when to stop taking insulin?

Bangkokbuddy
By Bangkokbuddy Latest Reply 2014-06-17 06:54:26 -0500
Started 2014-06-07 05:52:35 -0500

hi, my name is jerry. I live in Thailand. I was diagnosed diabetic on june 2, 2014. my first ever glucose count was 552. this thai doctor prescribed me 2 shots of insulin (humulin 70/30 cartridge) each day (40 units breakfast/24 units dinner), and just told me to come back on june 17, 2014 to see how things were coming along. she didn't offer me a phone number to call her. (I'm thinking because she doesn't speak English too well.) anyway, so, today is june 7, 2014. I did as she told. 2 shots a day. and NOW my glucose count is 118. my question to you all is - should I continue with the prescribed dosage? or hold off until I somehow contact the doctor to see what she says? last, I've started getting headaches.


22 replies

Bangkokbuddy
Bangkokbuddy 2014-06-11 22:41:13 -0500 Report

the latest… this morning, I woke up at 7am with my hands trembling. did a quick BG to see what was up. reading was 72. got scared. didn't know what to do. normally I take my morning insulin shot at 10am - breakfast time. so, I pig out on 2 peanut butter and jelly sandwiches, and a couple of small slices of watermelon to take care of my hunger feeling and more importantly bring up my BG. felt better. went back to sleep.

…at 10am, I wake up to do my usual scheduled insulin shot. do BG. it's 236. YIKES! wait 20 minutes. eat a small snack.

any comments?

Pin Cushion
Pin Cushion 2014-06-17 05:26:40 -0500 Report

I like to take glucose tablets for low blood sugar. They each have 4 grams of sugar. Eat 4 of them and 15 minutes later test again.

Bangkokbuddy
Bangkokbuddy 2014-06-17 06:54:26 -0500 Report

over here in Thailand, they don't have glucose tablets available. I spoke to some of the pharmacies here. they said people just take hard candy when the need arises. personally, I find myself getting the trembles when my BG reaches close to 70. I even experienced it at 78. mind you, I've only been diagnosed diabetic for about 2 weeks now. this last time, I took jelly beans for the low BG. I told my doctor what I did, and she said It was the wrong way to deal with it. yeah. I was thinking. well, then.. how should it be handled? her reply was to eat a piece of bread, or drink a glass of milk. quote, "NEVER take sugar." she then told me that I shouldn't be worried until BG is down near 40. to which I thought, "isn't that too late????"

yeah. I switched doctors overnight. lol.

for those of you considering medical tourism here in Thailand or anywhere for that matter.. understand that you may not have the option of malpractice recourse if something "bad" happens. know what I mean?

if you are curious… my new routine… instead of humulin 70/30 cartridge 40 units/breakfast, 24 units/dinner, I'm now on the levenir flexpen 30 units bedtime with cozaar/minidiab/trajenta pills at breakfast. I'm not on obamacare or have any insurance. everything can be had over the counter. my levenir flexpen cost me 700 baht or 23 dollars. I inject my first shot from the levenir tonight before I go to sleep.

Bangkokbuddy
Bangkokbuddy 2014-06-11 07:44:10 -0500 Report

just went below 100 the first time. BG 94. what next? at this rate, thinking of decreasing insulin a little if it BG gets to 80. in my mind, I'm thinking if I can switch from insulin to pills? anybody? next doctors appointment on the 17th.

Pin Cushion
Pin Cushion 2014-06-08 12:39:36 -0500 Report

the insulin you are taking (70/30 mix) is part long-acting (lasts 24 hrs) and part fast-acting (to process carbohydrates consumed in a meal). Something to consider if you skip a dose. If you miss a meal and do not take it you will also reduce the amount in your system through out the rest of the day. If you want to know how a meal affects your sugar test 2 hours after your meal began.

Bangkokbuddy
Bangkokbuddy 2014-06-10 10:27:43 -0500 Report

curious, I did as you suggested today. "test sugar 2 hours after meal". the results.. before dinner BG 116. 2 hours later BG 185.

Pin Cushion
Pin Cushion 2014-06-08 08:31:53 -0500 Report

Hypoglycemia is considered below 70. None of your tests show near that. Your tests look close to normal. But if your system is accustomed to being 500 and all of a sudden you are normal you could experience symptoms of hypoglycemia. Maybe you just need to get used to it. I would not change anything.

Bangkokbuddy
Bangkokbuddy 2014-06-08 10:28:20 -0500 Report

thanks for the response. I skipped one shot. but I'm back on the prescribed dosage. my last glucose count was 108. now that I know the redline to watch out for is 70, I'm not as scared to continue with the insulin.

jayabee52
jayabee52 2014-06-07 11:47:36 -0500 Report

Howdy Jerry
WELCOME to Diabetic connect.
Sorry you qualify for this shindig, but since you do I'm glad you're here!

What could be happening is you are probably having what I call a "false low" My late wife used to have them when her BG (Blood Glucose) was very high for a while then started coming down. She'd have all the symptoms of a hypo, but to measure her BG levels she was above normal with her levels. I agree with the others that 118 mg/dl is a very good BG reading. So as far as continuing your dosage of insulin you may want to back off a bit.

I hate suggesting to you that you should change your insulin dosage without consulting your Dr,

Even though you don't have Dr's tel number, could you look her up in the Bancock yellow pages and consult with her over the phone?

Regarding the length of time for us to reply may be due to the differences in the time zones. If we don't see your discussion because we're sleeping or out living our lives, please don't hold it against us.

God's best to you and yours

James Baker (Las Vegas NV USA — Pacific Time Zone)

wraithmb
wraithmb 2014-06-07 10:43:16 -0500 Report

I find my vision gets blurry or spotty, I get weak and shaky, headaches, and tiredness can be symptoms as well, but as gabby has said, anything above 70 is still good. Ultimately a blood glucose test is the best indication. I know for me a headache will start around 5 or 6 mmol/L (100) but my average previous to the last month was 17 (300). I'm in canada so we use a different scale, so my conversions are probably a bit off, but it gives you a general idea. I think the headaches that I get are a warning from my body that my sugars are dropping…

A word of caution on the aspirin/ OTC painkillers in general, I find that if I take Tylenol my symptoms of low blood sugar aren't as apparent. For that reason I just put up with the headaches as long as I can, and do an extra test between my scheduled ones if they have gotten bad enough that I have taken any painkillers.

Gabby
GabbyPA 2014-06-07 10:05:48 -0500 Report

Getting a 118 is great. If your insulin is working and doing this for you, then you need to keep using it as prescribed. The closer to 100 you get the better it is. So your medication is working. If you find you are going below 70 on a regular basis, you may need to contact your doctor (or one who does speak english well enough to guide you)

If you have fasting numbers between 70-100 that is great. If you have numbers after your meal below 140, you are doing great.

How often do you test?

Bangkokbuddy
Bangkokbuddy 2014-06-07 10:45:06 -0500 Report

hi gabby. thx for responsing. I test at least twice a day. it's only been about 5 days since I started on insulin. the most I tested in one day is 5 times. that was because I was learning how to use the glucose meter. using your advice, I will continue with the prescribed dosage tomorrow. I did skip the insulin before dinner because I was scared.

Gabby
GabbyPA 2014-06-07 13:41:37 -0500 Report

I would not skip a dose, but if you are scared, maybe cut it back a little and then test to see where you are and take the rest if you need to. It is a huge learning curve for sure. All of us react differently and if you have a particularly low carb meal, you may want to use caution. But these are things you really need to talk to your doctor about.

Do you have items in the house to help you if you go below 70? Like juice or glucose tablets? And if you don't live alone, please make sure other people in the house know how to deal with your lows if you might get one.

As you are learning what your body does, you may want to test more. My testing schedule when I first was learning what foods affected me was this:
Fasting before any food in the morning
Then I would test after breakfast
Sometimes I would test before lunch and then 2 hours after
I also would test before and after dinner
Then my final test was before bed.

I don't test that much now, but it helped me see patterns in how my day went. What kind of foods make me spike and what doesn't.

16694343
16694343 2014-06-08 11:59:52 -0500 Report

May 2013 I stopped injecting. Cost became unaffordable. Have been managing ok since. had A1c running high 6's last one was a 7. But medicare quit paying for test strips and Doc wants me to test 3 time a day… Refuse to pay 1.20 per strip.

BogeyGolfer
BogeyGolfer 2014-06-09 16:28:02 -0500 Report

Walmart has the Reli-on prime strips for $9 per 50 strips..You will have to spring for the machine @$15 .. works just fine.

wraithmb
wraithmb 2014-06-07 08:45:00 -0500 Report

Hi jerry, it does take awhile to get a response some days, I understand how frustrating it can be. Your 118 blood sugar is actually pretty normal. I recently started bringing my counts down as well and get headaches too, but they are starting to go away. I personally think it was my body's way of complaining about something being drastically different. The things to really watch for are the low glucose symptoms as they can get bad really quick. Did your doctor go over any of that with you?

Bangkokbuddy
Bangkokbuddy 2014-06-07 09:55:29 -0500 Report

thanks for the response. regarding my doctor.. I don't think she speaks English very well. she didn't go over anything with me except to say that everything is too high. prescribed me (40 units breakfast/24 units dinner). come back for another appointment on june 17, 2014. that was it. being a geek, I went on the internet to educate myself. learned what diet to follow by myself. still a novice. so much I don't know. changing the subject.. I started getting headaches this morning. started right around when I took the 40 units before breakfast. my glucose count was 123. had to take 2 separate aspirin for 2 separate minor headaches since then. (don't hurt, but throb.) I took my last glucose reading 2 hours ago. about the time I first posted. my glucose reading was 112. I didn't inject. it's about 10pm now here in Bangkok. this is 2 hours after dinner. I just now took another glucose reading 126. you mentioned low glucose symptoms.. I will research online now that you mentioned it, but what are they?

4mouseketeers
4mouseketeers 2014-06-10 13:57:56 -0500 Report

Your doctor sounds like mine. And he can speak English. But I think both of us need to see a diabetes specialist. My low glucose symptom is shaking. I probably overdo it in eating to get it raised when that happens. I am not on insulin yet. Pills as of now. I would be happy with a reading of 126.

Bangkokbuddy
Bangkokbuddy 2014-06-07 07:13:23 -0500 Report

nobody is saying anything. so, using my common sense, I've decided to hold off on the next shot. also, thinking of finding another doctor who CAN speak English. this forum seems to be useless for me. my 2 cents.