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Posted 10/26/2011 8:09 PM (GMT 0)
After being in the hospital for my Heart Attack, I was told my Diabetes caused it and my A1C was 8.2 my A1C has always been close to 7 and my choleterol was 2.8, I have had problems with my stomach since probably February which I think accounts for my high A1C, they switched my insulin from Humilin N and R too Lantus and Novorapid, my question is this.

Lantus is a 24hr long acting same as Humilin N and is Novorapid just a faster acting Humilin R, my numbers are extremely high even when I was in the hospital, if I keep this up I am going to have another one (which I don't want)

I don't get to see my new Endocrinologist till Nov 7 instead of the same week I got out of the hospital, foul up on hospital part any suggestions    

Posted 10/26/2011 9:17 PM (GMT 0)
Will, why don't you call the Endo tomorrow and see it they could fit you in..especially if there is a cancellation.  Let them know your concerns.  You have been through a lot and they just might accommodate you. 

 

Sherrine

Posted 10/26/2011 10:53 PM (GMT 0)
You are a little misinformed about your insulins.

There are 3 base categories of insulin. Rapid or Fast acting, Mid duration and Basil or Long Acting.

Fast acting insulins start working within 10-20 minutes and stop working within 2 hours or so. They are usually prescribed to help prevent spikes in BGL right after eating.

Mid duration BGL's take a little longer to start working, 30-45 minutes, and do not bring down BGL's as fast as the rapid, but the remain working longer. These insulins usually stay working for 4-6 hours, basically from meal to meal.

Basil Insulins take the longest to start working, 1+ hours, and effect BGL's the slowest, but the remain working the longest at 12-24 hours. They are usually prescribed to keep BGL level though out the day.

Novorapid, Humilin R, Humolog R, etc are all fast acting insulins.
Humilin N, and other insulins with the N tag are mid duration insulins.
Lantus and Levemere are long acting or basil insulins.

Beyond that you get into combination insulins such as 70/30 mixes which combine both rapid and mid duration insulins into a single injection.

The insulin treatment they have you on now is a rapid and basil combination. Your doctor is hoping that this combination will keep your BGL from spiking too much after meals, bring down your BGL quickly after meals, and keep your BGL at a decent level overnight. The mid duration insulins are not capable of this since they will stop working 4 hours or so after you take them where as the basil insulin will be working for a lot longer.

I hope this helps clear things up a bit for you.
Posted 10/27/2011 2:22 PM (GMT 0)
Actually, there are 5 insulin categories: fast-acting, short-acting, intermediate-acting, long-acting, and pre-mixed.

Rapid-acting/Fast-acting:
Humalog® (lispro)
Novolog® (aspart)
Apidra® (glulisine)

Regular/Short-acting:
Humulin® R
Novolin® R

Intermediate-acting:
Humalin® N (NPH)
Novolin® N (NPH)

Long-acting:
Levemir® (detemir)
Lantus® (Glargine)

Pre-mix:
Humalog® Mix 75/25
Humalog® Mix 50/50
Humulin® Mix 70/30
Humulin® Mix 50/50
Novolog® Mix 70/30
Novolin® Mix 70/30

As a Type 1, insulin injector I just wanted to be clear that regular and rapid insulin are not the same. You have to be very careful with the rapid because it literally starts within 5-15 minutes whereas, with regular you've got about a half hour before it ramps up. I've even gone hypo WHILE eating because Rapid works so fast.

BD's web page has some more info....
http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7246
Posted 10/27/2011 8:00 PM (GMT 0)
 

"Novorapid, Humilin R, Humolog R, etc are all fast acting insulins."

Part of my question was Novorapid just a faster acting Humilin R,

Lantus is a 24hr long acting same as Humilin N was quoted and shown to me in a chart by the resident

I miss the good old days of Beef and Pork insulin confused

Posted 10/27/2011 8:47 PM (GMT 0)
The only insulin profile aspect that NovoRapid and Humulin R share is their duration (how long it lasts in the system).

NovoRapid is a fast-acting insulin. Humulin R (the 'R' stands for regular), is a regular/short-acting insulin. They are not the same in that:
- Rapid starts working within 5-15 minutes, it peaks (works the hardest) at the half hour to an hour mark, and lasts 3-5 hours
- Humulin R starts working at the half hour mark, peaks between the 2-3 hour mark, and lasts 3-6 hours.

With Rapid you'll want to inject just before eating - it can be very quick to start working.
Posted 10/27/2011 9:49 PM (GMT 0)
Thanks Phishbowl, so basically I can adjust my dosage similar to when I was on Humilin R, taking into fact of the quick start (which I haven't seen yet)
Posted 10/28/2011 2:34 PM (GMT 0)
I would think your doses would be similar, yes.

With Rapid though you may find yourself fine-tuning your doses much more to your carb counts. It certainly mitigates the BGL spikes after eating because it starts right away and peaks at about the hour mark BUT you'll have to be more careful with certain meals.

Pizza for example, has such a long digestion period that I will inject about 60% of my dose just before eating, then the other 40% at about the hour mark. This spreads out the dose so I don't go hypo and can still manage the spikes. (With a pump, they have special features that do something similar - dual wave or square wave bolusing).

I find my daily logbook invaluable when changing/altering regimens - it's the only way to truly see any patterns.
Posted 12/4/2011 10:11 PM (GMT 0)
Well time for a brief update, still no luck with my sugar levels, I'm on carb counting now and that is not working well my insulin dosage has been changed so many times, no wonder my body is confused, I am going for a info session on the pump on Friday, not that I want to use one, but to keep my Diabetic Nurse specialist happy I will listen, she doesn't like the lows and I don't like the highs so it is a fight
Posted 12/5/2011 1:17 AM (GMT 0)
Hang in there, Will.  Maybe a pump would be a good idea.  It's worth a listen.
Posted 12/5/2011 2:51 PM (GMT 0)
Thanks Lanie, just the stuff I've seen on the internet is that it is seems like so much work
Posted 12/5/2011 2:55 PM (GMT 0)
I don't have a pump so I can't say either way but at this point maybe it would be better.  I think Kris (Phishbowl) has one. She's much more knowledgeable.
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