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Re: [IPk] Lantus



Hi Helen,

I've thought about a DIY way to mimic the variety of basal rates on a pump. 
Of course, it would require 3 injections that the tissue damage is still an 
issue, but if there were a way to minimise the scarring, it would be cool to 
experiment with a weird regimen involving several different insulins, so 
that:
c. 8 a.m. Humalog to cover food + Regular to pretend to be basal
Lunch: Humalog to cover food + Regular to pretend to be basal
c. 5 p.m.: Regular to pretend to be basal + Lantus so that it can start its 
6-hour 'warm-up'
c. 7 p.m. (i.e., dinner): Humalog to cover food; 5 p.m. Regular still acting 
like basal
c. 11 p.m.: the Lantus has finished its 6-hour 'warm-up' and will work 
through the night.
--sleep--
c. 8 a.m. Humalog + Regular
&etc.

What do y'all think? I don't remember any stone tablets that said we needed 
to be on a maximum of 2 insulins (any 2, but only 2) or that it would be a 
sin to combine very fast and not-so-fast-but-*not-long-acting* insulins in 
the same syringe.

If someone needs the variety available with several basal rates, why not 
think about the length of time for which he/she might need each sort of 
basal and pick the insulins accordingly? We have so many options that 
deciding on the insulin type(s) and _then_ working out the precise amount(s) 
is almost a backward way to determine dosage. If someone's been on an 
unsatisfactory regimen, he/she knows when more insulin or less is required. 
Low every day at 10 a.m.? Reduce the breakfast insulin, right? But what if 
that leads to being _high_ every day at 10 a.m.? Why not try a _different 
insulin_ because the one that's being used is obviously not working?

[Warning: cynicism/sarcasm/irony/petulance below]

'Nooooo', the doctor says, 'You are obviously a BAD person or your insulin 
would work. If you weren't so EVIL--if you didn't tell LIES--maybe your 
blood sugars would be PERFECT, but you insist on doing silly things like 
working for a living, having a family, and exercising (nevermind I told you 
to exercise and you know you feel better when you do...oh well, your problem 
has to be your *fault* at some level, doesn't it?). Now, speaking of LIES: 
your "frequent hypos". How could your HbA1c be over 8% if you EVER had a 
hypo?! You don't even know what a hypo is because you are BAD and you have 
high blood sugars.'

I am sure there are many well-meaning physicians in the UK who actually care 
and are willing to be educated, but from what I've seen on this listserv 
they must be few and far between.

Melissa
IDDM 9+ years; MiniMed pumper 6+ years; avoiding preparing for an interview 
scheduled for Friday since I got up this morning. (Say, any management 
consultants hanging around?)

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