Questions

NY said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now. Last year I was diagnosed with
thrombosis in my left leg and is currently using warfarin.
I would like to know if this is common in diabetics. I am
also very worried about having children and how pregnancy
will affect me. Is it at all advisable for me to have
children???

Please let me know if there are any good sites to get more
info on diabetes.

Thanks Landie

I haven't heard of thrombosis being common in
diabetics. I've been readings diabetic newsgroups
and lists for eight years and see only an occasional
post on the topic. Being diabetic doesn't protect us
from having other non-diabetic problems.

I'd like to recommend Dr. Bernstein's web site.
You should find his book, at the library or
bookstore, and read it. It's excellent basic
training for the diabetic.

diabetes-normalsugars.comindex.shtmlOpen ↗

Yes, you can still have children, you know,
depending on many factors beyond my range of
knowledge. Diabetics have healthy babies these days
and live long happy lives to tell about it. The key
is tight control, especially tight discipline during
the pregnancy. Modern insulins enable us to do that
better than in the past. Dr. Bernstein's book should
be a big help in fine tuning your control.

Good Luck.

E

NY said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now. Last year I was diagnosed with
thrombosis in my left leg and is currently using warfarin.
I would like to know if this is common in diabetics. I am
also very worried about having children and how pregnancy
will affect me. Is it at all advisable for me to have
children???

Please let me know if there are any good sites to get more
info on diabetes.

Hi landie

I don't know much about T1's so I hope Mack or Kate answer
this post. I just wanted to say hi and welcome because I
have not seen you post here before.

This is a real good site joslin.orgjoslin.orgOpen ↗

--
R-

www.ronnieruff.org

rxlist.comwarfarin wcp.htmOpen ↗

Do not take warfarin sodium during pregnancy and do not
become pregnant while taking it (See CONTRAINDICATIONS.)

Pregnancy Category X

Pregnancy: Warfarin sodium is contraindicated in women who
are or may become pregnant because the drug passes through
the placental barrier and may cause fatal hemorrhage to the
fetus in utero. Furthermore, there have been reports of
birth malformations in children born to mothers who have
been treated with warfarin sodium during pregnancy.

looks like you will have to check with your Dr and
change your treatment plan BEFORE you even consider
getting pregnant

good luck

i know that diabetes by itself puts you into a high risk
classification for having a baby..... you are given tighter
guidelines for bg control, however having a baby is totally
possible with JUST diabetes to manage

maybe 81 mg of aspirin a day will be a substitute
medication for the thrombosis..... although the warfarin is
a better choice

note.... don't take aspirin while you are taking warfarin
because of the compounding effects of the meds

good luck kate
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"NY" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now. Last year I was diagnosed with
thrombosis in my left leg and is currently using warfarin.
I would like to know if this is common in diabetics. I am
also very worried about having children and how pregnancy
will affect me. Is

it

Quoted message said:

at all advisable for me to have children???

Please let me know if there are any good sites to get
more info on

diabetes.

Quoted message said:

Thanks Landie

"NY" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now. Last year I was diagnosed with
thrombosis in my left leg and is currently using warfarin.
I would like to know if this is common in diabetics. I am
also very worried about having children and how pregnancy
will affect me. Is

it

Quoted message said:

at all advisable for me to have children???

Please let me know if there are any good sites to get
more info on

diabetes.

Quoted message said:

Thanks Landie

Hi there Landie,

Welcome to the group.

There are some very good sites on diabetes, including the
one run by Rick Mendosa; mendosa.commendosa.comOpen ↗

If you simply put the word "diabetes" into your search
engine, you'll find heaps of them. Select the ones that
appear to come from reputable organisations, and avoid those
that are little more than advertisments for their products.
It can be a good idea to check out your local library as
well, there are quite a few excellent books on the subject,
and if you really like one of them, you may then be able to
purchase it at a book store for future reference.

A lot of communities have diabetic advisers, clinics and
classes, where one can ask questions, learn more, as well as
associating with others with the same disease. Your local
hospital can be a good place to find out what is available
in your community.

Thrombosis *could* be a complication related to diabetes,
(other things cause it too), because there are a variety of
complications that are associated with diabetes, like
claudation of the blood vessels in the legs, platelet
"clumping", artiosclerosis, and various other circulatory
disorders that can occur with diabetes. You *may* also be at
risk of a stroke or heart attack. You should discuss these
and any other possibilities with your doctor, and follow his
instructions. Do NOT try self-help supps or OTC treatments
while taking any blood thinning medications like warfarin.
Quite a number of them are also blood thinners, and could
cause serious harm. Did your doctor also advise you to avoid
blood thinning foods, like onions and garlic for example?

If you plan to get pregnant, or are in a relationship where
this is possible even if unplanned, this is another area
that needs serious discussion with your doctor. As Kate
said, the warfarin is contra-indicated, before you even make
this decision, and the diabetes will need careful management
all through the preganancy.

All the best, take care,

Annette

NY said:

Hi there I am a 26 years old and I am a type 1 diabetic for
three years now. Last year I was diagnosed with thrombosis
in my left leg and is currently using warfarin. I would
like to know if this is common in diabetics.

it is fairly common in diabetics.

I am also

Quoted message said:

very worried about having children and how pregnancy will
affect me. Is it at all advisable for me to have
children???

Please let me know if there are any good sites to get more
info on diabetes.

childrenwithdiabetes.comchildrenwithdiabetes.comOpen ↗

diabetics have children all the time. But they need to be
under proper medical care before, during and after
pregnancy.

there are several women here who can share their personal
experiences with diabetes and pregnancy.

Quoted message said:

Thanks Landie

Mâck©® Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗
diabetic-talk.orgdiabetic-talk.orgOpen ↗ insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Have you heard of the NO-CARB Diet for 2004?

NO C-heney NO A-shcroft NO R-umsfeld NO B-ush

Thank you very much for your replies. It's good to know
there are people out there who care and want to help!!!

"NY" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now. Last year I was diagnosed with
thrombosis in my left leg and is currently using warfarin.
I would like to know if this is common in diabetics. I am
also very worried about having children and how pregnancy
will affect me. Is

it

Quoted message said:

at all advisable for me to have children???

Please let me know if there are any good sites to get
more info on

diabetes.

Quoted message said:

Thanks Landie

NY said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now.

i'm a type 1 diabetic for 47 years now. :\

Quoted message said:

Last year I was diagnosed with thrombosis in my left leg
and is currently using warfarin. I would like to know if
this is common in diabetics.

in my opinion, most everything that happens to you will get
written off to you being a type-1 diabetic. 🙁

only some of it will be true. 🙁((((

Quoted message said:

I am also very worried about having children and how
pregnancy will affect me. Is it at all advisable for me to
have children???

Please let me know if there are any good sites to get more
info on diabetes.

Thanks Landie

my suggestion is that you go to a basal/bolus routine
(a.k.a. MDI/DAFNE) using 2x of Lilly's "human"-UL (Humulin-
UL) for background, and Lilly's pork-R for meals ($42/vial
from www.hocks.com)

i'm not female, but i'm totally serious about having at
least 50+% of your insulin as pork and/or beef insulin

trust me on that, coz most of the other responders (with the
possible exception of "Tiger Lily"😉 have little clue on the
importance of insulin choice for some type-1 diabetics. for
that matter, T.L. only has
1/3 of a clue and keeps "panting" over Lantoss. 🙁

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

ahh..... Levemir is going to be much better than
Lantoss..... and with the "news" back from the peanut
gallery on Lantoss...... i won't bother even trying it (my
endo currently imports it and sells it thru his office)

and try as i might... my pharmacy still insists that i can't
have pork insulin.... that it simply doesn't exist..... and
they have called the 2 suppliers of their insulin supplies
to get the same response.... does not exist any longer

i KNOW it does exist..... i just haven't found someone who
can buy any for me

:-) nice to see you again , Bill....... you have been a
:fountain of
information and training for me and i still appreciate every
word you have said to me......... i mean this totally
sincerely, so don't take this wrong

for the other poster..... Bill has some very good advice to
give..... follow what he says, research it and do what you
have to do

kate
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"willbill" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

NY said:

Hi there I am a 26 years old and I am a type 1 diabetic
for three years now.

i'm a type 1 diabetic for 47 years now. :\

Quoted message said:

Last year I was diagnosed with thrombosis in my left leg
and is currently

using

Quoted message said:

Quoted message said:

warfarin. I would like to know if this is common in
diabetics.

in my opinion, most everything that happens to you will
get written off to you being a type-1 diabetic. 🙁

only some of it will be true. 🙁((((

Quoted message said:

I am also very worried about having children and how
pregnancy will affect me. Is

it

Quoted message said:

Quoted message said:

at all advisable for me to have children???

Please let me know if there are any good sites to get
more info on

diabetes.

Quoted message said:

Quoted message said:

Thanks Landie

my suggestion is that you go to a basal/bolus routine
(a.k.a. MDI/DAFNE) using 2x of Lilly's "human"-UL (Humulin-
UL) for background, and Lilly's pork-R for meals ($42/vial
from www.hocks.com)

i'm not female, but i'm totally serious about having at
least 50+% of your insulin as pork and/or beef insulin

trust me on that, coz most of the other responders (with
the possible exception of "Tiger Lily"😉 have little clue
on the importance of insulin choice for some type-1
diabetics. for that matter, T.L. only has
1/3 of a clue and keeps "panting" over Lantoss. 🙁

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x, simple
MDI/DAFNE

Tiger Lily said:

ahh..... Levemir is going to be much better than
Lantoss.....

more "panting"

🙁

Quoted message said:

and with the "news" back from the peanut gallery on
Lantoss...... i won't bother even trying it (my endo
currently imports it and sells it thru his office)

good. 🙂

Quoted message said:

and try as i might... my pharmacy still insists that i
can't have pork insulin.... that it simply doesn't
exist.....

i've run into the same thing 6 or 7 times in the Los Angeles
area, and more recently also the Chicago area

each time i've *INSISTED* that they are wrong and that pork
insulin is still availiable; and that they look for "Iletin-
II" and/or Lilly insulin (most of which is rDNA synthetic)

Quoted message said:

and they have called the 2 suppliers of their insulin
supplies to get the same response.... does not exist
any longer

i KNOW it does exist..... i just haven't found someone who
can buy any for me

you're in Calgary, right?

you need to get to a competent pharmacy and ask the
right questions

the price for Iletin-II-R in Canada is almost certain to be
very friendly, and there's a fair chance that you will
notice "feeling better" with using it after about 3 months

if you feel better with it, there's more than a fair chance
that your overall health and chance(s) of having fewer or no
diabetic complications will likely be better (i.e. less)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

"willbill" <.net> wrote in message .com...

Quoted message said:

Tiger Lily said:

ahh..... Levemir is going to be much better than
Lantoss.....

more "panting"

🙁

the UL is giving me such troubles....... too many wide
fluctuations in bg.... i never know if the am number is
going to be 16 or 3.2 (or less) and i've tested at night....
it's not symogi ........ it sure can be menopause though
....... joys!

Quoted message said:

Quoted message said:

and with the "news" back from the peanut gallery on
Lantoss...... i won't bother even trying it (my endo
currently imports it and sells it thru his office)

good. 🙂

Quoted message said:

and try as i might... my pharmacy still insists that i
can't have pork insulin.... that it simply doesn't
exist.....

i've run into the same thing 6 or 7 times in the Los
Angeles area, and more recently also the Chicago area

each time i've *INSISTED* that they are wrong and that
pork insulin is still availiable; and that they look for
"Iletin-II" and/or Lilly insulin (most of which is rDNA
synthetic)

Quoted message said:

and they have called the 2 suppliers of their insulin
supplies to get the same response.... does

not

Quoted message said:

Quoted message said:

exist any longer

i KNOW it does exist..... i just haven't found someone
who can buy any

for

Quoted message said:

Quoted message said:

me

you're in Calgary, right?

you need to get to a competent pharmacy and ask the right
questions

the price for Iletin-II-R in Canada is almost certain to
be very friendly, and there's a fair chance that you will
notice "feeling better" with using it after about 3 months

if you feel better with it, there's more than a fair
chance that your overall health and chance(s) of having
fewer or no diabetic complications will likely be better
(i.e. less)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x, simple
MDI/DAFNE

i'm sure you are right, Bill....... it's just finding that
place that will FIND the pork insulin for me...... i guess
people are afraid to have some sitting in their fridge with
an expiry date ticking away....... i'll give it another go
and see if i get better replies this time..... noting the
different name that the Ilentin-II-R can go under...... that
IS ilentin, right?

ta kate

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Tiger Lily said:

"willbill" <.net> wrote in message .com...

Quoted message said:

Quoted message said:

Tiger Lily wrote:

Quoted message said:

Quoted message said:

Quoted message said:

ahh..... Levemir is going to be much better than
Lantoss.....

Quoted message said:

Quoted message said:

more "panting"

🙁

Quoted message said:

the UL is giving me such troubles....... too many wide
fluctuations in bg.... i never know if the am number is
going to be 16 or 3.2 (or less) and i've tested at
night.... it's not symogi ........ it sure can be
menopause though ....... joys!

OK all bets are off with menopause, but lessee... which "human"-
UL are you talking about?

you seemed to be OK with Novo's "human"-UL 2x/day, but that
got pulled about a year ago, right?

so i assume you are now talking about Lilly's "human"-UL,
which you think you have allergy problems with, right?

<snip>

Quoted message said:

Quoted message said:

you're in Calgary, right?

you need to get to a competent pharmacy and ask the right
questions

the price for Iletin-II-R in Canada is almost certain
to be very friendly, and there's a fair chance that you
will notice "feeling better" with using it after about
3 months

if you feel better with it, there's more than a fair
chance that your overall health and chance(s) of having
fewer or no diabetic complications will likely be better
(i.e. less)

Quoted message said:

i'm sure you are right, Bill....... it's just finding that
place that will FIND the pork insulin for me...... i guess
people are afraid to have some sitting in their fridge
with an expiry date ticking away....... i'll give it
another go and see if i get better replies this time.....
noting the different name that the Ilentin-II-R can go
under...... that IS ilentin, right?

why don't you start importing CP's beef-Lente for you
background. you did well on Lilly's beef insulin in the
past, and odds are HUGE that you'll not only do well with CP
beef-Lente but also that you'll be able to use it 1x within
a basal/bolus routine (aka MDI/DAFNE)

few t1s can do that with Lantoss, and i'm betting that
few t1s will be able to do that will Levemir when it
does show up

this last 22 years with "wonderful" synthetic insulin has
been anything but. 🙁

one other thought, which i've said before, is to ditch
Humalog as your meal insulin

be brave and cautiously try different insulin (keep
changes to a minimun until you've done one new thing for
at least 3 months)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

"willbill" <> wrote in message .com...

Quoted message said:

Tiger Lily said:

the UL is giving me such troubles....... too many wide
fluctuations in bg.... i never know if the am number is
going to be 16 or 3.2 (or less)

and

Quoted message said:

Quoted message said:

i've tested at night.... it's not symogi ........ it
sure can be

menopause

Quoted message said:

Quoted message said:

though ....... joys!

OK all bets are off with menopause, but lessee... which
"human"-UL are you talking about?

you seemed to be OK with Novo's "human"-UL 2x/day, but
that got pulled about a year ago, right?

so i assume you are now talking about Lilly's "human"-UL,
which you think you have allergy problems with, right?

i stocked up on the Novo UL :-)

i have about a years supply on hand right now (it was all i
could "stock up on" from July when they first announced they
had stopped it)..... i figure i did ok

however, i'm still having a real rollercoaster with the
UL overnight

example...... last 3 days....... 3.2, 3.4, 5.5 then this
morning 24.2

??????? go figure and testing at 2 am and 3 am tells me it's
not symogi or rebound

:-(

why does an insulin appear to work during the day, yet fail
so miserably over night?

i have tried LESS UL at night i have tried MORE UL at night

i'm at a loss..... and i have stuck to each change for a
week or two to ensure it's not just my imagination

my latest A1c also reflects this sort of control :-(

Tiger Lily said:

"willbill" <> wrote in message .com...

Quoted message said:

Quoted message said:

you seemed to be OK with Novo's "human"-UL 2x/day, but
that got pulled about a year ago, right?

so i assume you are now talking about Lilly's "human"-UL,
which you think you have allergy problems with, right?

Quoted message said:

i stocked up on the Novo UL :-)

i have about a years supply on hand right now (it was all
i could "stock up on" from July when they first announced
they had stopped it)..... i figure i did ok

assuming that my posting on "stocking up" with decent
insulin that is about to be discontinued gave you some
confidence in doing that, i'll take THAT as a BIG
compliment. 🙂

Quoted message said:

however, i'm still having a real rollercoaster with the UL
overnight

example...... last 3 days....... 3.2, 3.4, 5.5 then this
morning 24.2

??????? go figure and testing at 2 am and 3 am tells me
it's not symogi or rebound

:-(

why does an insulin appear to work during the day, yet
fail so miserably over night?

i have tried LESS UL at night i have tried MORE UL
at night

per the excellent Owens study (1986) of the potency/timing
of beef-UL vs pork-UL vs "human"-UL, "human"-UL is the
peakiest of the 3, and peaks at roughly 14 hours

given that you are dosing "human"-UL 2x, adjusting your
"nightime" shot of UL will do nothing for your rising
b/g values

iow, carefully/slowly try adjusting your "morning"
shot of UL

one other thought is to take that "morning" shot as late as
possible. so assuming that your bedtime shot of UL is 11:00
PM, take your "morning" shot of UL at 11:00 or 11:30 AM

and take slighly MORE UL in the morning than you do at
bedtime (but not a lot more)

bill t1 since '57

"willbill" < wrote :...

Quoted message said:

Tiger Lily said:

"willbill" <> wrote in message .com...

Quoted message said:

Quoted message said:

you seemed to be OK with Novo's "human"-UL 2x/day, but
that got pulled about a year ago, right?

so i assume you are now talking about Lilly's "human"-
UL, which you think you have allergy problems with,
right?

Quoted message said:

i stocked up on the Novo UL :-)

i have about a years supply on hand right now (it was
all i could "stock

up

Quoted message said:

Quoted message said:

on" from July when they first announced they had stopped
it)..... i

figure i

Quoted message said:

Quoted message said:

did ok

assuming that my posting on "stocking up" with decent
insulin that is about to be discontinued gave you some
confidence in doing that, i'll take THAT as a BIG
compliment. 🙂

take it as a BIG compliment.... i had NO worries over
stocking up the pharmacist checked the expiry dates and THEY
had worries and i told them there was less then 5% potency
loss into yr ?7? in the refrigerator, so if i had to shoot
5% more..... what difference would that make....... EVERY
box of insulin has an expiry date sticker added to it by the
pharmacy..... lol...... and i got the last 2 bottles of UL
available in Alberta.... the wholesaler shipped it down from
Edmonton for me (not the regular supplier either.... an
alternate for my pharmacy)

Quoted message said:

Quoted message said:

however, i'm still having a real rollercoaster with the
UL overnight

example...... last 3 days....... 3.2, 3.4, 5.5 then this
morning 24.2

??????? go figure and testing at 2 am and 3 am tells me
it's not symogi or rebound

:-(

why does an insulin appear to work during the day, yet
fail so miserably over night?

i have tried LESS UL at night i have tried MORE UL
at night

per the excellent Owens study (1986) of the potency/timing
of beef-UL vs pork-UL vs "human"-UL, "human"-UL is the
peakiest of the 3, and peaks at roughly 14 hours

given that you are dosing "human"-UL 2x, adjusting your
"nightime" shot of UL will do nothing for your rising
b/g values

iow, carefully/slowly try adjusting your "morning"
shot of UL

one other thought is to take that "morning" shot as late
as possible. so assuming that your bedtime shot of UL is
11:00 PM, take your "morning" shot of UL at 11:00 or
11:30 AM

and take slighly MORE UL in the morning than you do at
bedtime (but not a lot more)

hmmmmmm....... my night time dose is about 8pm and my
morning dose is at 7am

12 units am and 10 units pm (more and i DO hypo at night)

i would expect to have a "low" around 10:30 in the am if
there was an UL low...... or have i read things wrong and
need to back track?........ and that explains why i do
better with a snack before bed with the 7am shot having a
peak 3 hours after i go to sleep (we are talking a VERY
SMALL snack..... 5 or 6 veggie thins and some cheese

kate still confused..... still trying....... po'd at the 8.0
A1c she just got.... up from the 7.2 she's been running for
a while (since UL)

Tiger Lily said:

"willbill" < wrote :...

Quoted message said:

Quoted message said:

Tiger Lily wrote:

Quoted message said:

i had NO worries over stocking up the pharmacist checked
the expiry dates and THEY had worries and i told them
there was less then 5% potency loss into yr ?7? in the
refrigerator, so if i had to shoot 5% more..... what
difference would that make.......

fwiw, i've now used 4 different insulins out to 4 years past
the expire date, and any potency loss is imho well under 5%.
i expected the R insulins to do fine with age, and all 3 of
them have. to my happy surprise, the beef-Lente (which has
more potency loss with time than R insulin), has also held
up just fine. 🙂

Quoted message said:

Quoted message said:

Quoted message said:

however, i'm still having a real rollercoaster with the
UL overnight

example...... last 3 days....... 3.2, 3.4, 5.5

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

Quoted message said:

Quoted message said:

Quoted message said:

then this morning 24.2

^^^^^^^^^^^^^^^^^^^^^^^

Quoted message said:

Quoted message said:

Quoted message said:

??????? go figure and testing at 2 am and 3 am tells me
it's not symogi or rebound

:-(

why does an insulin appear to work during the day, yet
fail so miserably over night?

i have tried LESS UL at night i have tried MORE UL
at night

<snip prior willbill response>

am i correct in guessing that the real issue with the above
4 rising b/g values is not only the variability
24.2 (436) is a very high rising number, but also that
you don't have much confidence that you won't
go much, if any, lower than the moderately low
3.2 and 3.4?

looking at my own rising b/g values, i also get some high
rising values: 196 (10.9) 188 and 175 were the worst this
month; but the key is that i have good confidence that my
lows won't go any lower: 53 55 53 47 45 41 38 (2.1) 48

Quoted message said:

hmmmmmm....... my night time dose is about 8pm and my
morning dose is at 7am

12 units am and 10 units pm (more and i DO hypo at night)

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

Quoted message said:

i would expect to have a "low" around 10:30 in the am if
there was an UL low...... or have i read things wrong and
need to back track?........ and that explains why i do
better with a snack before bed with the 7am shot having a
peak 3 hours after i go to sleep (we are talking a VERY
SMALL snack..... 5 or 6 veggie thins and some cheese

kate still confused..... still trying....... po'd at the
8.0 A1c she just got.... up from the 7.2 she's been
running for a while (since UL)

i want to change my last comments/suggestions on your 2x
dosing of "human"-UL for background

(so ignore what i suggested in my last post. 🙂 )

the one time of day with the greatest likelyhood of basal
variability is at some time in the morning

(and can happen anything from as early as 2:00AM or 3:00AM
to as late as an hour or two after rising)

so, to start with, set your total insulin background
amounts by skipping meals in the afternoon and evening,
which is *the* time of day when you are most likely to
have an even/level basal need. iow, set your UL amounts
based on your relatively flat basal needs of the afternoon
and evening

only then should you turn your attention to what you can do
in response to high morning rising b/g values (if you do
have significantly higher morning basal needs, the ideal
solution would be to replace some or all of the evening UL
with Lente, except that all that's left in the USA and
Canada is Lilly's "human"-Lente, which you don't like. maybe
taking a page from JD's book and adding a 2 unit shot of "human"-
NPH right at bedtime might be workable for you. for me, i'd
never do that coz my basal needs *while* *asleep* are very
small and very flat)

anyhow, given your comment about going hypo at night if you
were to increase your current UL amounts (underlined
above), it might be best to drop them a small amount, say
9u and 9u (which is 4u less than what you currently take),
and assuming that your 7am morning dosing time is more
important (for overall convenience), move your evening time
to 7pm (if you onveniently can, although your current
7am/8pm isn't bad)

once you have some confidence in skipping lunch and dinner
with whatever new amounts of UL you wind up with, keep in
mind that as you get to the last 1/3 of the vial of UL that
you'll likely find that the concentration of UL crystals
(in the vial) is lower because more of the heavy UL
crystals (proportionately) get sucked out when you 1st
start using a new vial; so you need to increase the amounts
during roughly the last 1/3 of the vial (YMMV, and you test
it by again skipping lunch and dinner when you reach the
last 1/3 of the vial)

thse adjustment(s) of your UL amounts will likely take well
more than a month to figure out (it's hard to skip two meals
in a row because it's hard to eat breakfast and then have an
ideal b/g value at noon, with little meal insulin active)

if your rising b/g values go high with the newly lowered UL
amounts, take a shot of meal insulin upon rising until
you've got some confidence about skipping lunch and dinner
with your new UL amounts

when you get to that point, if you need more insulin due to
you being one of those who have increased basal needs in the
monrning, the question is *when* does your morning b/g value
go up, and by how much, and how consistent is it from
morning to morning, and how much does it seem to depend on
what you ate the previous night?

e.g., i either have a flat morning b/g increase or a small
increase, and it only happens *after* i get up (and it
doesn't seem to matter if i get up at 6am or sleep in to
11am, the b/e rise only happens *after* i get up)

so if my rising b/g is 50, i'll eat a single small teaspoon
of frozen OJ in the morning (i never eat solid food in the
morning anymore, since it is when i take my thyroid pills
(on an empty stomach))

if my rising b/g is 40 or lower, i'll eat 2 heaping
teaspoons of frozen OJ

if i have a rising b/g value of 65-to-90 i figure i'm good
to go (my b/g isn't going down in the next two hours, if
anything it'll either hold where it's at or go up by some
amount (which in my experience seldom exceeds 60 points); so
i take my thyroid pills with water and/or green tea and/or
black coffee and check my b/g in another 2 hours

above 90 and i'll take 1 unit (or more) of "corrective" R
insulin (another factor in the amount of corrective R
insulin that i might take upon rising, is what i ate
yesterday evening, and especially when and how much), and
i'll check my b/g in 3 hours which is when 50% of the
corrective R will have been used up (YMMV)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

"willbill" <> wrote in message .com...

Quoted message said:

fwiw, i've now used 4 different insulins out to 4 years
past the expire date, and any potency loss is imho well
under 5%. i expected the R insulins to do fine with age,
and all 3 of them have. to my happy surprise, the beef-
Lente (which has more potency loss with time than R
insulin), has also held up just fine. 🙂

good to note!

Quoted message said:

am i correct in guessing that the real issue with the
above 4 rising b/g values is not only the variability
24.2 (436) is a very high rising number, but also that you
don't have much confidence that you won't go
much, if any, lower than the moderately low 3.2
and 3.4?

i have been lower than the 3.2 i think a 2.1 was the
lowest i woke up to and that was 1 hour before normal wake
up time..... hypo's do wake me up fortunately........
however the variability AND the potential for hypo drives
me nuts ! sigh

Quoted message said:

looking at my own rising b/g values, i also get some high
rising values: 196 (10.9) 188 and 175 were the worst this
month; but the key is that i have good confidence that my
lows won't go any lower: 53 55 53 47 45 41 38 (2.1) 48

low.... nice to have a "bottom" but low numbers still :-)

Quoted message said:

i want to change my last comments/suggestions on your 2x
dosing of "human"-UL for background

(so ignore what i suggested in my last post. 🙂 )

the one time of day with the greatest likelyhood of basal
variability is at some time in the morning

(and can happen anything from as early as 2:00AM or 3:00AM
to as late as an hour or two after rising)

so, to start with, set your total insulin background
amounts by skipping meals in the afternoon and evening,
which is *the* time of day when you are most likely to
have an even/level basal need. iow, set your UL amounts
based on your relatively flat basal needs of the afternoon
and evening

ok.... good idea...... and easy enough to do..... i can
typically shoot to get the am high in line by lunch
time..... i often skip lunch with no rise or drop in the bg
level......... i can drop a dinner meal however i KNOW i
will be too hungry to skip some sort of snack pre
bedtime...... why can i skip breakfast or lunch but the
evenings are SO SO SO hard to skip food??

Quoted message said:

only then should you turn your attention to what you can
do in response to high morning rising b/g values (if you
do have significantly higher morning basal needs, the
ideal solution would be to replace some or all of the
evening UL with Lente, except that all that's left in the
USA and Canada is Lilly's "human"-Lente, which you don't
like. maybe taking a page from JD's book and adding a 2
unit shot of "human"-NPH right at bedtime might be
workable for you. for me, i'd never do that coz my basal
needs *while* *asleep* are very small and very flat)

nope.... NPH gave me no end of 2am hypo's when i used it and
it would drop me fast in the morning as well........... NPH
is like sticking my wet finger between the prongs of
something plugged into the electrical socket!

i'll have to think about this Lente idea

Quoted message said:

anyhow, given your comment about going hypo at night if
you were to increase your current UL amounts (underlined
above), it might be best to drop them a small amount, say
9u and 9u (which is 4u less than what you currently take),
and assuming that your 7am morning dosing time is more
important (for overall convenience), move your evening
time to 7pm (if you onveniently can, although your current
7am/8pm isn't bad)

hmmmmmm........ good idea... another drop in the basal and
retest it from the beginning..... and 7pm isn't a huge
problem either...... easy enough to do and i don't risk
forgetting to take the UL before bed (dang, when i do that
it takes me days to get the bg back on track!)

Quoted message said:

once you have some confidence in skipping lunch and dinner
with whatever new amounts of UL you wind up with, keep in
mind that as you get to the last 1/3 of the vial of UL
that you'll likely find that the concentration of UL
crystals (in the vial) is lower because more of the heavy
UL crystals (proportionately) get sucked out when you 1st
start using a new vial; so you need to increase the
amounts during roughly the last 1/3 of the vial (YMMV, and
you test it by again skipping lunch and dinner when you
reach the last 1/3 of the vial)

hmmm...... i tend to have better control at the end of the
vial...... that again states that i'm over shooting the
basal..... ok

Quoted message said:

thse adjustment(s) of your UL amounts will likely take
well more than a month to figure out (it's hard to skip
two meals in a row because it's hard to eat breakfast and
then have an ideal b/g value at noon, with little meal
insulin active)

if your rising b/g values go high with the newly lowered
UL amounts, take a shot of meal insulin upon rising until
you've got some confidence about skipping lunch and dinner
with your new UL amounts

when you get to that point, if you need more insulin due
to you being one of those who have increased basal needs
in the monrning, the question is *when* does your morning
b/g value go up, and by how much, and how consistent is it
from morning to morning, and how much does it seem to
depend on what you ate the previous night?

had a bit of this test for a fasting lab not too long
ago...... woke up to
3.4 at 6:30 am and went to the lab for 10:30 (their advice)
and tested at
4.8 when they did the lab draw..... lab draw read spot
glucose of 5.0

Quoted message said:

e.g., i either have a flat morning b/g increase or a small
increase, and it only happens *after* i get up (and it
doesn't seem to matter if i get up at 6am or sleep in
to 11am, the b/e rise only happens *after* i get up)

yup... ditto here...... again from times where there is a
delay before breakfast...... i don't have to worry about
sleeping in anymore (now that i'm away from NPH from hell)

Quoted message said:

so if my rising b/g is 50, i'll eat a single small
teaspoon of frozen OJ in the morning (i never eat solid
food in the morning anymore, since it is when i take my
thyroid pills (on an empty stomach))

if my rising b/g is 40 or lower, i'll eat 2 heaping
teaspoons of frozen OJ

if i have a rising b/g value of 65-to-90 i figure i'm good
to go (my b/g isn't going down in the next two hours, if
anything it'll either hold where it's at or go up by some
amount (which in my experience seldom exceeds 60 points);
so i take my thyroid pills with water and/or green tea
and/or black coffee and check my b/g in another 2 hours

above 90 and i'll take 1 unit (or more) of "corrective" R
insulin (another factor in the amount of corrective R
insulin that i might take upon rising, is what i ate
yesterday evening, and especially when and how much), and
i'll check my b/g in 3 hours which is when 50% of the
corrective R will have been used up (YMMV)

hmmmm...... i think you have more of a rise than i have to
deal with...... i couldn't shoot a 1 unit correction at 90
and NOT hypo on it..... but then i'm using Humalog as well

thanks for your well thought out responses.... i AM saving
the messages to re read over and over again until i get this
right (again!! lol)

kate

Tiger Lily said:

"willbill" <> wrote in message .com...

Quoted message said:

Quoted message said:

looking at my own rising b/g values, i also get some high
rising values: 196 (10.9) 188 and 175 were the worst this
month; but the key is that i have good confidence that my
lows won't go any lower: 53 55 53 47 45 41 38 (2.1) 48

Quoted message said:

low.... nice to have a "bottom" but low numbers still :-)

"low" but workable. 🙂

my '91 dry eye injury/problem was the key thing that drove
me to the decision to make every effort to keep lower b/g
values while i was asleep at night

i got the idea from mookie (remember her? a female t1 with
really good humor ("wink, wink" and all that 🙂 )), and the
only "wrinkle" that i added was to minimize my evening meals
in order to help in accomplishing lower b/g's while i am
asleep (not to mention my switch back to beef/pork insulin,
and my re-thinking of my diet with slow R insulin vs. the
Humalog that i was then pumping! 🙂 )

the fact that running lower nighttime b/g's also helped make
a MAJOR improvement in lowering my past too high HbA1c's,
was icing on the cake. 🙂

figuratively speaking, of course. <LOL!>

fwiw, it didn't happpen overnight (took more than 2+ years
of constant small changes)

coz while it was a "logical" thing to do, actually doing it
also scared the [censored] out of me, at least initially...

i mean, the last thing i want to get is another unconscious
hypo. unlike you i was fortunate to recover on my own, and
have never been into hospital emergency due to an
unconscious hypo event

btw, my lower nighttime b/g values indeed solved my dry eye
problem. 🙂

no thanks to two fairly good eye doctors (one excellent and
both real opthalmologists!) who didn't seem to have a clue
that diabetic high b/g values are often (sometimes?) a cause
of dry eye. and yes, they were both *well* *aware* of my
being a long term t1!

<snip>

Quoted message said:

...i can typically shoot to get the am high in line by
lunch time..... i often skip lunch with no rise or drop in
the bg level......... i can drop a dinner meal however i
KNOW i will be too hungry to skip some sort of snack pre
bedtime...... why can i skip breakfast or lunch but the
evenings are SO SO SO hard to skip food??

only you can answer that, and only with more experience

if your b/g was OK at lunch and you've skipped lunch and
gotten to 5:00 PM with your b/g still "OK" (say 80-to-130),
try eating 1/8 cup (or at most,
1/4 cup) of raw pecans coz they're one of the lower carb
nuts, and imho have one of the highest satiation factors
for any raw nut (raw filberts are a decent 2nd choice)

Quoted message said:

Quoted message said:

only then should you turn your attention to what you can
do in response to high morning rising b/g values (if you
do have significantly higher morning basal needs, the
ideal solution would be to replace some or all of the
evening UL with Lente, except that all that's left in the
USA and Canada is Lilly's "human"-Lente, which you don't
like. maybe taking a page from JD's book and adding a 2
unit shot of "human"-NPH right at bedtime might be
workable for you. for me, i'd never do that coz my basal
needs *while* *asleep* are very small and very flat)

nope.... NPH gave me no end of 2am hypo's when i used it
and it would drop me fast in the morning as
well........... NPH is like sticking my wet finger
between the prongs of something plugged into the
electrical socket!

i'll have to think about this Lente idea

your basal needs are starting to "sound" a bit like mine. 🙂
only diff being that mine are lower than yours

given your other comments in this entire thread, i suggest
you keep to using only UL for the immediate future

btw, using Lente in the evening (whether it's some or all),
will likely also require you to go to shot times of
something like 11:00 AM and 11:00 PM, coz your b/g values
stay low while you are asleep

...meaning that the 30% SL (in Lente) peaks somewhere from
6-to-8 hours after the shot (YMMV and also specific to "human"-
SL), whereas "human"-NPH peaks much sooner and more severely
than "human"-SL

<snip>

Quoted message said:

Quoted message said:

once you have some confidence in skipping lunch and
dinner with whatever new amounts of UL you wind up with,
keep in mind that as you get to the last 1/3 of the vial
of UL that you'll likely find that the concentration of
UL crystals (in the vial) is lower because more of the
heavy UL crystals (proportionately) get sucked out when
you 1st start using a new vial; so you need to increase
the amounts during roughly the last 1/3 of the vial
(YMMV, and you test it by again skipping lunch and dinner
when you reach the last 1/3 of the vial)

hmmm...... i tend to have better control at the end of the
vial...... that again states that i'm over shooting the
basal..... ok

bingo! 🙂

<snip>

Quoted message said:

yup... ditto here...... again from times where there is a
delay before breakfast...... i don't have to worry about
sleeping in anymore (now that

coz you are no longer on "human"-NPH, right?

Quoted message said:

i'm away from NPH from hell)

for you, "hell" being "human"-NPH, right?

for that matter, and from my own perspective, maybe pork-NPH
is also hell

but not beef-NPH (which i've never used)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x
simple MDI/DAFNE