Re: Insulin - A Voice for Choice

willbill wrote:
percy wrote:

willbill wrote:

snip

i admire your willingness to do something uncommon

how many shots of Novolog/aspart did you take
in that 27 hours?

if you don't accurately know, kindly say that
and give your best guess

btw, did you do that out of necessity?
if yes, what forced it?

It was 13 shots, if you include the bolus once my pump was hooked back up.

Screen failure was the main problem with the IR1200, it happened to me twice. It took a bit longer to get a new pump to me than they promised, and I did not want to take a shot of basal. Control was far from perfect, but I managed to stay between hypoglycemia and the renal threshold. The pump still worked fine, but it was the first time and I was too scared to use it with no screen. The second time, I just left the pump in place and bolused with a syringe.




The only backup I need is a syringe and a blood test kit.


meaning that you'd take the empty syringe,
and pull out the pump's cartridge and fill
the syringe from that?

it doesn't cover all of bases of "pump failure"
possibilites ...but it's an interesting thought

fwiw you might actually try it once before you
need to do it for real

It is easier to get insulin from the cartridge. I found it is easy to get insulin from the tubing with a short syringe, but more difficult with a regular one.


factor in that if you let it go too long your
hands will shaking so badly that you won't be
able to do it by yourself (from my own experience)

i'd still carry separate prefilled syringes
(which i do now with some frequency, when i'm
out and about, even through i no longer pump)


trust me, i went through one pump failure,
and it was both scary and an eye opening
experience

if i ever pump again, i will *always*
also carry 30u syringes that are preloaded
with a meal insulin


Even if the cartridge is dry, there's still 18 units in the tubing that's easy to suck out. Live dangerously!


another interesting thought! :)

odds are that that might be easier than
sucking it out of the cartridge

probably be good practice to try that
on the next cartridge change. :)


snip



I was diagnosed T2a (thin) but put on insulin from the start. I argued for a couple of years for a c-peptide. After 4 1/2 years on the pin and a failed 7 months on Avandia,


was it your current endo that put you on Avandia?

Yes, I have only had one endo since diagnosis.



I finally got a c-peptide test. Endogenous insulin >0.01 "unmeasurable".

I found out much later that the c-peptide test can only be requested if there is ketones. I never threw a ketone at diagnosis and it never occurred to me to put myself into DKA afterwards. Again, the nature of the public system.
I don't blame my endo at all, she works within the system.


you seem to be well on the way to being an
equal member of your team

yet if she (the endo) is the same one who put you
on Avandia, that should emphasize the importance
of you insisting that you are given alternatives,
and time to look into them

She has not received any training with animal insulins, so she is hesitant to allow me to use something she has never prescribed.




Needless to say, she now now leaves everything pretty much up to me. I have it made now I'm pumping and the hypo unawareness is pretty much gone.

I'm a big fan of rapid insulin.


it has it's points, and i say that from
actually using it for 9 months (via pump)


I'm not going to change that.


fwiw i was taken aback when i ditched
Humalog and went back to slow pork-R,
and even slower beef-R

it took roughly
two years
two years
two years
of using slow R to realize that it not
only has minuses (per you and many others),
it also has some very serious upsides (yes
i really do mean that, which is why i'm
unlikely to try adding aspart to my routine)


Now because UL is gone I have NPH, Lantus or Levemir for basal. I was overdosed on human NPH for years, so no to that.

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

agreed with that!


Lantus just gives me the creeps and my endo knows it.


you actually tried Lantus?

for how long?

how long have you used insulin for?

Nope, never used Lantus, it was approved for use in Canada only after I started pumping. It is that nasty mitogenic potential that scares me. I am not young anymore, and I really do not want to use something that may make abnormal cells grow faster.

I have been an insulin junkie for 13 years. Still a newbie.



So, it's pork NPH or Levemir. 2x pork would be more manageable than 2x human NPH for me, IMO.


imo, forget pork-NPH. i mean, i had the chance to buy
it when Lilly ditched it 2/3 years ago. i did buy a lot
of the pork-R at the end; at $44/vial from 2 sources

everything i've seen shows that pork-NPH is only slightly
slower than human-NPH

fwiw, roughly 2001/early 2002 i used up the last of
my human R, and did a detailed comparison of my
estimate of the profile of a large shot of pork-R
vs. a large shot of human-R

they are almost identically the same for me; which
matches up with what real detailed studies have
shown of the action of pork vs. human


Levemir is 2x as well, according to reports here and by my endo.


agreed

but i know nothing other than that about Levemir,
and only a little more about aspart (i've never
used either of them)

I may have some antibody action happening, NovoRapid has a shorter than reported curve for me. I have action for only 3.5 hours and onset is 30 - 45 minutes. My IOB is set for 3 hours, and I calculate at 20-50-30%.



Beef would be best as it is flatter and is 1x.


beef-Lente works surprisingly well 1x; it is not
flat due to the 30% SL, but the 70% UL is. CP also
used to have (still has? haven't looked) beef-PZI,
which has always looked (to me) as slightly more
peaky than beef-Lente. i'm also not sure about
just how long the residual goes for but my best
guess is that it is less than that of beef-UL

the attraction of beef-Lente is that it has
70% beef-UL, which is virtually flat with
1x/day dosing; and best real info i've seen
suggests 96+ hours for the residual (as well
as my own real experience, a couple of times,
this past 9 years)

Lunch is usually my lowest carb meal of the day. Adding more carbs then would cover the SL peak, I assume.



I really don't feel any pressure, now that I have a pump, Even if I lose the excellent insurance coverage I have through my husband, I can still get supplies covered under the plan at my work or the provincial plan (but no new pump coverage).


if you lose the coverage it will change
your view

otoh, i'm more than a little impressed
with what you've said in your post. :)


best, bill t1 since '57, ex 8-yr pumper

Sorry it took so long to reply, but my computer decided to commit seppuku. The worst part is, I have an English keyboard and a French OS. This is my apostrophe key: è - that is why you do not see any contractions ;-) Computer goes back for an English OS today.

Fortunately, because of the public system and the province I live in, I will never have less than 80% prescription coverage.

BUT, if I were to use Beef-L, it would not be covered by insurance because it is not on the Canadian formulary. That I could live with...

Vicki
.

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