firecat

I'm feeling discouraged right now after reading a whole lot of bad news, which you probably already know about. If you feel like it, tell me about something good in your world.

Some good in my world:
I have enjoyable work.
I have two wonderful healthy cats.
I love and am loved. By the same people for the most part even.
My health problems aren't bothering me today.
I had a good education and I put it to good use.
I know a bunch of smart, compassionate, involved people.

Current Mood: discouraged

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From:

penngwyn.livejournal.com

When I started using insulin in Jan 2005, it was NPH (slow acting) only, "inject xx units morning and bedtime and increase xx by 5 units each week until numbers look good". That seemed to help for the first few months, but I kept having to ramp it up to where the amount I was using was scaring Mud, and my A1C was continuing to inch upward. Best results were if I took the evening shot before supper, rather than at bedtime.

This past Spring, we added Regular insulin before meals, on the so-called "sliding scale": 2 units if bg is 150-200, 4 units if bg is 200-250, 6 units if bg is 250-300. This didn't seem to do much, and A1C continued to inch upward.

Since around Labor Day, I've been using a version of the procedure from the Joslin guide. I take 25 units of NPH morning and evening (recently increased from 20) as a base. I supplement that with R to bring it down if bg is high, and I take R before meals calculated to (a) bring down a high if any and (b) cover the glycemic load of the meal (I usually just estimate the grams of carbs, but glycemic load is a better approximation).

How much R? I've determined that currently a unit of R will bring my bg down 3 points in 2 hours and 5 points (total) in 4. So knowing where I am and where I should get to dives me this component. Looking at the esamples in Joslin, one unit of R covering 10 grams of carbs seems about average, so I've started with that and so far it works pretty well. I'm seriously thinking about making this a spreadsheet that can be handy in my PDA.

So that's it. Mud has been using Aspart (fast acting) lately, but this mix of N and R seems to work for me so far. (Don't mix insulin types. I inject them on opposite sides, with different kinds of needles....)

From:

firecat

I'm glad that's working for you! A lot of the folks on the fa-diab list use a process similar to that. Some of them have switched to or added Byetta, but I'm waiting until it's been on the market a few more years before I consider it.