We currently dilute her insulin to U-20 (which means there is 5 units of diluent to 1 unit of insulin, or 10 units of the diluted stuff = 2 units of full-strength). Right now, Elise takes 11 units of DH at each meal, which in theory means she should get a dose of 2 (well, 2.2) units of full-strength.
Both times we've tried to switch , we have the exact same problem... her numbers seem fine at first, actually on the low side of normal. Then, they go up, and up, and up until they're in the high 400s. The more insulin we give, the higher she goes. Which is totally backwards, right?
Our theory is that the full-strength stuff is just still too strong for her (the first time we did this, we started out with a dose that was below what she should be getting). We think that her liver might be kicking out extra glucose because of the strength of the insulin. This, of course, is our non-medical opinion... call it an instinct. The NP we saw at our endo appointment yesterday thinks it's more likely that she's going low, then rebounding. My gut says no, just because I think we would have caught a low, since we test her so much.
But our NP encouraged us to try again, especially since she wears a CGM and we'll be able to see what happens. So today is the first day... right now she's out with Fred at a local farm festival where they have a petting zoo, pony rides, hay rides, and lots of open space to run around. I'm VERY curious to see what happens!
And if we get weird results again, we have to go ahead to give her a less-diluted dose of insulin (this was the wonderful Meri's idea!), like U-60 instead of U-20. The idea is to ween her off the diluted stuff. The NP wasn't too excited about the idea, but he checked with Dr. T (Elise's endo), who gave us the green light. So at least we have a back-up plan!
So here's hoping that it works! To end this post, I have a picture of the lovely Eileen; who is displaying 6 hours of absolutely bea-u-tiful numbers. The best part? These numbers are after Elise had ice cream for dessert at lunch and pizza for dinner. That's not usual around here, but yesterday was just a pizza and ice cream kind of day!
You always AMAZE me!! Diabetes is hard enough to figure out on "modern" insulins and pumps....but you know Elise and the NPH thing like the back of your hand! I dont know how you do it! :) Im seriously so proud of you :)
ReplyDeleteSomeone the other day was saying how NPH should NEVER be used in this day and age....and of course...I HAD to tell them about you! Elise has AMAZING "control" because YOU ARE ON IT SISTA!!! ((HUGS))
Awwww, thanks Kelly! Your comment made me tear up. Sometimes I think we're crazy doing it the way we are, but then I start thinking, "hey, it works! Why change?"
ReplyDeleteThanks for putting a smile on my face this morning.
AWESOME!!!!!!!! You guys are seriously amazing :) Addy was itty bitty when she was on NPH/R and no one ever considered diluted insulin....that's when THE LOWS started :(
ReplyDeleteI'm so happy to see that Eileen is having a good day....YOU GUYS ROCK IT!
My thought, even before I read the great Meri suggested it, was to change the diluted ratio. Wonder why the NP wasn't all about that?
ReplyDeleteI hope you guys get it all figured out ;)
@ Lora - THe reason he was hesitant is because there really is no protocal for diluting the insulin less... so if we were ever to run into a problem and needed help, it's harder to figure out the exact dosage. I think they only dilute to U-20 and that's it.
ReplyDeleteI am proud of you for jumping back on the horse!! I am going to send you super sonic successful California vibes today...I'm channeling now...hoping it all is a big success!!
ReplyDeleteHope it works! Sending lots of good luck wishes your way!!!
ReplyDeleteI wish I could get "it" downpat as you have it and I have been at this a long long time girlfriend . Im still not with "it" as you are . It makes me crazy . well take care and smile , smile , smile .
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