Insulin family that is.
Let me start by introducing the long-standing members. From left to right we have; Pink Lady, Greenie, Mr. Blue, and Agent Orange.
Pink Lady. Our basal. NPH. Our behind the scenes gal.
Greenie. Humalog. The breakfast bolus. He handles the heavy lifting for us.
Mr. Blue. Diluted Humalog. U-20. Diluted to 1/5 the strength of full strength. Mr. Fix-it. He handles our screw-ups and is used for the smallest of jobs.
Agent Orange. Also diluted Humalog. U-50. Diluted to 1/2 the strength of full strength. Our NEW dinnertime bolus.
Why 4 insulins? Because we've been experimenting, and the U-50 is our solution. Remember all my posts about Elise's crashing dinnertime BG? It seemed no matter what we would do, we couldn't fix it. We'd give her shot up to an hour afterwards and she would still come crashing down. So Fred and I decided to try something.
A few nights ago, we decided to give her NO insulin at dinner. She was 94, ate 36g of carbs. She stayed steady for awhile, but about 1 hour after eating, she starting rising rapidly. So we chickened out and gave her 1/2 a unit of full strength. About 45 minutes later, she was 50. FAIL.
So the next night, we stuck to our guns. No insulin at dinner. She was 110 going in, ate 35g of carbs. Held steady at 180 for over 2 hours. We were elated. Except by three hours later, she was 357. FAIL.
When Elise was on U-20 for her bolus, she would get 12 units at dinnertime. That is just too huge of a shot. So we decided to make U-50. Here's how it went down on night #1:
She was 92 at dinner. We gave her 2 units of U-50 (theoretically the same amount of insulin as her full strength dose). She ate 36g of carbs and two hours later she was 213. One hour after that she was 133. YEAH!
Night #2
She was 129 going into dinner. She had 2 units of U-50 (given BEFORE her meal... something we haven't be able to do with full strength). She had 33g of carbs and was at 124 three hours later. Can I get a HOLLA?
Night #3
64 going into dinner (oopsie). She had 45g of carbs, and the 2 units of U-50. Three hours later, she was 134. I'm sensing a pattern. Again, no spike and no crash.
As an added bonus, her nighttime numbers have been so much steadier than they have been in a long time. It's so weird to me that she can received the SAME amount of insulin, and just because it's diluted, we don't get a crash.
Her 24 graph... Nice (well except for the low we had waiting for that 2-hour start-up)!
I am so relieved that we seem to have a handle on this dinnertime stuff. Those horrible crashes had been going on for MONTHS. We had wanted to try diluting her insulin like this for awhile, but it seemed so unorthodox, we were afraid to try it.
Let's hear it for thinking outside the box!
***Please Note*** This is in NO WAY medical advice. It's not. I'm not a doctor. Just a crappy stand-in for my daughter's pancreas . Just because this worked for us doesn't mean it will work for everyone. You should discuss changes to your child's treatment with their doctor.
11 months ago
HOLLA, fo sure!!
ReplyDeleteWay to figure it out...I commend you big time!!
Nice job, pancreas stand in! ;)
Way to rock the pancreatic abilities!! Great job!!
ReplyDeleteVery interesting that the same amount of diluted insulin doesn't lead to a crash. I'm impressed by the way you thought this all through and experimented. Way to go!
ReplyDeleteYou are officially amazing. That is all just too much information for me. My brain is overloaded, I dont know how you do it!
ReplyDeleteOh, I am so jealous of that 24-hour line! You are doing one absolutely amazing job, Joanne! Way to go, mama!
ReplyDeleteAnd so glad you're all enjoying the hats!
Thats awesome Joanne!!! Way to think outside the box.
ReplyDeleteHonestly, you AMAZE ME!!! AND...I have NEVER seen a 24 hour trend line like that on Joe's Dex. Yesterday's was soooo bad I almost posted it for it's suckiness. :)
ReplyDeleteHow does your mind even think of these things? I guess experience. But, no one has ever talked to us about diluted insulin. You're the only one who I've ever heard talk about it. It makes sense with little kids. I think you're a genius.
ReplyDeleteI love when we DMamas can figure it out and you did an amazing job Joanne getting to the bottom of it all. Great job hon!
ReplyDeleteI don't know why I was never told about diluted insulin when we were on MDI!
ReplyDeleteMuch, much kudos to you! I would have been crazy with that much to experiment with! lol
I am seriously giddy for you. Great detective work!
ReplyDeleteSweet! (in a good way.)
ReplyDeleteNICE GRAPH! Glad you figured it out; and sure I could not have done so. Diluted and diluted once again.... makes my mind reel. Kudos to you and your D Math skills!
ReplyDeleteI have been meaning to ask you something - did you or your docs suggest the diluted insulin? We're strongly considering it as we've been having major pump issues, well honestly part of it is Isaac doesn't want to wear it very often lately...so I've been wondering how you guys came to this decision, if you don't mind sharing. And BRAVO for finding a solution to the nighttime crashes :)
ReplyDeleteHuh. Definetely strange. So, let me get this straight. 1 unit of full strength insulin will drop her like it's hot, BUT 2 units of 50% insulin (and saline?) keep her smooth as a baby's butt?
ReplyDeleteI don't get it. But, then again, I SO don't 'get' diabtetes.
Your mad science skillz are wicked mad ;)
You did it!
ReplyDeleteI totally knew you would! You and Fred are fighters! No wonder Elise is so amazing. :)
You did it!
ReplyDeleteI totally knew you would! You and Fred are fighters! No wonder Elise is so amazing. :)
Rock on, Joanne! Awesome! So glad it worked!
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