Insulin Change

Katie has been having super bad swings.  This is *very* hard on her body...I would assume it would be hard on anyone....but I can only attest to what I've seen with Kate.  She's been working about 30-32 hours a week and I think she's been a bit annoyed that the numbers haven't leveled off.

I suspect that it will always be a bit like this....especially with any physiological changes (illness, monthly stuff, etc and so on).  Any little change can wreak swings in her blood sugars.  What's the hardest isn't being at 70 or 200 or even 300.  It's the swinging within an hour from one to the other.  Her cells aren't ever working at 100% and she's getting exhausted.

Luckily we have a great endo and office- we had an appointment to see Dr. Kassar anyway- and so we talked it over with him.  We made the switch from Humalog 75/25 to Humalog and Lantus.  More on them below:

Humalog 75/25 is a great starting point. Humalog 75/25 is a man-made insulin that combines both intermediate acting insulin with fast-acting insulin.  It's great for a few reasons- because it only requires you to stick yourself with a needle two times a day.  And because it could be good if your body responds well to it.

For my bio/geek friends:
(From RxList:)

Chemically, insulin lispro is Lys(B28), Pro(B29) human insulin analog, created when the amino acids at positions 28 and 29 on the insulin B-chain are reversed. Insulin lispro is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered to produce insulin lispro. Insulin lispro protamine suspension (NPL component) is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation.

Insulin lispro has the following primary structure:  Insulin lispro has the empirical formula C₂₅₇H₃₈₃N₆₅O₇₇S₆ and a molecular weight of 5808, both identical to that of human insulin.

Humalog:  This insulin is similar to the 75/25 but it's only a rapid-acting human insulin analog.  (Insulin Analog is simply an altered form of insulin that is different from what happens in nature but works like human insulin.  The amino acid sequence is genetically modified (engineered) to change its adsorption, distribution, metabolism and excretion characteristics.  This alone would not help Katie.  Which is why she now also takes Lantus.

Lantus:  It's a long-acting basal insulin analogue.  The insulin is inside microcrystals so the insulin is slow acting.  Katie takes this at night so she can have it work over a long period of time(18+ hours).  Unlike Humalog- this insulin does not peak.  It's the best long acting insulin on the market according to our doctor.  It's not cheap..but then none of the insulin out there is.

Dangers of High Blood Sugar:  Blindness, loss of limbs, kidney failure and nerve problems to name a few- these appear OVER time.  And might not appear until much later in life.

Dangers of Low Blood Sugar (under 70 mg/dl):  Seizures, unconsciousness, accidents (while driving, walking or falling) The danger of something happening to you because of the low blood sugars is low..but things that CAN happen while you are confused and lethargic and have low blood sugar are scary.  Repeated seizures can cause brain damage, you can get in a car accident while you have a low (we've already had a major accident that we suspect was a result of the undiagnosed diabetes - and it WAS scary- they could have been killed!)

It's important to control Katie's blood sugar and work on the lows first since these cause danger to her body now.  But that doesn't mean you ignore the highs.  You can't because eventually if you ignore your diabetes it will come back to bite you when you are much older.  So right now Katie is taking Humalog before every meal.  She has to calculate a correction factor and other data in order to get the right amount of insulin.  Then at night she injects the Lantus.  She has gone from two sticks a day to four.  And I suspect more will occur before we get this figured out.  We really, really hope that six months passes quickly so we can get that OmniPod insulin pump and that Humana doesn't give us anymore issues about it.  We are still researching fighting and having an external review of the pump for Katie.  But right now all of our time and energy is going into making sure her numbers get to be in a tighter range.  Especially before school starts!