Replies to This Discussion

Permalink Reply by boedica on June 1, 2010 at 9:23am

im sorry...its so frustrating!

my insulin needs make absolutely no sense to me....they seem to change from day to day.

you aren't alone in wonky bs readings, and trying to figure it all out :(

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Permalink Reply by Zoe on June 1, 2010 at 9:59am

I'm not at all sure why you are calling yourself "brittle" ( a term when docs don't know how to manage?) or why you think you are sensitive to insulin. Have you learned what your I:C (insulin to carb) ratio is? 1/2 unit of short-acting is not very much, especially if you eat a lot of carbs for breakfast. I'm a bit confused, did you take the 1/2 unit AFTER eating? As a correction? I suggest figuring out your I:C ratio (start with 1:15 and work backwards or forwards depending on results), then learn to count your carbs and bolus accordingly. I totally don't get the concept of your endo "taking you off the short-acting"!! because you were going high? It sounds like you need more, not less. Also is your basal correct? If your basal is too low also, you would be high at fasting, before meals and bedtime which is fighting a losing battle. I highly recommend the book Using Insulin by John Walsh, it makes it all more logical. There is a lot to learn, I was stressed to the max for the first couple months. It doesn't sound like your endo is too helpful (welcome to most of our worlds!). Hang in there, it will get easier!

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Permalink Reply by D.D. on June 1, 2010 at 10:59am

I have several other autoimmune disorders (rheumatic) that relapse into an inflamed state - right now I am having a bad relapse - swollen joints from arthritis, etc. The endo and my PCD said that I am actually getting better and need less insulin - my endo just put me back on metformin. still using long term at night - 6 months ago my daughter and her baby lived with me and I was caught up in her dramas - she is a T1 with an attitude. She and my granddaughter moved out and now I have peace and serenity in my 1 br apt. :) I was put on a ratio of 1:30 and found out that as my situation evened out I could go down to 1:20 if needed (in morning) and could adjust ratio in evenings up to 1:60. I just became unable to handle the short-term (still don't understand yet...) I was bottoming out all the time - waking up at night in the 40s and falling off cliffs during the day - some 30s and 1 28 - very scary - that's why endo took me off the short term. The term brittle means that due to ? your body becomes very sensitive to even minute changes. I'm just weird I guess. Thanks your feedback and or recommending the book. DD

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Permalink Reply by Brian (bsc) on June 1, 2010 at 11:29am

This just does not sound right. You are a type 2? Yet you are taking a miniscule bolus and going hypo? What is your basal rate? Is it possible that your rhematism is highly variable and that your basal rate is just not properly matched to your changing inflammation? Why are you going low hours after your bolus should apparently have worn off?

It just seems very odd, most T2s tend to be insulin resistant, having an I:C below 1:15.

The books "Using Insulin" by Walsh and "Think Like a Pancreas" by Scheiner are really helpful. It really sounds like you are not brittle, rather your basal is at times set much too high (except when your daughter is giving your grief).

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Permalink Reply by D.D. on June 1, 2010 at 12:12pm

thanks. I have so many questions! I've wondered if I'm not a 1.5 instead of a T2??? my endo just put me back on metformin and to continue on the lantus at night...I am EXTREMELY fatigued today and need to go lay down for awhile, thanx everyone...

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Permalink Reply by Anthony Holko on June 1, 2010 at 4:53pm

Weird metformin is used to combat insulin resistance by the sound of things you are very insulin sensitive so why metformin?

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Permalink Reply by D.D. on June 2, 2010 at 6:27am

I don't know - I am kinda confused about all of this myself - my docs tell me I'm getting better - maybe that means that I'm not as insulin-resistant as I was - still...if I eat too many carbs or things with sugar I shoot up into the 300s so ?????I have lots of questions and no concrete answers or understanding at this point...

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Permalink Reply by s6954118 on June 1, 2010 at 11:54am

I am type 2 on Lantus(41 units at night) and Novolog(on average 8 to 10 unit a day). I diet on low carb/no carb and I shot to adjust before I eat. My last A1C was 5.5 so my unusual system works for me. I have arthritis on both knees and take pain meds most days. I use to walk to help control my sensitivity and that worked well when I cold walk. My usual 2 hr after meal is in the 170 area.

i have been on no carb/low carb this time about 7 months before I started I was taking 85 units Lantus at night and 15 to 25 units before each meal. I have lost 28 lbs. I hope this helps.

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Permalink Reply by TS on June 1, 2010 at 3:06pm

Can you find a new Endo? Do you have a diabetes education center close by? Diabetes education centers are often very valuable resources, sometimes MD's know too little about too much, whereas an education center knows a lot about 1 thing - diabetes.

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Permalink Reply by Zoe on June 1, 2010 at 5:13pm

I agree, there are a lot of things that need sorting out. If you are going low at night and "falling off a cliff during the day" that may be too much basal, not bolus. When my doctor was treating me as a type 2, not the 1.5 I am, he had me on too high a dose and I was always low when it was just before mealtime, I thought that was normal. He also had me do insulin two hours after eating ""if I was high" and at much too high doses which resulted in a scary low. (I contributed to this a bit, because I didn't know anything, like what a "correction" was for, let alone I:C ratios and decided I liked doing insulin "PRN" Talk about the blind leading the blind.... off the edge of a cliff! I would suggest either traveling to find someone better or doing what I and many others of us have done and educate yourself through this board and do what works for you!

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Permalink Reply by D.D. on June 2, 2010 at 6:30am

my endo is one of the best in the SE and I love him - I think a lot of this is revealing itself as we go and things change - I don't mind taking the metformin again - it's nice not to have to give myself all those shots during the day - but I know that in a flash things can change - that I can really count on with the big D!

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Permalink Reply by Tim G on June 2, 2010 at 7:21pm

Hey, I thought I'd share my two cents on this - we have a lot in common.

I was diagnosed type1 in december, and until last week when I started my pump, I was on long and short acting insulin as well. (lantus and novolog)
Until reading this post I thought I was in rare form because of the "brittleness" of my D.

Normally I'm running about 10 units a day on my pump now. (.2 units/hour of basal and the rest being boluses - it works out to ~ 50/50)

But I had a similar day to yours as well, just the other day......

Woke up at 77 - ate my usual breakfast - bolused just like always... Went for a walk with the dog, hung out and took a nap... 5 hours after my breakfast I was 216! (Which for me is totally unheard of... dialed a correction of 1 unit of novolog... Had a pounding headache... took 600mg of motrin and tried to sleep again.... Now it's about 7 hours after breakfast... 250!!! What the heck was going on.. took 2 units of novolog (via my pen) switched infusion sets/resevoirs (thought it was an air bubble and sure enough it was). Hung out for an hour and watched tv/messed around on the computer... 6:15 comes around.. 194 (right direction, still high) bolused normal for dinner (3 units of novolog via my pump), ate my normal dinner. did a 2 hour post and I was 51.. had no signs of a hypo... ate a little ice cream and by bedtime i was 135...

so anyway, there are other "brittle's" out there!! You're not alone!

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