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Old 09-03-2003, 02:14 PM   #1
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dyana HB User
Post blood sugar 530-PLEASE HELP

my best friend is type 1 diabetic. had been for 25 yrs. normally his level is around 200 but for the last month his level has been between 400 and 600. he was hospitalized and insulin was given thru iv. his doctor
said he need less insulin and the specialist says he needs more. he takes 23 units in the am and 8 in the pm. he is losing alot of weight, is fatigued and dizzy all the time. he feels he is getting no where with the drs. has anyone had this happen and can anyone suggest anything for him to do.
thanks in advance
dyana

 
Old 09-03-2003, 06:34 PM   #2
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Hi
I have been there on many occasions. I have had prideful doctors say they were not at fault even after they have put me into DKA that they were not at fault.
Your friend needs insulin. He needs to keep his sugars much lower. Since he is fatigued and loosing weight he is most likely entering Diabetic Keto Acedosis. Get him to a pharmacy to get some Keto Stix. This will measure the Ketones he is spilling. If he is, registering high. He needs much controlled input of insulin. It is the only thing that will save him from bad doctor judgments. If all of this is true, he is in great health danger. If all of these things are not true he still needs good care. I would follow the specialistís suggestions, not the doctor.

 
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Old 09-05-2003, 01:16 PM   #3
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What I know about diabetes, you have to balance your insulin against your diet habits to get a good balance.He certainly does not seem to be getting enough insulin at this point to get his numbers down. Also, what does he eat, is he very high on carbs, which is a real killer for diabetics, does he eat smaller portions and smaller meals thru the day? Diet is crucial to getting good BS numbers, along with the right kinds of insulin for his case. I hope he gets the kind of help he needs.

 
Old 09-05-2003, 09:03 PM   #4
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Quote:
Originally posted by dyana:
my best friend is type 1 diabetic. had been for 25 yrs. normally his level is around 200 but for the last month his level has been between 400 and 600. he was hospitalized and insulin was given thru iv. his doctor
said he need less insulin and the specialist says he needs more. he takes 23 units in the am and 8 in the pm. he is losing alot of weight, is fatigued and dizzy all the time. he feels he is getting no where with the drs. has anyone had this happen and can anyone suggest anything for him to do.
thanks in advance
dyana

Dyana -
Do you know what type of insulin he's taking? Most Type 1 diabetics are now on multiple injections per day. It's nearly impossible to achieve good blood glucose control with only 2 shots a day.

Also, do you know if he had frequent lows? If so, this might be why one doctor thinks his insulin should be reduced...lows cause the liver to pump out glycogen, which raises the blood sugar (called "rebound high"). If that's what is happening, lowering his insulin dose would actually help lower his blood sugar.

See if you can find out what he's on...Lantus, Lente, Ultralente, NPH, Regular, humalog, etc. Also, is he fairly well motivated and do you think he would consider an insulin pump? I've not only achieved excellent control with a pump, but I have much more freedom to eat what I want(within reason) and when I want. The biggest plus is that I've eliminated BOTH the highs AND the lows.

 
Old 09-06-2003, 03:58 PM   #5
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The insulin pump is a great idea - but you should also find out where you friend injects his insulin. If he is not rotating often enough and tends to use the same spots over and again, that could be a huge cause of large blood sugars (if he is doing everything else correctly).
I believe it's called lypodystrophy er something like that - that's kinda what I have.
If I have a 300 blood sugar, I can take an entire syringe full of insulin but none will get absorbed. The doctors always said to inject in my stomach because the fat there absorbs it faster and more evenly than any other place on the body. Although I'm only 23 (diabetic for 10 years) taking insulin for that long in just my stomach at 4-5 shots/day caused this to happen - regardless of how much I rotate.
Apparently the fat forms these little pockets where the insulin will just sit and can't go anywhere...it eventually is absorbed, but very slowly and not at any specific rate (so possibly would't even effect you for several hours).

Anyways, don't know quite where I was going with that --sorry-- . Even if he only takes the 2 units a day, given he's had it for so long, it's possible that he too has developed a problem with the fat in the injection site if he doesn't regularly rotate.

I hope everything ends up ok. Hang in there - it's good to have loyal friends like you!

 
Old 09-06-2003, 09:04 PM   #6
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Hi Breakin,
Are you now using other sites for injections? Like front of thighs, backs of hips, backs of upper arms, etc.? It's true that insulin usually absorbs fastest in the abdomen, but you can just inject a bit earlier (for meals) if you use the other sites, plus another thing you can do is exercise the area to cause the insulin to absorb faster (like, if you use your thighs, go for a 5-10 minute walk after injecting).

I'm not sure if the lipodystrophy goes away after a while if you avoid injecting in those areas?

Also, you can use all of those areas for the pump insertion site, too, so if you really want to try a pump, you probably could find enough spots to make it feasible. You only change the pump insertion site about every 3 to 3 1/2 days, so it would take quite a while before you'd get back to the same spot. I use mainly my abdomen, but have also used the fronts of my thighs. I can't use my lower left abdomen due to having had surgery in that area (another cause of poor absorption), but it still takes me about 48 days before I have to re-use a spot.

 
Old 09-09-2003, 12:08 PM   #7
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breakin_kssentials HB User
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Hi SamQ,

Yes, Recently I have been using a lot of other areas to inject my insulin now. I really want to go on an insulin pump, but that's the problem with my doctors - they don't believe that I'm rotating because of my absorption problems. Because of this, they don't think I should get an insulin pump. They say "even with a pump you still have to rotate your sites every couple of days". Somehow though, no matter what I seem to tell these people they just don't believe me. I've even gone to the point of drawing all over my stomach to mark my injection sites just to prove that I was rotating.
That's one thing I really can't stand about the different doctors I've seen - they live by textbook standards and don't even consider other possibilities -and most of them in my area are so much more concerned with the research, that they forget about the patients.

I remember when they tried to give me that stupid insulin pen so I could take my shots at school easier, but the insulin never worked and I told my doctor I thought the needle was too short. He told me that was impossible - it doesn't matter how long the needle is and that I was just managing myself poorly. Then he went on to tell me that I was fat(I was 16 at the time too...not something a young girl wants to be told). After this I got a new doctor and about a year later, a study came out about the insulin pens and how the needles were too short for the insulin to be absorbed properly and they ended up taking the shorter needles off the market. go figure, huh

I'd think though that one injection from the pump every couply of days is a lot better than the 4-5 shots/day, thus over time my stomach would heal.
I was told that it takes about 6 months for the lypodystrophy to go away - maybe I should just boycott using my abs until I get an insulin pump and a new doctor.

 
Old 09-20-2003, 06:59 PM   #8
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Gene Orrico HB User
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Dyana: Most posts on this accentuate the drug, yet
no one is questioning what this person eats and drinks.

There is a lot more going on than the writer is telling, and no doctor can regulate someone who refuses
to adopt reasonable eating habits and I expect that someone is required to padlock the refrigerator.
Unless I'm mistaken, the road to hell is paved with
white bread, potatoes,cookies, and high starch
carbohydrates. Unless more is known about the dietary
intake and the amount of specific foods this person
consumes, then there can be no help. I'll bet the
doctor wasn't informed.

GenO

 
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