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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 
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.
c. 8 a.m. Humalog + Regular

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.

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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