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Discussion Starter · #1 ·
When looking online for a place to get some help, answers to questions and just plain moral support, I came upon this site. I think I posted here several years ago, sure looks familiar.

I have many questions even though I have been diagnosed for several years. Had a med change yesterday, a new doctor (my doc fell very ill) and this new doctor is so totally opposite. He put me on novalog. I am currently on Levimer and Byetta. The Novalog has not done much, readings after meals are higher 200's. I know it is only two days but it is a concern.

He started me out with 10 units, he does not believe in carb counting although everyone I know on short term insulin does the carb counting.

Any information from Novalog users would be appreciated. He did say I could use Byetta with it but he did not sound convincing.

Glad to find this forum again..

Maureen
 

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When do you use your Novolog -- before or after meals?

I carb count, and use Novolog before meals. I try to take it at least 5 minutes before eating (the stuff works pretty quick for me). I use 4 units per 15g of carbs ... but everyone needs to find their own insulin/carb ratio. Most of the time, I try to keep my carbs extremely low, so I don't need to use any Novolog at all.

If I spike one or two hours after eating, I take a corrective dose. The dosage depends on how high I've spiked.

Is your doc recommending Novolog alone? That sounds waaaayyyy too high-maintenance for me! I'd have to test myself every 2-3 hours, whether I've eaten anything or not.

Please let us know a bit more about how you're taking Novolog.
 

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Hello Maureen, welcome! I have used Humalog for many years, and it is about the same as Novolog. Shalynne has given good advice. You will have better results if you establish an insulin:carb ratio. I use 1 unit of humalog for every 8 carbs. That is called a 1:8 ratio. Do you know your ratio? You may need a 1:10 or 1:15 or 1:20 ratio, or somewhere in between. Your personal ratio can be found by trial and error. My ratio varies, depending on the time of day.

When you have a spike, or high blood sugar,you need to know how many points 1 unit of your Novolog will lower your BG. That will enable you to determine how many units you need to correct a high.

The book "Using Insulin", by John Walsh, is a good reference for getting good control with insulin.

Richard
 

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Hello Maureen, welcome! I have used Humalog for many years, and it is about the same as Novolog. Shalynne has given good advice. You will have better results if you establish an insulin:carb ratio. I use 1 unit of humalog for every 8 carbs. That is called a 1:8 ratio. Do you know your ratio? You may need a 1:10 or 1:15 or 1:20 ratio, or somewhere in between. Your personal ratio can be found by trial and error. My ratio varies, depending on the time of day.

When you have a spike, or high blood sugar,you need to know how many points 1 unit of your Novolog will lower your BG. That will enable you to determine how many units you need to correct a high.

The book "Using Insulin", by John Walsh, is a good reference for getting good control with insulin.

Richard
My mom takes between 10-14 units of insulin for a meal of about 20 grams of carbs depending on pre meal levels. Thats really bad isn't it or is it that the insulin is different here ?
 

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When looking online for a place to get some help, answers to questions and just plain moral support, I came upon this site. I think I posted here several years ago, sure looks familiar.

I have many questions even though I have been diagnosed for several years. Had a med change yesterday, a new doctor (my doc fell very ill) and this new doctor is so totally opposite. He put me on novalog. I am currently on Levimer and Byetta. The Novalog has not done much, readings after meals are higher 200's. I know it is only two days but it is a concern.

He started me out with 10 units, he does not believe in carb counting although everyone I know on short term insulin does the carb counting.

Any information from Novalog users would be appreciated. He did say I could use Byetta with it but he did not sound convincing.

Glad to find this forum again..

Maureen
Maureen. Welcome to the forum. In the few days that I've been helping my mom control her diabetes numbers I cannot imagine why a doctor should not be recommending carb counting.

Unless you have the same meal everyday, the concept fixed doses of insulin sounds really wrong. If and when I get on insulin I am definitely going to carb count for my insulin dose
 

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Welcome back Maureen!

I have to say that a doctor who does not believe in carb counting is a quack! Carb counting is essential to a diabetic, simply because that is the one part of eating that sends our bg's through the roof. Obviously our bodies do not work with the carbs or else we wouldn't need insulin right? I use Humalog and it is on a sliding scale. So depending on my pre-meal number I have a baseline of 12 units and then 2 extra units for every 50 points higher than my baseline. I also try to add a unit or two for the amount of carb I will be eating. I haven't perfected this yet, but I think I'm going to look the book up that Richard suggested. I need better control of the insulin. Also, you are taking a long acting, or basal, insulin with Levemir. When do you take the Levemir? I am also on Levemir and take mine at bedtime. I am currently taking 56 units every night, but I still have not gained great control of morning fbg. Sometimes it is good, sometimes not, but I've noticed more Levemir does not make a difference beyond the 56 units, so that is where I am sticking for now. I do take my Humalog three times a day. Sometimes I will take extra if my bg's seem excessively high due to sickness or extreme stress.
Keep us posted on your progress.
 

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Discussion Starter · #7 ·
When do you use your Novolog -- before or after meals?

I carb count, and use Novolog before meals. I try to take it at least 5 minutes before eating (the stuff works pretty quick for me). I use 4 units per 15g of carbs ... but everyone needs to find their own insulin/carb ratio. Most of the time, I try to keep my carbs extremely low, so I don't need to use any Novolog at all.

If I spike one or two hours after eating, I take a corrective dose. The dosage depends on how high I've spiked.

Is your doc recommending Novolog alone? That sounds waaaayyyy too high-maintenance for me! I'd have to test myself every 2-3 hours, whether I've eaten anything or not.

Please let us know a bit more about how you're taking Novolog.
This new doctor said nothing about ratio, just take 10 units. I take it just before the meal. I am on Levimer at night, currently at 58 to 60 units because the sugar numbers are so out of control.

I was on Byetta, he said to stop it, then said it was ok... he is very confusing. He took over for my original doctor who became very ill. My old doctor did gradual changes and this guy changes everything at once. I have only used 10 units of Novalog and my readings are still in the 200's after a meal.

Thanks for your response, any help I can get here is so appreciated.
 

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Discussion Starter · #8 ·
Hi Richard,

Thank you for responding. This doctor does not believe in "ratio", he said it was the "old way" Not ever being on a quick acting insulin, I know enough people who do the ratio. I see this new doctor in a month, will at least give this new process a chance however I may go back on Byetta with it, if the numbers do not come down. Thank you for the book reference, I will order it today. Look forward to using this site, it is a wealth of information.
 

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Discussion Starter · #9 ·
Tony, I agree with you. I a trying to have an open outlook with this new doctor, but everything I have heard or read does not compute. We shall see what happens in the next month. Thank you for your response.
 

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Discussion Starter · #10 ·
Welcome back Maureen!

I have to say that a doctor who does not believe in carb counting is a quack! Carb counting is essential to a diabetic, simply because that is the one part of eating that sends our bg's through the roof. Obviously our bodies do not work with the carbs or else we wouldn't need insulin right? I use Humalog and it is on a sliding scale. So depending on my pre-meal number I have a baseline of 12 units and then 2 extra units for every 50 points higher than my baseline. I also try to add a unit or two for the amount of carb I will be eating. I haven't perfected this yet, but I think I'm going to look the book up that Richard suggested. I need better control of the insulin. Also, you are taking a long acting, or basal, insulin with Levemir. When do you take the Levemir? I am also on Levemir and take mine at bedtime. I am currently taking 56 units every night, but I still have not gained great control of morning fbg. Sometimes it is good, sometimes not, but I've noticed more Levemir does not make a difference beyond the 56 units, so that is where I am sticking for now. I do take my Humalog three times a day. Sometimes I will take extra if my bg's seem excessively high due to sickness or extreme stress.
Keep us posted on your progress.
The only thing this doctor has me on now is the Novalog and Levimer. I take 58 to 60 units of Levimer at night, and 10 units of Novalog before three meals. I am also ordering the book Richard recommended.

Thanks for your response.
 

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Hi Richard,

Thank you for responding. This doctor does not believe in "ratio", he said it was the "old way" Not ever being on a quick acting insulin, I know enough people who do the ratio. I see this new doctor in a month, will at least give this new process a chance however I may go back on Byetta with it, if the numbers do not come down. Thank you for the book reference, I will order it today. Look forward to using this site, it is a wealth of information.
Sorry, but it is your doctor that is giving you the "old way" of managing diabetes. I've been carb counting for over 8 years with Novolog. I've finally got my A1C in the lower 6's after being close to 9. It is my opinion that maybe your Doctor doesn't have any experience with successful carb counting, either that or he is too lazy to teach you how to do it.
 

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Taking a fixed amount of insulin before a meal will not necessarily help you lower your bg's once you eat. My sliding scale works on 12 units baseline, and anything over 150 I add an extra 2 units for every 50 points above 150. So if my number is say 234, I take 16 units, or if I know I'm going to eat more than say 10-15 grams of carb with the meal, I add an extra unit or two to compensate. This has worked pretty well for me. Most of my post-prandial numbers are below 200, if not in a better range than that. I usually only have a 200 or over with morning numbers (I have horrible time with DP) and alot of times after an hour of cardio exercise (I still haven't quite figured out how to combat this). In any case, you must be aware of the amount of carbs you are eating with each meal, and snacks, and you must stay away from all carbs that are wheat based, pasta, rice, bread, potatoes. Keep in mind most veggies have carbs as well, but if you know which ones don't spike your numbers then indulge in those. Also fruit is high in carbs, so you should probably stay away from most of those as well (most berries are okay). I don't know how you dealt with your diabetes back when, but the low carb, high fat diet has been rather successful for most here. I'm still tweaking and still have some ups, but for the most part mine have drastically improved. I don't know about taking Byetta with both a fast acting and slow acting insulin. The whole purpose of insulin is to give your pancreas a rest. How was the Byetta working for you? Were your numbers under 140 at all whether morning, noon, or night? If your numbers were higher than 140, then you have not been in good control, no matter what the doctors tell you. The ADA's recommendations for good control is 180 or below. Damage begins occurring to your body with any numbers above 140. If you are having premeal numbers above 140 and you are taking 10 units of insulin ( a fixed rate), then eat some carbs this is doing nothing to help your body deal with the glucose from those carbs. And, if you are taking 10 units when your number is say over 200 before your meal, you are not doing the full amount of what needs to be done. I hope this all makes sense. Please go to bloodsugar 101 and read up on the information there. It is great information and will get you to be able to get your mind around all these numbers. I still go back and read from that website alot because much of this can be so darned confusing. Keep us informed, and welcome back.
 
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Maureen, if you order the book, it will specify using carb ratios. So using a pump. Carb ratios are absolutely necessary for pumping. Carb counting and the use of ratios is not old fashioned, it is the best possible way of getting the correct dosage of Novolog before meals. If a doctor told me it was old fashioned, I would not see him again. You will not get the best possible control with this doctor.
 

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Discussion Starter · #14 ·
Hi naynay,

Since I am not familiar with how to take insulin other than what the doc said, do you mean you start out with 12 units, then add units depending on carb intake?

Regarding Byetta, I was doing pretty well on it until a couple of months ago, with stress and illness everything went south! I have not been on any specific diet and know that is a lifestyle change I really need to do.

Is bloodsugar101 a thread on this site? You are correct, all is confusing to me right now but with these message boards and all of you that are so helpful, I am sure I will get the hang of it soon... Thanks again!
 

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Discussion Starter · #15 ·
If a doctor told me it was old fashioned, I would not see him again. You will not get the best possible control with this doctor. >>

So far I am getting about the same readings as I was on Byetta. This doc seems a bit arrogant and pretty much his way. I do have another option with a doctor that is even closer to home, I will see this guy in a month and if not satisfied, I shall change. He will be getting a call after the holiday, especially if the numbers do not improve at all. Thank you again!
 

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Is bloodsugar101 a thread on this site?
It's a website by a woman who has diabetes and is a thorough researcher and reporter. All the info is backed by cited studies, and it's easy to navigate and absorb.

Blood Sugar 101
 

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Maureen, yes I have what is called a baseline of 12 units if my blood sugar is 150...anything above 150 in increments of 50 points I add two more units to the 12. So for instance if my blood sugar number before a meal is 184, I take 12 units baseline (150) and then I add 2 more units for a total of 14 units (since the 184 is between 150 and 200). So if my number were say 234, then I have 12 units baseline, and add an extra 4 units of insulin for a total of 16 units. Now of course this does not take into consideration the amount of carbs I might have with my meal, so if I know I'm going to have say 15-20 grams of carbs with my meal, I might add another unit or two of insulin. However, sometimes I overshoot the amount and end up low, but not normally. I'm getting better with getting it spot on.
I have taken Byetta in the past and although it started out working really well for me, after a couple of months it just stopped working. That is what happens with many of the meds I've taken over the years for the diabetes. I always felt like a real oddball because what worked for everyone else didn't work for me. That is why I'm so glad I found this forum because I don't feel like such an oddball anymore.
Richard is right about carb/insulin ratio. I haven't figured mine out yet, but I'm getting better with it. I just have to behave myself and not eat bad things.

Blood Sugar 101 is a website, like Moon said, and it is a wonderful site to visit. It is extremely informative and explains alot. Lifestyle change is a definite must. Look into low carb, high fat way of eating. It really does work and you will be amazed at how well your numbers improve. It doesn't happen overnight, so be patient. Insulin can work very well for you, and as you get your numbers in a better place you will be able to lessen the amount of insulin you require.
 
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Discussion Starter · #18 ·
Renee, thanks for all that information. Totally makes sense. There is a lot for me to learn even though I have been diagnosed for a long time. Byetta worked for a long time and still may, just I went on a pity party for about two months and let things get out of control.
 

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Renee, thanks for all that information. Totally makes sense. There is a lot for me to learn even though I have been diagnosed for a long time. Byetta worked for a long time and still may, just I went on a pity party for about two months and let things get out of control.
Maureen, I can totally understand how you feel. I have been diabetic for alot of years now, and I've been the pity party route a few times. I also just tried to ignore it thinking it would go away, but that didn't happen. Also I've tried diligently in the past to follow what the ADA and doctors told me how to eat and such and it just didn't work. Things kept getting worse and worse, and I was about to just throw in the towel and let things happen how they will when I found the fabulous doctors I am now with, I found this website, and I found all these wonderful people here. This site literally saved my life because I finally now understand that there are many others who have been where I have been and they have found the true road to recovery and control of diabetes. There is much to learn, but just stay focused and read and listen to what others here have to say. Most here are much more knowledgeable than any doctor I've ever been to, and they don't beat around the bush. Always do research to any question you have and you will find the truth about what really works. We are all here to help you out, so don't be shy, don't be afraid, and visit here often.
 
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Discussion Starter · #20 ·
I have to agree the folks living with diabetes are sometimes more knowledgable with what works for them. I shared information that I found with other diabetics to my old doctor and he would not agree then a couple months later come up with the same idea. I like to think some doctors really listen to their patients...
 
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