Replies to This Discussion

Permalink Reply by MaryMary on May 21, 2011 at 7:26am

This has got to be a misunderstanding. Never a reason for a type 1 not to take their insulin, period. Fasting has nothing to do with your insulin. There is no way in hell that I would withhold my kids insulin for any blood test. Lots of years between them both and never been asked to do so, nor have I seen a post like this on any diabetes message board. Now, a person that can go for days without insulin is a completely different story, although I still don't believe a lab or doctor would tell a patient not to take insulin.

• ▶ Reply

Permalink Reply by Anne on May 20, 2011 at 2:15pm

I once asked "What if I have a low bg in the morning" and if it was okay to take glucose tabs in that case of if I had to get a new appointment then. I was told that, if I must, I must take some. They agreed that I'd have to be at a bg level that made it possible for me to get there save.

I actually had a few cases I needed some. Never had any problems with inaccurate blood values.
If not even that takes a noticeable influence, why would basal insulin do so?

You forget: A healthy person does always have insulin in their body - even if they are fasting to have lab tests done. Why would any doctor tell a diabetic to stop taking their insulin for the tests?

• ▶ Reply

Permalink Reply by Kelly WPA on May 20, 2011 at 3:23pm

You are right Ken!

• ▶ Reply

Permalink Reply by Brian (bsc) on May 20, 2011 at 3:32pm

The only reason to skip an insulin dose is to test what level of natural fasting insulin remains. For most T1s, this is a "useless" test. Exogenous insulin will "suppress" your natural insulin production to a certain degree, and that is why it is necessary to stop insulin. But this is by no means a standard test.

My experience is that I am asked to fast with no food or other nutritive liquids in preparation for a cholesterol test. And even in that case, the only level really affected is your triglycerides which surge following a meal. I actually have a dr appointment monday at 4:3pm. I "refuse" to fast. They can test my cholesterol and obsess over it without making me not eat all day, and it won't matter anyway, cause I won't do anything about my cholesterol levels.

So don't skip your insulin unless you are specifically instructed and given a specific test which it will confound.

• ▶ Reply

Permalink Reply by Anne on May 21, 2011 at 5:13am

Isn't it usually enough to not have breakfast the morning they are going to take the tests?

• ▶ Reply

Permalink Reply by Brian (bsc) on May 21, 2011 at 7:27am

If you have an appointment first thing in the morning, yes. But most guidelines ask for 10-12 hours of fasting, with an appointment at 4:30 pm, that means that I have to not eat all day.

• ▶ Reply

Permalink Reply by Anne on May 21, 2011 at 9:32am

oh, okay, I can see that now.

I have never had an appointment due to tests in the afternoon since most doctors/endos send everything off to the lab no later than 11:30 AM, so all tests are taken in the morning.

But it makes sense. If you go without breakfast, you'll have about that time of fasting.

• ▶ Reply

Permalink Reply by Natalie ._c- on May 20, 2011 at 10:01pm

I've NEVER been asked to omit my insulin for labs. Granted that I am on a pump, and my basal takes care of my fasting needs, but I can't imagine anyone telling you to omit insulin. Do they want you to start working on going into DKA? Or are they simply sure that EVERY adult is a Type 2 producing lots of insulin, who can conceivably go without if they are not eating? (I've been there and done that, and it wasn't pretty).

I would simply ignore their instructions and take your basal. You COULD argue with them about it, or you could simply keep your mouth shut -- what they don't know won't hurt THEM, it will only hurt you.

Good luck!

• ▶ Reply

Permalink Reply by Donna H on May 21, 2011 at 5:42am

I would definitely bring that lab instruction to the attention of your doctor and make sure the medical director of the lab you are using knows that there is likely a problem with the instruction. I have never been told not to take my insulin and that instruction simply makes no sense. Even if they wanted to check your insulin production - that is a c-peptide test and synthetic insulin would not interfere with it because it does not have c-peptides. And the others are right -- some people will go into DKA very quickly. This instruction could be truly dangerous for some people.

• ▶ Reply

Permalink Reply by FatCatAnna on May 22, 2011 at 3:43pm

I know for myself - where I'm too stubborn to fork out dollars for a taxi to go to the lab - and drive myself (all my friends are working stiffs like myself) - I drive myself to the lab for my "fasting" blood test (I do not use motorcycle for this trip - just incase). I have had a few occassions where I go low AFTER the blood test - or while waiting for #XXX to be called up. I did manage to slip the line by telling nurse my BG was 2.5 mmol/l - and she said they'd have to do a blood test to confirm it - but I think I did a semi-freak out show - and they took me in toot sweet (pays to be a good actor sometimes). I told my endo about this - and he said - "ahh - just eat" - but all I've ever been told on the form we have here in Quebec - is no liquids / food for 12 hours prior to fasting blood work. I will sometimes give some insulin if my BG is abit high - but sadly - it doesn't really do much - especially in the A1C area.

• ▶ Reply

Permalink Reply by LaGuitariste on May 22, 2011 at 5:22pm

I have a couple of elderly T2 friends who wouldn't be able to figure out for themselves that "no food = no morning bolus". I'm not sure about my uncle, but I suspect he'd have the same confusion unless you spelled it out for him.

One of these ladies has been on Lantus and Novolog for over a year and she argues with me every time I mention that she needs to keep track of her grams of carbs not just her total calories. She simple cannot grok that insulin dosing is related to carbs, not calories (and no, she's not TAGing -- she's just stuck on every diet she's ever been on since her 30's.) She'll be so proud that she only had 500 calories for breakfast -- even if the entire breakfast was one big 500-calorie carb bomb: cereal, milk, toast, jam.

Her ignorance and stubbornness make me want to scream, but I still love her, the hard-headed old bag!!! (That's one old bag calling another old bag an old bag -- we're exempt.) Of course, her doctor is the person I really want to slap -- they have her convinced that she only needs to inject Novolog per a sliding scale based on her pre-meal BG's with zero reference to the amount of carbs in the meal -- sheer insanity which regularly results in post-prandials over 200, which she now feels are "normal". Gah.

Telling her to not bolus in the morning would do no one any good as she has no idea what the word bolus means.

• ▶ Reply

Permalink Reply by Natalie ._c- on May 23, 2011 at 1:52am

Well, that's the way I was treated when I was in the hospital, and they couldn't figure out why I wouldn't come down under 400, even though I was eating as few carbs as I could manage. Much of the medical profession is WAY out of date, and many older people were trained to take their doctors' advice with no questions asked. And they are NOT willing to believe that you may know something they don't know, because you have no letters after your name.

It actually may be that early-stage Type 2's can function with the sliding scale for corrections only, because most of them do have significant endogenous insulin production, but Type 1's and many late-stage Type 2's don't, and the sliding scale is simply a disaster for them. I really wish the medicos would catch on!

• ▶ Reply

• ‹ Previous
• 1
• …
• 4
• 5
• 6
• 7
• Next ›
• Page