Replies to This Discussion

Permalink Reply by Shayla on May 13, 2012 at 2:07pm

I'd test right before I'm about to eat and ive noticed it does burn sometimes when I'm injecting humalog and lantus maybe its to close to a blood vessel not sure

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Permalink Reply by christy on May 13, 2012 at 2:10pm

Hi, um injection techniques...are u first of all pinching up your skin before injecting? Getting that fatty pouch of skin ensures the insulin is getting into that subcutaneous area. Also maybe there is something in the additive of Lantus that is making you sensitive to it.

As far as testing four times a day, my best advise is its just something you are going to HAVE to make habit...like going to the bathroom to pee. You dont just go twice a day, you go when you feel the need. I think it doesn't really matter so much that u may or may not be eating meals at a regular time...just more to see where your numbers are at a particular time of the day. I mean lets say you blood glucose level is 98 @ breakfast...you eat...you dont check at noon...but by the time you check again your bg level is say 111...but the Dr's don't know what it was during the noon hours...and if say you are spiking to say 200 at noon...then adjustments need to be made because you should not be spiking and maintaining a spike for a long peroid of time. So I think just make it part of your routine during the day and definately either get a watch with an alarm you can set..or a little timer you can set to remind you to go test. After a few days of doing it consistently it will become habit.

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Permalink Reply by Josh on May 13, 2012 at 3:04pm

Christy,

Thanks :)

I have been pinching the skin before injecting and have been getting what i think is a good chunk of skin/fat. Is there a wrong way to do it that is different from the theigh stomach region?

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Permalink Reply by Zoe on May 13, 2012 at 3:06pm

Don't you need to test before each meal to determine your insulin dose?

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Permalink Reply by Josh on May 13, 2012 at 3:08pm

My dr has me on 20 units of lantus at morning and bed time then 14 units of novolog with meals. they stopped the sliding scale with me back when i started seeing and ENDO

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Permalink Reply by christy on May 13, 2012 at 3:13pm

It should all pretty much be the same technique. Legs I think can be a little trickier just because they tend to be muscular in nature. When I was doing injections I'd try to go to the kinda sides, of thighs where they are a bit more fatty and less muscular.

I find it so interesting how they dose for Type 2's..and Dr's really seem almost reluctant to start carb counting and actually dosing for what you eat versus just a standard dose of insulin. I've seen other type 2's that were dosed in this same fashion, and well as being a Type 1...Im just not sure if this is kinda the standard of care for Type 2's and if it is Im not sure what the rationale behind it is. I would THINK carb counting and dosing precisely for what you eat regardless of whether you are Type 1 or Type 2 would be the ideal treatment.

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Permalink Reply by Josh on May 13, 2012 at 3:24pm

not sure if it the standard either:

short story is when the first dr started me on novolog it was on the sliding scale. I requested to see and ENDO and the endo put me on the set 14 units. I do question it 2 but i have only seen the endo once so far.

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Permalink Reply by Zoe on May 13, 2012 at 3:33pm

I'm pretty cynical and think the "rationale" (or lack thereof) is that they expect very little out of their Type 2 patients, which is of course, doing those Type 2's a great disservice.

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Permalink Reply by still_young_at_heart on May 13, 2012 at 3:23pm

Really?? The standard protocol would be to move from sliding scale to carb counting rather than from a sliding scale to a fixed dose. My guess is that most people here on MDI (lantus and novolog) would test before and two hours after every meal and before bed. Once you get a handle on your blood sugars, you'll likely go low from time to time so that you will also want to test before driving and exercise.

Using insulin is a time management problem which is much more difficult if you don't give in and buy a watch.

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Permalink Reply by Zoe on May 13, 2012 at 3:39pm

LOL. Never worn a watch in my life and never will. Between the time on my meter/remote and my pump, and all the clocks in my house, computer and car, I can't really lose track of time even if I try to

I agree with Maurie that before eating (to determine dose) and two hours after (to see how food affected you and if you need a correction) is pretty minimal. I have an acquaintance who is Type 2 now on insulin and his doctor told him he only needed to test twice a day because he's Type 2. Insulin is insulin and not testing is both dangerous and guaranteed to lead to poor control. As for remembering the "two hours after"? I'm a space case by nature but I've been doing it for 3 years and it's now automatic. But perhaps you can tie it to activities that are routine in your life to help until it becomes a habit

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Permalink Reply by christy on May 13, 2012 at 3:54pm

I do not understand some of the type 2 standards of treatment, my endo's office seems like they are pretty aggressive in treatment but as Im not type 2...obviously I cant say for certain. But it does seem I think a lot of Endo's are reluctant to start insulin on Type 2's and when they do...it seems they put them on old standards of dosing with insulin. Philmore, I would maybe bring up the subject of dosing for carbs at a later visit. I think its an ideal way of dosing insulin.

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Permalink Reply by Zoe on May 13, 2012 at 3:32pm

A set dose for meals, unfortunately, is no more accurate than a sliding scale. You need to figure out your I:C ratio and then bolus according to the food you are actually going to eat. A salad needs a lot less insulin than four slices of pizza!

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