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My blood glucose has been out of control for like 3 weeks! Last week my doctor increased my 24-hr insulin from 43 units to 45. This past Friday he increased it to 50 units and told me to call him Monday. I HATE BEING DIABETIC. My mom has girl scout cookies in the freezer and there's candy all over the place and I can't have any. It blows. Really, why try to control it with diet and exercise when it stays high anyway? This is the current source of my depression. It actually makes me cry. I sit in my room all day because of it. I'm never hungry, but I *have* to eat. I hate this.

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Thought I'd mention--at my last doctor visit, when I was changing the long-acting insulin due to, ahem, lack of insurance and bloody pricing...the subject came up of how the Lantus was so good for me, and how there'd been times when I hadn't needed and fast-acting insulin.

Well, he proceeded to tell me, in no uncertain terms, that you really can't go with **just** a fast-acting or long-acting insulin.  Certainly, I've seen that when I ran out of Lantus for a few days due to (ahem) cash problems, my glucose was WAY out of control.  And, now that I'm om Novolin, it's rather poorly controlled.

I love my Lantus...

Anyway, I'd think that if your glucose was that far gone, a fast-acting insulin would at least be suggested.  Hell, I've been diabetic for 22 1/2 years, and i was only at 25 units of Lantus.

And, the good thing about a fast-acting insulin is, once you know how you react to it, you can eat damn near anything.  Personally, my freedom to eat whatever, whenever, is quite worth a few more sticks in the arm!

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Another diabetic checking in.  I'm type two so am just on orals.  Now I only take glucophage, but in the past when I was somewhat heavier I also took a few others and got to experience the joys of low blood sugar.  My lowest verified reading was 27 which had to happen when my new wife and I were visiting her brother and Mom the Christmas before last.  I didn't bring any glucagon on the trip (stupid) so had to rely on orange juice.  It worked but I was shaky for a long time. I was diagnosed back in 1990 and have had normal A1C's for the last 7 years.  I don't like diabetes, but at least it is familiar to me, this BP crap is all new and kind of bewildering.

The weight loss side-effect from the abilify seems to be helping even more.

Tommy

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  • 2 weeks later...

My last A1c was 9.6!!!! Holy crap! And my fasting blood glucose was 133. Jesus. My doctor increased my Lantus form 43 to 46, then to 50, then 53, and now 56 units per day! I asked if he would just increase my sliding scale of Humalog, he said no, he didn't want my sugar dropping too low. Ugh. I have experimented with the Humalog and now I know that if I want a candy bar, 15 units will keep my sugar from spiking. I know if my sugar is over 400 and I can't get to the gym, 20 units will bring it down without it bottoming out. I can now eat pretty much whatever I want as long as I take insulin with it. I am going to get my GP to refer me to an endocrinologist for my diabetes. I just feel like there has to be another way to do this besides upping the Lantus like crazy. Thank GOD I have insurance. At 56 units a day, 3 vials is a 30 day supply. The insurance cost was over 200 dollars!!!!

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Wowsa...14 units to counteract a candy bar???

OK, a little story: one time, I accidentally took 25 units of humalog instead of the 25 of Lantus i was SUPPOSED to take before bed.  (whoops!)  About 3 hours later I woke up nearly comatose, hollering as best I could for my fiancee to bring me sugar, ANY sugar.  I can't remember if the first bs test i took was 8 or 12--but certainly the lowest I've ever had, or ever WANT to.

And note, I ONLY took the humalog, no Lantus.

So what does this tell me?  That there's something seriously screwy here--maybe too much insulin resistance.  That woukd be the only thing I can think of.  I mean, shit, you're taking like 3 times the insulin I am, and at 22 years of diabetes, i ain't exactly a spring chicken regarding insulin.  (Pancreases are for WIMPS!)

The only time I've ever had problems requiring more insulin was A: while on Zyprexa and B: times like now, when I can't afford Lantus and must go with Novolin, which works like crap.

Definately see an endocrinologist.  This just sounds sooo fucked up to me.

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Indeed I didn't realize.  Normally I keep the Lantus in the fridge and the Humalog in my go-bag, but as I no longer had a job and didn't need to always carry it with me, i put the Humalog in with the Lantus.  I figured the different bottle sizes would help me keep them separate, but nooo, that's not so true when you're drunk and have taken a handful of benadryl!

Anyways, yeah, it was close--considering it'd take maybe half an hour for an ambulance to get here, just TOO damn close.

A thought on catching the problem early though:  I think in your case, you went higher up than expected because A: rather than attack already-present sugar on your body to the point of danger, you added new sugar for the insulin to handle, which of course is the *reason* for fast acting insulin (I feel it's less, er, "effective {a  poor way to put it though} when dealing with "added" sugar vs. "present/steady state" glucose), and B: homemade oatmeal cookies (oh, i GOTTA make some soon) aren't so easily determinable as to sugar content, and C: yeah, i thin at higher levels the ration gets thrown off--I jnow that after, say, a big Easter dinner that I have to take a good twice as much as i normally might.

So yeah.  A big fun tightrope walk sorta thing.

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I haven't had to take any extra shots in over a week, just the 56 units of Lantus. That's good news.

My actual sliding scale of Humalog is:

150-200: 2 units

201-250: 4 units

251-300: 6 units

301-350: 8 units

351-400: 10 units

>400 call the doctor

I don't know why my doctor is playing with the Lantus so much. It seems to me that 56 units is A LOT to be taking. I haven't strayed from my sliding scale since the increase. I also haven't been eating candy bars, cookies, etc. I am sticking to my diet and exercising at least every other day, though I try to get to the gym every day. I am going to call Monday about an Endocrinologist referral. I also want to go to a diabetes class. I haven't been to one. My mom used to do diabetic teaching at a hospital she worked at, but she doesn't know everything I'd be able to learn in an actual class.

I have hypothyroidism. I found that out when I was inpatient in December. It didn't seem to affect my blood sugar though. My TSH is normal on 50 mcg of Synthroid.

Why aren't you supposed to exercise if your sugar is over 250? Exercising brings it down easier than fast-acting insulin--at least in my case, it does.

Lately I have been wondering if I am actually type II or if I have type I. I don't know how to tell. I know that you don't *have* to be born with it to be Type I...or even diagnosed in childhood. I know that not all adult onset diabetics are Type II, even though that is the case 9 times out of 10. Is there a test that can tell which type you have?

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Heya she,

Tired  ;)

But.

1.  That's just the amount of Lantus you happen to need.  Nothing high or low about it.

2.  Here's a website that might help out a bit:

http://www.diabetes.ca/

Canadian Diabetes Association.

The numbers/units are different, but the explanations/definitions are the same.

Hope this helps.

--ncc--

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as far as the exercise goes, my guess is its probably too much work on the heart and the body when your blood sugar is that high.  your blood has a much thicker consistency, and your heart probably haves to work overtime to pump it all around.  but its just somethign i remembered from the diabetes classes - you could probably ask someone more knowledgable.

i got type I diabetes when i was 22.  i didn't really come down with a lot of symptoms - my mom just noticed i was sluggish and sleeping a lot, and since she had been diagnosed with type II the past summer she had a glucose monitor and wanted to test me.  i didn't want to at first, but i relented and my blood sugar first thing in the morning when she tested it was 200 something.  so a couple of blood tests later through my gp and then an endo they diagnosed it as type I.  as far as determining which kind it is, i think they ordered an antibodies test.  they must know how to look for the specific antibodies that attack your pancreas - and mine matched the profile.  so i didn't even start the metformin or whatever i had been prescribed.  i was working out when i heard a call for my name over the pa system - the endocrinologist had called my mom to tell her that they wanted me in that day to show me how to give myself insulin shots.

even with that though, it took over a year, a switch to a different endocrinologist, and two sets of diabetes education classes before i got them to switch me over to the three fast acting humalog shots, and the lantus - instead of the 75/25 long vs. short acting pre-mixed insulin they started me on.  and now i have to pretty much do my own legwork to get the process for an insulin pump started before my insurance runs out.  so a lot of the burden ends up falling on the diabetic to push things along, and make sure they're doing everything right to keep their blood sugars under control.  my new endocrinologist is so overloaded with patients that i'm lucky if i get to see her every five months.  and i have a thyroid condition as well for her to manage.  so yeah - i guess you have to be your own advocate.

good luck getting an endocrinologist referral and taking those diabetes education classes.  they probably helped a lot for me, but there's still plenty you have to learn on your own.  to make sure its not type I they could probably order the antibodies test.  i remember my cousin - who was in pharmacy school at the time - mentioning something she had heard about a mixed type (type I and type II) but i don't know too much about that. 

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