Thanks for dropping by to read what’s on my mind today. I so appreciate it! Writing in this space is fun for me, and I hope my words are encouraging and inspiring to you. Today I’d like to walk you through the reintroduction of insulin injections in my diabetes management plan. Why did I need to start it again? How did I reintroduce insulin? Has my blood sugar stabilized? Is it in normal range? Let’s jump right into the transition from insulin-free diabetes to insulin dependent diabetes!
The ability to control my blood sugar through diet and lifestyle alone began to deteriorate in September of 2018. Due to lack of care on my part, I had several food cross-contamination which sent me on a roller coaster of blood sugar levels: climbing up after cross-contamination then slowly back down over the course of two weeks. My glucose levels would stabilize for 1-3 days then I would be hit with another cross-contamination and hop on the roller coaster again! It was a frustrating time, to say the least.
After a sudden rise in my blood sugar following Thanksgiving, I began taking insulin again on December 8, 2018, when I could not lower my blood sugar using my usual methods. Much to my dismay, insulin-free diabetes is over (for now at least), but my goal of optimal health is not over. I want to show that great health, energy, and vitality can happen while on insulin.
Stabilizing Blood Sugar
NPH
First things first, I needed to bring my blood sugar down to normal levels. As I noted in my last diabetes post, I began taking NPH insulin, an “OG” insulin from the 60’s, because it was so stinkin’ cheap.
If you do some reading up on it, you’ll find recommendations to take 2/3 of the daily insulin need in the morning and 1/3 at night. This is two-fold:
- The morning dosage will cover breakfast and lunch, 2/3 of the meals for the day.
- To avoid going low while you sleep, dosing less insulin in the evening is necessary.
NPH insulin is not a steady releasing insulin, like current day long acting insulins. It peaks at 2-4 hours then declines rapidly until leveling out for another 8-10 hours or so. In real life, this looks like eating a lot of carbs at breakfast, next to nothing at lunch and just a tad at dinner…with no snacks in between. It was very tricky.
After trying this insulin for one week, I was fed up with it. My blood sugar was not in range, and I could see that if I were to take a higher dosage, I was guaranteed to go low a couple times a day. No thank you. Not worth it.
Long Acting and Rapid Acting Insulin
Onward! After giving up on NPH, I filled prescriptions for Lantus, a long acting insulin, and Novolog, a rapid acting insulin.
The long acting insulin is taken once a day and steadily lowers blood sugar all day long, lasting for 24 hours. The fast acting insulin is taken prior to eating a meal and begins working in 10-15 minutes, peaks at 30-90 minutes, and is out of the system in 3-6 hours.
Ok, now you’ve got the low-down of how modern day insulin works!
Insulin Dosages
Figuring out insulin dosages is a guessing game. The endocrinologist will help give guidelines, but it is a calculated guess-and-check process to figure out how your body responds to insulin with the other factors of your life: diet, exercise, sleep, etc. I began with small doses, 4 units of long acting once a day and 1 unit of rapid acting at each meal.
The long acting was increased every day by 2 units until my pre-meal blood sugar was in line. I went as high as 14 units per day, and I’ve settled back to 11 units per day.
The rapid acting insulin is very tricky as the dosage depends on how many carbs you eat. In my experience, not all carbs are the same. A meal full of fresh vegetables, meat, and fruit will elevate blood sugar much less than a meal of processed (even gluten-free!) carbs like crackers, pasta, and baked goods.
Figuring out the rapid acting insulin is a guessing game. I began with 1 unit per meal, while keeping track of how many carbs I was eating. Meal by meal, I guessed and adjusted until landing on 15 grams of carbohydrates to 1 unit of rapid acting insulin.
Guess what happened then? It changed!
I went a little crazy in my eating the first week on this new insulin regime (I’ll go into more detail in another post. I learned some good lessons!), so when I calmed down and went back to normal eating, I found myself adjusting my carb/insulin ration gradually up to 30/1. Since most of my meals are 30 carbs or less, I do not need to take the rapid acting insulin at this time.
Woot!
A1c Including All This Craziness
Just as I was leveling out my blood sugar with this new insulin routine, it was time for my quarterly A1c. The A1c gives an average blood sugar for the previous 2-3 months, approximately October-December. Not the best period of diabetes management for me…
On January 3, I went to the lab for an official A1c test.
The result? 7.4. Less than 7 is the goal, but with the crazy-town fall/early winter I’ve had, I’LL TAKE 7.4!
At this point, I’ve had stable, in range blood sugar readings for 8 days! Woohoo! A huge victory after so much struggle for so long! It took 13 days of slowly ramping up my insulin doses and carb counting to get to this place.
So all this long story to say, if your health has taken a turn for the worse. Keep your chin up. Keep reading, and looking for alternatives. Be open to suggestions and move forward!
The transition from insulin-free diabetes to insulin dependent diabetes has not been a smooth road, but I bet it isn’t for any diabetic. Diabetes takes constant monitoring and adjusting. (If you have diabetes or any autoimmune disease, I highly recommend starting a food journal! It will help you make sound decisions about your health!) Now I’ll be moving forward into more Autoimmune Protocol reintroductions which has me so excited about the possibility of expanding my diet!
Any health changes on the horizon for you? Have you explored alternative solutions? What good articles/books/journals have you read lately?
“I went a little crazy in my eating the first week”….I would have done the same thing! For me, that would have meant pasta, eggs, and milk products galore! I’m so happy your levels have evened out. It will be interesting to see how your diet might progress as you get everything figured out.
Yeah, I ate my gluten-free, almond crackers at every meal. Every. Meal. The scale did not appreciate it. 🙂