General fitness, health and nutrition · Public discussion

A question

Guy · 2004-01-13T03:23:02+00:00

I see people saying the long acting insulin are very flat. It still looks to me like they the follow the published curves If you normalize the data the curve has the typical mountain shape. I see if you can get a more even distribution when you can allow the overlaps to add up. It has been a while but I used to excess high dose of insulin to prevent the sudden rises of blood glucose. I usually gained weight when I had to eat to prevent lows. I once read a report that excess insulin caused the deposition of fat in the blood vessels. Scared me. Does the activity time of long acting insulin vary from person to person. I have used Lantus because it is flatter and drops out more sharply. Before that I went to a three hour "R" schedule. I could get a flat action there because of the time element. The use of things like "NPH" and "L": was a disaster and were a factor in my problems. The old just use this schedule and be a good boy. I developed a problem with the intermediate insulin I called "insulin flu". Now I know they dropped me below basal in about 8 hours and were a factor in my extreme highs of blood sugar. I am familiar with some of the "non synthetic" types and cleaned out my expired "pork" supply about a year ago. I am asking if I am missing something. Other people report good results. I am on a MDI and that seems to be the best I can do using a Lantus and a humalog with close monitoring. As far as I can tell, I am different from a lot of you.. Comments invited. . Guy

Started by Guy · 13 January 2004 · Last activity 13 January 2004 · 3 posts · 464 views

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Original section: General fitness, health and nutrition
Published: 13 January 2004
Last activity: 13 January 2004
Original author: Guy
Posts: 3
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Original post
Guy
Archived post

13 January 2004, 03:23 UTC #1

I see people saying the long acting insulin are very flat. It still looks to me like they the follow
the published curves If you normalize the data the curve has the typical mountain shape.
I see if you can get a more even distribution when you can allow the overlaps to add up.
It has been a while but I used to excess high
dose of insulin to prevent the sudden rises of blood glucose. I usually gained weight when I had to
eat to prevent lows.
I once read a report that excess insulin caused the deposition of fat in the blood vessels.
Scared me.
Does the activity time of long acting insulin vary from person to person.
I have used Lantus because it is flatter and drops out more sharply. Before that I went to a three
hour "R" schedule. I could get a flat action there because of the time element.
The use of things like "NPH" and "L": was a disaster and were a factor in my problems. The old just
use this schedule and be a good boy. I developed a problem with the intermediate insulin I called
"insulin flu". Now I know they dropped me below basal in about 8 hours and were a factor in my
extreme highs of blood sugar.
I am familiar with some of the "non synthetic" types and cleaned out my expired "pork" supply about
a year ago.
I am asking if I am missing something. Other people report good results. I am on a MDI and that
seems to be the best I can do using a Lantus and a humalog with close monitoring. As far as I can
tell, I am different from a lot of you.. Comments invited. . Guy

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Jim Dumas
Archived post

13 January 2004, 03:23 UTC #2

Guy said:
Does the activity time of long acting insulin vary from person to person.
Hi Guy,
I think this is the gist of your question.
Insulin action profiles for long-acting insulin do vary with people, injection site location,
injection site temperature (cold slows absorption by reducing blood flow), dose size and injection
method (proper mixing and depth, as more blood flow is near the surface of the skin so insulin has
faster absorption near the surface of the skin and shorter needles should theoretically have faster
absorption). (Some articles on insulin absorption from Lilly [Howey et al, lispro vs R, Diabetes
1994] used a 45 degree angle to an abdominal skin pinch for injecting. This has the effect of
placing the bolus depot closer to the skin surface thereby producing faster absorption. So you have
to look at the study methods in detail to see if "tricks" are being used by the researchers to
enhance the results.)
I always inject in the abdominal region to keep temperature constant thereby improving
predictability/consistancy. The people differences are in the enzymes required to decompose
ultralente crystals, as an example. Each of us produce different quantities of enzymes necessary to
slice the crystals apart so they are no more than dimers in size (maximum size to pass between
capillary endothelial cells and get into the bloodstream).
So yes. We're all slightly different. That's life,
--
Jim Dumas T1 4/86, background retinopathy, rarely hypoglycemic: <1/mo. lispro+R+U+NPH daily,
moderate exercise, typically <6% HbA1c

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Guy
Archived post

13 January 2004, 03:23 UTC #3

Thanks Jim, The number of variables never ends. I see more items every week. It must be a twenty or
more significant variables, so the solution would not be reasonable. I guess we do most things by
trial and error. I do keep the Lantus near the threshold of basal and once and a while the glucose
release shows up. My biggest worry is when the situation comes up where my blood sugar is creeping
down. I do not have the normal correction to recover. My inclination is to think that some insulin
would guarantee me frequent hypos. That was happening before I went to the crazy "R" routine. Lantus
was my only alternative, It does have some problems but the three hour timer was a burden. There is
a spectrum of possible practical solutions so we pick what works. I seem to lack the luxury to have
many choices. I am trying to prolong the life of my heart blood supply. Is it helping. I do not
know. Hey fellow, I do learn a lot from you. Thanks again. Guy
Jim Dumas !mindspring.com said:
Guy said:
Does the activity time of long acting insulin vary from person to person.
Hi Guy,
I think this is the gist of your question.
Insulin action profiles for long-acting insulin do vary with people, injection site location,
injection site temperature (cold slows absorption by reducing blood flow), dose size and injection
method (proper mixing and depth, as more blood flow is near the surface of the skin so insulin has
faster absorption near the surface of the skin and shorter needles should theoretically have faster
absorption). (Some articles on insulin absorption from Lilly [Howey et al, lispro vs R, Diabetes
1994] used a 45 degree angle to an abdominal skin pinch for injecting. This has the effect of
placing the bolus depot closer to the skin surface thereby producing faster absorption. So you have
to look at the study methods in detail to see if "tricks" are being used by the researchers to
enhance the results.)
I always inject in the abdominal region to keep temperature constant thereby improving
predictability/consistancy. The people differences are in the enzymes required to decompose
ultralente crystals, as an example. Each of us produce different quantities of enzymes necessary to
slice the crystals apart so they are no more than dimers in size (maximum size to pass between
capillary endothelial cells and get into the bloodstream).
So yes. We're all slightly different. That's life,

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