Let me be a little more emphatic. DON"T INJECT INTO MUSCLE!
From the prescribing information:
Inject LANTUS under your skin (subcutaneously) in your upper arm, abdomen (stomach area), or thigh (upper leg). Never inject it into a vein or muscle.
Lantus is formulated so that it forms little crystals in your bodyfat layer which dissolve over time. Inject it into a mucsle or vein and BLAMMO, you have a rapid insulin.
Did I actually say BLAMMO?
It saddens me to still read all these horror stories. Thank God for Tudiabetes…
wouldn’t you know if you hit a muscle though? In the years I was shooting, I don’t think I ever hit a muscle although I did experiment with (intentional) IV R shots? Muscles are pretty sensitive and I think you’d have at least a sense that you’d gone into something else?
You’d know because it’s painful to inject into muscle. Hurts! As fast as most inject, it’s already done before you realize it.
Ugh for me (with a few DUMB Drs but not my Endo) it’s called insurance. I have to rely on who they pay as to who I see.
At the present : I have no desire to fire my Docs , including my Dentist and Eye Specialist …they hear what I am all about ; they give me thoughts to ponder over and we come to an agreement …or better yet, I am happy and grateful to have them as part of my Team .
So you went from being a controlled LADA to a coma that quickly? That’s just scary…
Well, not quite that quickly. My sugars had been going up for a couple of months (since my last appointment), and so a month before that, he tried Apidra instead of Novolog, and told me to come back in a month. It didn’t work, and he should have seen by the labwork that I was in trouble.
The problem is that an A1c of 10.7 is NOT life-threateningly high for most people, nor is a fasting BG of 302 – I’m a low-glycator, and so it was dangerous for ME. He should have known that, after having treated me for 16 years – I never had an A1c above the 6’s for that whole time. When something is that wildly out of line, someone should have taken notice. I tried calling my CDE, and she didn’t understand that I was in trouble either. I was having blackouts, and it’s only a miracle that I didn’t crash my car! My friends knew there was something wrong, but they didn’t know what it was, or what to do, until they found me unconscious. There is a medical saying, “When you hear hoofbeats, think horse, not zebra.” Which is a wise saying, except when you ARE a zebra!
This thread is pretty intense. Lots of interesting points. I have medical training, I also have Type 1 (30 yrs) and I have been set back in my diabetes management during my life time.
I was referred to an endo 10 + years ago to better plan my regime. I did my research and informed him that I wanted to go on a run and shoot method—that is common now but back then not so common. I met with the Endo and he completely shot my idea down, he recommended I stay on 2 shots a day. My control in terms of self monitoring, A1C, etc was good, so I assumed he would okay my suggestion and help me out.
On the contrary, he did the above. I was so bumbed, I was well read, and knew that tight control (DCCT trial info) New insulins, would improve my control but none of it mattered.
What did I do. I fired him! I was pissed and discouraged. Well, I went back to my GP, and was referred almost a year later to a new endo. She put me on the pump.
I think we need to be well informed, and do have the right to treatment that optimizes our control. There is nothing more dis-empowering then a so called health ally shooting down a very viable solution to a problem.
Now I sit on both sides of the table, I work as a diabetes educator, and my first priority is to understand the person, their life, how they are handling there diabetes and then I ask how I can help.
People first!
As for misdiagnosing type 2 when they are later onset type 1 it does happen, but the docs are learning, keeping in mind they are general practitioners(Jack of all trades).
Cheers!
it’s pure laziness. All it takes is that first complication!! Well, sometimes not even that…
From my experience (and this is not to label all people in the health field), too many LPN, DR, CDE, Clinicians, etc., are still working with dated knowledge back from the 1970’s. This is 2011 already!! Wake the ***** up!! Our lives are literally in their hands. I don’t want to have to deal with a nurse who thinks my pump is a beeper!! This frightens me. Or even worse, an EMT who disconnects my pump, and leave it in the ambulance; or someone who doesn’t have any idea who to check for my ISF & I/C ratios on my pump. It’s not like pumps just came out, they’ve been with us for years!!! That aggravates me to no end.
If not for us diabetics, do it for your careers. The way the economy is today, you can get laid off tomorrow, and no employer wants to waste a lot of time training a nurse on basic things such as insulin/pumps; they want professionals that are current, relative, as well as knowledgeable too, and so do their patients.
Yogi
Amen! There are a lot of health workers who know jack **** about current therapies. What do you suggest as a solution?
I’m not sure if a single solution exist. However, if I were forced to suggest one… In a perfect world, I believe that since diabetes is growing more than ever imagined, every person in the medical community (and in my opinion, this should include HHA), should be required to take a course dedicated to diabetes, AND to re-certify every two years.
Encourage professionals to use their computer to research relevant diabetes information, instead of shopping on amazon.com on company time… LOL
Become diabetically cultured & aware, and in tuned to other practices, belief systems, etc, around the world. There are doctors that are still telling people that only skinny American Caucasian kids can get type1; they never get fat, and they’re life expectancy is cut in half… HUGH??
The stigma the surrounds both type 1 and type2 are unreal…
I always try to teach people that, it’s not how you look that makes you a diabetic, or even the type of diabetic, but what happens in your body that makes you the type of diabetic you are…
Yogi
That’s a tough one. In hospitals, they have their protocols, and if you don’t fit the protocol, you are SOL. I had a coma last September, and they were treating me with their Type 2 protocol, and it wasn’t working. (This is hearsay, because I was out of it). The CDE assigned to me finally told them I was a Type 1, BUT that’s not strictly true – I’m a zebra. But I needed the Type 1 protocol.
Then I was transferred to a rehab hospital (my BGs were still in the 300’s and 400’s), and we started all over again with the Type 2 protocol which didn’t work. They let me sit for 4 hours with a BG of 388, because the Type 2 protocol said test and correct only before meals, but don’t give insulin to cover the meal. And then use sliding scale to correct. From the DARK AGES!!!
It took me 3 days to find the hospitalist, who agreed to make them test more often (both before and after meals) correct when necessary, and cover meals with insulin (but only with a fixed dose, which meant I had to eliminate almost all carbs, which often left me with little to eat).
The answer: hospitalists are NOT qualified to treat diabetics, and there needs to at least be a CDE with experience with both Type 1 and Type 2, and if I were lucky, zebras. And the knowledgeable diabetic (I’ve had it for 20 years) should perhaps be consulted about insulin regimens and food choices? I got so tired of them talking ABOUT me, but never TO me.
I hope I never have another hospital experience like that one – it was agony, and could have been shorter and more successful if I had had appropriate care.
While I do agree that many health care professionals are operating with dated knowledge I have to disagree in that I don’t consider insulin pumps to be a basic thing I expect them to know. I consider pumping a highly specialized thing and really don’t expect those in healthcare to be competent with all the pumps. And I sure as heck do not want them scrolling through my pump to get the settings. If I’m in the hospital my pump will be locked so no one else can touch it. If I’m unconscious or unable to manage the pump then I feel it’s safer to go off and be put on IV insulin drip or shots till I’m able to manage it myself again. There are some things I consider to be diabetes basics but pump therapy isn’t one of them.
There are so many areas of medicine and knowledge outside of what we live and experience in terms of our diabetes. No one can master it all. I would much much rather have a health care professional just say that’s not my area of practice or expertise. When that happens we can work together to to get things figured out.
To a certain extent, I guess your right, however, think about this… If your EXTREMELY insulin sensitive, and your not able to speak for your self, and they are more likely to use the standard 1:10 I/C ratio, that can be life threatening to some. The other thing is, more important than learning how to use a pump, a health care professional should at least know how to identify it, because not every diabetic will wear a medic id. This will help them give clues as to what to look for…
I agree, I have been looking for a diabetic doctor for years and found one about 20 years ago. He even wore one of the pumps available at that time, strapped to his leg. He was great, but retired about 2 years later and I’ve not seen or heard of him since. He had a lot better “knowledge” than any of the others.
Although, my newest endo is excellent (and only the 2nd endo I’ve ever been to (until pumping I only went to GPs, but the insurance company required an endo to get pumping) and I believe she puts more trust in me and how I am doing than the books. She realizes that books are very general whereas diabetes is very individual.
And to continue “stomping” on my face while I am down, my former endo was highlighted on NPR this morning as the Virginia doctor with the biggest “take.” And then, when I got in, I thought I would do a little search and found that he actually had a “handler.” I feel so dirty. Excuse me while I go wash my hands.
A great system when doctor have handlers. What matters is that he’s not your endo any more. Hopefully the word will get out among his patients. No doubt they were treated as well as you were.
Funny thing that you feel like washing your hands & he’s probably not even fazed.
Guess those fancy T2 drugs he had you taking that did not work for you earned him more money than a script for insulin would. What happened to do no harm or was that just a dream?