And, if so, then kudos to him, because it's working!
I've just finished my second week of switching from oral meds / insulin to only insulin for treatment of my diabetes. A couple of obvious facts over this initial phase.
a) Switching from a somewhat lackadaisical glucose testing routine to a consistent, tightly regulated testing schedule 7-8 times a day is, quite literally, a pain. There are only so many times a day you can draw blood from your fingertips before you absolutely must start researching alternate site testing methods, and implementing them
b) Trying to make sense of the different insulin medications, the various delivery device options for each, plus wading through page after page after page of conflicting info on what the insurance company will or will not cover is, quite literally, mind numbing.
c) Despite tons of guidelines on dosage ranges for every conceivable situation, the bottom line is, proper dosing is at best, a guessing game, due to the wide range of variations on how any one individual's body reacts to insulin, as well as carbohydrate consumption. It takes a ton of trial and error, as well as meticulous notes, to work up an effective individual dosing range.
d) Surprisingly enough, the glucose testing is almost always more painful than the subsequent insulin shot, about 80-85% of the time.
e) Doing my glucose testing, as well as subsequent insulin shots, in front of a curious group of Cub Scouts and their parents, explaining what I am doing and why, is turning out to be a great way to deal with my initial self consciousness on doing these activities in public
f) At this initial stage of things, it seems like testing, dosing, testing, dosing, over and over again, is taking over my entire life. Ironically, this is pretty much the same effect as when I was first diagnosed, and was using oral meds and diet as a therapy regimen.
I've just finished my second week of switching from oral meds / insulin to only insulin for treatment of my diabetes. A couple of obvious facts over this initial phase.
a) Switching from a somewhat lackadaisical glucose testing routine to a consistent, tightly regulated testing schedule 7-8 times a day is, quite literally, a pain. There are only so many times a day you can draw blood from your fingertips before you absolutely must start researching alternate site testing methods, and implementing them
b) Trying to make sense of the different insulin medications, the various delivery device options for each, plus wading through page after page after page of conflicting info on what the insurance company will or will not cover is, quite literally, mind numbing.
c) Despite tons of guidelines on dosage ranges for every conceivable situation, the bottom line is, proper dosing is at best, a guessing game, due to the wide range of variations on how any one individual's body reacts to insulin, as well as carbohydrate consumption. It takes a ton of trial and error, as well as meticulous notes, to work up an effective individual dosing range.
d) Surprisingly enough, the glucose testing is almost always more painful than the subsequent insulin shot, about 80-85% of the time.
e) Doing my glucose testing, as well as subsequent insulin shots, in front of a curious group of Cub Scouts and their parents, explaining what I am doing and why, is turning out to be a great way to deal with my initial self consciousness on doing these activities in public
f) At this initial stage of things, it seems like testing, dosing, testing, dosing, over and over again, is taking over my entire life. Ironically, this is pretty much the same effect as when I was first diagnosed, and was using oral meds and diet as a therapy regimen.
g) It's patently obvious that, although I am starting to get a feel for how many units of insulin I need for carb coverage, as well as the number of units I need to use to deal with high glucose levels, I really need to address the testing routines needed to determine the correct basal insulin dose levels.
My plan is to follow the steps for basal insulin testing using the method, guidelines, and using this tracking form from Acu-Check. Testing a Basal Rate Technically, these are instructions for basal rate testing for pump users, but I suspect that the same method can be used to help my PCP determine the correct basal dosing for Manual Daily Injection (MDI) therapy.
h) My first change to my approach to basal insulin dosing is to go back to my previous dosing schedule that I used when pairing Lantus® with oral meds. I had switched to a 7:30am / 7:30pm schedule when the change to insulin only therapy started, but find I have consistent high fasting glucose levels. I've long suspected that Lantus® does not last the entire 24 hours in my system, which was one of the reasons I originally went to a 2 X day dosing schedule. If true, then that 7:30am dose is not longer helping to keep those fasting glucose levels where they need to be. So, with that in mind, I'm going to revert back to a 10am / 10pm dosing schedule, which, even if I'm not getting a full 24 hours from Lantus®, should provide extra coverage for fasting glucoses levels, as well as additional dinnertime coverage. Any possible lags in coverage at breakfast, or in the evening before bedtime, can be adjusted using the routine Novolog® injections.
Next up, the promised blog entry on how you can refill certain brands of disposable pens, using insulin from a vial, to save money, or simply because, like me, your insurance won't pay for the disposable pens. Here's a sneak peek:
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