On Day 3, I got to the DRI and went for my vitals.
After I got to the classroom, we were quickly put into our divided groups. We evaluated the transparencies from the night and day before to see if the changes the CDE’s and endos made worked for us. Well, that one little change of my basal rate completely turned my numbers into a good looking range of numbers over night. I could not believe it. I went from ranging in the 180s-200s to 120s. Totally unbelievable! If you don’t believe me, check this out:
If you look at Friday @ 4 pm that's when they changed my basal rate to 1.0 for 24 hours. At 7 pm, my number was already at 108 and I had Cheesecake Factory for dinner, too! It may have been because I corrected my high at 4 pm when I was at 240, but if you look at all of Friday night into Saturday, you can see how more stable my blood sugars became at a 1.0 basal rate.
After looking at all of the transparencies, I was in complete amazement of how everyone’s blood sugars were so different than when we first got there two days prior.
Granted we were doing it all day long and had people to answer any question we had for 8 hours straight for 5 days, but that's besides the point!
We finished going over the transparencies and then returned to our main group of 9 members. We had a session on altering the rate of insulin absorption; the fastest insulins are Novolog, Humalog and Apidra, which enter the blood stream quickly, and are used in insulin pumps. For people that use injections, they use fast acting insulins plus an intermediate by combining regular insulin with NPH. There is also Lantus, which lasts for 24 hours with no peak. For people that use Lantus insulin and have the dawn phenomenon, you can use NPH to control your higher blood sugars in the mornings. Something I never knew until this class. We were told that when using rapid acting and longer acting insulins together it is important that you inject immediately since the additives of longer acting insulins could slow the absorptions of rapid acting insulins. The amount of insulin you inject can alter the peak time and duration of insulin action. So, lets say you inject 5 units of regular insulin with your NPH of 20 units. In this case, you will have an earlier peak and still have NPH on board. Depending on where you inject your insulin, you can also affect insulin absorption. The fastest and most consistent place to inject is in your stomach, then arms, thighs and butt. Insulin injected into areas that have more blood supply (deeper areas of the body) have better absorption. So, for instance, if you use regular insulin and want it to be absorbed as fast as Humalog or Novolog, inject it into your muscle in the forearm or in the calf.