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[IPk] Various 'lifespans' of insulin(s)

Totally--it is in no one's best interest to put up with high bgs just 
because that's what happens. It might be that you should take glargine 
injections every 20 or 22 hours (or at some other interval) rather than 
every 24 like clockwork. I don't know enough about glargine to say more than 
that. Or, as Abi says, you might need more insulin in the evening. Given my 
wacky idea of the other day, maybe a late-afternoon injection of a couple of 
units of Regular on top of whatever the glargine is doing would be of use? 
Don't try that without checking with someone who knows something about 
Lantus--I do not want to put you in A&E!! On the other hand, perhaps your 
carb. ratio for breakfast and lunch should be adjusted in the evening 
(instead of, say, 1u. to 15g. carb., 1u. to 12g. carb.)? Do what Abi said 
and delay dinner for a couple of hours some night, testing every half-hour 
between when you normally eat and when you sit down. If your bg rises on its 
own, you have a basal problem; if it stays constant, you need more insulin 
with dinner.

As Abi said, NPH/isophane is not predictable. It usually works for 8-12 
hours. The people who developed it back in the day probably couldn't be 
bothered over a 4-hour margin of error. With the results of the DCCT and 
comparable studies, the advent of the pump, and the release of Humalog, I 
think Abi's right that NPH has had its day.

A laissez-faire response to high bgs resulting from an ineffective insulin 
injection regimen will only increase one's risk of complications and make 
one's doctor think one is noncompliant. When we notice patterns in bgs, it 
is imperative that we address them or we will only hurt ourselves. Will a 
doctor blame him/herself if a patient develops neuropathy or nephropathy or 
retinopathy? I think not! If a doctor doesn't like being told that what 
he/she has prescribed is not working, I would reply that he/she can tell my 
body what 'should' work all day long but that won't fix my bgs. If a doctor 
insists that all insulins work the same way in everyone, that's wrong and 
you can find a lot of evidence to prove it.

Good luck,
be impatient,

IDDM 9+ years; MiniMed pumper 6+ years

----Original Message Follows----
From: "Abigail King" <email @ redacted>
Reply-To: email @ redacted
To: <email @ redacted>
Subject: Re: [IPk] Pens for Lantus for Caroline B
Date: Thu, 23 Jan 2003 11:07:54 -0000

 > throughout the day but then BG's rise sharply by 8PM it's as if the
 > Lantus just doesn't last long enough.
have you  tried delaying a meal . If BG still rises ( no food and no
humalog) then it is because glargine doesn't match your basal requirements.
It may not be that it runs out but that you just happen to need more insulin
at this time

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