Pump Questions

Evon said:

Thanks for all your replies. I read Dr.? PHD paper on

insulin

Quoted message said:

resistance. I think I have become immune to insulin. I use

between 40

Quoted message said:

- 50u of Humalog/day and 50 u of Lantus,(30@bed time and

20 in morn).

Quoted message said:

Yet my BG for the past year runs between 220 - 400. 2 hrs

after

Quoted message said:

eating my BG's are always in the 300-400 range. I have

even taken as

Quoted message said:

much as 30u of Humalog 1/2 hr. before eating. The endo,

( only one

Quoted message said:

with in 70 miles) says if you don't cooperate I can't help

you. I

Quoted message said:

show him my daily logs of food and drink intake and

insulin use and

Quoted message said:

he says so what? If you were following my advice you would

be getting

Quoted message said:

better instead of worse. So, I went back to my FP and told

him what I

Quoted message said:

think of the Endo. I have tried vitamins, minerals, spices

etc. When

Quoted message said:

I try something new it helps for two - four weeks, then

boom bg's go

Quoted message said:

back up. Yesterday I mowed the yard, walking mower about

11/2 acres,

Quoted message said:

went to Pilates class, felt really crappy afterwards, took

my bg's

Quoted message said:

after Pilates down to 158. Lowest it's been in months.

Have a great

Quoted message said:

day!

Hi Evon, are you type 1 or type 2? Are you overweight? What
exactly do you eat? Type of food and amounts. Are you
consistent with your diet? If something works for 4 weeks it
should work indefinitely.

Evon said:

Thanks for all your replies. I read Dr.? PHD paper on
insulin resistance. I think I have become immune to
insulin. I use between 40 - 50u of Humalog/day and 50 u of
Lantus,(30@bed time and 20 in morn). Yet my BG for the
past year runs between 220 - 400.

Hi Evon,

Just want to mention that insulin resistance is usually when
daily dosing gets up to 200U or more per day. This is Dr
John Davidson's definition in his textbook "Clinical
Diabetes Mellitus." So you have a long way to go.

IMO, your BGs are high in the 200-400 mg/dl range, and this
takes more insulin than if you had more normal BGs at 90-150
mg/dl. So if you could get lower BGs, your insulin doses
should drop as a result. If the brain is set to the higher
BGs, then you may feel terrible for a day or two at a BG of
100 mg/dl. But it will pass.

However, if you have ever stopped using insulin, for say 3+
months, and then started back on insulin, this would cause
your immune system to attack your insulin dose much like a
flu shot works: The immune system makes antibodies from the
first attack that are made at a higher rate the second time
the virus attacks. This is called the "booster effect" or
secondary immune response. So if you have stopped insulin
therapy and then resumed it after a few months, you could
find that you're insulin resistant. See this paper for more
detailed information:

j_dumas.home.mindspring.comimmunogenicity potentialOpen ↗
_human_insulin_DC1293s3.pdf

This is a long download at 56k but worth it. Print it out
and show it to your Docs.

HTH,
--
Jim Dumas T1 4/86, background retinopathy, rarely
hypoglycemic: <1/mo. lispro+R+U+NPH daily, moderate
exercise, typically <6% HbA1c

Type II since 1996, on insulin since 1999 Humalog/Lantus/Glucophage. I
pretty much follow the Atkins style diet in that I eat a lot of salads and
breadless sandwiches. My weight at diagnosis was 190lbs. I been between
165 - 170 lbs since about 1997. I'm very active physically, Pilate's and
weights/machines when at home. On the road what ever the hotel has available
or just Pilate's floor exercises. I eat almost all my meat plain, no sauces.
Most of the time my meat consist of fish or fowl. Sashimi as often as
possible. Usually less than a 100 carbs per day. Usually about 60 carbs/day.
"Ozgirl" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Evon said:

Thanks for all your replies. I read Dr.? PHD paper on

insulin

Quoted message said:

resistance. I think I have become immune to
insulin. I use

between 40

Quoted message said:

- 50u of Humalog/day and 50 u of Lantus,(30@bed time and

20 in morn).

Quoted message said:

Yet my BG for the past year runs between 220 -
400. 2 hrs

after

Quoted message said:

eating my BG's are always in the 300-400 range. I have

even taken as

Quoted message said:

much as 30u of Humalog 1/2 hr. before eating. The endo,

( only one

Quoted message said:

with in 70 miles) says if you don't cooperate I
can't help

you. I

Quoted message said:

show him my daily logs of food and drink intake and

insulin use and

Quoted message said:

he says so what? If you were following my advice
you would

be getting

Quoted message said:

better instead of worse. So, I went back to my FP
and told

him what I

Quoted message said:

think of the Endo. I have tried vitamins, minerals,
spices

etc. When

Quoted message said:

I try something new it helps for two - four weeks, then

boom bg's go

Quoted message said:

back up. Yesterday I mowed the yard, walking mower about

11/2 acres,

Quoted message said:

went to Pilates class, felt really crappy
afterwards, took

my bg's

Quoted message said:

after Pilates down to 158. Lowest it's been in months.

Have a great

Quoted message said:

day!

Hi Evon, are you type 1 or type 2? Are you overweight?
What exactly do you eat? Type of food and amounts. Are you
consistent with your diet? If something works for 4 weeks
it should work indefinitely.

I downloaded your suggested reading. I quickly read it and
tonight I will read it in more detail. Interesting, but I
haven't stopped taking Insulin since I started. I eat a lot
of green salads, lettuce, cucumbers, green peppers, chopped
clams. 99% of the time my dressing is V/Olive Oil. A salad
like this will jump my BG 80-100 points with 12u of Humalog
no crackers/bread. Pasta is the best bang for the buck I can
get to 300-400 BG's with 20u of Humalog and a child's
portion of pasta! My Endo had me on 1u of H-log/10g of
carb's. Yesterday I visited the pumpers list. Now I'm trying
1u of H-log/8g of carbs. I use the plain H-log not the
70/30.

"Jim Dumas" <[email protected]!mindspring.com> wrote in
message -"]news:[email hidden]-
ink.net...

Quoted message said:

Evon said:

Thanks for all your replies. I read Dr.? PHD paper on
insulin

resistance.

Quoted message said:

Quoted message said:

I think I have become immune to insulin. I use between
40 - 50u of Humalog/day and 50 u of Lantus,(30@bed time
and 20 in morn). Yet my BG

for

Quoted message said:

Quoted message said:

the past year runs between 220 - 400.

Hi Evon,

Just want to mention that insulin resistance is usually
when daily dosing gets up to 200U or more per day. This is
Dr John Davidson's definition in his textbook "Clinical
Diabetes Mellitus." So you have a long way to go.

IMO, your BGs are high in the 200-400 mg/dl range, and
this takes more insulin than if you had more normal BGs at
90-150 mg/dl. So if you could get lower BGs, your insulin
doses should drop as a result. If the brain

is

Quoted message said:

set to the higher BGs, then you may feel terrible for a
day or two at a BG of 100 mg/dl. But it will pass.

However, if you have ever stopped using insulin, for say
3+ months, and

then

Quoted message said:

started back on insulin, this would cause your immune
system to attack

your

Quoted message said:

insulin dose much like a flu shot works: The immune system
makes antibodies from the first attack that are made at a
higher rate the second time the virus attacks. This is
called the "booster effect" or secondary immune response.
So if you have stopped insulin therapy and then resumed it
after a few months, you could find that you're insulin
resistant. See this paper for more detailed information:

j_dumas.home.mindspring.comimmunogenicity potentialOpen ↗
_human_insulin_DC 1293s3.pdf

Quoted message said:

This is a long download at 56k but worth it. Print it out
and show it to your Docs.

HTH,
--
Jim Dumas T1 4/86, background retinopathy, rarely
hypoglycemic: <1/mo. lispro+R+U+NPH daily, moderate
exercise, typically <6% HbA1c

On Thu, 15 Apr 2004 14:19:14 GMT, Jim Dumas

[email protected]!mindspring.com said:

Evon said:

Thanks for all your replies. I read Dr.? PHD paper on
insulin resistance. I think I have become immune to
insulin. I use between 40 - 50u of Humalog/day and 50 u
of Lantus,(30@bed time and 20 in morn). Yet my BG for the
past year runs between 220 - 400.

To the original poster: have you ever tried using regular
insulin as a meal bolus?

Quoted message said:

Hi Evon,

Just want to mention that insulin resistance is usually
when daily dosing gets up to 200U or more per day. This is
Dr John Davidson's definition in his textbook "Clinical
Diabetes Mellitus." So you have a long way to go.

IMO, your BGs are high in the 200-400 mg/dl range, and this
takes more insulin than if you had more normal BGs at 90-
150 mg/dl. So if you could get lower BGs, your insulin
doses should drop as a result. If the brain is set to the
higher BGs, then you may feel terrible for a day or two at
a BG of 100 mg/dl. But it will pass.

However, if you have ever stopped using insulin, for say 3+
months, and then started back on insulin, this would cause
your immune system to attack your insulin dose much like a
flu shot works: The immune system makes antibodies from the
first attack that are made at a higher rate the second time
the virus attacks. This is called the "booster effect" or
secondary immune response. So if you have stopped insulin
therapy and then resumed it after a few months, you could
find that you're insulin resistant. See this paper for more
detailed information:

But everything I've read suggests this attack does not
destroy the injected isulin, but only slows it down. I
believe this is why animal insulins can have an effect that
lasts for several days in some individuals. If this is the
case for the original poster, then he should be experiencing
highs during the first few hours after a meal and lows after
any long fasting period.

Quoted message said:

j_dumas.home.mindspring.comimmunogenicity potentiaOpen ↗
l_human_insulin_DC1293s3.pdf

This is a long download at 56k but worth it. Print it out
and show it to your Docs.

HTH,

Hi Evon:

I have been a pumper since 1986, and love it. I was taking
up to 6 mdi p/day and found myself not wanting to do that,
but I was just 17 then. if your health insurance would
allow, I would highly recommend a pump to you. You really
need to get those bg's down before serious problems begin. I
was just switched to Novolog insulin about 4 months ago,
because of some similar problems and that really did help,
Humalog and Novolog are very similar but just different
enough that by switching insulin's has help dramatically.

Good luck To you! Sam T1 since 1982 Pumping since 1986

On Sat, 17 Apr 2004 07:00:50 -0700, "Sam" <[email hidden]>

Quoted message said:

Hi Evon:

I have been a pumper since 1986, and love it. I was taking
up to 6 mdi p/day and found myself not wanting to do that,
but I was just 17 then. if your health insurance would
allow, I would highly recommend a pump to you. You really
need to get those bg's down before serious problems begin.
I was just switched to Novolog insulin about 4 months ago,
because of some similar problems and that really did help,
Humalog and Novolog are very similar but just different
enough that by switching insulin's has help dramatically.

Novolog and humalog are probably much more similar to each
other than either is to regular insulin. I use either
regular or novolog as a meal bolus, depending primarily upon
the type of food being eaten and how fast I want to eat it,
and sometimes the time of day (in relation to peaks of basal
insulins, bedtime, etc.). I've found that paying attention
to post meal readings will tell me which insulin is best in
particular circumstances. This is nothing the doctor could
have told me, unless he were to spend many hours reviewing
my results.

Quoted message said:

Good luck To you! Sam T1 since 1982 Pumping since 1986

Leon Fortunato said:

Quoted message said:

However, if you have ever stopped using insulin, for say
3+ months, and then started back on insulin, this would
cause your immune system to attack your insulin dose much
like a flu shot works: The immune system makes antibodies
from the first attack that are made at a higher rate the
second time the virus attacks. This is called the "booster
effect" or secondary immune response. So if you have
stopped insulin therapy and then resumed it after a few
months, you could find that you're insulin resistant. See
this paper for more detailed information:

But everything I've read suggests this attack does not
destroy the injected isulin, but only slows it down.

Hi Leon,

In most cases, antibody binding just delays insulin action
without destroying insulin.

But Dr John Davidson's "Clinical Diabetes Mellitus" text,
2nd ed., p 307 has a flow chart of immune reactions to
exogenous insulin. One path for generalized systemic
allergies/immune responses has a box for [IgG, IgA, IgM]
antibodies and the following box is: [Neutralizing
antibodies]. "Neutralizing antibodies" means insulin gets
destroyed or neutralized. Two boxes later we see
[Immunologic Insulin Resistance]. So it is possible for
insulin to be "degraded" by high antibody concentrations
with the result being insulin resistance. This is usually a
problem for people that have intermittently used insulin as
mention in my previous post.

This book also mentions on p 306:

1) "In 1942, Lowell demonstrated the presence of two
antibodies in the sera of two patients with dermal
hypersensitivity to insulin and insulin resistance [one
antibody associated with generalized urticaria...; one
antibody that neutralized the biologic effect of
commercial crystalline beef insulin but not of human
insulin]."

2) "Patterson et al. demonstrated that immunoglobulin E
(IgE) and P-K (Prausnitz-Kustner) titers fall slowly (1
to 4 years) when insulin therapy is discontinued..."
<<This quote is for Alan Mackenzie as a follow-up to
another thread on anti-insulin antibody binding and the
time for these antibody concentrations to fall.>>

Quoted message said:

I believe this is why animal insulins can have an effect
that lasts for several days in some individuals.

Beef crystalline ultralente has a different lattice
structure than human or porcine crystalline insulin. This
different stacking of insulin hexamers is what causes beef
insulin to last for several days in some patients per:

"Structural and morphological characterization of ultralente
insulin crystals by atomic force microscopy: evidence of
hydrophobically driven assembly." With full text at (note
how the beef hexamers are stacked):

biophysj.org1172Open ↗

Quoted message said:

If this is the case for the original poster, then he
should be experiencing highs during the first few hours
after a meal and lows after any long fasting period.

Good question. Evon will have to respond to that one,
--
Jim Dumas T1 4/86, background retinopathy, rarely
hypoglycemic: <1/mo. lispro+R+U+NPH daily, moderate
exercise, typically <6% HbA1c