Replies to This Discussion

Permalink Reply by Holger Schmeken on May 10, 2011 at 7:02am

a) the most important thing is to improve your level of glucose control. With numbers in the 200 range nothing will stop the progression of your neuropathy. On Lantus alone you should be in the normal range of blood glucose. The Humalog is just needed to cover additional carbohydrates. So try to do some shifted fasting to see if your Lantus is sufficient to cover your basal needs (1/2 day without food => are your blood glucose numbers then stable and good?)

b) learn to count carbs and to calculate your dosage of Humalog according to the carbs you are about to eat. Try to find a book like "Think like a Pancreas" in the public library.

c) you can take alpha-lipoic acid to treat your neuropathy. It should be available in your pharmacy. If possible choose the R-ala form but if you get the mixed one it is also okay.

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Permalink Reply by Brian (bsc) on May 10, 2011 at 8:01am

Holger has given you some really good advice. High blood sugars can really accelerate neuropathy and many of us try to keep our blood sugars below 140 mg/dl after meals to manage these sorts of complictions. Your blood sugar is just too high. In addition to the great comments already recieved, I would like to offer four more suggestions:

1) Take personal responsibility for your diabetes. Set your own targets, make your decisions about treatment and learn to make specific choices about diet, exercise and most importantly insulin dosing.

2) Learn how to properly adjust your insulin to meet your blood sugar goals. The books, "Using Insulin" by Walsh or the book Holder recomments"Think Like a Pancreas" by Scheiner will pay you back many times over their price.

3) Consider a low carb diet, many people have had outstanding success with low carb diets. Consider the "Atkin" or Dr. Bernsteins "Diabetes Solution."

4) This is the most important thing. Become an active member of this community. There are many people here who understand what you are going through, they can really help you

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Permalink Reply by deliashellynn on May 11, 2011 at 9:17pm

I take Lantus and Apredra and started counting carbs in Jan. By March my A1C dropped from 9 to 6. My bs have been dropping in the afternoon and evening ( 77 to 87) because I forget to eat and I get freaked out. My BS this morning was 115.
I to reuse my needles, I have insurance and I pay $75.00 for 12 viles of insulin, a 3 month supply. I adjust my morning dose of Lantus to reflect my morining bs, so a bs of 115 I took 90 units. The Apredra I use only on high carb meals or if my bs is high before I eat. My feet and ankles swell and are tingling but no real pain. I do have big bloated stomach and learned I have a diabetic stomach, not passing food through the stomach fast enough. (I don't get hungry very often, therefore I forget to eat.)
I have problems with my eyes, blurred and double vision, enlarged spleen and a growth on my left adrenal gland. Both are still functioning and we are on a wait and see for both. I am changing Dr., my is not working with me, took me 10 years to get my bs under control and I did it with carb counting.

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Permalink Reply by Robert on May 12, 2011 at 5:55am

I am going to have to do that also; how do you count carbs? Do you have a chart or a book, or what? Like - one slice of bread is 15 carbs ? (? ? ?). Only three times in my life has my blood sugar been below 100; and I was ecstatic.

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Permalink Reply by Stardust31 on May 12, 2011 at 7:24am

Counting carbs is like this: 1 carb serving is 15 grams of carbs. So 2 carb serving would be 30 grams of carbs and so on. With your insulin your carb ratio would be(this is an example and not your carb ratio) 1:6 so for every 6 grams of carbe you would use 1 unit of insulin so for the 30 grams of carbs you would inject 5 units of rapid insulin. So to count carbs you just look on the items label for ther serving size get the carb number, and then figure out how much you want. Hope that helps!

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Permalink Reply by Zoe on May 12, 2011 at 8:49am

"Exchanges" (15 unit servings) is an outdated method of counting carbs. The listings on packages list individual units of carbs, not exchanges. That makes it easier to do insulin carb ratios. You have to first figure out your own insulin to carb ratio (I:C). One suggestion is to start with 1:15 (one unit covers 15 carbs) and then to work up or down depending on your results to see what works for you. So if you do 1 unit for 15 carbs and end up high, try one unit for 14 or 13 carbs; if you end up low, try 1 unit for 16 or 17 carbs until you reach the ratio that works well for you to be in target two hours after eating. Many of us have different ratios for different times of day. For example mine are 1:6, 1:7 and 1:18 for the three meals. It takes a while to figure out but then you can use your ratio to bolus more accurately for what you are actually eating.

There are lots of carb listings for foods that don't have labels, both online, in books and in phone apps. I use calorieking.com and another printed one I got from a book. Calorieking.com is a bit heavy on chain restaurants for my taste, but you can also find raw ingredients.

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Permalink Reply by Stardust31 on May 12, 2011 at 8:56am

Although it may be outdated it does work. They aren't really exchanges either zoe. Like 2 slices of bread would be 30 carbs..depending on the bread, which would be 2 servings of carbs. It is how I have done it and it works. I may have not explained that the best but I tried. Yes the labels are for 1 serving like cereal is 1 cup and 27 carbs plus 11 carbs for one cup of milk...again depending on cereal and milk used. so 27 plus 11 is 38 which would be divided by whatever his carb factor is. He was just asking how to count carbs and that is how. so that would be 2.5 servings of carbs. It's just a different way because we should aim for 30 carbs or less per meal. Just wanted to be a little more clear. Myfintnesspal is another one for nutritional info. The book Zoe got I got and she is correct it is a great book!

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Permalink Reply by Zoe on May 12, 2011 at 9:42am

If it works for you, that's great. I just wanted to give a newcomer the current way of counting carbs. People don't really talk in terms of carb "servings" much anymore, so I didn't want him to be confused. Also you say "we should aim for 30 carbs or less per meal". I think people on here eat a wide range of carbs, from 30 carbs per day which is what Richard Bernstein recommends to 75 carbs or more per meal. Everyone needs to find what works for them.

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Permalink Reply by MyBustedPancreas on May 12, 2011 at 10:10am

When I was in college, there was a period of time that I didn't have insurance. I was thankfully able to get insulin and supplies via Children's Hospital where I had been a patient for years. I was really, really thankful, but before I accessed stuff through that program, I had actually started to ration out my insulin. My family would have certainly helped, but I was really determined to be an adult about things and deal with them on my own.

Also, Walmart now sells Regular and NPH insulins for just $25/bottle, which is a pretty good deal all things considered. It means that, in a pinch, I have a way to keep myself alive at a reasonably nominal cost.

The big issue for me when I lacked insurance or was later underinsured was test strips. Insulin is actually pretty easy to come by through a variety of programs, but test strips are harder, and they are really expensive (each one costs about $1.20). And without the ability to test, it's impossible to know how much insulin to take!

I am now on the pump and, thankfully, have great health insurance. I am also very thankful that I stayed in school all those years and have a high-paying job, because my monthly copays for everything are running upwards of $400-500. Diabetes ain't cheap!

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Permalink Reply by Robert on May 12, 2011 at 11:32am

I test five times a day. I use the Bayer's Ascencia Breeze-2. I am lucky that my insurance pays 100% for all my testing supplies, test strips, meter, lancets, etc. as long as my doctor signs off on it. Sometimes my diabetes testing supplier will require a copy of my log sheet to see my blood glucose levels for the insurance company; but that is no problem. My niece is on the pump; and she is a raging alcoholic; she believes because she is young that she is invincible; and when she goes on one of her binges she just ups her insulin dosage. I go to a diabetes support group here in Houston at the Memorial-Hermann Hospital System; they meet the fourth Thursday of every month. I am on a first-name basis with the Nurse Diabetes Program Coordinator at Memorial-Hermann; and also with the Registered Dietitian at Memorial-Hermann. The dietitian has Type-I diabetes and she is a very young woman. Whatever you are going through - whatever your circumstances - believe me, somebody has been there before. This website is a Godsend.

Rob

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