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Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 20, 2012 04:33PM
I am taking 25 units of Lilly Humulin N about 8 AM. My readings had been averaging 145 - ranging from about 120 to 180. I quit checking regularly during the flu period because I was loaded with sugary cough syrup and there wasn't much I could do but eat proberly. I've started checking twice a day the last dew days.

Now it averages 193 - never below 185. This is even eating only 15 grams of carbs or less per meal. It never goes down during the day, where it used to get lower as the day went on.

I want to get some general knowledge before I see my doctor about this because he doesn't have time to totally fill me in on what I would like to understand.


Here are some thoughts:

I have heard the flu will make it run high. I don't have any scar tissue where I inject. The vial is pretty new and hasn't sat around or got warm. I walked while ago and worked in the yard after meals with less than 5 carbs for breakfast and lunch, but 3 hours after the last meal, it's 195. I've seen several threads where this has happened to people, but didn't get many answers.

Is this one of the many things a diabetic has to deal with from now on?
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: freeradical
Date: October 20, 2012 04:49PM
I'd go to some site like web md for that kind of information instead of coming here.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Stavs
Date: October 20, 2012 05:44PM
Quote
Dennis S
he doesn't have time to totally fill me in on what I would like to understand.

Get a new doctor, or see a specialist. I take control of my diabetes, and if my Dr. cant take the time to fill me in, then I will take my insurance dollars elsewhere.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Jack D.
Date: October 20, 2012 06:16PM
I see a nurse educator/dietician who spends the time with me to teach me what I need to know. Ask to see an educator, your insurance will/should cover it (no co-payment with Tufts for me).



- Jack D.




New tasteless sig coming soon!
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: mrlynn
Date: October 20, 2012 06:28PM
My wife, a physician, says any infection will raise your insulin requirements. Chances are that if they are still up, you still have the infection, and it probably was not 'the flu'. Could be anything, e.g. Lyme disease.

See your doctor and get checked out.

/Mr Lynn
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: bruceko
Date: October 20, 2012 06:53PM
Do you ever make adjustments to your insulin? You might bump it up a little for a few days and see if it drops your levels.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: cbelt3
Date: October 20, 2012 09:54PM
Dennis-
Let me tell you that I'm proud of you for doing some research on your own. The better informed you are from multiple sources, the better your health will be. None of us should depend on our doctor to provide end to end instruction on how to live our lives and maintain our health... such information is available readily all over the place. What you DO depend on is for your doctor to understand YOU, and explain what's wrong from your perspective.

Good luck !
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: ahs
Date: October 20, 2012 10:27PM
I am a diabetic but on different meds than you. The web says your Humulin N is an intermediate long acting insulin. You might need a short acting insulin before each meal in the short run since you had the flu. I wouldn't put off talking to your doctor about your dosage. Also, your meals don't seem balanced. the low carb levels seem too low, imho.



Edited 1 time(s). Last edit at 10/20/2012 10:30PM by ahs.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 20, 2012 11:50PM
Quote
bruceko
Do you ever make adjustments to your insulin? You might bump it up a little for a few days and see if it drops your levels.

No. He hasn't authorized it and was very conservative in increasing the dose to prevent low sugar. I have considered it and haven't ruled it out.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: bruceko
Date: October 20, 2012 11:52PM
Sounds like you should look for a new doctor.
If you are in the Seattle area PM me and I can give the the name of a very good on at the U of W
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 20, 2012 11:59PM
Quote
ahs
I am a diabetic but on different meds than you. The web says your Humulin N is an intermediate long acting insulin. You might need a short acting insulin before each meal in the short run since you had the flu. I wouldn't put off talking to your doctor about your dosage. Also, your meals don't seem balanced. the low carb levels seem too low, imho.

The Humulin N is the first type I've been on. I have to buy it out of my pocket, which is empty. After 23 years of paying for my own insurance, I lost it. So, I get a vial a month from Walmart. It was working pretty good before. I would tailor my food after the first reading to get it lower and lower through the day. Typical was 150 at 8 AM and 125 by suppertime.

The extra low carb meals is to try to get it to break and go lower than the almost constant 190 it has been for 4 days of tests. I used to set a goal of 30 grams per meal which was working great for my sugar and the meals were pretty healthy. I only tried the very low carb meals to try to get it down or prove the insulin wasn't working like it should.

We didn't pick fast acting insulin for meals because I was new to this and didn't think I could hit a moving target yet. I probably could now. I'll ask him about that. I was getting good at tailoring everything to the intermediate insulin and and it's curve and was hoping to bump it up a little more and try to get the test averages under 130.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 12:07AM
Quote
mrlynn
My wife, a physician, says any infection will raise your insulin requirements. Chances are that if they are still up, you still have the infection, and it probably was not 'the flu'. Could be anything, e.g. Lyme disease.

See your doctor and get checked out.

/Mr Lynn

A lingering infection is my "favorite" theory, but I think I had the flu or "bug" of some sort. My niece had it, then my mom, then me. We all spend a lot of time together.

When I took a round of Azithromycin, the fever went away and the cough started getting better - gradually. Then, a round of Amoxicillin didn't seem to help any. I still feel like my ears are infected, so maybe that's it.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 12:13AM
Quote
Jack D.
I see a nurse educator/dietician who spends the time with me to teach me what I need to know. Ask to see an educator, your insurance will/should cover it (no co-payment with Tufts for me).

I don't have insurance or money. I have done this a couple of times and didn't have any luck with the orthodox system. They have you eat too many carbs for it to work with me. I have done lots of reading and talking to people and what works for me is about 30 grams per meal, which is low but not ultra-low. The dietitians' and ADA plans are ridiculously high in carbs. Maybe I will flesh out my rant later.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 12:24AM
Quote
Stavs
Quote
Dennis S
he doesn't have time to totally fill me in on what I would like to understand.

Get a new doctor, or see a specialist. I take control of my diabetes, and if my Dr. cant take the time to fill me in, then I will take my insurance dollars elsewhere.

Sorry, but I didn't mean to speak ill of my doctor. I mean there is so much to know that I will have to learn much of it own my own - I can't just ask him questions all day and there's always something I don't quite understand fully or something I forgot to ask. I agree with cbelt - you must educate yourself. If I just did exactly what the doctors told me with no questions, I would be dead now.

The closest specialist is 2 hours away. I tried that and it doesn't work. This doctor is the first one in many many years who took control and whipped me into shape with a systematized plan with goals. Many others just threw samples or prescriptions or pamphlets at me. I am grateful to him and he's working out well and I'm staying with him.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 12:27AM
Quote
bruceko
Sounds like you should look for a new doctor.
If you are in the Seattle area PM me and I can give the the name of a very good on at the U of W

I'm sorry, but I made it sound like I have problems with the doctor. I didn't say what I meant clearly. I appreciate the offer, but I am in Arkansas. (Maybe that's part of the problem.)
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: riley5108
Date: October 21, 2012 07:39AM
Quote
mrlynn
My wife, a physician, says any infection will raise your insulin requirements. Chances are that if they are still up, you still have the infection, and it probably was not 'the flu'. Could be anything, e.g. Lyme disease.

See your doctor and get checked out.

/Mr Lynn

agree smiley
Good advice!
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Blurb
Date: October 21, 2012 01:14PM
Mr Lynn's post wins: any infection will cause your sugars to increase. Think of it as a red flag to warn you you have an infection somewhere. Yes, there is still something infected in you that needs to be treated properly, despite the 2 prior rounds of antibiotics. So, go see your doctor tomorrow and make sure they check your ears and sinuses and lungs especially, in light of your symptoms. Also, one recommendation: quit the "sugary cough syrups" and use mucinex-dm. It has the same active ingredients, but none of the alcohols and sugar the cough syrups do. And do NOT accept the same antibiotic rx that you have already had (azithromycin or amoxicillin). There are others very cheap that will work well for these needs, like doxycycline or even septa/bactrim (sulfa based).
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 03:56PM
I'm sure I'm still infected. My left ear hurts and pops and I lost 50% of my hearing in it. My lungs still feel wrong. I might ask for a series of 2 or 3 antibiotic prescriptions to try in series until one works unless that is a bad idea. I guess prescribing them is just playing the odds. It will be good if that is what is causing the blood sugar problems because I had such high hopes for the insulin as it was working so well.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: mrlynn
Date: October 21, 2012 04:05PM
Are there free clinics in your area, or are you eligible for Medicaid? Sounds to me (without consulting wife) that you need some workup (blood work, physical exam, maybe chest X-ray, etc.) to determine what's going on, if an infection what germ is responsible, etc. Could be viral, of course, in which case antibiotics won't work. Mono? Pneumonia? Lyme? Maybe a couple of things? Make sure you give the doctor a complete history of this current illness, with all symptoms.

/Mr Lynn
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dick Moore
Date: October 21, 2012 04:58PM
You didn't say if you are a Type 1 or Type 2 diabetic, and this does matter. N insulin has an active range of about 12-14 hours, roughly peaking at about 6-8 hours. It's onset time is quite long, and the ramp-up is slow, so it doesn't help to bring Bg down quickly. So your carb intake at breakfast won't start to get taken care of until after you have lunch -- that lets you Bg build up quite a bit before anything useful happens, then it's just covering your breakfast and not your lunch intake, so you're always playing catch up.

For many years I used a mix of Regular and N taken in the morning before breakfast, and now they package that in a 70/30 (N/reg) mix. This might be more helpful for you, as explained above, and especially now during recovery. I find that my Bg tends to range high long after most of my infection symptoms have ended -- which is happening to me right now as I'm recovering from a sinus infection.

Sorry about your insurance issues -- maybe at some point, depending on many things, like elections, the Affordable Care Act will help a lot.



What it is, man, a low-down and funky feelin'
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 05:27PM
Type 2. Sorry. Aren't you Type 1, Dick? I have a chart on the fridge that has the different activity curves. I was really hopeful, because I was continually adjusting better and better the the N and the doctor was happy with my progress. I have learned to cook good meals with roughly 30 grams of carbs or between 20 and 40 anyway. I am really hopeful it's the infection doing this and that I can knock it out. I was going to ask to take more of the N and get my levels better and better since I pretty much eat where I shouldn't go too low.

When I get back under control, I might try to get fancy with the 70/30 and see how it goes. One good thing is that, so far anyway, I don't dread the shots. It might get worse if I have to take more (I only take one a day) or I get scar tissue or have to use longer needles.

"So your carb intake at breakfast won't start to get taken care of until after you have lunch -- that lets you Bg build up quite a bit before anything useful happens, then it's just covering your breakfast and not your lunch intake, so you're always playing catch up."

I have learned how to keep the breakfast carbs pretty low and the level never goes up too much. After lunch, the insulin seems to be cranking pretty good the rest of the day and even working quite awhile after the chart says it should be through.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 21, 2012 05:34PM
mrlynn, I am working to get into a place not too far off that does tests on a sliding scale. I'm not eligible for Medicaid.

Also, can anyone recommend a good forum? I get frustrated looking for them on dialup. Frankly, after being on this forum with such a high level of intelligence and broad range of expertise, I really don't like other forums that specialize in one topic but are populated with a cross-section of people that... I'll go no further.
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dick Moore
Date: October 22, 2012 03:25PM
Dennis, Type 2 changes the picture a fair amount, and I have no experience in actually dealing with the complicated hormonal interactions that produce this form. Sounds like you were on a good run there before the illness, and your management routine sounds pretty good to me. I think a moderate increase in your dose is called for. You can "titrate" up in 10% steps until you get some relief. Then if and when the problem eases, titrate back down.

Yes I'm Type 1, and take four or five injections daily. I'm a good candidate for a pump, but that's more fooling around than I'm interested in doing, and at age 72, I'm also a little set in my ways.



What it is, man, a low-down and funky feelin'
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Re: Insulin not working since I had the flu 6 weeks ago
Posted by: Dennis S
Date: October 22, 2012 05:10PM
Dick, my Mom has a Medtronic pump and loves it. She got the idea from a boy I know who grew up taking shots from the get-go. He was sickly and clingy (understandably - his mom made several trips to school every day.) He got a pump around age 12 and shot up over 6 feet tall in a few years, swam, played basketball, and totally changed his life. He now has an even smaller Metronic pump.

My mom got hers a little older than you are and is now 82 and going strong. There wasn't much of a problem learning how to use it - just some adjustments at first until it was optimal. I'm taking her to see the guy with the smaller pump to see if she wants one.
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