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Denise

A Lil Mishap

Well I had a little mishap with my insulin. I was suffering with high bg in the evenings so my doctor felt that splitting my dose of lantus into two shots daily may help. Well then I began having serious lows in the afternoon and early evenings. Then my doctor said that I may be having my lantus lasting longer than the twelve hour interval and be seeing a overlap in working insulin causing the lows. So we returned to one shot at night. Well I then began seeing a steady rise from about 3 to 11 pm and over a few days my bg got totally out of control. The night of the 11th I checked my bg and it just read "HI". I tried to correct and it came down to 481 and then 362 but shortly afterwards read "HI" again. I couldn't get it down and got so ill that I couldn't hardly sit up and my vision was really blurry. Soooooo I called my doctor and she wanted me to meet her at the hospital, I then called my sister and she comes over and takes me in. My bg was 723 and I was promptly admitted.
They hooked me up to an insulin drip and we got the numbers down. My doctor adjusted my bolus Novolog doses where I'm now taking the same for breakfast but a little higher dose for lunch and dinner and bolusing for my evening snack. They also added a small dose of Lantus at noon since they think my lantus is only lasting about 16 hours. I normally take my Lantus around 9:30 at night so it was only lasting till around noon the following day. The theory was that if I took a small dose around noon that it would control me until I took the larger dose at night. Well that didn't work so well and I was having serioius night time lows so my doc said lets try Levemir at noon and Lantus for my basal nighttime dose and continue the novolog for meals and snack. This seems to be working great. Levemir is also a long acting insulin so I couldn't understand why I could tolerate an additional dose of it at noon and not Lantus but hey it works. She said that she had seen this in a few other patients and thought it was worth a try. She said some people can't tolerate a multiple dose of Lantus or even a large dose but if you do one of Lantus and one of Levemir it is well tolerated and also that for some Levemir doesn't last nearly as long as Lantus. My insurance was going to give me a headache about paying for two different long acting insulins but my doctor faxed them a letter and they said ok. Thankfully I was given samples of the Levemir until the insurance can get the approval into their system.
Soooooooo I now take 10 units of Levemir at noon and 30 units of Lantus at 9:30 PM and then Novolog 8 Units for breakfast and 10 units for lunch and dinner and bolus 2 units for bedtime snack of 15 g carbs. My numbers today have been good with not having to do any correction shots so hopefully we solved the problem, well at least for now <grin>. I got to come home this afternoon and I'm glad to be home and feeling better.

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Denise Comment by Denise on August 14, 2007 at 6:40pm
Bernard, yes we are in the process of trying to get approved by my insurance to get a pump. I learned today from Metronic that my insurance will pay for it so next step is for them to contact my doctor to get the authorization. I think the pump will be a godsend for me. Thanks again everyone.
Denise Comment by Denise on August 14, 2007 at 6:38pm
Thanks Bernard, Travis and Chloe. It was scary when I looked at my monitor and all I saw was the word "HI" and then trying to get it down was really tough and I couldn't do it. Thankfully it has got better and today my bg has held pretty good with a two episodes of going a tad low (60's) but it easily rose with a little juice. I appreciate the well wishes.
Bernard Comment by Bernard on August 14, 2007 at 6:23pm
Denise

That sounds very complicated, with three different insulins. I hope you can work it all out.

Have you ever considered using an insulin pump?
Travis Grubbs Comment by Travis Grubbs on August 14, 2007 at 5:06pm
Hi Denise: I am glad that you are ok, and that your sister was available to assist you.
Chloe Comment by Chloe on August 14, 2007 at 1:21pm
Wow, what a roller coaster! I'm glad you're OK, and feeling better. I hope things continue to look up.

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