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Reply: i need help

Auriga, sorry to hear the bad news about your hubbie's job layoff and the loss of your...

Posted by NutriJoy

Auriga, sorry to hear the bad news about your hubbie's job layoff and the loss of your health insurance. The Reli-On insulin that WalMart sells is just a private label brand manufactured either by Lilly (Humalin) or by Novo Nordisk (Novolin), depending upon their contract. Up until October. 2012, the insulin that Walmart provided was Humalin-R and Humalin-N. Even Lilly's name and packaging was the same as its own branded product except that the ones sold by Walmart included a small Reli-On logo on the box; apparently to differentiate it from the branded product sold elsewhere. Then in October, 2012, Walmart switched over to the Novolin brand of insulin (Novolin-R and Novolin-N). However, the price remained the same (approximately $24 per vial) and the two insulins are virtually identical (i.e., equivalent, interchangeable). In my body, I did notice a slightly faster initial onset with Novolin-R (approximately 30 minutes) compared to Humalin-R (approximately 45 minutes) but the two insulins are otherwise virtually the same in every other respect.

"Regular" insulin is similar to the human insulin that your body normally produces but, when injected, has a slower initial onset (and longer duration) of activity than the Humalog that you are currently using. Regular insulin is also not as "strong" so that a unit of regular insulin lowers blood glucose less than a unit of the analog insulin (regular insulin is reportedly about two-thirds as strong as analog). As a consequence, you may have to inject more units of regular than the comparable amount of analog insulin that you are accustomed to. If you are currently using relatively small doses of analog insulin, making the adjustment to regular is no big deal since small doses are easily corrected and/or adjusted with a little experimenting. For example, if you normally use 4 units of Humalog 15 minutes before a meal, using six units of regular (e.g., Walmart's Novolin-R) 30 minutes before a meal should produce equivalent results.

I use regular exclusively and re-use the syringe for as many injections that I require for a particular day. Unlike most, I re-use syringes not for financial reasons but to reduce the amount of medical waste that my insulin use generates. In extreme circumstances (e.g., when traveling overseas), I have re-used a syringe for up to three days but only if refrigeration was available. FYI, I refrigerate used syringes in a syringe holder to minimize the potential for bacterial growth and contamination and have never experienced an adverse event in over five years. I also don't use alcohol swabs as I am very hygienic and use aseptic techniques. This is not to be construed as a suggestion or recommendation for others to follow; only to indicate that syringe re-use can be performed quite safely if a few commonsense rules are followed. Also, to offset the lack of a basal insulin, I simply use multiple injections of regular. For example, like yourself, my blood glucose tends to rise even if I don't eat anything. I simply inject a couple of units of regular during certain time periods (based on history, track record, and experience) and it keeps my blood glucose levels fairly stable yielding near-normal A1c test results.View Thread

Posted byNutriJoy

12 Replies | Reply | Watch This DiscussionReport This| Share this:i need help Auriga, sorry to hear the bad news about your hubbie's job layoff and the loss of your...

Reply: i need help

Many cities have health clinics that are either free or run as a satellite by larger...

Posted by NutriJoy

Many cities have health clinics that are either free or run as a satellite by larger hospital systems. These clinics may have partnerships with diabetic supply companies and will provide free equipment to qualified (usually low income) diabetes patients. The RxAssist.org (Patient Assistance Program Center) website may be able to offer assistance. You can also check with one or both of the following:
"022 Abbott Pharmaceuticals--offers direct assistance for patients needing help with getting diabetic supplies. You can call 1-800-222-6885 or go to the website at www.abbottpatientassistancefoundation.org . Abbott also offers a $15 co-pay program for users of its Freestyle blood glucose meters.
"022 Islets of Hope Program--offers a database of diabetic assistance programs listed by state. The URL for this program is: www.isletsofhope.com/diabetes/assistance-programs/main_1.html

If all else fails, your son can always check with his doctor and inquire about switching to regular insulin. Walmart pharmacies sell Novolin-R and Novolin-N for about $24 a vial and insulin syringes cost about $12.50 per hundred. Using regular insulin may require dosage adjustments from what he is currently using. He will also have to use standard insulin syringes instead of the more convenient insulin "pens." Your son's doctor is the best qualified to determine if a change in insulin regimen is suitable for your son but the significant cost difference does make it worth investigating. FYI, I have been using regular insulin exclusively for the past three years. I embarked on the experiment to see if regular insulin alone could successfully control my BG levels without having to use the more costly analogs and/or basal (Lantus and Levimir) forms of insulin.

The experiment so far has been 100% successful (for me personally) in keeping my A1c in the 5% club (my latest A1c test was 4.8 but has been decreasing steadily over the past three years from 5.2, 5.1, 5.0, 4.9, and now 4.

. Of course, the use of insulin alone won't automatically provide such good test results. Lifestyle modifications in diet and exercise are extremely critical factors and both play more important roles than the average patient realizes.View Thread

Posted byNutriJoy

12 Replies | Reply | Watch This DiscussionReport This| Share this:i need help Many cities have health clinics that are either free or run as a satellite by larger...

Reply: diet and supplements for elevated blood sugar

I'll address your supplements query. Banaba leaf, bitter melon, green tea extracts,...

Posted by NutriJoy

I'll address your supplements query. Banaba leaf, bitter melon, green tea extracts, cinnamon, chromium, vanadyl sulfate, fenugreek, and alpha-lipoic acid are among the many dietary supplements that have been studied for diabetes management. These ingredients are rarely included in standard formulations of daily multivitamins due to the added cost and other factors. However, you can often find combinations of the aforementioned substances in various proprietary, "miracle diabetes formulas" that are sold at premium prices far beyond their cost-benefit ratios. Many of these natural herbs and extracts have shown some value in lowering blood glucose levels in laboratory animals but provide only marginal benefits in humans with the possible exception of alpha lipoic acid.

A small percentage of users have reported that it helps them "dramatically" lower their blood sugar levels but I believe that, on closer analysis, it could just as readily have been due to improvements in their lifestyle modifications. These include diet, exercise, and weight loss (particularly the reduction of BMI and belly fat). If you have the funds, you might want to experiment with them on a short term basis (e.g., three to six months) but carefully monitor and evaluate your results. Don't make the mistake of purchasing or committing to long term quantities such as the auto-ship programs promoted by many vendors as well as hucksters. Many of these substances work by exerting a modest effect on the reduction of insulin resistance but it is inconclusive as to whether they lower blood glucose levels directly (with the possible exception of alpha lipoic acid).

If your own problem is primarily one of insulin resistance, these substances "might be" of some value. I have personally tried most of these herbs and extracts in various blends and combinations. In fact, I spent well over a thousand dollars (U.S.) per year purchasing various formulations that claimed to specifically target or benefit diabetes. My experiment ended after two years with very disappointing results. Although I still take quite a few nutritional supplements, all are focused on improving general health and not on diabetes specifically. These include coenzyme Q10 (ubiquinol form), vitamin D3 (6,000 IU daily in divided doses), benfotiamine, alpha lipoic acid (in combination with biotin), gamma tocopherol, a high quality multivitamin (special multi-dose daily formulation), EPA/DHA, GLA with sesame lignans, curcumin, lutein/zeaxanthin/astaxanthin blend, L-acetyl carnitine, and others.View Thread

Posted byNutriJoy

4 Replies | Reply | Watch This DiscussionReport This| Share this:diet and supplements for elevated blood sugar I'll address your supplements query. Banaba leaf, bitter melon, green tea extracts,...

Reply: getting BACK on track

Using insulin is pretty basic but does require learning how it affects you personally....

Posted by NutriJoy

Using insulin is pretty basic but does require learning how it affects you personally. Although basal insulin (e.g., Lantus) doses are usually static, bolus insulin (e.g., Humalog) doses are dynamic and should be self-adjusted as required if you truly want to self-manage your diabetes and gain the tight control needed to prevent future complications. In other words, using bolus insulin dynamically simply means that you have to adjust your doses to match your food consumption, activity levels and other lifestyle factors. To do that safely and minimize/prevent the risk of hypo episodes, you must know or learn what your individual insulin-to-carb ratio is so that you can gauge the correct bolus dosage needed for a particular meal or snack. You must also know (or learn) how other lifestyle factors such as exercise (or lack thereof) will impact that dose. Initially, much of this will require some degree of trial and error. Maintaining a written log of all factors involved will enable you to fine tune your dosage regimen over time and to better understand variances. This will help you minimize chronic occurrences of things getting off kilter when your BG levels read higher or lower than expected. The written log will also help ensure that everything won't be forgotten in the event that you encounter future fuzzy brain episodes; the latter can be caused by persistent or frequent elevated BG levels.

To respond to your questions more directly, your Lantus should be injected at the same time each day and using your BG meter is usually not tied to the time of that injection nor is it required unless your doctor wanted you to check it. Your BG meter is normally used to measure your BG levels upon arising, before meals (usually 15 to 30 minutes before eating), 2 hours after meals (i.e., 2 hours after taking the first bite of the meal), and at bedtime. The duration of action of bolus insulin is about 5 hours (4-6 hours for most people) and if you test 2 hours after a meal, the resulting reading should definitely be recorded in your log but it is usually NOT actionable because your mealtime insulin dose is still at work in your system. You'll have to wait 5 hours after the injection before the insulin dose has been expended or depleted. In other words, retesting your BG levels is not based on "x" number of hours after the injection. You test to find out how a meal affected you and there are many factors that can skew the results such as if you have gastroparesis and/or insulin resistance. A simple forum posting or response is insufficient to provide you with the extensive background information that you may require and you should either go to the library or your favorite book store to gain more knowledge. A good place to start is "Think Like A Pancreas " by Gary Scheiner (which was recently updated) or "Using Insulin " by John Walsh (the latter is a bit dated (2006) but is till well worth the read).View Thread

Posted byNutriJoy

2 Replies | Reply | Watch This DiscussionReport This| Share this:getting BACK on track Using insulin is pretty basic but does require learning how it affects you personally....

Reply: Fell off the wagon

Ang, never, ever be afraid or embarrassed to go to your doctor to get your health back in...

Posted by NutriJoy

12 Replies | Reply | Watch This DiscussionReport This| Share this:Fell off the wagon Ang, never, ever be afraid or embarrassed to go to your doctor to get your health back in...

Reply: Extremely low diabetic 2 level

You can relax. You did just fine. The wine was unnecessary but the tablespoonful of sugar...

Posted by NutriJoy

1 Reply | Reply | Watch This DiscussionReport This| Share this:Extremely low diabetic 2 level You can relax. You did just fine. The wine was unnecessary but the tablespoonful of sugar...

Reply: Consistent Lows without insulin ?

{quote} ...my blood sugar has not gotten over 140, so I stopped taking novolog {end...

Posted by NutriJoy

2 Replies | Reply | Watch This DiscussionReport This| Share this:Consistent Lows without insulin ? {quote} ...my blood sugar has not gotten over 140, so I stopped taking novolog {end...

Reply: dawn syndrom

There has been a lot of discussion in the medical and health communities about the level...

Posted by NutriJoy

1 Reply | Reply | Watch This DiscussionReport This| Share this:dawn syndrom There has been a lot of discussion in the medical and health communities about the level...

Reply: Amazing Dolphins are "Bi-Diabetics" (they go both ...

Extremely low calorie diets have been shown to reverse diabetes in some people (see this ...

Posted by NutriJoy

1 Reply | Reply | Watch This DiscussionReport This| Share this:Amazing Dolphins are "Bi-Diabetics" (they go both ways) Extremely low calorie diets have been shown to reverse diabetes in some people (see this ...

Reply: High blood sugar

In non-diabetics, small amounts of insulin are released into the bloodstream 24/7. This...

Posted by NutriJoy

In non-diabetics, small amounts of insulin are released into the bloodstream 24/7. This type of "background" insulin is called basal insulin and helps control blood sugar between meals and during sleep. Lantus and Levimir are two brands of so-called 24-hour basal insulins that work around the clock to control blood sugar between meals and when you sleep. In actual practice, many patients have reported that the injected basal insulins only last 18 hours or even less but that doesn't make it a deal breaker. Dr. Bernstein often prescribes basal insulin to be taken in divided doses at 12-hour (twice a day) intervals, injected at the same time every day, to resolve this problem.

When a basal insulin is prescribed for diabetics, the usual intent is to have the slow working insulin stabilize a patient's blood sugars between meals and overnight while sleeping. It is rarely used to actively lower blood sugar levels (e.g. to lower or counter food-induced rises). You did not provide any information to reveal what your food intake is, the composition of your meals, your A1c test results over the past 12 months, your BMI, and other info that might provide some insight as to why your fasting BG levels are so uncontrolled. However, your past history of having FBG of 220 "prior to starting Lantus" suggests that you are probably in need of a mealtime or bolus insulin in addition to the Lantus. This is something that you should discuss with your doctor and it is important that you do so.

I would strongly recommend that you start to maintain a written log to record and analyze your current diet (composition, portions size, frequency, snacks, etc.), how close to bedtime you ate any food or caloried beverage, and your exercise/activity levels. The log may help you better understand some of the factors responsible for the problem you are experiencing. Just FYI, blood glucose levels over 120 will lead to cell-damaging glycation and the development of complications over the long term. I recommend that you research this matter yourself using online sources and your favorite search engine (e.g., this article ) and monitor it more closely to try to get your fasting blood sugars down to the ~100 level ("normal" is ~83). However, that's something you must talk to your doctor about to see if this is a viable option for you because s/he is the only one qualified to make that assessment for you.View Thread

Posted byNutriJoy

2 Replies | Reply | Watch This DiscussionReport This| Share this:High blood sugar In non-diabetics, small amounts of insulin are released into the bloodstream 24/7. This...

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