May be switching back to shots. Looking for tips...
So I spent the morning on the phone with my insurance company trying to decipher some changes made to my policy recently.
What I found out is that they are now adding insulin to the diabetic coverage section of the policy. Meaning I can now get my insulin 100% covered instead of my normal copay. At this point, When I figure out & switch to all the preferred brands, the only supplies they won't cover are my pump supplies.
This has me thinking. I absolutely love my pump & am intimidated by the thought of going back to MDI, but if I were to switch I'd get all my supplies free. (with the exception of the monthly insurance premium.) I've got a bit of debt at the moment, so even a short-term switch would help me to play catch-up on my bills.
I've learned a lot since switching to a pump 6.5 years ago & I think I could manage MDI much better now than I did before but I'm still nervous at the thought.
I should also mention that I have about 1 month's worth of pump supplies left & will have difficulty making the payment required to release a new shipment.
Has anybody else been in this situation? What would you do? Any tips for a smooth transition?
Thanks in advance. :)
What I found out is that they are now adding insulin to the diabetic coverage section of the policy. Meaning I can now get my insulin 100% covered instead of my normal copay. At this point, When I figure out & switch to all the preferred brands, the only supplies they won't cover are my pump supplies.
This has me thinking. I absolutely love my pump & am intimidated by the thought of going back to MDI, but if I were to switch I'd get all my supplies free. (with the exception of the monthly insurance premium.) I've got a bit of debt at the moment, so even a short-term switch would help me to play catch-up on my bills.
I've learned a lot since switching to a pump 6.5 years ago & I think I could manage MDI much better now than I did before but I'm still nervous at the thought.
I should also mention that I have about 1 month's worth of pump supplies left & will have difficulty making the payment required to release a new shipment.
Has anybody else been in this situation? What would you do? Any tips for a smooth transition?
Thanks in advance. :)
Replies to This Discussion
-
Permalink Reply by Kim on -
I was pumping for almost 2 years and since the beginning of the year I have switched because of the supply cost. I actually love it!! I switched to an insulin pen which I have never used before and absolutely love it. I think it is so much easier to control my blood sugar now because I actually "think like a pump". Of course I miss being lazy and letting my pump think for me because now I have to do all the numbers in my head. :)
-
Permalink Reply by Holger Schmeken on -
Most insulin dependent diabetics can reach good control with MDI. The key to this success is the basal insulin. One of the biggest mistakes is that the basal insulins are advertised as being active for x hours. In reality the duration depends on individual factors. For example Lantus and Levemir state in their description that they are active for 24 hours. They can claim that because the length of duration is also dependent on the dosage. The more the longer is the rule here.
With high dosages the Lantus shows more constant delivery but in most cases the duration will not reach 24 hours. Thus it is no miracle that Lantus users have problems at least one hour before the next shot. Some circumvent this by adjusting their insulin factors. But this makes it impossible to skip the meal at that time because a portion of the bolus insulin is used to replace the degrading Lantus. More badly is that most user try to increase their dosage to reach 24 hours. As a side effect they have lows in the night for example (probably many undetected lows). Another problem of Lantus is that it will connect to the body tissue and from there it is constanly released at a slow rate into the blood stream. If you hit a blood vessel and inject the Lantus there it will not connect fully to the body tissue. Thus several Lantus users have experienced sudden lows after their Lantus injection.
At the last diabetes fair in Germany I asked several diabetes trainers about the claim of Levemir to last for 24 hours. Most of them said that Levemir is a very stable and good insulin and should be taken twice a day for optimal performance. None of them thought that one shot is sufficient for type 1 diabetics.
I am using Levemir too and I think it is the best basal insulin you can get. It will connect to the haemoglobin of the blood first. From there it is released constantly into the blood stream. This connection to the haemoglobin is very much preferable to the tissue connection of Lantus because there is no risk of having a low by injecting into the blood stream. To need two shots is a little more work but you will be rewarded with a real 24 hour coverage. Furthermore you can adjust your dosage for example for the night to compensate for higher physical activity on that day. Most Lantus users do not adjust their dosage at all but with the two shot regime (every 12 hours) you will have more flexibility for fine-tuning.
If the basal is working properly you have to find a quick acting bolus insulin. The choice between Apidra, Novolog and Humalog is purely individual. You should tests these brands to find the quickest insulin for you. It is really worth to investigate the differences because it will tremendously influence you post meal values.
As a last point: After the switch you will have no pump to save all your glucose values and injections. Thus you need to keep a log with MDI. You can do that manually with a written log or you use our project Glucosurfer.org to do that via mobile or smart phone or web.
-
Permalink Reply by DiabeticRadio.com on -
Hi Holger,
You are a fountain of information.. I did not know that about Levemir. I have LADA and I still have some insulin production, I am also insulin sensitive. I only use 20 units of Levemir a night. This seems to work for me best. if I split my dosages, oddly I experience hypos (probably because of my morning walks).. I love both Novolog & Levemir.. They work so well with me. I know exactly how they work in my body, and their timing in my body (which really helps a lot in terms of predicting lows and so forth..)
I really do wish that pumping supplies wasn't so damn expensive. It is absolutely appalling that some of us have to financially struggle, with a technology that everyone has a right to use and experience!!
-
Permalink Reply by Holger Schmeken on
-
One little correction: Levemir binds to albumin not haemoglobin as I have learned here.
Your comment has a very important message: you do what works best for you. This also means to be proactive and to explore better alternates if necessary. If your control is good and stable with one Levemir shot there is no need to change something. But if your control deteriorates you will have the option to go on two shots again. It is just something to keep in mind: the day may come when the blood glucose shows a rise before the next shot of Levemir. This would be a clear indicator that the basal coverage is not sufficient anymore.
-
Permalink Reply by Amanda on -
Wow Holger,
Thanks for all the great tips! you've really got some good info. I was using humalog & lantus when I was doing MDI before the pump. I really didn't have great results, but I think I really just didn't know what I was doing either. I use Novolog with the pump & I've been curious about both Levemir & Aprida.
I think with enough work I'll be able to get pretty decent control with MDI. It will just take a bit more effort & planning. Which will be worth it to cut back on my expenses.
-
Permalink Reply by Jake on -
Funny you should mention the problems with "surprise" really early morning lows with lantus. Didn't realize it untill I started testing at 2-3 am when i woke up, getting ready for a pump... Even tried splitting it in odd amounts, half and half... Never quite got it right untill i cranked down the ENTIRE lantus dose.. then i was higher than i liked..
-
Permalink Reply by Sheila on -
Personally I would never, unless I actually had to go back to MDI. I was on MDI for the first FIFTY years or so.....it was always "hit-or-miss"...with MDI, never knowing when the insulin would kick in...forgetting to do the shots....being embarrased, constantly checking and going to the bathroom....and just "pure" laziness....my control was horrible with MDI. I love my pump and my A1c's went from 9 point something to 6.5-7'ish My control on the pump is so much better and I am hoping for a much longer D life using the pump. The long term effects of pumping are so much better on a pump, and hopefully less complications...
Sheila
-
Permalink Reply by Terrie on -
Thanks for that detailed explanation Holger. Now that sounds like a Good reason to use Levemir. I've been doing pretty Good with Lantus and have raised/lowered to suit my situations better. I usually take 19-22 units total daily split. But there is always room for improvement, sometimes with the help of different meds.
Good Luck Amanda and thanks fo the topic. :)
-
Permalink Reply by Holger Schmeken on
-
If I understood that correctly you have split your Lantus dosage. As a result you are taking two shots per day. I have heard that this leads to a good basal coverage too. Lantus will most likely act longer than Levemir if applied in the same dosage. Thus the two shots of Lantus stack on each other. I have a little problem with that: let us assume you inject 10 units every 12 hours. If every dosage is active for 16 hours you will have times where the dosages overlap or stack. I would fear that this would lead to chaos but many users have good results with splitting Lantus so it might be that the stacking effect is very small. In my last diabetes training I had one guy who was told to split his 48 units of lantus (24 in the morning and 24 in the afternoon). Well, he did not listen carefully and injected 48 units in the morning and afternoon. The amazing thing was that he had superb numbers and the team encouraged him to continue this treatment. Again a case of: do what works best for you.
-
Permalink Reply by Terrie on
-
Sorry Holger, I wasn't aware of your reply.
In 2006, I tried the 50/50 with Bad results. So then I gradually turned my dosages to 60/40. My basal testing had shown this to be the right dosage and split for me @ 12 hours apart.
Wow! on the 48 units twice a day. That's a lot of Lantus. Great that it worked for him though. Diabetics are amazing!! :D Thanks! I appreciate your input.
-
Permalink Reply by Anna Kingsbury on -
I decided for the summer I would return to shots. I was using the OmniPod. I lasted exactly one month back on shots. While I have a better understanding of how things work, I never realized how much I depended on my pump to "take care" of me. I do not mind shots, but having to remember to take the Lantus once a day, then Novolog before every meal got to be too much for me. I always was good testing, so that was not the issue. Money is tight for me too, so I know where you are coming from. Good luck!
- ‹ Previous
- 1
- 2
- 3
- 4
- Next ›
Advertisement
REsources
Groups
From the Diabetes Hands Foundation blog...
Congratulations Diabetes Advocates Scholarship Recipients!
The Diabetes Hands Foundation and Diabetes Advocates Program is proud to announce and congratulate the members of DA who were granted scholarships to attend diabetes conferences in 2013! Thanks to a generous grant from Novo Nordisk, in 2013 we were …Continue Reading
La Familia de EsTuDiabetes Sigue Creciendo
El Centro Nacional de Prevención de Enfermedades Crónicas y Promoción de la Salud en el Estados Unidos encontró que a partir de 2002-2009, el 11,8% de los hispanos mayores de 20 años, que viven en los EU, viven con diabetes …Continue Reading
TuDiabetes Team
DHF STAFF
 Manny Hernandez(Co-Founder, Editor, has LADA)
|
DHF VOLUNTEERS
Lead Administrator
 Bradford (has type 1) |
Administrators
 Lorraine (mother of type 1) |
 Marie B (has type 1) |
|
|
|
|
|
|
LIKE us on Facebook
Spread the word
This site complies with the HONcode standard for trustworthy health information: verify here.
© 2013 A community of people touched by diabetes, run by the Diabetes Hands Foundation.
