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Mimi - 17 Oct 2005 14:41 GMT

Hello...

I posted a couple of weeks ago with a question and I would like to thank all
of you that responded, although late. I was re-admitted to the hospital
(this just a few days after being discharged with a bout of diverticulitis)
with c-diff and severe hives (cause unknown) was in there for almost 9 days.
I was just discharged again a few days ago and am currently on vacomycin. I
was on a high dose of prednisone IV due to the hives but that was tapered
off before being discharged.

I'm just starting to feel better and like myself again, although I still
feel weak if I do too much. Started back on my diet, very carefully, and
exercise. Last night I did get on the treadmill for an hour prior to going
to bed. Most of my carb comes from veggies and whole wheat products
(yesterday I had 1 wheat bread and egg omelet-onion and red peppers for
breakfast, 1/2 cup of brown rice as the main carb source with stir fried
chicken and miso soup with tofu for lunch, dinner was only miso soup, no
snack)

Now this is my question(s)....

Yesterday, I did my glucose test and these were the results:
FBS 160/2u BF 1hr/pran 193 BF 2hr/pran 176/4u Lunch 1hr/pran 195
Lunch 2hr/pran 145 Dinner 1hr/pran 145 Dinner 2hr/pran 115

I walked for 1/2 in the morning and 1hour at night last night. Than this
morning when I tested my blood sugar..... 156! I know that my body has been
under stress and it's going to take a while for the glucose level to
normalize but I'm not sure where to go from here. I am taking regular
insulin at this time to help with the results but I'm wondering what I am
doing wrong.

Sorry that this post is so long. After a few years with diabetes I have
finally decided to not fight it but to live with the best I can. It took
awhile but I am so set in getting this under control and diabetes not
controlling me.

Thank you so much for your replies in advance. I have learned so much from
this group.

mimi

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Mimi - 17 Oct 2005 14:43 GMT

I forgot to add that I am on Actos 30mg and Amaryl 4mg once a day.

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oldal4865 - 17 Oct 2005 17:34 GMT

Mimi wrote in message ...

>Hello...
>
[quoted text clipped - 37 lines]
>
>mimi

A few remarks on technique:

1. Regular insulin is slow. That's why they invented Humalog and Novolog.
When I use Regular insulin, I often inject at least one hour before eating.
If my before-eating blood sugar is high, I might inject 2 hours before
eating.

Take a look at the activity curve (speed of absorption) for Regular at:

http://www.lillydiabetes.com/using_insulin/what_types_of_insulin.jsp

(short form: http://tinyurl.com/9vmxw)

2. Mornings are awful for diabetics. I inject twice as much insulin per
gram of carb at breakfast than at any other meal. The Morning Effect
hormones cause glucose release by the liver as well as interference with any
insulin in our blood.

3. Although Regular Insulin is slow to start, it is still too fast to last
the night. If you want to use insulin to attack the Dawn Effect which
raises fasting blood sugars, you need a long lasting insulin like Lantus or
NPH. Lantus is the easier to use of the two, NPH (Insulin N) is the
cheaper.

4. Prednisone causes your liver to continually release glucose into the
blood. I don't know how long your shots take to wear off but the net
effect is an increase in blood sugar until they do. Often, you don't
have to eat any carbs at all to see the increase. Any increase from
eating carb comes in addition to the increase from the Prednisone.

5. I was in a high stress position earlier this year. Part of my routine
was to get up, test bG, inject a lot of Insulin R, then wait for my
Fasting blood sugars to come down before eating. I even waited if they
weren't very high to start with.

6. If your sugars "run away with you" in the morning, you run the risk of
high blood sugar-induced Insulin Resistance. That extra bit of Insulin
Resistance can interfere with your attempts to control for hours (It
certainly does for me). Your problems with that Lunch might have been a
result of a runaway at breakfast. If I start high, I just "jump all over
the blood sugar" with extra insulin in order to knock it down and give me a
better start at the rest of the day.

Regards
Old Al

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Mimi - 18 Oct 2005 03:42 GMT

Thank you, Al, for your reply. It is very helpful. I was wondering if this
could be a "dawn effect" or "somogyi" phenomenon.

Mimi

> Mimi wrote in message ...
>>Hello...
[quoted text clipped - 99 lines]
> Regards
> Old Al

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Andrew B. Chung, MD/PhD - 23 Oct 2005 18:30 GMT

> Hello...
>
[quoted text clipped - 5 lines]
> was on a high dose of prednisone IV due to the hives but that was tapered
> off before being discharged.

Sorry to hear about your trials.

> I'm just starting to feel better and like myself again, although I still
> feel weak if I do too much. Started back on my diet, very carefully, and
[quoted text clipped - 17 lines]
> insulin at this time to help with the results but I'm wondering what I am
> doing wrong.

For many increased stress --> increased hunger --> eat more --> higher
blood glucose.

> Sorry that this post is so long. After a few years with diabetes I have
> finally decided to not fight it but to live with the best I can. It took
[quoted text clipped - 3 lines]
> Thank you so much for your replies in advance. I have learned so much from
> this group.

You are welcome, Mimi :-)

In Christ's love and service forevermore,

Andrew

--
Andrew B. Chung, MD/PhD
Board-Certified Cardiologist

**
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