Anything wrong with taking insulin?

[Verna Jan]

Is it more desirable to get control of blood sugar with
oral meds than with insulin? What are the pros and cons of
taking insulin?

[Thad O]

On 26 Jun 2004 04:22:33 GMT, vernajan@aol.comnojunk (Verna Jan) wrote:

>Is it more desirable to get control of blood sugar with
>oral meds than with insulin? What are the pros and cons of
>taking insulin?
Insulin takes more monitoring, but I believe it gives
more control.

[Oldal4865]

Verna Jan wrote in message <20040626002233.12055.00000721@mb-
m01.aol.com>...
>Is it more desirable to get control of blood sugar with
>oral meds than with insulin? What are the pros and cons of
>taking insulin?

.

Insulin is a fine idea, perhaps a great idea. . .but you
have to take a look at the big picture:

1. 80% of T2 have high Insulin Resistance. High Insulin
Resistance encourages premature heart attack. Your #1
priority is that heart attack risk. Knock down your
high I.R. by:

a. Losing fat lb
b. Gaining muscle lb
c. Daily Exercise
d. Taking anti-Insulin Resistance meds (metformin,
Actos, Avandia)

2. Type 2 is a disease in which your beta cells slowly die.
Manufacturing self-generated insulin is thought to
slowly destroy your sick beta cells. Try to protect them
since they fine-tune your blood sugar control. Do so by:

a. Rationing your carb intake
b. Injecting insulin to take the load off the betas

3. Finally, lastly, almost as an afterthought, if #1 and
#2 don't give you absolutely superb blood sugar, fine-
tune your daily insulin injection doses to finish the
control job.

The Pro's: superb blood sugar control and probably protect
your failing beta cells to ensure a longer period of superb
blood sugar control

the big Con: The superb blood sugar control might fool you
into thinking you have everything "licked" so you ignore the
high Insulin Resistance and thus do nothing about reducing
your heart attack risk.

the little Con: You encourage hypos if you try to get by
with a very few very large injections instead of a couple of
small daily injections. IOW, it's more bothersome than
taking a pill.

A somewhat biased viewpoint from a T1 who shoots 7 - 12
times a day (HbA1c
= 5.6)

Regards
Old Al

[Simm Webb]

In my case, after many years of orals, and tight control, my
blood sugar went awry, and uncontrollable. After a 72 hour
fast, with no improvement in my results, the Doctor decided
that I must go onto insulin. I have been taking it since. If
you don't need it, don't use it. If and when you need it,
don't ignore it.

On 26 Jun 2004 04:22:33 GMT, vernajan@aol.comnojunk (Verna
Jan) wrote:

>Is it more desirable to get control of blood sugar with
>oral meds than with insulin? What are the pros and cons of
>taking insulin?

Grateful to be back.

Eddie MD OTF

[Bay Area Dave]

Verna Jan wrote:

> Is it more desirable to get control of blood sugar with
> oral meds than with insulin? What are the pros and cons of
> taking insulin?
the pro's are that it provides better control (ideally).

the cons are that you can suffer hypos, unconsciousness, or
heaven forbid, death.

I've been on insulin since '78 because my doctors at the
time didn't feel orals were appropriate for someone in their
early 30's as they can cause serious health issues over
time. I don't know anything about today's orals, however.

dave

[Willbill]

oldal4865 wrote:

> Verna Jan wrote in message <20040626002233.12055.00000721@mb-
> m01.aol.com>...

>> Is it more desirable to get control of blood sugar with
>> oral meds than with insulin? What are the pros and cons
>> of taking insulin?
> ..

> Insulin is a fine idea, perhaps a great idea. . .but you
> have to take a look at the big picture:
>
> 1. 80% of T2 have high Insulin Resistance. High Insulin
> Resistance encourages premature heart attack. Your
> #1 priority is that heart attack risk. Knock down
> your high I.R. by:
>
> a. Losing fat lb
> b. Gaining muscle lb
> c. Daily Exercise
> d. Taking anti-Insulin Resistance meds (metformin,
> Actos, Avandia)
>
> 2. Type 2 is a disease in which your beta cells slowly
> die. Manufacturing self-generated insulin is thought
> to slowly destroy your sick beta cells. Try to protect
> them since they fine-tune your blood sugar control. Do
> so by:
>
> a. Rationing your carb intake
> b. Injecting insulin to take the load off the betas
>
> 3. Finally, lastly, almost as an afterthought, if #1 and
> #2 don't give you absolutely superb blood sugar, fine-
> tune your daily insulin injection doses to finish the
> control job.
>
> The Pro's: superb blood sugar control and probably protect
> your failing beta cells to ensure a longer period of
> superb blood sugar control
>
>
> the big Con: The superb blood sugar control might fool you
> into thinking you have everything "licked" so you ignore
> the high Insulin Resistance and thus do nothing about
> reducing your heart attack risk.
>
> the little Con: You encourage hypos if you try to get by
> with a very few very large injections instead of a couple
> of small daily injections. IOW, it's more bothersome than
> taking a pill.
>
> A somewhat biased viewpoint from a T1 who shoots 7 - 12
> times a day (HbA1c
> = 5.6)
>
> Regards
> Old Al

nice post!

especially for a t1 speaking to a t2 !!

your HbA1c of "5.6" prompted me to check mine (with a
$18 Metrika kit that i've had in my fridge for the
last 2 months)

i got 6.1. :)

which is in fact the worst of my last 4, but still in the
normal range for normal people

(2/19 = 5.6, 2/22 = 5.9, 3/1 = 5.1)

("normal" = non-diabetic, with Metrika giving 4.0-to-7.0 as
"normal," 7.1-to 7.9 as "ADA Target for Diabetes," and
3. and higher as "Action suggested...")

my control has been "off" this last 2 weeks, so i was
curious to see how bad my A1c might be

best, bill t1 since '57

[Willbill]

willbill wrote:

> oldal4865 wrote:

>> A somewhat biased viewpoint from a T1 who shoots 7 - 12
>> times a day

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

>> (HbA1c = 5.6)
>>
>> Regards Old Al

imho, injecting insulin 7-to-12 times/day is way over the
top!

the reason i mention it, is that you seem to treat it as a
badge of honor

i'll add that imho it not only increases your need for
*more* frequent b/g testing, but also likely increases your
chances of getting a bad hypo (which is the reason you are
forced into testing more often; since the more shots you
take, the greater the chance of dosing screwup(s))

and you're not getting any better A1c values than either
myself or nas (who is using a fixed 2x routine (and
likely averaging something like 2.2 shots/day (the .2
being my guess at his occasional solo R shot to correct a
too high b/g))

since both you and i use a basal/bolus type routine (the
main diff being that you use very fast Humalog as your
meal insulin whereas i use pork-R (or even slower beef-R
for big meals) as my meal insulins, and out of real
curiosity, i went thru a recent 14 consecutive days of my
logs (6/3 thru 6/16)

... and found that i averaged 3.7 shots/day

and as long as I eat low carb (when I don't have much active
insulin above my basal needs), using fewer meal shots (of R)
doesn't cause me to have to skip eating meals with others

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

[BjøRn B. Larsen]

"willbill" <trek@worldwide.net> wrote in message
news:cbodpr02c56@enews1.newsguy.com...
> willbill wrote:
>
> > oldal4865 wrote:
>
> >> A somewhat biased viewpoint from a T1 who shoots 7 - 12
> >> times a day
>
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>
> imho, injecting insulin 7-to-12 times/day is way over
> the top!
>
> the reason i mention it, is that you seem to treat it as a
> badge of honor
>
> i'll add that imho it not only increases your need for
> *more* frequent b/g testing, but also likely increases
> your chances of getting a bad hypo (which is the reason
> you are forced into testing more often; since the more
> shots you take, the greater the chance of dosing
> screwup(s))
>
> [ ... ]

Allow me to enter this thread.

Multiple injections (MI) is a great way to treat my T1. It
allows me to live my own life, and not be controlled by by
my previous injection.

Before MI, my day was set once I had done my injection for
breakfast. Some days I was not hungry, but I had to eat
because the insulin would send my BG way down if I didn't.
Some days it would start snowing and I had to clear away the
snow and eat a lot to compensate.

In my present life, which I have been living for many years
I take my fast acting insulin according to my next meal,
which is on the table in front of me, and my level of
activity for the next 3-4 hours.

Then I have some small bolus of long acting insulin to cover
the periods of the day when the fast insulin is used and
there is still some time for my next meal.

All in all I inject slow acting insulin 2 times a day and
fast acting insulin 4-5 times a day. More if I want to award
myself to an extra treat. Not because I want to be the world
champion of MI, but because I want to be in control of my
own life and my own body.

As you write, I may experience a bad hypo, but I do not
agree that MI increase the possibility for this. I may
inject a too high dose, and because I do more injections,
the overall possibility for this is increased. But if this
happens, the problem is gone in 4 hours which is the
approximate activity period for this insulin. I may also
inject and forget to eat, but as I have my injections at the
table, the possibility for this is next to nothing. On the
other hand, if I get an uncontrolled hypo, I may be
unconcious and my brain may suffer from low BG. The insulin
lasts for 4 hours from the injection, and then my body will
start releasing glucose to cope with the low insulin level.

With slow acting insulin, a too high dose will bother me
for a long period. A hypo comes just as fast as with fast
acting, but the insulin may still be active for many hours.
This may cause my brain to be exposed to too little BG for
a longer period of time, making the situation more
dangerous for me.

--
Have a nice day! Bjørn BL.

[Bay Area Dave]

willbill wrote:
> willbill wrote:
>
>> oldal4865 wrote:
>
>
>>> A somewhat biased viewpoint from a T1 who shoots 7 - 12
>>> times a day
>
>
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>
>>> (HbA1c = 5.6)
>>>
>>> Regards Old Al
>
>
>
> imho, injecting insulin 7-to-12 times/day is way over
> the top!
>
> the reason i mention it, is that you seem to treat it as a
> badge of honor
>
> i'll add that imho it not only increases your need for
> *more* frequent b/g testing, but also likely increases
> your chances of getting a bad hypo (which is the reason
> you are forced into testing more often; since the more
> shots you take, the greater the chance of dosing
> screwup(s))
>
> and you're not getting any better A1c values than either
> myself or nas (who is using a fixed 2x routine (and
> likely averaging something like 2.2 shots/day (the .2
> being my guess at his occasional solo R shot to correct a
> too high b/g))
>
> since both you and i use a basal/bolus type routine (the
> main diff being that you use very fast Humalog as your
> meal insulin whereas i use pork-R (or even slower beef-R
> for big meals) as my meal insulins, and out of real
> curiosity, i went thru a recent 14 consecutive days of my
> logs (6/3 thru 6/16)
>
> ... and found that i averaged 3.7 shots/day
>
> and as long as I eat low carb (when I don't have much
> active insulin above my basal needs), using fewer meal
> shots (of R) doesn't cause me to have to skip eating meals
> with others
>
> bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x, simple
> MDI/DAFNE
>
i inject insulin about 100 times a day...using a pump. is
THAT a badge of honor or just good DM management?? :)

dave

[Willbill]

Bjørn B. Larsen wrote:

> "willbill" wrote...

< originally "talking" to oldal (or maybe myself? <grin>),
but now talking to Bjørn :) >

>>> oldal4865 wrote:
>>>
>>>> A somewhat biased viewpoint from a T1 who shoots 7 - 12
>>>> times a day
>>
>> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>>
>> imho, injecting insulin 7-to-12 times/day is way over
>> the top!
>>
>> the reason i mention it, is that you seem to treat it as
>> a badge of honor
>>
>> i'll add that imho it not only increases your need for
>> *more* frequent b/g testing, but also likely increases
>> your chances of getting a bad hypo (which is the reason
>> you are forced into testing more often; since the more
>> shots you take, the greater the chance of dosing
>> screwup(s))

> [ ... ]
>
> Allow me to enter this thread.
>
> Multiple injections (MI) is a great way to treat my T1. It
> allows me to live my own life, and not be controlled by by
> my previous injection.
>
> Before MI, my day was set once I had done my injection for
> breakfast. Some days I was not hungry, but I had to eat
> because the insulin would send my BG way down if I didn't.
> Some days it would start snowing and I had to clear away
> the snow and eat a lot to compensate.
>
> In my present life, which I have been living for many
> years I take my fast acting insulin according to my next
> meal, which is on the table in front of me, and my level
> of activity for the next 3-4 hours.
>
> Then I have some small bolus of long acting insulin to
> cover the periods of the day when the fast insulin is used
> and there is still some time for my next meal.
>
> All in all I inject slow acting insulin 2 times a day

out of real curiosity, what are you using for your slow
basal insulin (a.k.a. background insulin
(a.k.a. = Also Known As)), and at what times of day do you
inject your basal insulin?

> and fast acting insulin 4-5 times a day. More if I want to
> award myself to an extra treat. Not because I want to be
> the world champion of MI, but because I want to be in
> control of my own life and my own body.
>
> As you write, I may experience a bad hypo, but I do not
> agree that MI increase the possibility for this.

to me, taking more shots of meal insulin (within a
basal/bolus routine (a.k.a. MDI/DAFNE)) increase the risk

...and if your amounts and/or timing of your background
insulin shots aren't closely matched to your true basal
needs, then even more extra b/g testing has to be done in
order to avoid a bad hypo from your meal insulin shots

> I may inject a too high dose, and because I do more
> injections, the overall possibility for this is increased.
> But if this happens, the problem is gone in 4 hours which
> is the approximate activity period for this insulin.

which fast meal insulin are you using? i mean "4 hours"
suggests either lispro? or aspart?

and for how long?

also, how long are you t1 for?

> I may also inject and forget to eat, but as I have my
> injections at the table, the possibility for this is next
> to nothing. On the other hand, if I get an uncontrolled
> hypo, I may be unconcious and my brain may suffer from low
> BG. The insulin lasts for 4 hours from the injection, and
> then my body will start releasing glucose to cope with the
> low insulin level.
>
> With slow acting insulin, a too high dose will bother me
> for a long period.

assuming that by "slow acting" you in fact mean slow acting
*meal* insulin, (any of the R insulins (R = Regular a.k.a.
soluble/neutral)), then i agree. :)

my own experience of the tail length of pork-R and "human"-R
(both non-acid formulation) is that the tail action goes to
8 or 9 hours. with slow beef-R, the tail action goes to
about 12 hours. (YMMV (Your Mileage May Vary))

> A hypo comes just as fast as with fast acting,

meaning, "human"-R insulin?

not in my experience

could/would you give some additional detail and/or examples
of what you mean?

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

> but the insulin may still be active for many hours. This
> may cause my brain to be exposed to too little BG for a
> longer period of time, making the situation more
> dangerous for me.

[Guy]

When someone has the answer to insulin dosage let me know.

I do the best I can and will not try to tell others except
general principles. Even that seems to change every year. Do
what works for you. Others be very different. The glucose
release mechanisms do vary in individuals and as of now you
find that out yourself. There is no one answer. Guy

I will not last long without taking insulin.