Introduction on behalf of my mom

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Introduction on behalf of my mom


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Old 11-16-2011, 07:25   #1
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Default Introduction on behalf of my mom

Guys,

I need some help for my mom.

She's been a diabetic for last 25 years. She's on insulin and needs to loose 40lbs. Luckily no complications so far. But her BGs have been over 250 for a while. Her current medications include metformin, Januvia, supplements and the following insulin

1. With meals fast acting (novarapid) = 16 units x 3 times
2. long acting (i think levemir) at night (once) = 16 units

I've tried to replicate my low carb high fat diet on her. Her numbers have come down. For example we are seeing most readings in the 100s and some post meal numbers in the 80's and 90's. Which is excellent.

My problems/questions are

1. Since most of her premeal numbers are higher than post meal numbers I think we can reduce the meal time insulin doses, right ?

2. Though she sleeps around 100 every night, fasting numbers are very high. Last few fasting numbers were 230, 212, 185, 175, 211. She is getting frustrated with the fasting numbers, If this continues I don't think the will last on this diet.

3. I have to get her fasting numbers down. I know this appears to be DP but If I don't help her get these down I will not be able to convince her to stick on this diet. Can you suggest some quick fixes that show atleast some improvement ?

4. One of the things I am thinking is to ask her to reduce 2 units from her dinner shot and add it to the the bedtime(long acting) shot. But I'm scared of pushing her into a hypo

Your advice or comments are welcome

Tony

__________________

HbA1c 5.9 (Feb 2019)
Medication
Novarapid = 4-5 at breakfast (no other insulin)
Metformin 1000 mg

Lifesytle: LC, exercise most days


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Old 11-16-2011, 12:53   #2
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Have you tried asking her to walk for 30 mins to 1 hour at night after dinner?

The 30 mins to 60 mins walking at night does help in morning fasting sugars levels.

Some of my Diabetes support group members do that every night..

The group members I am with are age between 55 to 73 yrs old and they walk every night 30 mins and morning 30 mins..

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09-09-11 HBA1C - 11.2% (First Diagnosed Type 2)
17/11/11 HBA1C - 6.9%
25/02/12 HBA1C - 5.5

23/06/12 HBA1C - 5.6[/COLOR]
8/10/12 HBA1C - 5.7[/COLOR]


No meds. Only Exercise.

Last edited by JT.; 11-16-2011 at 13:00.
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Old 11-16-2011, 13:15   #3
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Quote:
Originally Posted by JT. View Post
Have you tried asking her to walk for 30 mins to 1 hour at night after dinner?

The 30 mins to 60 mins walking at night does help in morning fasting sugars levels.

Some of my Diabetes support group members do that every night..

The group members I am with are age between 55 to 73 yrs old and they walk every night 30 mins and morning 30 mins..
But last night she slept at 90 and woke up at 212

__________________

HbA1c 5.9 (Feb 2019)
Medication
Novarapid = 4-5 at breakfast (no other insulin)
Metformin 1000 mg

Lifesytle: LC, exercise most days


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"Be the change you want to see in the world" - Mahatma Gandhi
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Old 11-16-2011, 13:24   #4
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Quote:
Originally Posted by tony0611 View Post
But last night she slept at 90 and woke up at 212
IT happens to us that sometimes like : stress, anxiety, other meds involve, depression etc etc.. Does she walks after Dinner? and sometimes out meals takes longer to digest up to 4- 6 hours depending on the person's body.

Is she taking other meds than the ones you mentioned?

__________________

09-09-11 HBA1C - 11.2% (First Diagnosed Type 2)
17/11/11 HBA1C - 6.9%
25/02/12 HBA1C - 5.5

23/06/12 HBA1C - 5.6[/COLOR]
8/10/12 HBA1C - 5.7[/COLOR]


No meds. Only Exercise.
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Old 11-16-2011, 14:24   #5
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Is she on a sliding scale on her meal time insulin or does she count the specific carbs and adjust her insulin accordingly? Also the higher morning numbers could be DP or it could be Somolgi effect caused by going too low and a huge rebound. Have her wake up several times during the night and record her bg. Have you read Dr Bernsteins's book Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site He has a whole chapter on Insulin. He advises splitting long acting insulin. I think he even splits his in 3 shots to avoid those morning jumps. Also different insulins may peak at different times, so sometimes changing insulins may be an option. Everyone is going to need a different amount of insulin to achieve good bg control. On first look with your moms's higher pre meal numbers it leads me to believe that her basal may be too low.

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moderate exercise- mostly walking 3-5 miles, tennis - 4 hours per week, weight training, hiking on weekends and vacations 7-10 miles

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Old 11-16-2011, 14:54   #6
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Quote:
Originally Posted by JT. View Post
IT happens to us that sometimes like : stress, anxiety, other meds involve, depression etc etc.. Does she walks after Dinner? and sometimes out meals takes longer to digest up to 4- 6 hours depending on the person's body.

Is she taking other meds than the ones you mentioned?
I just went through her stuff.

She has Januvia, Zyltan (losartan pottasium), Aspirin delayed release in her huge but not very effective arsenal (other than the insulin)

__________________

HbA1c 5.9 (Feb 2019)
Medication
Novarapid = 4-5 at breakfast (no other insulin)
Metformin 1000 mg

Lifesytle: LC, exercise most days


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"Be the change you want to see in the world" - Mahatma Gandhi
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Old 11-16-2011, 14:56   #7
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Quote:
Originally Posted by jwags View Post
Is she on a sliding scale on her meal time insulin or does she count the specific carbs and adjust her insulin accordingly? Also the higher morning numbers could be DP or it could be Somolgi effect caused by going too low and a huge rebound. Have her wake up several times during the night and record her bg. Have you read Dr Bernsteins's book Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site He has a whole chapter on Insulin. He advises splitting long acting insulin. I think he even splits his in 3 shots to avoid those morning jumps. Also different insulins may peak at different times, so sometimes changing insulins may be an option. Everyone is going to need a different amount of insulin to achieve good bg control. On first look with your moms's higher pre meal numbers it leads me to believe that her basal may be too low.
I have ordered the book online. I am aware of the DP and Somolgi effects. I am thinking of making her have an omlette just before she sleeps (protein). Do you think that'll work, atleast a bit ?

I've convinced dad that all of us will go for a walk after dinner.

Lets see

__________________

HbA1c 5.9 (Feb 2019)
Medication
Novarapid = 4-5 at breakfast (no other insulin)
Metformin 1000 mg

Lifesytle: LC, exercise most days


--------------------------------------------------------
"Be the change you want to see in the world" - Mahatma Gandhi
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Old 11-18-2011, 19:16   #8
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She's slept at 140 after taking 16 units of her Levemir (increased it by two units) I made her take a walk tonight and she had a spoon of peanut butter before she slept. Hoping for something better in the morning

__________________

HbA1c 5.9 (Feb 2019)
Medication
Novarapid = 4-5 at breakfast (no other insulin)
Metformin 1000 mg

Lifesytle: LC, exercise most days


--------------------------------------------------------
"Be the change you want to see in the world" - Mahatma Gandhi
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Old 11-20-2011, 23:46   #9
 
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Tony, would it be possible for you to have a talk with your mom's doctor and let him or her know what is going on with her? The doc might want to adjust her meds and/or insulin.

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Old 11-22-2011, 03:18   #10
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Hi
Just wanted to update you guys. Mum's fasting was 178 today which is better than last several days. She had slept at 141 last night.

Her lab reports came back yesterday. HbA1c came at 8.0. Not that bad since I was expecting over 10. All other numbers like lipids, kidney,liver etc were in range

We are meeting her doc on Saturday

__________________

HbA1c 5.9 (Feb 2019)
Medication
Novarapid = 4-5 at breakfast (no other insulin)
Metformin 1000 mg

Lifesytle: LC, exercise most days


--------------------------------------------------------
"Be the change you want to see in the world" - Mahatma Gandhi
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