Diabetes Talking

Question:

Ok, I have been talking to the doctor for a long time now about extremely high pre meal glucose readings, followed by extreme hypo within 1 hour of injection and meal. I have been told this can’t happen. I was also told I must inject more insulin because of the hi pre-meal readings. Surely this was caused by having to eat loads of sugar to prevent passing out due to hypo? Eventually I stopped Humalog and started using Actrapid instead after a long discussion with my doctor. Result is the hypo’s have stopped so now I can start increasing the dose to get better pre-meal readings, and post meal. I battled for a couple of months to get off Humalog, so my kidney specialist suggested novorapid (Novolog) instead of the actrapid I switched to, isn’t this very similar to Humalog? At least I don’t have to listen to him about the diabetes. I must say that I find the Lilly pen far better than the Novo Nordisk pen, shame about the insulin. Now I just have to get a proper basal, protaphane is no use for this and the doctor refuses to let me change. Regards, Sid. mwillia at mweb dot co dot za (looking forward to lower Hba1c)

Response:

Sid, all I can recommend is do a bit of research on the various basal insulin’s (how long they last etc). I was on Humulin Isophane combined with Humalog but I suffered a hell of a lot of high readings before bedtime and suffered lots of nocturnal hypos. I changed back to my previous basal (Human Ultratard) a couple of months ago, after persuading my doctor that Isophane was not working for me, and so far I’m back to near normal BG’s. Have a look at http://www.yorkshirediabetes.com/treatment/ and look at the long acting insulins to discuss with your doctor and to research yourself. Phil — Type 1, dx Nov91. Control Humalog & Human Ultratard.

– Hide quoted text — Show quoted text – Ok, I have been talking to the doctor for a long time now about extremely high pre meal glucose readings, followed by extreme hypo within 1 hour of injection and meal. I have been told this can’t happen. I was also told I must inject more insulin because of the hi pre-meal readings. Surely this was caused by having to eat loads of sugar to prevent passing out due to hypo? Eventually I stopped Humalog and started using Actrapid instead after a long discussion with my doctor. Result is the hypo’s have stopped so now I can start increasing the dose to get better pre-meal readings, and post meal. I battled for a couple of months to get off Humalog, so my kidney specialist suggested novorapid (Novolog) instead of the actrapid I switched to, isn’t this very similar to Humalog? At least I don’t have to listen to him about the diabetes. I must say that I find the Lilly pen far better than the Novo Nordisk pen, shame about the insulin. Now I just have to get a proper basal, protaphane is no use for this and the doctor refuses to let me change. Regards, Sid. mwillia at mweb dot co dot za (looking forward to lower Hba1c)

Response:

Ok, I have been talking to the doctor for a long time now about extremely high pre meal glucose readings, followed by extreme hypo within 1 hour of injection and meal. I have been told this can’t happen. I was also told I must inject more insulin because of the hi pre-meal readings. Surely this was caused by having to eat loads of sugar to prevent passing out due to hypo? Eventually I stopped Humalog and started using Actrapid instead after a long discussion with my doctor. Result is the hypo’s have stopped so now I can start increasing the dose to get better pre-meal readings, and post meal. I battled for a couple of months to get off Humalog, so my kidney specialist suggested novorapid (Novolog) instead of the actrapid I switched to, isn’t this very similar to Humalog? At least I don’t have to listen to him about the diabetes.

Hi Sid, I originally started on Actrapid (and Monotard), two injections a day. Unless it’s changed radically you’ll need to watch out after meals because Actrapid works for longer than Humalog. I think Humalog starts working 30 minutes after injection and works for about 2 1/2 to 3 hours then gives up, while for Actrapid it’s more like onset in one hour and duration is four or five hours. I do know I used to have to eat a mid-morning, mid afternoon and evening snack to ensure that I didn’t go hypo. Novorapid is very similar to Humalog, but I have no ideas about the onset and duration periods for it. I wonder if this information is available anywhere on the web? I’ll have to go have a look. Good luck,  |/| — | IDD: 4 Feb 1976    Driving lic: Feb 1984    Motorbike lic: Sept 1993 | |   Bungee jump: 1992    Parachute jump: 1995    OW Diver: July 2002   |

Response:

– Hide quoted text — Show quoted text – Ok, I have been talking to the doctor for a long time now about extremely high pre meal glucose readings, followed by extreme hypo within 1 hour of injection and meal. I have been told this can’t happen. I was also told I must inject more insulin because of the hi pre-meal readings. Surely this was caused by having to eat loads of sugar to prevent passing out due to hypo? Eventually I stopped Humalog and started using Actrapid instead after a long discussion with my doctor. Result is the hypo’s have stopped so now I can start increasing the dose to get better pre-meal readings, and post meal. I battled for a couple of months to get off Humalog, so my kidney specialist suggested novorapid (Novolog) instead of the actrapid I switched to, isn’t this very similar to Humalog? At least I don’t have to listen to him about the diabetes. Hi Sid, I originally started on Actrapid (and Monotard), two injections a day. Unless it’s changed radically you’ll need to watch out after meals because Actrapid works for longer than Humalog. I think Humalog starts working 30 minutes after injection and works for about 2 1/2 to 3 hours then gives up, while for Actrapid it’s more like onset in one hour and duration is four or five hours. I do know I used to have to eat a mid-morning, mid afternoon and evening snack to ensure that I didn’t go hypo. Novorapid is very similar to Humalog, but I have no ideas about the onset and duration periods for it. I wonder if this information is available anywhere on the web? I’ll have to go have a look.

Hi Martin, The actrapid is not new o me, before the pre-mix I was also on 2 actrapid/ monotard mix shots. Thanks for the heads up though. The other thing is the slower onset than Humalog so it is at least 30 mins before meal when I inject, with humalog, If the food was not on the table it was not safe for me to inject. With the better more predictable action though, I am happy with this. I found some activity curves, novolog and novorapid are the same thing and very similar to humalog. Novorapid is the name used in South Africa and some other countries. Regards, Sid. mwillia at mweb dot co dot za

Response:

Sid posted this… I found some activity curves, novolog and novorapid are the same thing and very similar to humalog. Novorapid is the name used in South Africa and some other countries.

http://www.novonordisk.co.uk/view.asp?ID=57 Some links there (.pdf files) of the NovoNordisk short-acting insulins. Ratty — A BTOpenworld Asylum Seeker ratty at flyingrat dot net

Response:

Sid posted this… I found some activity curves, novolog and novorapid are the same thing and very similar to humalog. Novorapid is the name used in South Africa and some other countries. http://www.novonordisk.co.uk/view.asp?ID=57 Some links there (.pdf files) of the NovoNordisk short-acting insulins. Ratty — A BTOpenworld Asylum Seeker ratty at flyingrat dot net

Hi, In addition to Ratty`s link there is the following about Lilly`s http://www.lillydiabetes.com/Products/TimeActivityProfiles.cfm I suppose your doc, who sounds a bit pig-ignorant from what you say, mught take some notice if you print these out and stick them up his nostrils. I am a bit pig-ignorant too lol — Al, Melton Mowbray, uk, LADA dx Jan97 Control basal/Beef lente bolus/Novorapid I am NOT a doctor! But I DO care.

Response:

– Hide quoted text — Show quoted text – Sid posted this… I found some activity curves, novolog and novorapid are the same thing and very similar to humalog. Novorapid is the name used in South Africa and some other countries. http://www.novonordisk.co.uk/view.asp?ID=57 Some links there (.pdf files) of the NovoNordisk short-acting insulins. Ratty — A BTOpenworld Asylum Seeker ratty at flyingrat dot net Hi, In addition to Ratty`s link there is the following about Lilly`s http://www.lillydiabetes.com/Products/TimeActivityProfiles.cfm I suppose your doc, who sounds a bit pig-ignorant from what you say, mught take some notice if you print these out and stick them up his nostrils.

Not pig ignorant but too arrogant to listen to the patient "I have treated diabetes for over 20 years and I know more than you, that can’t happen". The problem I have is that the kidney specialist keeps pestering me and making suggestions which contradict (in some cases) what the diabetes specialist says. Also my DSN local equivalent was unwilling to try anything except change by a couple of units here and there, certainly not change the insulin type. It was not possible to change this any other way because of the crap medical aid company rules. I could get a prescription from another doctor but as insulin is "chronic" medication, the medical aid company won’t pay for it unless it is approved as a medication on a per patient basis and with a repeat prescription for 6 months, this is a real pain to go through as it can take a month to get approval and as soon as you do, the old insulin is no longer approved. The doctor actually has the Novo activity curves on his office wall, they prefer not to use Lilly except for humalog, not too sure why but Novo sponsored setting up the pharmacy in this establishment. Regards, Sid. mwillia at mweb dot co dot za

Response:

– Hide quoted text — Show quoted text – Sid posted this… I found some activity curves, novolog and novorapid are the same thing and very similar to humalog. Novorapid is the name used in South Africa and some other countries. http://www.novonordisk.co.uk/view.asp?ID=57 Some links there (.pdf files) of the NovoNordisk short-acting insulins. Ratty — A BTOpenworld Asylum Seeker ratty at flyingrat dot net Hi, In addition to Ratty`s link there is the following about Lilly`s http://www.lillydiabetes.com/Products/TimeActivityProfiles.cfm I suppose your doc, who sounds a bit pig-ignorant from what you say, mught take some notice if you print these out and stick them up his nostrils. Not pig ignorant but too arrogant to listen to the patient "I have treated diabetes for over 20 years and I know more than you, that can’t happen". The problem I have is that the kidney specialist keeps pestering me and making suggestions which contradict (in some cases) what the diabetes specialist says. Also my DSN local equivalent was unwilling to try anything except change by a couple of units here and there, certainly not change the insulin type. It was not possible to change this any other way because of the crap medical aid company rules. I could get a prescription from another doctor but as insulin is "chronic" medication, the medical aid company won’t pay for it unless it is approved as a medication on a per patient basis and with a repeat prescription for 6 months, this is a real pain to go through as it can take a month to get approval and as soon as you do, the old insulin is no longer approved. The doctor actually has the Novo activity curves on his office wall, they prefer not to use Lilly except for humalog, not too sure why but Novo sponsored setting up the pharmacy in this establishment. Regards, Sid. mwillia at mweb dot co dot za

I don`t know the import laws in Sarf Africka, but at least in France you can buy insulin without a scrip. OldAl has more info on that, perhaps he will help, but it could be expensive, I suppose. Perhaps worth a try, after all, what price your health? — Al, Melton Mowbray, uk, LADA dx Jan97 Control basal/Beef lente bolus/Novorapid I am NOT a doctor! But I DO care.

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