Just in case anyone can offer info or suggestions?
Question:
>oh. honey…. sorry…. don’t know what to say for you…. it’s that darn t2 >difference that has me confused >but i do hope you work this out soon….. take care
Thanks, Kate. I really feel more positive today, like I actually have something to work with. This morning was the first time I’ve had a FBS below it, I guess. Keep your fingers crossed, ‘k? Bev Remove the "SpamFree" for email, please.
Response:
>I hope he’s doesn’t blame you for being "non-compliant"! You know, if >the program doesn’t work it must be our fault for not toeing the line >properly. 
December. I tried to get my blood pressure lowered all year last year, doubled this, tripled that, tried a new one, tried another one, etc. The last one they tried threw me into tachycardia, in direct opposition to the Lopressor I have taken since 93 to control it. I had no choice but to cut it, and I couldn’t get anyone to return my calls or call me in something different. I finally just added another 50mg a day to my daily dose (I knew from past research that I was far from the max dose) to last me till I could get one of the "group" to see me. Some doctor I had never seen comes in and chews my backside for going against doctor’s orders like my blood pressure being 176/117 is MY fault. He demanded that I do as I was instructed. I told him if they’d return my phone calls and not wait two friggin weeks to get me some medication, I’d have never gotten into that mess. He shut up. I now am going to another member of the group, a new guy. He’s a furriner, heavy accent hard for my southern ears to understand (he laughs when I ask him to please repeat;) but he actually CARES. Imagine my surprise when he was concerned that the Clonodine made me sleepy! "My goal is to control your blood pressure with as few side effects as possible" Hell, I’m just glad he’s willing to control it without blowing my heart clean out of my chest 
My motto is, if they can’t deal with you, find another one. They’s tons of ‘em Bev Remove the "SpamFree" for email, please.
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oh. honey…. sorry…. don’t know what to say for you…. it’s that darn t2 difference that has me confused but i do hope you work this out soon….. take care — kate – Hide quoted text — Show quoted text – > To make a long story short, I got an Rx for Lantus called in today by my PCP. > I was sick, and didn’t get to talk to him about it, so I’m on my own for the > weekend. of > NPH, 30/30. When I went to bed last night, my Bg was 137 (around 11pm). At > 2am, it was 144…..I thought that was very little difference, and I thought I > was ok. > When I got up at 7:52am, imagine my surprise at finding a Bg of 212. I felt > shaky and sick, like my heart was beating faster than activity called for. My > fasting Bg has been from the low to mid 200’s for weeks, and I cannot seem to > get control no matter what I do or eat. > As an update, I started on 4mg Avandia mid January, Went to 8mg end of > February. I’ve tried everything from splitting the dose, to taking the full > 8mg in the am and adding an 850mg Glucophage at night ( did well on Glucophage > for years, but had a problem with it all of a sudden in January and had to make > a fast change. So far no problems with one a day). > I’m on twice the H I used to take when I was on 850mg Glucophage twice a > day(gone from an absolute max of 15u per meal to 20-25), gained 15lbs, from a > dosage of 25/20 N to 30/30) and from a normal fasting of 90-120 to up to an all > time high of 268. I’ve just about had it. > I have an appt with my endo on Tuesday (and he’s gonna be ticked, I was in > control when last he saw me in December) , but I absolutely HAVE to survive the > weekend in order to make the appt, so my question is: > The PCP called in the Lantus with a dosage of 10u at bedtime. Considering that > I have been taking 30/30 N, does a dosage of 10u Lantus sound comparable? I > cannot take a chance on things getting any worse or I am going to end up in the > hospital before Monday. > Yeah, I know I should call my doctor, but to be honest, I have more faith in > practical experience. I’m sitting here trying to decide whether I should just > increase the N to 35, or take the 10 of Lantus. Any thoughts? > Remove the "SpamFree" for email, please.
Response:
>night, > I feel pretty much ok, and my bg is 160, with just the 10u of Lantus. >However, > I took 25u of H with dinner last night. Used to be I would have taken 12 >to > 15u for what I ate and I would have come out at a max FBS of 130.
My fasting BG on 25/20 N, and 10-15 H per meal with a dosage of Glucophage 850mg twice daily usually ran an avg of 105, so you can see why I’m freaking out. >Bev, >I couldn’t really follow your first post.
Not surprising, Marilyn. I was in a bit of a "state" Were you taking the Lantus "When >I went to bed last night, my Bg was 137 (around 11pm). At >2am, it was 144… When I got up at 7:52am…Bg of 212) or was this after >taking 30 units of N?
This was before I had the Lantus. It was on 30u of N. >Lantus should be taken once a day and should provide you with stable blood >sugars if you don’t eat anything. You then take H to cover what you eat. >The H will take care of the food but is long out of your system and has no >affect on your FBS.
Is Lantus supposed to overcome the problem of Dawn Phenomenon? I have never had too much problem with it when I was on Glucophage full time. It seems to have kicked in with a vengance. Within 50 minutes while sitting at the computer this morning I went up to 181 from 160. While that doesn’t sound so bad, a week ago I went up over 50 points in half an hour, same circumstances. This morning, I ate a small container of pudding and took 13u H, and went back to bed. (Hey, I know, but it was handy and I was sleepy) I figured this would stop the DP, anyway. When I got up again later on and took my Bg at 10:51, it was 132. I usually don’t eat (due to medicating problems) until about 3 hours after I get up during the week. On the weekends, I can wait an hour after my med to eat and it’s ok. The wait isn’t negotiable, so getting the DP under control is an absolute must. I’m hoping that once I get used to the Glucophage being in my system, eventually taking the full dose I was on before December, that the DP problem will decrease. >What was you bG before you went to bed? If it was 160 and you woke with >160, changes are good that the Lantus will keep you around this number all >day. Do you tend to go high if you do not eat anything for an extended >period of time (liver dumps)?
Well, I do NOW. I didn’t use to have such a problem when I was on Glucophage. Now I’m taking 8mg Avandia in the AM, and 850mg Glucophage in the PM with dinner (usually close to 8pm) for the sole purpose of desperation since my blood sugar has been so out of control. Something HAS to be done. I asked to switch to Lantus to try to at least hold things stable once I got them down with H. If not, the best way to check your Lantus is >to fast for as long as you can and test frequently to ensure that your bG is >remaining constant. If it is constant but a bit too high (as the 160 is) >then add a unit or two of Lantus and wait three days. If this does not get >things where you want them, do this again.
That is what I was thinking. >Once you have your Lantus dosage correct, it is easier to figure the H >dosages based upon the amount of carbs you eat and your bG at the time. >Hang in there! I am amazed that your PGP made this change and not your >endo. My endo would be furious with the PGP for doing something like this.
Well, it’s hard to get in to see my Endo, and he really isn’t familiar with my case, as I’ve only seen him once. When I got sick on the Glucophage back in January, I couldn’t wait to get a referral, make an appt, etc. I had to do something THAT DAY, so I did what I knew had to be done. I had to find an alternative to Glucophage (this has happened before) and get it in motion ASAP. I told my PCP’s NP what was going on, and she seemed to realize I wasn’t shooting blind, so she gave me the Rx for Avandia. I guess they assumed that if I didn’t have side effects like on Actos that it would work for me. It brings my numbers down during the day, but it does’t hold me 24 hours, and if I split the dose, the night dose doesn’t seem to have any effect. *I explored the possibility that Clonodine was interfering somehow, and I eliminated the dose a couple of times. I couldn’t tell a real change, but because the Clonodine knocks me out, I take the Glucophage with dinner and the Clonidine at bedtime now* when you try to get a doctor to work all of them out for you, they get this blank look, a kind of stupified stare. I had a smartass PCP not too long ago who ticked me off. I wrote down a list of all the health problems I needed help with, and he just sat and stared at it. He told me he was overwhelmed. I am asking for is a little help. I don’t have that doc anymore. I try to handle as much of the load as I can, and usually as long as I can get the doc to give me what I want, I do allright. I’m agressive when it comes to my healthcare, and I don’t mind making suggestions. If I hadn’t, I would be DEAD by now, without a doubt. Thanks for your imput Marilyn. You’ve been very helpful. Bev >– >Marilyn >Type 1 for 35 years, pumping for the last 14
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> I have an appt with my endo on Tuesday (and he’s gonna be ticked, I
was in control when last he saw me in December) , > …
I hope he’s doesn’t blame you for being "non-compliant"! You know, if the program doesn’t work it must be our fault for not toeing the line properly. bj
Response:
Bev, Lantus is great if you give it the time to start working. My personal experience is that it takes 1-2 days to get going and give you a good number. But I’m different also. and yes 10u sounds mighty low for Lantus if you were taking a total of 60u per day of NPH. You might want to experiement a bit with it, and figure out what 80% of the total NPH was and start from there. But remember – it takes 3 days for most to see a change .. because Lantus is so flat, it doesn’t peak to lower you like NPH or UL. Good Luck Bev… I know how you feel, had my own agravations of late. — RK [T1 that was smarter then her previous Doctors!][dx'd 5/00][Lantus Lover w/Novolog] http://www.diabeticnet.com – Main alt.support.diabetes website – Be fooled by no other imitations! http://www.zerolimit.net/files/zl-mirc.exe (#diabeticnet chatroom software)
– Hide quoted text — Show quoted text -> To make a long story short, I got an Rx for Lantus called in today by my PCP. > I was sick, and didn’t get to talk to him about it, so I’m on my own for the > weekend. of > NPH, 30/30. When I went to bed last night, my Bg was 137 (around 11pm). At > 2am, it was 144…..I thought that was very little difference, and I thought I > was ok. > When I got up at 7:52am, imagine my surprise at finding a Bg of 212. I felt > shaky and sick, like my heart was beating faster than activity called for. My > fasting Bg has been from the low to mid 200’s for weeks, and I cannot seem to > get control no matter what I do or eat. > As an update, I started on 4mg Avandia mid January, Went to 8mg end of > February. I’ve tried everything from splitting the dose, to taking the full > 8mg in the am and adding an 850mg Glucophage at night ( did well on Glucophage > for years, but had a problem with it all of a sudden in January and had to make > a fast change. So far no problems with one a day). > I’m on twice the H I used to take when I was on 850mg Glucophage twice a > day(gone from an absolute max of 15u per meal to 20-25), gained 15lbs, from a > dosage of 25/20 N to 30/30) and from a normal fasting of 90-120 to up to an all > time high of 268. I’ve just about had it. > I have an appt with my endo on Tuesday (and he’s gonna be ticked, I was in > control when last he saw me in December) , but I absolutely HAVE to survive the > weekend in order to make the appt, so my question is: > The PCP called in the Lantus with a dosage of 10u at bedtime. Considering that > I have been taking 30/30 N, does a dosage of 10u Lantus sound comparable? I > cannot take a chance on things getting any worse or I am going to end up in the > hospital before Monday. > Yeah, I know I should call my doctor, but to be honest, I have more faith in > practical experience. I’m sitting here trying to decide whether I should just > increase the N to 35, or take the 10 of Lantus. Any thoughts? > Remove the "SpamFree" for email, please.
Response:
night, > I feel pretty much ok, and my bg is 160, with just the 10u of Lantus. However, > I took 25u of H with dinner last night. Used to be I would have taken 12 to > 15u for what I ate and I would have come out at a max FBS of 130.
Bev, I couldn’t really follow your first post. Were you taking the Lantus "When I went to bed last night, my Bg was 137 (around 11pm). At 2am, it was 144… When I got up at 7:52am…Bg of 212) or was this after taking 30 units of N? Lantus should be taken once a day and should provide you with stable blood sugars if you don’t eat anything. You then take H to cover what you eat. The H will take care of the food but is long out of your system and has no affect on your FBS. What was you bG before you went to bed? If it was 160 and you woke with 160, changes are good that the Lantus will keep you around this number all day. Do you tend to go high if you do not eat anything for an extended period of time (liver dumps)? If not, the best way to check your Lantus is to fast for as long as you can and test frequently to ensure that your bG is remaining constant. If it is constant but a bit too high (as the 160 is) then add a unit or two of Lantus and wait three days. If this does not get things where you want them, do this again. Once you have your Lantus dosage correct, it is easier to figure the H dosages based upon the amount of carbs you eat and your bG at the time. Hang in there! I am amazed that your PGP made this change and not your endo. My endo would be furious with the PGP for doing something like this. — Marilyn Type 1 for 35 years, pumping for the last 14
Response:
>Well Bev I am not an insulin guy but I hope you get the answers you >need and I hope you feel better… >Ronnie Ruff
Thanks, Ronnie, me too Bev Remove the "SpamFree" for email, please.
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Bev, As you know, I don’t use insulin. But others have said here that their Lantus doses were running somewhere around 80% of their former basal. If this is true, then it looks like your doc has erred on the side of conservatism with the new doseage. I hope you get some answers on Monday. Jim
Response:
>But others have said here that their >Lantus doses were running somewhere around 80% of their former basal. If >this is true, then it looks like your doc has erred on the side of >conservatism with the new doseage.
I feel pretty much ok, and my bg is 160, with just the 10u of Lantus. However, I took 25u of H with dinner last night. Used to be I would have taken 12 to 15u for what I ate and I would have come out at a max FBS of 130. It’s clear the Avandia is not working for me, and my only option is to try to work back up to the Glucophage dosage I was on before. I’ve started back taking my Pepcid twice a day, and it seems to combat the heartburn from the But deal-with-able at this point. I may add the second dose in next week and see how it goes……and drop the Avandia. I’ll talk to the endo and get his imput. I’m just relieved that I don’t feel like I did yesterday morning, so bad I was actually afraid to get out of bed. I tried to sleep an extra couple of hours, and still when I had to leave home, I could hardly make it to the car, I was so sick. It’s over an hour commute, and I ate breakfast and took my meds and insulin before I left, so I started feeling better by the end of the drive, but during the day, that feeling kept coming back. I was expecting I’d have to make a visit to the PCP this morning, but maybe not….. Thanks for the info, Jim. You know how it goes, some of us just don’t retain info that doesn’t pertain to us UNTIL we get in a tight, then we start scrambling. Glad SOMEBODY was paying attention Bev Remove the "SpamFree" for email, please.
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To make a long story short, I got an Rx for Lantus called in today by my PCP. I was sick, and didn’t get to talk to him about it, so I’m on my own for the weekend. NPH, 30/30. When I went to bed last night, my Bg was 137 (around 11pm). At 2am, it was 144…..I thought that was very little difference, and I thought I was ok. When I got up at 7:52am, imagine my surprise at finding a Bg of 212. I felt shaky and sick, like my heart was beating faster than activity called for. My fasting Bg has been from the low to mid 200’s for weeks, and I cannot seem to get control no matter what I do or eat. As an update, I started on 4mg Avandia mid January, Went to 8mg end of February. I’ve tried everything from splitting the dose, to taking the full 8mg in the am and adding an 850mg Glucophage at night ( did well on Glucophage for years, but had a problem with it all of a sudden in January and had to make a fast change. So far no problems with one a day). I’m on twice the H I used to take when I was on 850mg Glucophage twice a day(gone from an absolute max of 15u per meal to 20-25), gained 15lbs, from a dosage of 25/20 N to 30/30) and from a normal fasting of 90-120 to up to an all time high of 268. I’ve just about had it. I have an appt with my endo on Tuesday (and he’s gonna be ticked, I was in control when last he saw me in December) , but I absolutely HAVE to survive the weekend in order to make the appt, so my question is: The PCP called in the Lantus with a dosage of 10u at bedtime. Considering that I have been taking 30/30 N, does a dosage of 10u Lantus sound comparable? I cannot take a chance on things getting any worse or I am going to end up in the hospital before Monday. Yeah, I know I should call my doctor, but to be honest, I have more faith in practical experience. I’m sitting here trying to decide whether I should just increase the N to 35, or take the 10 of Lantus. Any thoughts? Remove the "SpamFree" for email, please.
