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Medical Forum / Diseases and Disorders / Diabetes / July 2009

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Insulin advice needed

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JC - 29 Jul 2009 01:01 GMT
Last night we had a major power blackout that resulted in total
darkness.

Normally, I inject 66 units of Lantus at around 10PM -10:30PM
but, due to the total darkness I couldn't do it.   This morning,
at 7AM, my fasting BG reading was 6.4 mmol/L so that wasn't too
bad.

I normally inject 30 units of NovoRapid at 8AM, have a shower and
then breakfast.  This morning I did the NovoRapid injection and
then wondered if I should also inject a bit over half of the
daily Lantus as well.   After some indecision I went ahead and
injected 40 units of Lantus.

Did I do the right thing?

One reason for the indecision was that the injection sites for
the Lantus and NovoRapid are about 75mm (3 inches) apart on the
left side of the stomach.   Normally this isn't a problem as the
two injections are done at least 4 hours apart but this time it
was almost simultaneous.  I can't use the centre or right side of
the stomach due to operation scars.

Should I have used another site for the Lantus if injecting at
the same time as NovoRapid?   If so, where would be a good spot
to use?
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Cheers . . . JC

Kurt - 29 Jul 2009 02:11 GMT
> Last night we had a major power blackout that resulted in total
> darkness.
[quoted text clipped - 25 lines]
>
> Cheers . . . JC

Hi JC.

IMO it would not be a good idea to suggest any kind of injection
advice for you since no one here knows your particular medical history
or needs. Your doctor should have discussed with you how to adjust
your insulin if need be and you should be aware of how the different
kinds of insulin you are taking, and amounts, affects you personally -
it will probably be different from others, that is why it would be
wrong to suggest amounts and timing to you.

As far as injection sites, sorry to hear you can't use a good portion
of your stomach area due to scars. However, it is important to rotate
injection sites and not inject in the same place every time. What
about your thighs? Is it possible to get a few more sites there?

Whenever I miss an injection time, and thankfully that is rare, I know
how to make the adjustments and my meter gets a good workout that day
because I check every half hour to make sure I don't go too high or
too low due to the change of routine. I'm a T1 and take Humalog and
Lantus.

Bottom line - if you're not sure and you have to ask these kinds of
questions, call your doctor.

Best,
Kurt
Julie Bove - 29 Jul 2009 04:00 GMT
> Last night we had a major power blackout that resulted in total
> darkness.
[quoted text clipped - 22 lines]
> the same time as NovoRapid?   If so, where would be a good spot
> to use?

I don't know if you did the right thing or not, but you should keep a
flashlight or battery operated light in each room.  That way you'll never
have this problem again.
pico - 29 Jul 2009 19:04 GMT
> Last night we had a major power blackout that resulted in total
> darkness.
[quoted text clipped - 22 lines]
> the same time as NovoRapid?   If so, where would be a good spot
> to use?

Why couldn't you take your shot? Are you saying because you didn't
have any other form of alternative light? I've actually injected by the
light of a BIC lighter.  Have a cell phone? The lights on them are pretty
bright.  Where there is a will there is a way.  With that said, I have to
agree with Kurt in that while we might have an idea, no one here really
should say either way about if you did the right thing or not. I can tell
you what I would have done. I would have found a light source and
injected normally.  If not able to, I would have waiting until morning and
injected not a full dose, what dose? I would have calculated out how
many units it was per hour and how long until my next injection and
went from there.  But I'm a bit anal when it comes to exact doses like
that.  At the 6.4 reading, I would have also have done a correction bolus
to get me down a bit further.  I also agree with Kurt, your doctor should
have gone over some sort of "emergency" plan, if they haven't you should
ask.  Also ask for a sick day plan if you don't have one.  Sorry I couldn't
be of more help.  You might try reading John Walsh's "Using Insulin" it's
an excellent source of information and does give a generic answer to your
question.  Walsh is a CDE with a medical degree, none of us are here.

pico blvd... where it's hot hot hot today!
Anon - 29 Jul 2009 23:35 GMT
> Last night we had a major power blackout that resulted in total
> darkness.
[quoted text clipped - 22 lines]
> the same time as NovoRapid?   If so, where would be a good spot
> to use?

I am not giving you advice, just telling you what I do when I forget my
nightly Levemir shot. I just skip it for the day and inject the next night
as usual. Me being a T2, my own beta cells can pick up some/most of the
missing insulin.

Anon
T2 Novolog and Levemir
 
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