Sunday, July 20, 2008

Blood sugar and regular insulin..or why I've been MIA

Okay, so back in the middle of June I realized that although I was using my Novolog as directed, it didn't seem to be working well and basically not working at all. My BG was still ridiculously high, even after a very low carb meal. I was exhausted, had no energy at all, and was depressed from it. If I ate a few pieces of celery or cheese I spiked. If I ate a baked chicken breast I spiked. Even a leafy salad caused a spike and I was very worried...not to mention hungry and tired of being hungry! I was at the point of practically tearing my hair out in frustration.

Eventually, being the nerdy girl that I am, I googled 'ineffective Novolog' and the word 'cause' and found out that one cause could be the insulin getting too warm. I suspected that's what happened and was devastated because in my fridge I had 5 pens of the stuff which had been provided free of charge via a PAP and it was time to re-apply. Getting approved for the program and receiving more insulin would take awhile and I didn't (and still don't) have the funds to spend almost $200 for a pen or even $90 for a vial. Add to that the fact that I'm now working and though I don't have insurance through my job yet, it's just recently been offered to me and the PAPs insist that if it's offered, one must take it. It won't even touch the cost of insulins but just having it will more than likely disqualify me for the PAPs. Talk about a catch 22 situation!

Throw in my oldest son getting married in early August and we've been very short of employees where I work and what do you get? Long work hours and high stress, which for me mean higher blood sugar. I simply haven't been online much and haven't felt like blogging or doing much of anything. The lack of energy and exhaustion have kept me on a very short leash. All of this brings to mind the saying, "I'm sick and tired of being sick and tired." That's exactly how I've felt lately.

I knew I had to do something but didn't have the money for even a visit to a physician (who would want to run so many tests that I'd be fortunate to get out for less than $400) and regular 'old fashioned' insulin came to me as a possible solution so I returned to the ever trusty google and found a great entry at the Diabetes Update blog, which in turn led me to the same author's bloodsugar101 site. I spent hours over the next few days reading both sites. While much of it is stuff I already knew there's quite a bit of new to me information. I have to admit here that I haven't read much on diabetes in the last three years or so. I'd become complacent in my own care and treatment and rarely tested my blood sugar. And yes, I even became lazy about my diet and exercise. To top it off, I knew I was killing myself, literally, so I stuck my head in the sand. Given those things, why would I read the latest and be reminded of my own failings? Errr, I wouldn't.

My last excursion a few years ago into the land of regular insulin was far from successful. I either shot too much or not enough and after a few days of spikes and hypos I gave up. I simply wasn't willing to do the work it took to figure out when and how much to shoot and was very afraid of the hypos so at the urging of my physician, I opted for Novolog and Lantus. However, this time I had to come up with a quick, inexpensive and effective solution. I knew that low carb eating helps the blood sugar but low carb alone wouldn't work for me. Recent experience had shown me that.

But when I read the entry at Diabetes Update I realized that regular insulin might be the answer I sought if I was willing to give it another chance. It was at least worth some further investigation. So I called the local pharmacies to find the best price, which it turns out, is at Wal-Mart. A vial costs less than $22 and requires no prescription. And I spent more hours reading up on regular insulin.

I started Novolin R on the 3rd of July, with apprehension I might add! However, we know that desperation leads us to do things we might not otherwise do or to do things that frighten us and in this case my desperation did just that.

But the big question was - how much to shoot? I found a sliding scale on the internet but the miniscule amounts of insulin recommended don't seem to affect me so this has pretty much been a crap shoot. The first few days were rough and reminded me of my first attempts to use R. I either under or over shot and had a few very high spikes and a few bad hypos, the latter generally between 2 and 4 AM but I stuck with it. I started with 5 units and have worked my way up to shooting between 15 and 20 units an hour before meals and 5 to 15 units before bed.

I still haven't quite figured out the corrective dose but am close.

The before bed dose seems to work for me just as well, or better than, the very expensive Lantus. I have a real problem with Dawn Phenomenon and generally can't make myself eat until I've been up an hour or two so mornings are the hardest times for me to manage. But shooting a few units before bed seems to tend to that morning high. This morning, my BG was 113 upon rising which is a tad higher than I like but manageable. Yesterday it was 86. I can't tell you the last time I had such a nice FBG. Starting the day with a decent number just makes the whole day go smoother and if I can wake up with it under control I can generally keep it under control the rest of the day.

My goal is to have an A1c of 5.0 or below and to get it there, I need the BG to run around 97 all the time. It's hard to get it there but it's harder still to keep it there.

So for now the regular insulin is working beautifully, better than
Novolog and Lantus ever did. And at a fraction of the cost. I have a long way to go to get to my goal but I see light at the end of the tunnel again.

There you have it - my blood glucose in a nutshell and some idea of why I've been MIA.

If you have experience, good or bad, with taking regular insulin, I'd love to hear from you.

And of course, if you have some good low carb recipes to share I'd love those, too. Meat, cheese, and vegetables get really old after awhile!