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Re: longacting insulins was Re: [IPk] Glucowatch by Cygnus

>How did you come up with your 3pm and 9pm shots?

Hi Ingrid -

It happened through experimentation and, frankly, having more time in the 
year after I was diagnosed than I do now. I got started off on a bedtime 
shot of ultralente, which is called Zn in these parts (except I'm in 
Illinois as I type, so it's not, but you know what I mean). After a few 
weeks, I told my diabetes nurse that it seemed to not give me coverage in 
the evening, and she looked at my numbers and suggested I add a 3 unit 
booster at noon. Things improved.

Eventually the 'bedtime' shot got moved to 10pm, because I was staying up 
when I was exhausted to have my shot at 'bedtime', which is generally 11pm. 
But I realised the important thing was to have the insulin at the same time 
everyday, so I moved that shot to 10pm. And I think, but I'm not certain 
without checking records, that the 12pm shot started creeping up toward 3pm 
as I checked my BGs against the action curve of Zn (begins work 4 hours 
after injection, hits peak at 10 hours, declines at 18. Claimed to be in the 
body for up to 36 hours, but it didn't do much for me after 18 hours).

My next big challenge was night time hypos. At this stage I was on the large 
dose at 10pm, booster at 3pm. I was living in Dundalk, the cesspit of 
backward diabetes thinking (but a nice town), so I had to sort it myself or 
suffer. And, looking at my numbers, I had the radical idea that perhaps what 
I needed to do was have the larger shot at 3pm and the booster at 10pm. So I 
did. And viola, no more frequent night time hypos.

Now, of course, you're not supposed to do anything like this without 
consulting your medical team. But what passed for my diabetes carers were 
either overworked, understaffed, and inexperienced, or a scandal to the 
medical profession.

The important thing to remember if you're experimenting is that a) you're 
responsible if anything goes wrong and b) you have to be able to climb out 
of any pit you dig for yourself. Generally, that climbing means going back 
to the regime you were on before.

That's the long tale. The short tale is: make the action profile of your 
insulin match what your body needs. It may be an injection schedule no one 
has seen before, but what's important is that it works.


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