my sugar dropped and I thought..uh oh! made a mad dash to the kitchen to eat. Too much basil that night, my fault.

I went to my regular doctor today, not endo, and talked to him about this too. He said not to bolus if the sugar is already low and I am not going to be absorbing alot of carbs. Well, if its vegetables thats one thing, if there is carbs involved thats another. Man, so much head work to do. Thanks again for the info, its all very informative and makes all the difference in the world to me.

delilahjed, < sorry, I'm use to using jedidiah too, LOL!

11

Yes, I see. A busy, physically active day of course makes a difference. Especially if you are very active one day and not very active the next. I am partially disabled right now and cannot be very physically active, but when I am active, yes I have to watch my basal or it will drop me too low in my sleep or the next morning. We are not robots, eh? Our days and nights vary in so many ways. it sounds like you are working very hard to learn and stay on top of diabetes -- good on you, for your dedication and all your efforts.

12

Well thank you very much on this JeanV..

And, bless your heart, sorry to hear of that disability, wow, that cant be easy. I will pray for you ok? its the one thing that keeps me going in the right direction is seeking a direction, that being said, The Lord is my strength in these things in life. I have found great comfort here with some very wonderful and real people, I also know it was a leading from the Lord, see,... I have learned so much in here. Its a blessing, a true blessing.

Thank you again
delilahed!