My blood sugar started going up fast shortly after I posted last night. I took 2/3rds of my usual bedtime NPH dose and was steady just over 200 the rest of the night. Blood sugars today have been unexceptional; highs and lows but not extreme ones (for me).
I went to see the optometrist today. He did a dilated eye exam and saw no evidence of retinopathy. I told him I've been having trouble seeing up, and he did a basic screening test for peripheral vision loss, where he held his fingers at the sides or up and down and wiggled one and asked me which one he was wiggling. One of the times he held one finger high up enough I wouldn't have been able to tell if he was wiggling it, but he wiggled the down hand finger that time. I'm still not convinced that I haven't lost the upper periphery of my vision, but I passed the screening test. And my glasses prescription is the same.
Wednesday, April 29, 2015
Tuesday, April 28, 2015
Lots of research shows that most type 1 diabetics do, in fact, make a little tiny bit of insulin.
More controversial is evidence for and against that little bit mattering.
Most of the time, I see absolutely no evidence in my blood sugars of any making of insulin going on inside me.
I have never had insulin requirements anywhere close to low enough to qualify for any of the sorts of research studies that want definite honeymooners; my insulin needs have consistently been in the 0.7- 1.0 u/kg range.
I don't have the immunity from highs or lows that a cushion of making insulin brings. And I haven't been prone to bizarre unexplainable lows since my first two years on insulin.
But every now and then...
Yesterday at lunchtime I was low, which on NPH has been unusual (which is exactly the opposite of what I expected from NPH, but it seems very little has happened as expected when I've changed insulins).
I ate 60 grams of uncovered carbs for lunch- a pita bread with jelly, plus pretzels with hummus. My blood sugar did not go above 100.
My supper blood sugar didn't go above 140. My overnight blood sugar stayed below 100.
Today after breakfast I went to 70, and I stayed between 70 and 100 until late afternoon, even though once again I ate an uncovered lunch. After work I ate 20 grams more uncovered and went up, but only to 160; I was down to normal range by suppertime. Blood sugar did not go up at supper. Around 9 PM I started thinking about a bedtime snack (on NPH I need one) and started wondering if I had taken my NPH. I don't remember doing so- I ate supper early so I may or may not have mixed the supper R with N.
My blood sugar took a dive so I ate that snack.
I keep checking my blood sugar because the CGM numbers look so unbelievable to me. My numbers haven't stayed so low for a two day period since before I started pumping.
There are explanations possible other than insulin production- in particular, I could have some previous site that's absorbing slowly, and I could just be more insulin sensitive and have used too high insulin doses and coincidentally eaten in ways such that the insulin release from injection sites was coinciding with the digestion.
I also could be digesting poorly- a distinct possibility.
Or hey- I could be minihoneymooning.
More controversial is evidence for and against that little bit mattering.
Most of the time, I see absolutely no evidence in my blood sugars of any making of insulin going on inside me.
I have never had insulin requirements anywhere close to low enough to qualify for any of the sorts of research studies that want definite honeymooners; my insulin needs have consistently been in the 0.7- 1.0 u/kg range.
I don't have the immunity from highs or lows that a cushion of making insulin brings. And I haven't been prone to bizarre unexplainable lows since my first two years on insulin.
But every now and then...
Yesterday at lunchtime I was low, which on NPH has been unusual (which is exactly the opposite of what I expected from NPH, but it seems very little has happened as expected when I've changed insulins).
I ate 60 grams of uncovered carbs for lunch- a pita bread with jelly, plus pretzels with hummus. My blood sugar did not go above 100.
My supper blood sugar didn't go above 140. My overnight blood sugar stayed below 100.
Today after breakfast I went to 70, and I stayed between 70 and 100 until late afternoon, even though once again I ate an uncovered lunch. After work I ate 20 grams more uncovered and went up, but only to 160; I was down to normal range by suppertime. Blood sugar did not go up at supper. Around 9 PM I started thinking about a bedtime snack (on NPH I need one) and started wondering if I had taken my NPH. I don't remember doing so- I ate supper early so I may or may not have mixed the supper R with N.
My blood sugar took a dive so I ate that snack.
I keep checking my blood sugar because the CGM numbers look so unbelievable to me. My numbers haven't stayed so low for a two day period since before I started pumping.
There are explanations possible other than insulin production- in particular, I could have some previous site that's absorbing slowly, and I could just be more insulin sensitive and have used too high insulin doses and coincidentally eaten in ways such that the insulin release from injection sites was coinciding with the digestion.
I also could be digesting poorly- a distinct possibility.
Or hey- I could be minihoneymooning.
Friday, April 17, 2015
Insulin Potency
When I filled my prescription for NPH, the pharmacy tech said it was good for 28 days. The patient insert, however, stated 42 days. I have so far used it for 42 days. I think maybe I've seen a loss in potency in the last week but am not sure. Looking for definitive answers, I found this non-answer of an article:
http://care.diabetesjournals.org/content/26/9/2665.full
In which none of the manufacturers advocates 42 days, one says 7 days (!) and much evidence is offered that the decline in potency of Lantus over time is more noticable than that of NPH.
When I personally tried using a Lantus vial (out of the fridge) for as long as I could, it was day 53 when I gave up on it due to very high blood sugar for the previous two nights. I have used Novolog past five months and it worked fine; I've used a vial of Novolin R for about two months with no problem.
Now I guess I'll give the NPH a whirl and see how long it lasts... maybe? I keep going back and forth with myself about whether I should bother.
http://care.diabetesjournals.org/content/26/9/2665.full
In which none of the manufacturers advocates 42 days, one says 7 days (!) and much evidence is offered that the decline in potency of Lantus over time is more noticable than that of NPH.
When I personally tried using a Lantus vial (out of the fridge) for as long as I could, it was day 53 when I gave up on it due to very high blood sugar for the previous two nights. I have used Novolog past five months and it worked fine; I've used a vial of Novolin R for about two months with no problem.
Now I guess I'll give the NPH a whirl and see how long it lasts... maybe? I keep going back and forth with myself about whether I should bother.
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