Re: Newbie Concerned for Mom

you also have to take into account that the dietary habits of someone of
that age change over time. just based on my own mother, she ate less meat,
vegetables etc as she got older & retreated to more bland food. her appetite
wasn't what it used to be. so there is that consideration when trying to
keep her from going hypo at night ... what she will eat vs what she won't.

Barbara

"*~*WiseWords - WiseWords4Diabetics"
<[EMAIL PROTECTED]> wrote in message
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> [EMAIL PROTECTED] (tioga 0630) wrote in message
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> > Hi.  My mother is 74, diagnosed with Type 2 for about twenty years.
> > Within the past three months, the Avandamet and Metformin seem to have
> > lost their punch, and she recently was told she had to take Insulin
> > (12 units twice a day).
> 12 units twice a day says nothing. It leads to guessing games
> and incorrect advice.
> One person made a guess at 70/30.
> The other choice would be Lantus,
> a favorite of many docs for Type 2 patients.
> But, is she still taking the oral meds along with the insulin?
> And, is her pancreas still producing some insulin,
> although not as much as it previously did?
>
> If it is not producing any insulin, then her treatment
> will be closer to that of a Type 1 diabetic, and she
> may very well be taking 70/30, although 12 units twice
> per day without any oral meds sounds like a small amount
> to me. However, you said she is getting low !
> With the 70/30 insulin, one is stuck with those percentages.
> Maybe she needs different amounts for only one of those two.
> You get those different amounts by drawing each insulin out
> of a separate vial into one syringe.
> There are a few extra steps, but it is not difficult to learn,
> and it will reduce the low BG at night.
> That is, if she is taking 70/30.
>
> I do not think she needs a so-called modern insulin regimen,
> which would mean multiple shots each day, and probably the
> use of Humalog, a fast-acting insulin. She doesn't have a
> problem with high blood sugars. Apparently, she is doing
> okay on two shots per day, and the problems are with being low.
>
> Having a snack at night is not a resolution until one
> finds a new doctor. It is a normal part of being an
> insulin dependent diabetic. Anyone taking insulin,
> who does not have an evening snack, is asking to get
> low at night.
>
> > She has been experiencing two troubling
> > symptoms--low readings at night (61 to 43) and
> > has felt hunger pangs within two hours after eating
> > (and food has never been an obsession with her).
> See above comments about a snack at night.
> Hunger is usually from a low BG. First, check the BG
> when she feels hungry, even if it is after a meal.
> If low, eat more at the meal, or reduce one of
> the insulin amounts if taking two, or the Lantus if
> taking that. If taking 70/30, it will not work to
> reduce that because she will be reducing two insulins,
> when she only needs to reduce one.
> When she is low, she should have a snack or
> some form of carbs.
> >
> > The doctor in her medical group on call when
> > she had a low recently said she should lessen the insulin.
> > However, her regular doctor said she should "up" it.
> Fire the regular doctor !
> First, make sure she understood what he meant.
> If he did mean to increase the amount,
> ask why, in no uncertain terms. Make him explain
> his reasoning to you, before you fire him.
> One does NOT avoid a low BG by taking more insulin.
> Reducing the insulin will raise the BG.
> Increasing the insulin will lower the BG.
>
> > I'm not asking for medical advice on this group;
> Yes, you are.
> > but I would like to hear if other people switching from oral
> >"regimens" to injected insulin have experienced these reactions.
> There can be many variations with either a Type 1 or Type 2.
> Switching from oral meds is not the main issue.
> The main issue is learning to deal with the insulin.
> Does this mean she is completely off of oral meds?
> Is her pancreas producing any insulin at all?
> >
> > Also, just an admittedly morbid question, but what should diabetics
> > worry about more--very high day readings, or very low night readings?
> Yes !
> Both are not good. It is six or a half dozen as to which will be
> more problematic. Having a slightly high BG is not a solution
> to a low BG. Good control is the solution.
> Possibly a more routine diet, with less change in the
> amount of the carbs at each meal from day to day,
> and more frequent monitoring of the BG for a few weeks
> while the insulin amounts are being regulated.
> This is not going to be a set thing without changes.
> > I ask this because the reason she began the injections
> > in the first place is because her day readings began to
> > stay consistently high (on the orals).
> >
> Makes sense, although there are other oral meds,
> such as Starlix or Prandin, which stimulate the pancreas
> to produce more insulin. These may not be indicated for
> some older people with other health considerations.
> > Thank you very much for reading this, and if anyone could point me to
> > a link where laypeople can learn more about the reactions of the two
> > different regimens--i.e., injected versus oral--I'd be very grateful
> > to learn about them here.
> I am not familiar with info sites about switching from
> oral meds to insulin. Each is generally used independently
> of the other, and for those who switch to insulin,
> any site with insulin info will be helpful.
> You can start by typing in the name of the insulin
> on Google.com to do a search for the manufacturer's site.
> They will also have other links.
>
> I am surprised that Julie Bove said, "If she is eating too
> many carbs, then all the meds in the world won't help her."
> This is true if there is a problem with a high BG,
> but with a low BG, carbs are exactly what an insulin
> dependent diabetic needs. How else would you get the BG up?
> It is not good to leave it between 43-61.
>
> >> Julie Bove
> >> Skipping meals can cause BG to go too high.
> Quite the contrary. Skipping meals causes the BG to go too low.
> >> Julie Bove
> >> High readings will kill you slowly and painfully.
> >> Low readings usually won't kill, but they can
> >> kill a person who is using insulin.
> If the reading is low enough, it can kill anybody.
> It usually won't get that low, and even if a person
> went into shock from a low BG, they generally come out of it
> as the body starts to digest fat into glucose.
> However, it is better not to get that low.
> Just take some fruit juice, or other source of carbs
> to raise the BG when it is low.