So confused - apidra?

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So confused - apidra?


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Old 08-03-2013, 22:10   #1
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Default So confused - apidra?

So my hubby went to the endo yesterday and she put him on fast acting insulin along with the long acting. But he didn't understand her instructions and I am lost. (I am the one who does his injections for him)

She gave us a sample apidra pen with instructions to do 10 units before meals. And a vial of lantus with instructions to do 70 units before bed. So I did that yesterday.

Today I picked up the prescription from the pharmacy and it is for only the apidra and it is in vials. The Rx says: use 40 units with VGO and 10 units with meals. What is VGO?? The pharmacy doesn't know and neither do we. It is Saturday and the doctor isn't in. I called and left message but so far nothing.

His BGL was 314 this morning!! After the 10 units of apidra from the pen this morning and a breakfast of eggs and cheese it was down to 227. Still super high. I don't know what to do at this point.

I called the pharmacy and they said they would call the doctor on Monday. I just don't know what to do for the weekend. Help?!

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Old 08-04-2013, 02:10   #2
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Hi

I do not know what VGO is however DO NOT give him 40 units of Apidra that is way to much insulin.

That much Apidra could be fatal.


It takes time to dial in the correct dose of insulin, the MD will slowly up the does until BG is to your goals.

So 10 IU of Apidra dropped his BG by about 100 Pts 314 to 227 so 40 IU could drop his BG by 400 pts that could be VERY dangerous.

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Old 08-04-2013, 02:15   #3
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Ok. I won't give him 40 if the apidra. I guess we will just keep doing the 10 before meals and see what they say on Monday.

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Old 08-04-2013, 05:47   #4
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The Lantus is his basal (long-acting) insulin and he still needs it, so continue giving him the bedtime dose of Lantus. That should help some too.




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Old 08-04-2013, 21:52   #5
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Quote:
Originally Posted by mareintx View Post
Ok. I won't give him 40 if the apidra. I guess we will just keep doing the 10 before meals and see what they say on Monday.

Im glad you saw the post before injecting 40 IU of Apedra.

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Old 08-04-2013, 22:39   #6
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Get one or both of these books: Using Insulin by John Walsh and Think Like a Pancreas by Gary Scheiner. These a wonderful reference works for new insulin users and will help you understand how to establish the optimal dose of Lantus (your husband's basal insulin) and Apidra (his fast-acting insulin).

I completely agree that 40 units of Apidra to start with is nutty. Perhaps the pharmacy tech misread the doctor's chicken scratch. For me, one unit of fast-acting insulin reduces my blood sugar by about 50 points, so if I wanted to correct from, say, 250 to 100 I'd inject 3 units of insulin. For meals, it takes 1 unit of insulin to process 10 grams of carb, so for a meal with 20 grams of carb I'd use 2 units of insulin. Pretend I'm both correcting for a pre-meal reading of 250 AND eating 20 grams of carb - my entire insulin bolus would be 5 units - a FAR, FAR cry from 40 units. The books I recommended will help you learn about this.

Best,
Jen

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Old 08-05-2013, 01:14   #7
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I'll look into those books, thanks Jen. His endocrinologist is just awful. We have an appointment with a new one in September.

I called the pharmacy to find out what VGO was and they had no idea. It's crazy!!

I've given him 10 units before eating and his BGL remains high. Tonight I'm going to try 15 I think. Before dinner. Assuming he is still in the upper 260's prior to eating that is.

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Old 08-05-2013, 01:24   #8
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I'm not on insulin and know almost nothing about it, but I do know that my mom was on a VGO pump at one point, before she switched to a different brand. Maybe it has to do with dosing insulin if you're on that kind of pump. Hope your visit with the new endo. goes well. Fingers crossed.

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Old 08-05-2013, 01:50   #9
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Well, Mary, that would sure make some sort of sense!! Except he has no pump!!

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Old 08-05-2013, 02:48   #10
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Looks like Mary solved the mystery - now if we only knew where the wires got crossed between the doc & the pharmacy. Somebody's asleep at the wheel!




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