Mark Luebbers's Comments

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At 12:16pm on September 23, 2013, Marie B said…

hey Mark, I was just reading your discussion about getting your levels down (an oldie, but imo, a goodie) and I was just wondering how you were doing.

At 6:55am on January 5, 2010, Gerri said…
Hi Mark,

So nice to hear from you! Wow, 18 lbs. That's fantastic! Happy you're doing well.

Happy new year.
At 10:12pm on May 4, 2009, Gerri said…
Very happy to hear the good news & glad I could help some.

Cheating--I hear ya. Cheat now, freak out 2 hours later.

I HATE it, too. I really do.
At 9:20pm on May 1, 2009, Gerri said…
Hi Mark,

Wanted to see how you're doing. Hope all is well & lower!
At 11:30pm on April 13, 2009, Gerri said…
He wasn't clear at all! It's confusing to begin with without him making it worse.
At 11:25pm on April 13, 2009, Gerri said…
Forget that exchange stuff. No one does that any more. But if he meant exchanges, than that's a lot more than 16 grams for the whole day. A lot more!

You really eating this tiny amount of carbs? I can't imagine your BG being that high eating like this.
At 11:20pm on April 13, 2009, Gerri said…
Ok, let's start again:) It is confusing & will try to unconfuse you.

Endo started you on 1 unit of Humalog for every 15 grams of carbs. Now, it's been raised to 1 unit of Humalog for every 10 grams of carbs. If you eat 50 grams of carbs at a meal (which I don't recommend), you'll take 5 units of insulin (plus sliding scale correction dose). Total carbs divided by 10--very simple.

How many carbs do you now eat per meal?

I take a lot more insulin, but you're Type 2 (maybe). Type 2s need less insulin than Type 1. I eat low carb, but 58% of protein turns to glucose so you have to be careful about this part. Talk about confusing!
At 11:11pm on April 13, 2009, Gerri said…
This makes no sense. Maybe you misunderstood him? One carb doesn't equal 15 grams. A carb is a carb, a gram is a gram. Carbs are measured in grams.

Maybe you're confusing two different things--insulin doses & carbs.

How many grams of carbs did he say you should eat per meal? I've never heard an endo tell anyone to eat 5-6 carbs per meal. Even very low carb isn't this low.

What did you eat for lunch & dinner today?
At 11:02pm on April 13, 2009, Gerri said…
I have no idea what 5 carbs equaling 15 grams means. This makes no sense. Really, 15 grams of what? You're only eating 5-6 grams of carbs per meal? This is barely possible.
At 10:54pm on April 13, 2009, Gerri said…
Nope, if you eat 50 (assuming you meant 50, not 5) grams of carbs you need 5 units of Humalog. Total carbs per meal divided by 10, plus whatever you're taking as a correction to bring down BG.
At 10:15pm on April 13, 2009, Gerri said…
Yep, you've got it! Totals grams per meal divided by 10 for Humalog. To lower high BG, 1 unit Humalog for each 50 pts you need to lower it.

One thing, you'd better not be eating 75 grams of carbs at a meal. Hope that was just an example.

Next appt, ask for free insulin samples. Endos have tons.
At 10:00pm on April 13, 2009, Gerri said…
Just so I understand, you're doing corrections with Humalog when BG is over a certain number, right? This is in addition to what you take for meals, right?

Happy he got right back to you--that's great.

So now, your ratio is 1 unit of Humalog for every 10 carbs?

You say anything to him about taking Levemir in two doses to help your morning numbers?
At 9:44pm on April 13, 2009, Gerri said…
Didn't see the post below because you sent it to yourself, not me:) Now I'm reading it.

You don't want anything on your hands (like handling food) to effect your reading. See, I'm not the only who didn't know about the second drop of blood! Why don't they tell us these things! The first drop contains skin tissue, so when we wipe away the first drop, the second drop is just blood.

Glad you called the doc! Levemir takes about 2 hours to work & won't effect your immediate after meal numbers.

Yes , agree. I think you need increases in both insulins, esp. humalog.

Want you to have better readings also. Don't think you're being impatient at all! Insulin isn't like oral meds where you need to wait for them to work over weeks. You need to have the right dose & now. Honey, you're not rambling & I'm here for you. Is very, very frustrating & proud of you for being active & demanding results.

When I was diagnosed & just starting on insulin, I called my doctor every day for about 2 weeks. Lucky that I have a nice internist. This was when I was waiting for my endo appt.

Type 2 is being insulin resistant.

Did the endo do the C-peptide & GAD tests?

Diet soda isn't the best thing in the world for you, but depends how much you're drinking. If you need something sweet, better than eating something with sugar.

That diet is it just eggs, meat & cheese? No veggies?

Keep me posted.
At 3:22pm on April 13, 2009, Mark Luebbers said…
Thanks I didnt know about the hand washing and the second drop I will
try both.
The doc told me to take the Humalog 10 to 15 min before eating.
The bad thing is even after an hour or 2 after the humalog its still 260 to 300
The reading this morning was 260 and after the levemir it was 330 It went up!
I called the doc and the nurse didnt call me back until an hr ago. Their busy and shes the only nurse today. She said she would leave a note for him and said he may call me tonight or tomorrow. She said hopefully tonight. I said I hope he does too.
I personally think the dosage for levemir isnt enough and the humalog isnt enough either.
What do you think?
Also can I be insulin resistant? Is that possible for Type 2?
I so much want to see a reading in the low 100's Then I know that I can be controlled. I guess I'm wanting results to happen quickly and I am not being patient enough. Is that such a bad thing? I know the doc said to come back in 2 weeks but I want him to increase the dosage so I can see results quicker than that. :O) Am I rambling on too much? Are you tired of me Rambling?
Am I getting aggravated? Am I too impatient...... Just tell me and i'll try to shut up a bit...
At 12:19pm on April 13, 2009, Gerri said…
Take readings 2 hours after eating to get a better idea of what's happening.

How did your doc tell you take the Humalog--how soon before eating?

Not very much to eat. No coffee? Asking because caffeine can cause spikes.

If you have dawn phenonmenon, morning numbers go high pretty quickly. I need to take more insulin in the morning than any other time. Just eat eggs & cheese for breakfast--practically no carbs at all.

I meant your Humalog needs to be increased because your after meal numbers aren't where they should be.

after I took 40 units of levemir this morning and 10 units of humalog I waited and hour and my reading was 330 ????
I only ate 2 hard boiled eggs and some cucumbers and onions
Why does it go up?
At 11:29am on April 13, 2009, Gerri said…
Hey Mark,

Got to get those numbers way down. When you're high like this, do you take a correction shot to bring it down? Wondering why you're going to bed with such high BG. Since your numbers are still high, your insulin doses need to be raised.
Call your endo & tell him what's going on.

Ok, don't be mad for me asking this, but do you wash your hands before testing? I forgot to do this a couple of times & had crazy numbers. Also, are you wiping away the first drop of blood & using the second drop to test? No one ever told me this until a nurse saw me testing. I had no idea.

Maybe it's your meter, but doubtful--sorry. You could get another meter. When you call your endo, ask them for another. They have tons of free meters from the pharm reps.
At 7:51am on April 13, 2009, Patti Burns said…
At 11:04pm on April 12, 2009, Gerri said…
Hope it helps. Take the Lantus evening immediately before going to bed. Let me know what your BG is right before bed & then in the morning.

Wierd work hours doesn't help at all.

How were your after meal numbers today with the Humolog?
At 10:14am on April 12, 2009, Gerri said…
Need to know what your bedtime reading is to know how much your BG is going up overnight. Better to talk to your endo to see what you should take for a morning Lantus dose & an evening Lantus dose. Taking 20 units twice a day may be too much & splitting the dose in half (10 morning, 10 evening) is probably too little.

If he gives you the party line about how Lantus lasts 24 hours, tell him you've spoken to many diabetics who take 2 doses to get better control. My first endo gave me flack about this, so I did it on my own because I read here how many people did this. It helped me tremendously.

Perfectly fine to take your Lantus & Humolog at the same time. We all do.

Keep me posted.
At 9:53pm on April 11, 2009, Gerri said…
So sorry, know this is awfully frustrating.

What was your bedtime reading before the morning reading?

Sounds like you could have dawn phenonmenon. More common in Type 1's (I have this), but also possible in Type 2s. Did your endo determine that you are a Type 2 from C-peptide & GAD antibody tests?

Lots of info here about dawn phenon. Best thing for this is taking your basal insulin in two doses. Don't give a damn what the pharm literature & endos say, Levemir or Lantus do NOT last 24 hours. You need basal right before bed & another injection as soon as you wake up. Taking basal immediately before bed will keep your morning numbers from going sky high. Levemir & Lantus (basal insulins) take about 2 hours to start working. Also, no snacking before bed. After dinner, no more food so that you're done digesting when you go to sleep.

If you drink coffee with breakfast, caffeine can cause spikes for many people.

With dawn phenon, you need to take your rapid acting & eat right breakfast right away. Postponing eating causing your liver to dump even more glucagon (glucose) & so even higher numbers.

Rapid acting insulin (Humolog) takes about 15-20 minutes to start working.

The 40 unit basal shot doesn't control meal numbers much & takes about 2 hours to start working, so this wouldn't effect the reading you took soon after.

Try to keep meals 4 hours apart.

How are your other 2 hour post meal numbers for other meals?

Keep me posted. Am happpy to try to help.



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