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RE: [IPk] Lantus

Jackie wrote about Lantus:

>In theory it is supposed to mean that if you don't want to eat
>you don't have to.  Well certain meals at least.

in theory you can do this with any long acting insulin so long as the regime 
is tailored enough to fit your own body. I did this with Zn (Ultralente). 
The only time I had to eat was when I was walking home from work after 
6/6.30pm: then I had to eat upwards of 60g CHO to get myself home without 
trouble. Otherwise I was fine.

it's a matter of taking enough shots at the right time to take advantage of 
the peaks and troughs of the insulin. I tried it for a brief weekend with 
Lente insulin and discovered I'd need four shots of it a day to get the same 
coverage I got with Zn - so I returned to Zn and studied my patterns until I 
got one that suited my dawn phenomenon and activity levels. The problem with 
my Zn above was that I took an injection at 3pm, so it was starting to work 
around 6.30/7pm (4 hours between injection and onset of action w. Zn), so I 
was exercising while the insulin was acting. But if I moved the injection 
til later there wouldn't be enough of it overnight to support my other Zn 
injection before bed. it was the trade-off I made for getting good dawn 
phenomenon coverage without a danger of overnight hypos.

I know in Italy they've demonstrated an improved A1c when people take a shot 
of NPH at every meal. (NPH is either another name for Insulatard or an 
insulin with a similar timing profile.) That's something people here might 
want to consider doing if they're not on a pump but trying to improve their 
BGs: adopt this Italian approach.

And lastly, building on the previous comment, if you're looking to improve 
your BGs but not sure if a pump is for you, do look at what they do in 
different nations. There's the Italian model as above. In parts of 
Scandinavia many children use an infusion set and their parents inject the 
insulin through the infusion set (one injection (of the set) every few day 
rather than multiple injections every day). In the US, most MDI regimes are 
like mine above: developed so you don't have to eat at a particular time. 
Remember, your consultant is not god (although he or she may resemble the 
devil) and there is more than one way to solve the very individual problems 
of diabetes. Remember, YOU are your primary caretaker and your word is final 
on how you manage your diabetes!

feeling stroppy

and remember...

Grain is the enemy of the sedentary classes.

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