Am I An Insulin Junkie? Options

[Shayne H]

My last doctor's appointment I told my doctor that once in awhile I take a correction dose in between meals sometimes to bring my BG down. He replied that I am what he and the DEs call an "insulin junkie". He said that I shouldn't chase my BG so much.

Really though, what's the difference between that and giving yourself a bolus correction with the pump? I'd rather bring my BG down a bit so I feel better. If I'm between 9 and 12 (mmol/L) I feel terrible and don't really enjoy waiting until my next meal to correct.

Anyone experience this reaction from their med team before?

Cheers, Shayne

[Joanie]

My last doctor's appointment I told my doctor that once in awhile I take a correction dose in between meals sometimes to bring my BG down. He replied that I am what he and the DEs call an "insulin junkie". He said that I shouldn't chase my BG so much.

Really though, what's the difference between that and giving yourself a bolus correction with the pump? I'd rather bring my BG down a bit so I feel better. If I'm between 9 and 12 (mmol/L) I feel terrible and don't really enjoy waiting until my next meal to correct.

Anyone experience this reaction from their med team before?

Cheers, Shayne

That depends on a few things. Are you taking a short or long acting insulin? If you are taking something fast acting like Novolog or Humalog i'm not sure why your doctor would say no to a correction. The ONLY thing you need to do is keep tract of those extra boluses (like the Insulin On Board feature on pumps), you don't want to stack doses and go low.

[Shayne H]

That depends on a few things. Are you taking a short or long acting insulin? If you are taking something fast acting like Novolog or Humalog i'm not sure why your doctor would say no to a correction. The ONLY thing you need to do is keep tract of those extra boluses (like the Insulin On Board feature on pumps), you don't want to stack doses and go low.

Yes, I understand the insulin on board danger so I'm careful to watch that.

I'm using NovoRapid for before meals and correction. I also take Levemir for basal.

Not sure about his comment so maybe I'll ask on Monday when I see him again.

Shayne

[JeffC]

Yes, I understand the insulin on board danger so I'm careful to watch that.

I'm using NovoRapid for before meals and correction. I also take Levemir for basal.

Not sure about his comment so maybe I'll ask on Monday when I see him again.

Shayne

Sounds perfectly normal to me. Does this doctor also think testing more than 4 times a day is excessive?

Remember that doctors are not patients, they go by what they've been taught and it's often very conservative so as not to get patients (or themselves) in trouble. Taking extra injections for corrections is very beneficial on MDI and I do it whenever needed, it's the only way to keep your A1C down.

If you have your levemir dose at the right level, then after the rapid is done, your BS won't drop (much), so it's the only way to get it back to normal.

- Jeff

[JohnG]

Yes, I understand the insulin on board danger so I'm careful to watch that.

I'm using NovoRapid for before meals and correction. I also take Levemir for basal.

Not sure about his comment so maybe I'll ask on Monday when I see him again.

Shayne

Shayne
If your successful doing corrections your doing the right thing, the longer your BG is high the more damage. I do everything possible
to keep my BG under 140. The less deviation you have the better you'll be long term.
When I started using Novalog I always did corrections 3-4 hours post meal and had very few problems with stacking
I was trained form day one to correct my BG. When I started pumping my CI and sensitivity numbers where already
well established.

[Liz]

Before I got my pump I was told not to correct within 4 hours of my last Humalog injection. I admit that I had gotten myself in trouble in the past with stacking boluses (via injection) but I think that a blanket statement of not correcting is wrong. I think that as long as you're aware of when you last took fast acting insulin and when you last ate, it's not wrong to correct between meals.

It's easier with a pump because it will show you approximately how much insulin you have on board and you can also dose in smaller increments, so doing more frequent corrections probably won't get you in trouble.

[gigem99]

My last doctor's appointment I told my doctor that once in awhile I take a correction dose in between meals sometimes to bring my BG down. He replied that I am what he and the DEs call an "insulin junkie". He said that I shouldn't chase my BG so much....

...Anyone experience this reaction from their med team before?

Cheers, Shayne

I continue to be amazed that doctors take such a lackadaisical attitude towards our efforts to keep our blood sugars under control. My endo is great - he rarely even makes any recommendations to me. I have had other docs though, who have thought my efforts are dangerous.

I think that is their main concern - that we can do serious harm to ourselves or others due to hypodglycemia. I can appreciate that, but my hypocglycemic episodes have dropped to almost nothing since beginning pump therapy. I'm fairly certain I know better how to control my BG's than any doctor ever could. Well - they could make unrealistic recommendations to me that would help, but I just would ignore them, so what's the point? I know my lifestyle, and how I am going to live.

I do 6-7 boluses a day, and I only eat 3 times a day. I am not a "grazer" - I don't snack much. It would probably be better for me if I were to eat 5-6 smaller meals, but I just don't want to. Most of my correction boluses are very small, and are probably only possible with a pump.

Your thread title made me laugh. When my kids were younger (in school), they used to cringe when I would refer to my "junkie kit" around their friends. They would get mortified. Now, that's how they refer to it normally.

Tom

[J-girl]

I also take correction doses between meals, and before bed or in the middle of the night if needed, too. As long as you are aware of when and how much you last bolused, you last ate, or if you are about to do physical activity.. (I happen to write everything down on these spreadsheets i've made.) You should feel good about being so pro-active to manage your diabetes. Have you read Pumping Insulin yet? I've taken what i've learned from that book and started doing my MDI (yes, i still don't have a pump) like a pump.

oh, i assume you are counting carbs and have figured out what your correction factor is..
-jenny

This post has been edited by J-girl: May 9 2009, 01:21 AM

[Linda B]

I can't believe an endo would not want you to do everything you could to keep your BG under control. Correcting post meal highs is a standard treatment, so far as I know. What is the point in letting your BG stay high until your next meal? At that point, the insulin will never catch up to your food, because you are eating with your BG already high, your BG will increase way above your post meal target, and you will perpetuate the high. That makes no sense.

As so many others have said, it is absolutely the correct thing to do to correct a post meal high.

Linda B.

[Shayne H]

I was surprised by his comment as well but knew that deep down I'd keep doing it anyway.

This is my GP and not an Endo. I have not had access to an Endo in 20 plus years. I live in a small town and the closest is about 7 hours away. My GP is actually quite good at keeping up with diabetes treatment. Like someone posted it could be he doesn't want to see me get into trouble. We have very few T1s where I live and also very few that are motivated enough to take care of themselves and take the time to understand their disease and how best to manage it. These could all be factors.

I guess my thread was to see if others felt I was doing the right thing and reassure myself that I wasn't doing something bizarre.

I'll maybe bring it up at my appt on Monday and see what his reasoning is behind it. I'm kind of curious now.

Cheers, Shayne

[karen]

My last doctor's appointment I told my doctor that once in awhile I take a correction dose in between meals sometimes to bring my BG down. He replied that I am what he and the DEs call an "insulin junkie". He said that I shouldn't chase my BG so much. Really though, what's the difference between that and giving yourself a bolus correction with the pump? I'd rather bring my BG down a bit so I feel better. If I'm between 9 and 12 (mmol/L) I feel terrible and don't really enjoy waiting until my next meal to correct. Anyone experience this reaction from their med team before? Cheers, Shayne

I've never heard that term before and never experienced that reaction from my medical providers either. Luckily my care team likes the bg to be within normal ranges at all times. I do the same thing you do Shayne, and so no - you are not doing anything bizzare.

Maybe you could respond back by telling your doc that in a non-diabetic body if the bg was out of range the body would take proper action on it's own. You just have to intervene when yours is high (or low for that matter). Your doctor at the very least should not be sharing that comment with you even if he does think it, it's incredibly unprofessional regardless of any factors involved.

[Beatrice]

I've found some Dr's, CDE's or nurses put off by diabetics who take responsibility for their disease. It wouldn't matter what information you were to give them, they are cynical, judgemental or shaming (techniques that were used on diabetics in the past). Why can't they just say- good question...how's that working for you...? Mocking your plan of action is unhelpful. My endo is cryptic and sarcastic in a funny way, but he wants the best for me and I can tell him when his comments aren't helpful and it then remains professional. If you have a good MD, he's worth trying to convince you know what you want. When my teenagers were driving, I know the posted speed limit was safe and they knew it was safe, but since I didn't have my own hand on the wheel, I would wish they would be more conservative and drive slower. Those who (care for us) are not filling our syringes or pushing our pump buttons must feel that way. Yes, there is a safe way to never go low, but there is a safe way to not go low and not go too high and have better health.

A lot is put on our own shoulders in managing our daily care. As backward as it may be, it is our responsibility to get our doctors, CEs, etc., to take us seriously and provide good input. They are suppose to be serving us. I just looked at a continuing ed course for Drs, CE on 'Behavior Change Counseling to Improve Adherence to New Diabetes Technology' and I think we all need a counter course to get the most out of our visits with ambivalent health care providers.

Sorry your appointment went like it did on so many levels. Insulin Junkie, what next? For the record, with my pump, I correct all the time...post meals, snacks, just because...and even when I'm sick! I check my BG all the time, I bolus, I boost my basal % all to keep things smooth. I always thought I was more of a Mix Master, but now I find I'm an Insulin Junkie...

Good luck, Shayne and stay safe.

[Dave_]

My last doctor's appointment I told my doctor that once in awhile I take a correction dose in between meals sometimes to bring my BG down. He replied that I am what he and the DEs call an "insulin junkie". He said that I shouldn't chase my BG so much.

Really though, what's the difference between that and giving yourself a bolus correction with the pump? I'd rather bring my BG down a bit so I feel better. If I'm between 9 and 12 (mmol/L) I feel terrible and don't really enjoy waiting until my next meal to correct.

Anyone experience this reaction from their med team before?

Cheers, Shayne

Shayne, I refer to my aggressive correction boluses as "revenge boluses". Feel free to adopt that term for your own use--others have. (IMG:style_emoticons/default/smile.gif)

[lovethepump]

My last doctor's appointment I told my doctor that once in awhile I take a correction dose in between meals sometimes to bring my BG down. He replied that I am what he and the DEs call an "insulin junkie". He said that I shouldn't chase my BG so much.

Really though, what's the difference between that and giving yourself a bolus correction with the pump? I'd rather bring my BG down a bit so I feel better. If I'm between 9 and 12 (mmol/L) I feel terrible and don't really enjoy waiting until my next meal to correct.

Anyone experience this reaction from their med team before?

Cheers, Shayne

Before I was on my pump, especially with my first pregnancy when I was on injections, I was doing correction doses many times/day. My endo calls that "tight control" not "insulin junkie." In a perfect world it is better, obviously, to give the proper dose of insulin to cover the meal, but we all know that can be pretty tough sometimes. I really can't see the reasoning behind waiting until your next meal to bring down your bs, though - to give yourself the correction, wait to eat, retest, etc. makes no sense. My gosh, we would never be able to eat with our family. Sounds like a doctor without diabetes to me.

Just my two cents.
Amy

[Cin]

I think you are doing the right thing by giving correction doses. As long as you are aware of the insulin already in your system and take that into consideration, you should be fine.