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Discussion Starter · #1 ·
I've been a diabetic for 15 years. Had pretty much had control until the last couple of years. Started on Lantus about three years ago. Can't seem to get my protein levels in my kidneys down to a normal range. I had gone 3 months w/o eating any protein from meat (as recommended by diabetic specialist) and it still didn't lower it as much as I would have thought. I am taking the maximum amounts of blood pressure meds now, which is supposed to lower those levels.
Looking for help.
 

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Hello askinner, welcome aboard! I don't know what you can do except wait for those blood pressure meds to do their thing. How long have you been taking them? Are you Type 1 or Type 2? How long have you had diabetes?

Richard
 

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Welcome to you, askinner; thank you for joining us. This is far out of my range of knowledge, but there are plenty of others here who know lots more than I.

By 'diabetic specialist' I think you mean an endocrinologist, right?

take care & don't go away, ;)

 

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Discussion Starter · #4 ·
Hello askinner, welcome aboard! I don't know what you can do except wait for those blood pressure meds to do their thing. How long have you been taking them? Are you Type 1 or Type 2? How long have you had diabetes?

Richard
I have been a Type 2 diabetic for 15 years. I have been on these blood pressure meds, the maximum dosage, for at least 12 months with an additional Niacin pill about 5 months ago. My recent A1C level is 6.8 and would like to somehow get it lower. I am wondering in a pump might help. I have a Drs. appointment this coming Friday.
 

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Many people can reduce their A1c's with a pump, but others do not. It takes a lot of work and patience, but the potential is there. A book called "Pumping Insulin" by John Walsh is excellent for really understanding pumping.
 

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Niacin and Insulin

I have been a Type 2 diabetic for 15 years. I have been on these blood pressure meds, the maximum dosage, for at least 12 months with an additional Niacin pill about 5 months ago. My recent A1C level is 6.8 and would like to somehow get it lower. I am wondering in a pump might help. I have a Drs. appointment this coming Friday.
You can double check this info, but I had read in every prescription drug book that Niacin reduces the effectiveness of insulin. Check with your doctor as well. It may be a contributing factor in your bs levels. I lowered my A1C recently to 4.4. I attribute that to tight glucose control. I am not afraid to take the insulin needed to achieve a low
A1C. I have some hypo's but I just treat it with fast acting carbs and go on with my business. Do you use fast acting insulin in addition to Lantus?
 

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Discussion Starter · #7 ·
You can double check this info, but I had read in every prescription drug book that Niacin reduces the effectiveness of insulin. Check with your doctor as well. It may be a contributing factor in your bs levels. I lowered my A1C recently to 4.4. I attribute that to tight glucose control. I am not afraid to take the insulin needed to achieve a low
A1C. I have some hypo's but I just treat it with fast acting carbs and go on with my business. Do you use fast acting insulin in addition to Lantus?
No I don't use a fast acting insulin with the Lantus. I believe the Niacin was prescribed to help lower the protein level for my kidneys, but I don't think that helped much. How do you maintain "tight" glucose control? Maybe that is what I need, tighter control.
 

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No I don't use a fast acting insulin with the Lantus. I believe the Niacin was prescribed to help lower the protein level for my kidneys, but I don't think that helped much. How do you maintain "tight" glucose control? Maybe that is what I need, tighter control.
If you can get off the Niacin that might help with the effectiveness of your insulin. You seem to be taking the Niacin for a legitimate medical reason, so not taking that may not be an option. I am not a doctor, but I have used insulin for quite some time and I can give you my opinion. You may not be using enough Lantus, it is your basal insulin and it can help to keep your overall blood glucose lower. I am insulin resistant and need 88 units of Lantus per day. I use Novolog at mealtime and snacks and to correct a high. My I:C is 1:5. I test 5+ times per day. You might see a big difference in your A1C is you used a rapid acting insulin at mealtimes & snacks. Your A1C reflects your blood glucose all of the hours in a day. If your glucose is high after meals and other times of the day, then your A1C would reflect that. I achieve tight control by testing often, taking my insulin and enough to cover my carbs and taking enough basal insulin (Lantus) to keep my blood sugar in check during the day. I have read that the right amount of basal insulin is an amount that will keep your bs close to normal ranges without going hypo if you delay a meal or skip a meal. I am repeating myself, but I do go low about four times a week. There is no pattern so I can't pinpoint a reason for the lows. I seem to be more sensitive to insulin on some days. I also have gastroparesis, so my digestion is slow and this can cause problems with my insulin peak times. Also, I take Actos & Glucotrol XL. Adding rapid acting insulin at mealtime and possibly adding oral medication may help you keep your bs readings closer to normal. I keep my fasting bs under 80 and I try to keep my post meal bs under 140. How much Lantus are you on?
 

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Discussion Starter · #9 ·
If you can get off the Niacin that might help with the effectiveness of your insulin. You seem to be taking the Niacin for a legitimate medical reason, so not taking that may not be an option. I am not a doctor, but I have used insulin for quite some time and I can give you my opinion. You may not be using enough Lantus, it is your basal insulin and it can help to keep your overall blood glucose lower. I am insulin resistant and need 88 units of Lantus per day. I use Novolog at mealtime and snacks and to correct a high. My I:C is 1:5. I test 5+ times per day. You might see a big difference in your A1C is you used a rapid acting insulin at mealtimes & snacks. Your A1C reflects your blood glucose all of the hours in a day. If your glucose is high after meals and other times of the day, then your A1C would reflect that. I achieve tight control by testing often, taking my insulin and enough to cover my carbs and taking enough basal insulin (Lantus) to keep my blood sugar in check during the day. I have read that the right amount of basal insulin is an amount that will keep your bs close to normal ranges without going hypo if you delay a meal or skip a meal. I am repeating myself, but I do go low about four times a week. There is no pattern so I can't pinpoint a reason for the lows. I seem to be more sensitive to insulin on some days. I also have gastroparesis, so my digestion is slow and this can cause problems with my insulin peak times. Also, I take Actos & Glucotrol XL. Adding rapid acting insulin at mealtime and possibly adding oral medication may help you keep your bs readings closer to normal. I keep my fasting bs under 80 and I try to keep my post meal bs under 140. How much Lantus are you on?
Much of what you stated makes sense to me and may be my course of action. I take 50 units of Lantus once a day after the evening meal. That is the maximum my syringes hold. Will need to ask for larger syringes this week. How long after you eat do you test. That's an area I'm not sure about.
 

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Since I'm not on insulin, I'm reluctant to speak up in this conversation, but I do know that many patients split their Lantus dosage. You take the same amount, but it is divided into two doses, twelve hours apart. This doesn't have to a 50/50 split either, it would be whatever works best for you.

Perhaps one of our insulin members will jump in here & explain better than I can.
 

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Much of what you stated makes sense to me and may be my course of action. I take 50 units of Lantus once a day after the evening meal. That is the maximum my syringes hold. Will need to ask for larger syringes this week. How long after you eat do you test. That's an area I'm not sure about.
Try to get your doctor to increase your Lantus, this would be a good place to start. Ask him to allow you to increase your dosage by 2 or 3 units every 2-3 days until your fasting blood sugar is down. Test the minute you get out of bed, your blood sugar should be between 70 and 130. Yes, you will need a 1cc syringe if you take more 50 units of insulin. You can also give yourself 2 shots with the
1/2cc syringe. Test your blood sugar 2 hours after your 1st bite of food. If your blood sugar is more than 160-180 then you need some rapid acting insulin taken before meals. Novolog, Humalog or Apidra. You can also use short acting insulin before meals. I am not sure where you live, but you can buy short acting insulin at Walmart without a prescription, short acting insulin at Walmart would be Novolin R. Start with 1 unit of insulin for every 15 grams of carbs that you eat.
 

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Discussion Starter · #12 ·
Since I'm not on insulin, I'm reluctant to speak up in this conversation, but I do know that many patients split their Lantus dosage. You take the same amount, but it is divided into two doses, twelve hours apart. This doesn't have to a 50/50 split either, it would be whatever works best for you.

Perhaps one of our insulin members will jump in here & explain better than I can.

Thanks, I'm having to relearn everything.
 

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Oooooh, Niacin.

I HATE Niacin. I might not even have gotten a DIAGNOSIS, without Niacin.

I just came off a month of trying to control my BGs while AGAIN taking Niacin -- at MY OWN request, because it raised my HDL in the past. Supposedly you can adjust to it over time, but there was no evidence I was going to improve. Maybe with a VERY low dose, and SLOWLY ramping up? But it was terribly frustrating and I will not try it again!

There are certain statins that also raise HDL -- you might ask to try one of those, instead ...
 

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Niacin

Oooooh, Niacin.

I HATE Niacin. I might not even have gotten a DIAGNOSIS, without Niacin.

I just came off a month of trying to control my BGs while AGAIN taking Niacin -- at MY OWN request, because it raised my HDL in the past. Supposedly you can adjust to it over time, but there was no evidence I was going to improve. Maybe with a VERY low dose, and SLOWLY ramping up? But it was terribly frustrating and I will not try it again!

There are certain statins that also raise HDL -- you might ask to try one of those, instead ...

I bought some flush free Niacin before I read that it reduces the effectiveness of insulin. Niacin is supposed to be good for cholesterol. I need to raise my HDL about 14 points. I take Zocor for high cholesterol and high triglycerides. My doctor told me that low HDL can be genetic. In the past a doctor added Zetia to my statin med. It didn't help.
 

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Yes, I am pretty sure it is genetic -- have been monitored since < 35! My Trigs never were high ....

The slow release stuff is more hepatotoxic!
 
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