alrighty then!
No, that is not really small. Even still, it would be good to try the split doses as others have suggested.
Hey Timmy,
I use Lantus also. It works differently in all of us. I encourage you to try splitting or at least moving your daily shot to morning so you can be awake during the peak. I ended up moving my time to 2:30pm so I never peak when sleeping.
I have tried many changes, so I advise you to keep a log so you can always go back and figure out what happened. Also, remember that the effect of any change you make really can take 3 days to settle. By day 2, I get a pretty good idea of what a change is doing but day 3 confirms it.
Good luck. I'm sure it is scary to do it yourself but if I were getting the spike you are getting, I would feel like I've got nothing to lose. You may want to set your alarm and fingerstick at about the 4 hour mark the first time you a split shot in the evening just to be extra safe.
Hi TimmyMac,
Thanks so much for your reply! Sorry there's no health clinic at school.
MossDog said some really good things about trying to create more open communication with your mom. It's certainly going to be easier for you for the next four years if there is some way to get her to understand more about how you feel.
Is there a person in your life whom your mom respects whom you might be able to talk to? Would that person maybe be willing to mediate a conversation you would have with your mom about how you feel and about the Lantus and endo issues?
If that's not an option, think about talking with someone from the guidance center. You could start with: "I have diabetes and I'm concerned about my health," or something like that. You could ask if there is a particular counselor (if there is more than one) who has more of a medical background. You could talk some with a counselor and get a "feel" for how well you connect with that person. If things seem comfortable for you, you could go further on to talk about communication issues with your mom. You could see how fast you want to work into the specifics about your health and the issues with your mom about that--based on how good you feel about the counselor.
I hope this helps. I also know that someone else's well-meaning suggestions can feel useless because the person is not "there" inside your life. So I sympathize if what I'm suggesting is off the mark.
Please know that you are not alone! There are many people who care!
Best, best good wishes,
Marty
Hi TimmyMac,
I don't have any advice to offer about managing your insulin. I've only recently been diagnosed myself and I'm waiting to see an endo in two weeks.
I'm responding to your posts because I'm a mother. I think you're just a year older than my youngest son.
I really understand your frustration. It sounds like, for whatever reason, you and your mother have some communication problems and some struggles over who manages your health care and how. There could be many different reasons for your Mom's need to accompany you whenever you see the doctor yet appear not to take a lot of interest in how you're managing your diabetes otherwise.
I'm pretty sure that she does care about it even if her way of caring seems to be less helpful than you want or need right now. For example, maybe she trusts your family doctor a lot and is nervous about you doing anything other than what the doctor has suggested. Diabetes is a scary thing for everyone who has it and for our family members, too. When people are scared, sometimes it's difficult for them to set their fear aside and think of other ways to respond. I know that a lot of parents take their children's illnesses personally in that we feel responsible not only for our children when they're not well, but sometimes we also feel responsible for them being unwell to begin with. This is not a rational thing! Just know that your Mom's reaction isn't about you, it's about her life history, her experiences in other situations and her fears about herself, about other people and possibly about diabetes, too.
Having said all of this, I also want to say that I believe you're able to manage your health care on your own. You're old enough to understand everything you need to know and to do and it's pretty obvious that you both need to make some changes in your care and that you're ready to do so. My concern is that, in the event that something doesn't work out the way you expect it to--say you have a very difficult low, for example--you're safest when others know what's going on and what changes you may have made in your care plan.
Maybe you could keep a careful record of your blood sugar meter readings, what you've eaten and the amount and type of insulin you've taken, basal and boluses. If you did that for a couple of weeks, you'll have a clear record to show your endo (when you have one), your family doctor now, and also your Mom. I'm sure you've kept log books before. I know that many people only log things periodically after awhile. But if you kept a log book with you in addition to your meter, you'll remember to write things down. Having an objective record like this can help defuse some of the emotional tension so that you, your mother and your doctors can focus on what matters most of all: keeping you healthy!
The last thing I want to say is that I would be very surprised if there was a problem with your father's insurance company when it comes to getting to see an endo. You have Type 1 diabetes. No one is going to say that you don't need to see an endocrinologist. There's nothing frivolous about it! It's the safe, sensible thing for you to do, at least twice a year.
Timmy, it's hard for me to suggest you go against your parents and do something in secret, but that almost seems the way to go. Do you have a relationship with the last endo you saw? Sometimes, you can call or email a question and get a response back -- without paying for another visit. Then you can show your mom the response, citing "doctor's orders".
There could be many reasons she doesn't want you to go to a doctor: perhaps rational, possibly irrational, maybe even she's in denial. I don't know, but I wish that would -- or could -- change. But from what you've written, I doubt you're able to change that. Fortunately, you seem pretty bright when it comes to diabetes self-management -- which is really what this disease is. Self-management.
If you were to go onto a split-dose on your own, I would just caution you of one thing: the transition. When I went from a once-daily Lantus to a split Lantus, my doc gave me some NPH to cover me for the half-day I didn't have my full basal. Otherwise, if you do your first half of a split-dose 24 hours after your last dose, you'll run high for quite awhile. If you do your first half-dose 12 hours after, you'll run low. The transition can be tough, and it takes a few days to smooth everything out.
I wish you luck, and please keep us posted on how things go.
Same happened to me with Lantus. I switched to Levemir and split dose. More in the morning injection and less at night. You may want your Mom to understand that the risk of going low at night is a very serious thing....better to handle during the day. I wish you well. Splitting your Lantus would be a wonderful idea....more during the day less at night. Hope you can try this. Good luck.
hi lara, your situation sounds similar to mine. i could NOT figure out levemir either though, any advice for learning how to dose
thanks for all the replies guys. I'm going to split it tonight.
I'm currently at 136 and I'm going to take 12units... wish me luck
Edit: well.. 12 units definitely hurts less than 24. I almost hope it works just for that reason lol
TimmyMac, as a mom of a type 1 teen, my heart goes out to you. Please do whatever it takes to protect yourself. Nighttime lows are our biggest fear, good luck with the split and your continued effort in self managing. You've gotten some good suggestions hope you are able to act on them, keep us updated.
Best Wishes, Emily :)
thanks :)
This morning I'm at 210. I guess a 75 point gain is better than a 150 point drop during the night. I just took the 2nd half of my dose and I'm going to raise my breakfast dose from 1:10 to 1:8... lets see what happens now.
I really do want to show my mom this thread.. but after all the criticisms I've said, I'm scared too...
Thanks for this wonderful post. I honestly don't know how to reply or add anything to it. At the same time, I dont want you to feel like I've ignored you, so thank you again! It seems like if I try to change anything with my diabetes care, there is an argument about it. It's almost like I'm not allowed to change my doses without a doctor, but at the same time, it seems like I'm not allowed to go to the doctor either! Unless I absolutely HAVE to (like, my prescription will run out tomorrow, and theres no old pens lying around the house). My dad just lets me do practically what I want with my D-management, but at the same time, he isn't really home enough to know how this all effects me. He for some reason thinks pumps are surgically implanted!
You're right about logging... I really do need to start doing that again. The reason I stopped a while ago is that I could pretty much predict where my bloodsugar would go if I changed something. But with a change this drastic, I'll start logging again.
I posted about this on the CWD site before, but I guess complaining about my parents on a site with mostly parents wasn't the best of ideas. The only advice they offered was just "pay for it yourself or move out." Then when I explained that that's currently impossible, they either accused me of trolling, or just abandoned the thread. it make me feel even more alone in all this.
It seems like someone can post about anything here and we will be accepted with open arms (well.. maybe not about low carbing, but that's a debate that goes on in most forums)
Once again, thanks for all the support.
Hi TimmyMac,
About showing your mom the thread. I don't know enough about this stuff, but can you download the thread and then edit parts of the "criticisms" out and show her the edited version?
Best wishes!
Marty
Start another discussion that is more of a question / answer and we will try to be instructive in our posts to help your mom understand your needs. So good, your are not showing her this post -- shame on her and your family, its is unfathomable to me not to educate myself and provide the best care available to my son (the 3 month visits to the endo are just to touch bases and check A1C, we manage tighter than her suggestions). Even if we didn't have good insurance to cover pump and cgms, we would pull the funds from somewhere else. And if the cgms was not feasible, then he would go back to checking a lot. I don't how you relied on her all this years, hopefully she was a better mom when you were younger, but that when diabetes knowledge, resources and technology was in it infancy too, so your management was probably limited more. Can we put the word out if any members in your area that have a job opening at their work --with a company that has benefits. You got to love them and leave them! Just my opinion. Good Luck.
Fantastic. Looks like splitting the dose works for you. I agree with Mark to stay the course before increasing the dose.
+1
When you visit your doctor, does your mom come into the exam room with you? Could you arrange to speak to the doctor privately? My kids are 18 and over, and they are required to sign their consent to give their physicians permission to talk to my husband or me. They would also have to give permission for one of us to accompany them into the exam room, although we have not yet had a reason to do that.
Everything with T1 Diabetes is trial and error. What works in one person often may not work in another person. Your mom needs to understand that. You can split for a couple of days, check your numbers, and see how things fall out. Everyone's life is different and all those differences (activity level, stress level, etc) impact how insulin works.
I always like the idea of just making a single modification and then seeing how things go. If you go and change things a lot, then it will be hard to figure out if any of the changes help. I suspect you will find that an even split in your Lantus leaves you a bit high overnight and hypo during the day. A good thing to do with a basal change is make a change, then observe the how your blood sugar reacts over 2-3 days. You may be even higher tomorrow morning as the change you have made gets evened out. As long as you don't go too high, simply correct in the morning. Then after 2-3 days, you can figure out whether you need a change, and when you make a change, you only make an incremental change (10%).
ps. My daughter is 19. She is responsible for her own health and I expect her to act like an adult. I may remind her of stuff or give her my opinion, but she goes to the doctor, her health is her private matter and she needs to make the decisions. Becoming an adult is partly about the parent letting go and partly about the child "claiming their right" to be an adult. At the age of 18, in the eyes of health care, you are an adult.
Like Lara I would recommend to try Levemir. But I would recommend to split the dosage evenly at the beginning. The one shot pattern will not cover 24 hours for most people (also true for lantus BTW). An even coverage is the key to good control, evenly distributed I:C factors and reproducible effects in general.