Maybe the NPH is a little to much of a drop at the wrong times since it is an intermediate acting insulin. I would have to read more about it. Sounds like some peak times going on with how it works that are different than Lantus. Lantus for me has a 3 hour kick to it for me. I reduced it from 8 units to 7 the other night. I am sure when I go to bed the Apidra is close to being done working and I test at about 96 at bedtime. If I go to bed without a snack I am low by midnight. Sounds strange that it would be the Lantus. Since I lowered it though I have been ok with 7 units and snack. There have been times when I took 8 units of Lantus I was waking up in the morning at 70-75 after having a light snack. My Dr. always tells me it is the shorter acting insulin causing this which is true for most but for me it could not be when I take the Apidra at 6:00 PM and going low at midnight. I suppose after 6 hours their could be some action left in it especially if to much of it was taken at the meal for the carbs taken in. I do not want to take to little Apidra because than the 2 hour sugar would be to high. Same old balancing act daily. I am just glad generally I got it down pat. A1Cs 6.6 or less. Perfect for type 1. Any lower than that means to many lows must be happening.
Now that you are signed on to insurance, I would go back to lantus. It is much more mellow over the 24 hours and you can tell when the slight peaks happen and it will stop the lows and you will sleep better on it. See what the Dr. thinks and check the differences in peak times of NPH vs. Lantus.
Your husband's new insurance starts up July 1 right? That will sure help. Yes, for a family a lot will come out of the paycheck but much less than trying to find it elsewhere. It is almost impossible to think of the cost that we incur having this medical condition and treating it daily or else we are in deep trouble. Their are a lot of costly medical conditions out their so we have to go one day at a time and stay as positive as we can. The good news is if we stay on top of this we will outlive others that do not have it!!
Thank you Karen. I will look into those. The last time I checked Walmart was a while back. My Target meter and strips are great. It is amazing that these items can be produced and sold for such a low price. I firmly believe the Insurance Companies fell into a trap with these other high priced strips that other companies manufacture and sell and we wonder why insurance companies charge us skyrocketing premium and pay out like they do.
If Target and Walmart make perfectly good meters for $9.00 and can sell 100 strips for $36.00 or $18.00 as you mentioned Walmart is doing (for 100 strips), then why are we not speaking out to those companies that charge $1.00 a test or $100.00 for 100 strips which is ridicules and discourages people from testing more often if they feel they need to. I test many times a day for changes in activity and being a type 1 Diabetic and it is nice to know I can get 100 strips for the same price as a co pay for the strips on a prescription. I do not have them on a prescription because the Insurance company will only allow a certain number of tests per day in the prescription.
Auriga 1,I have definitely heard of NPH. I took it a long time ago before Humalog was recommended for meals. I probably took Regular? I think there was also one called R as in Regular for a faster acting Insulin to take with NPH? I am really dating myself.
The Dr. also changed me to Lantus at a later date off the NPH. I had a feeling you were still on Humalog for meals like you were before.
Amazing what physical activity does and it is nice if you can go without Humalog much of the day. I could if I tried harder but since I only have 1 kidney I have to cut back protein and have more of the better carbs. The kidney has a high count of protein and it could be because 1 kidney is doing all the work as if I had 2 kidneys. I did just see my Urologist and my Kidney overall is in great condition, better than many. My Internist said I am doing everything right and that I do not at this point need to see a Kidney Dr. They have meds to assist but no need now, overall the Kidney is fine. By Kidney Dr. I am referring to Nephrologist since my Urologist is a Surgeon he is not a Medical Dr. totally specializing in all Medical conditions of the Kidney or Kidney disease. I do not have Kidney disease pertaining to Diabetes or a failing Kidney at this time. Let's hope to keep it that way. If I eat right and control my blood sugars most of the time I will be fine for a long time. That goes for all of us with these problems.
I knew you were on Lantus at one time when we were both on Humalog and Lantus and doing very well. I just picked up my prescriptions on Lantus and Apidra. The Lantus costs $160.00 per vial now at Sam's club! My co pay went up from $35.00 to $38.00 on that one. The Apridra costs $130.00 and no copay right now (probably a promotion from the manufacturer).
The insurance companies always seem to limit how many tests you can do per day for blood glucose so a long time ago when I was not insured I found the Target UP and UP meter for $9.00 and 100 test strips for $36.00 and syringes for $13.00 a box. I still go that route since their would be a copay anyways and this way I can test as many times a day as I want. Can you imagine only 36 cents per test when those expensive meters have strips that cost $100. for 100 strips? My UP and UP Meter far surpasses Accu Chek for accuracy and my A1Cs improved partly do to that. Keep in mind though that the Target brand UP an UP strips are taxed so bring it to .40 cents per test and that is still great. Wal Mart is less I think. If I want to, now that I have insurance, I could get a prescription for syringes, meter and strips to see if the co pay will beat what I am doing now. I just do not want limitations. The only way I am de stressed is to know what my blood sugars are at all times if I am questioning it.
Tell me more about Novolin N, only once a day? When? Does it cover meals for you? Is it DNA origin? Beef/ Pork? I know you worked hard on mealtime spikes to regulate the Humalog like I did so what is up now with the lows? What is the peak time of Novolin N. Amazing no script needed for that.
So glad for you that new insurance starts soon! I did get married recently after numerous years and I was added to benefits. What a difference after being on COBRA for $586. a month blah!
I am glad to hear that you have heard nothing but good things about Apidra. I will start my doses lower and then slowly increase it and establish a carb counting formula. On Humalog I took 1 unit for every 20 carbs. On 80 carbs in a meal that would be 4 units and If I were to eat something a little higher in carbs I would pad it with another unit. I also have to be sure I get the hang of how much less to take when I work out. It will be done within a week I am sure and I will know how my body will respond regularly.
One other difference is that the Humalog works an additional hour and a half . I will hope the Lantus covers that gap enough, an hour is a long time when it relates to glucose levels.
Hope things are going great for you these days! Glad to hear your response. Thank you.
Thanks for the Reply. I think the marketing on Apidra is slow. I had never heard of it either but if you go to Apidra.com the information is there. I spoke to a Pharmacist that compared insulin for me and Apidra is a fast acting and a mealtime insulin made by the same company that makes Lantus. You take it 15 minutes before a meal or up to 20 minutes after a meal and it works for 4 to 5.3 hours. Novalog is 3-5 hours and Humalog 3 to 6.5 hours. The nice thing about the Apidra for now no co pay for most insurance. That is attractive. I will see how it goes, I will pick it up tomorrow!
Humalog start time I think is 5-10 minutes and Novalog 10-20 minutes according to the Pharmacist.
Are you by chance on Leveler for the long acting Insulin?
I hope things are going fine for you to. Very glad to hear from you again!
I have not been to the site in a while but I am krhudson one of the ones that has been type 1 for over 30 years. It all started at 19 yrs old and many have said the onset of Chicken pox could have set this in motion along with Rheumatoid Arthritis (which has been in remission for a very long time thanks to Myocrisine which is a horrible medication with a lot of known side affects which did not affect me). I posted a discussion on the Diabetes site that is made up mostly of type 2 patients. The discussion is about the newer fast acting insulin called Apidra. My insurance company will no longer cover Humalog and gave Apidra and Novalog as choices. I decided on Apidra since it is the shorter acting insulin made by the same company that manufactures Lantus which is the Insulin I take for the 24 hour basil Insulin. I will start it in a couple of days. Since that Insulin is a newer medication on the market have you heard good or bad about it? I spoke to the Manufacturer and went on line to check on it and it is DNA originated. Any comments good or bad? I am hoping I made the right choice. Thank you.
I have not checked in for a while now. Everything is still going great with my type 1 Diabetes keeping my A1Cs down to 6.5 - 6.7. I have been taking Lantus 24 hour Insulin and Fast Acting mealtime insulin Humalog. My Insurance company will no longer cover the HUMALOG and I had been on it for over 10 years. The Insurance companies gave me other choices to take with the Lantus and the 2 main fast acting choices are Novalog and Apidra. My Dr. said no use fighting with the Insurance company because you have to try each of the alternates before they will make an exception to continue HUMALOG based on documented evidence that the others do not work as well. We addressed Novalog since I took it at the hospital during a stay a few years ago and it was not the greatest but not much is after a surgery it takes a while for the body to heal before you get the maximum effectiveness out of certain medications.
I decided Apidra since it is made by the same manufacturer as Lantus. It is the new kid on the block. Anyone had great results on Apidra for fast acting insulin to go with the long acting Lantus? Both Pharmacists I spoke to said they get many more orders for Humalog than Apidra since Apidra is pretty new compared to others. The good news on Apidra.com is that their is no copay right now. I saved $35.00. One of the Pharmacists gave me the particulars about timing and when to inject etc....Now I need real feedback on results. Thank you!!
For 2 weeks test your blood sugars fasting, before meals, 2 hours after the meals and before bedtime. Log them on paper with date time and even add exactly what you ate since everybody's body responds different to each food they consume. Make sure and fax your information to the Dr. and the Dr. may call you in for adjustments of meds or have his/her nurse call you with the changes that you need to make.
Be sure and stick to just lean proteins, veggies and fruit in moderation. If you must have starches or carbs have whole grain only and not whole wheat or white rice. Stick to fresh food cooked (away from boxed frozen food if you can) since those are loaded with sodium in many cases. Load up on salads but careful of dressing types and get the dressing on the side.
Be sure to work out 1/2 hour minimum a day vigorously and add weight lifting for 10 minutes if you can. This all helps the sugar absorb into the cells to form energy correctly.
Once you have tested for 2 weeks how your body is reacting to the food choices and the exercise you will really be able to tell what is going on.
An example I can give is that I know my Dr. would like me to eliminate most carbs except veggies and berries. I told him I work out heavily and really need my morning oatmeal (old fashion only). He frowns upon it and I agree with his thoughts on this but I am a type 1 on insulin. The oatmeal does spike bad. I use milk for the calcuim benefit. In this case this morning I decided to take half of my normal dose of insulin and work out right after breakfast and yes, my sugar was higher after the work out for a couple of hours but on the third hour it was 118. This way I avoided the low I usually get at 10:30. This is the only exception for me on that type of carb. I must work it off immediatly or take more insulin and go low. I am on a sliding scale of insulin so ok for me to adjust my dose based on physical activity. My A1Cs are 6.3 to 6.7 which are remarkable for type 1.
Being a type 2 you also need like heck to monitor what you eat because you are not on insulin on a sliding scale like some type 1s are. Being a type 2 and able to take orals meds is a good thing but you really have to stay on a plan. You may lose weight which will help.
Be sure to call the Dr.'s nurse and tell her your concerns and that you have had bad morning readings and need adjustments. She will probably have you come in and talk to the Dr. further. Give him/her a chance to correct the situation with you but it is immediate adjustments you need if you have been on the Metformin for a while.
You can also suggest to the Dr. that you see a specialist for Diabetes called an Endocrinologist. You never know once you get this down, you may not need meds so strive for that moment but ask your Dr. if in your case that is a possibility. Not everyone gets that chance since the oral meds serve different purposes for your own metabolism.
I would also mention not to worry if you start on insulin. It has it's pluses and is painless. I take one kind with each meal after carb counting what I will be eating and using a sliding scale formula just for me. I also take an overnight 24 hour insulin to set the daily baseline.
It is all a miracle how the body responds to treatment for Diabetes and you will see how what you do on a daily basis will effect your blood sugar. It is a lifestyle change. I am sure you will do fine. Just jump on it . Your blood sugars should never go above 140 2 hours after the meal and best for most of the day to be anywhere from 100 to 110 and if you can get the fasting in tha AM at 80 -90 that is great.