Liver vs BG's

[Hi_Therre]

For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. Since last fall I've had about 3 oz colby cheese
to reduce the liver dump (1PP breakfast) readings. The graph on the
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.

Loading Image...

The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. Up to maybe a
week ago, the lump dump would drop to <120 at the 2PP mark. Something
is pushing my liver to dump glucose and keep dumping for quite a
while. Or, my insulin resistance has gone through the roof. One day
the liver dump is very explosive, and the next day the dump is almost
nonexistent. Today's dump of 163 is the highest reading I've seen in
a long time.

I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.

I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.

Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.

Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville. There has to be a solution to
controlling the morning explosion of BG's.

_____________________________________________
http://www.tcainternet.com/retired/index.html
Free Diabetic Software

[J. David Anderson]

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings.

Why do you think that what you are experiencing liver dumps? If your
fasting is ok, then the problem is not a liver dump.

Since last fall I've had about 3 oz colby cheese

Post by Hi_Therre
to reduce the liver dump (1PP breakfast) readings.

When are you eating the cheese? As a part of breakfast or the evening
before? With me cheese, because of the high fat content, is slower to
peak and takes longer to drop back, but I don't eat anything to control
fasting BGs, I just exercise before bed. It works quite well.

The graph on the

Post by Hi_Therre
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.
http://wave.prohosting.com/ugleeeee/bg_blowout.jpg
The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. Up to maybe a
week ago, the lump dump would drop to <120 at the 2PP mark. Something
is pushing my liver to dump glucose and keep dumping for quite a
while. Or, my insulin resistance has gone through the roof. One day
the liver dump is very explosive, and the next day the dump is almost
nonexistent. Today's dump of 163 is the highest reading I've seen in
a long time.
I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville.

Yes, you need to see an endo. You are *guessing* at things and this is
not a guessing game. I would see an endo before making any changes other
than perhaps increasing exercise. If I don't exercise in the evening, I
get both a higher fasting reading and higher post prandials the next
day. It might make a difference for you as well.

Regards

David

[Hi_Therre]

On Mon, 04 Oct 2004 01:43:06 +1000, "J. David Anderson"

Post by J. David Anderson

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings.

Why do you think that what you are experiencing liver dumps? If your
fasting is ok, then the problem is not a liver dump.
Since last fall I've had about 3 oz colby cheese

Post by Hi_Therre
to reduce the liver dump (1PP breakfast) readings.

When are you eating the cheese? As a part of breakfast or the evening
before? With me cheese, because of the high fat content, is slower to
peak and takes longer to drop back, but I don't eat anything to control
fasting BGs, I just exercise before bed. It works quite well.

Cheese is my breakfast. For the past year cheese has controlled this
explosion.

Post by J. David Anderson
The graph on the

Post by Hi_Therre
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.
http://wave.prohosting.com/ugleeeee/bg_blowout.jpg
The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. Up to maybe a
week ago, the lump dump would drop to <120 at the 2PP mark. Something
is pushing my liver to dump glucose and keep dumping for quite a
while. Or, my insulin resistance has gone through the roof. One day
the liver dump is very explosive, and the next day the dump is almost
nonexistent. Today's dump of 163 is the highest reading I've seen in
a long time.
I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville.

Yes, you need to see an endo. You are *guessing* at things and this is
not a guessing game. I would see an endo before making any changes other
than perhaps increasing exercise. If I don't exercise in the evening, I
get both a higher fasting reading and higher post prandials the next
day. It might make a difference for you as well.

I generally walk 2 miles in the morning which drives down the BG.
But, for the past few days, the BG's have shown a tendency to stay at
a higher level after I walk the 2 miles. Something inside me is
pushing the liver. Just don't know what.

[Boelkowj]

Bruce: I haven't heard of toxic effects to the liver causing higher BG levels.
I bet it has more to do with your diabetes. Have you tried a different lot # on
your stripps? Have they been frozen lately. Sometimes QC of your strips might
do it. Maybe things will settle down after a month or so. Maybe you need to be
patient for now. Are you exercizing? I good 30 min sweaty workout can knock it
down quite a bit. Easier said then done perhaps. I sort of wonder if you need
to change what you are eating for breakfast as your 1PP may be reflecting that
rather than a liver dump per se.. Good luck..

Larry

[Hi_Therre]

Post by Boelkowj
Bruce: I haven't heard of toxic effects to the liver causing higher BG levels.
I bet it has more to do with your diabetes. Have you tried a different lot # on
your stripps? Have they been frozen lately. Sometimes QC of your strips might
do it. Maybe things will settle down after a month or so. Maybe you need to be
patient for now. Are you exercizing? I good 30 min sweaty workout can knock it
down quite a bit. Easier said then done perhaps. I sort of wonder if you need
to change what you are eating for breakfast as your 1PP may be reflecting that
rather than a liver dump per se.. Good luck..

The meter is not the problem. When BG's start going crazy, I use two
meters on one blood sample to see any correlation between the two.

What I need is a cure to this god damned disease. I've been battling
this morning explosion for about a year. Normally eating cheese for
breakfast subdues the nastiness of the spike, but for the past few
days, the spike has become intolerable at the 160+ mark. If the spike
were more predictable, it could be handled easier. But, the darn
spike is very unpredictable. One day the spike rises to the 100 mark,
and the next couple days it rises to the 160+ mark. Just crazy.

[RK]

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. Since last fall I've had about 3 oz colby cheese
to reduce the liver dump (1PP breakfast) readings. The graph on the
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.

have you ever posted your diet? what have you been eating in the morning?
heh.. usually a liver dump occurs when there is NO food in the body and
the body needs to be refueled..

Post by Hi_Therre
I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.

You shouldn't adjust your oral meds like that without consulting a doctor.
More doesn't always mean better.

Post by Hi_Therre
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.

Well you aren't going to get it with Lantus. That first of all is a Basal
(background) Insulin, and is distributed over 24hrs. It's also available
by prescription only and costs abt $58.00 for 30 days.

Have you increased your exercise? That might help.

Post by Hi_Therre
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.

Its possible. As with anything.

Post by Hi_Therre
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville. There has to be a solution to
controlling the morning explosion of BG's.

A modification in diet and more exercise perhaps?

[Hi_Therre]

Post by RK

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. Since last fall I've had about 3 oz colby cheese
to reduce the liver dump (1PP breakfast) readings. The graph on the
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.

have you ever posted your diet? what have you been eating in the morning?
heh.. usually a liver dump occurs when there is NO food in the body and
the body needs to be refueled..

For breakfast I have about 3 oz colby cheese. For lunch I generally
have chicken and a big salad. For dinner I mostly have just fried
brocolli or something similar. I like to munch on several handfuls of
peanuts during the day. I've tried all sorts of food combinations at
breakfast to control/subdue the explosive dump. Cheese works best,
until a few days ago. Just no easy solutions to this damn disease.

Post by RK

Post by Hi_Therre
I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.

You shouldn't adjust your oral meds like that without consulting a doctor.
More doesn't always mean better.

The GP I'm presently seeing does not impress me. It is like I am
telling him what to do. Two weeks ago at the last appointment, I told
him what tests I wanted done (check cholesterol and kidneys) and that
I wanted Lovastatin. I asked him about deleting glipizide in favor of
metformin ER since glipizide causes premature failure of pancreas beta
cells. He favored the present scheme - regular metformin and
glipizide.

Post by RK

Post by Hi_Therre
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.

Well you aren't going to get it with Lantus. That first of all is a Basal
(background) Insulin, and is distributed over 24hrs. It's also available
by prescription only and costs abt $58.00 for 30 days.

I just guessed with lantus. I doubt insulin is the solution, just an
idea I'm tossing around.

Post by RK
Have you increased your exercise? That might help.

I generally walk 2 miles in the morning and 2 miles at night.

[RK]

Post by Hi_Therre

Post by RK

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. Since last fall I've had about 3 oz colby cheese
to reduce the liver dump (1PP breakfast) readings. The graph on the
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.

have you ever posted your diet? what have you been eating in the morning?
heh.. usually a liver dump occurs when there is NO food in the body and
the body needs to be refueled..

For breakfast I have about 3 oz colby cheese. For lunch I generally
have chicken and a big salad. For dinner I mostly have just fried
brocolli or something similar. I like to munch on several handfuls of
peanuts during the day. I've tried all sorts of food combinations at
breakfast to control/subdue the explosive dump. Cheese works best,
until a few days ago. Just no easy solutions to this damn disease.

3oz of cheese thats it? if thats the case, i can tell you with certainty
that
your liver is dumping because of starvation of the body... thats not enough
to eat... I'm not saying grab the pancakes.. try... 2-3 eggs and 3-4 slices
of
bacon or sausage and 1 slice of toast or even skip the toast .. try a few
combo's
maybe add some fresh fruit with it for vitamins and other nutrients your
missing.

lunch is okay..

dinner, suggest you add some protein into that meal... you need a "meat" of
some
sort, chicken, fish, beef, pork.. because your diabetic doesn't mean you
have to
starve yourself.. theres LOTS of great food combos to eat. veggies are fine
too
add some fruit in there as well. a good well balanced meal will help
control bg's
better then starving yourself. and going on a rollercoaster.

Post by Hi_Therre

Post by RK

Post by Hi_Therre
I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.

You shouldn't adjust your oral meds like that without consulting a doctor.
More doesn't always mean better.

The GP I'm presently seeing does not impress me. It is like I am
telling him what to do. Two weeks ago at the last appointment, I told
him what tests I wanted done (check cholesterol and kidneys) and that
I wanted Lovastatin. I asked him about deleting glipizide in favor of
metformin ER since glipizide causes premature failure of pancreas beta
cells. He favored the present scheme - regular metformin and
glipizide.

heh sorry can't help ya with the oral meds.. but i can totally relate to
having
to tell the doc what needs to be done.. very scary thought.. why I don't
like
discussing it with my GP and only my endo..

my new GP gave me a funny look when I told him I know when my bg is
up in corrilaton to my pain level increases.. I said, whatever, this is why
I
have a endo.. just gimme the damn drugs i request.. lol

Post by Hi_Therre

Post by RK

Post by Hi_Therre
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.

Well you aren't going to get it with Lantus. That first of all is a Basal
(background) Insulin, and is distributed over 24hrs. It's also available
by prescription only and costs abt $58.00 for 30 days.

I just guessed with lantus. I doubt insulin is the solution, just an
idea I'm tossing around.

If a change in diet and exercise dont work, then you might try some Regular
insulin... I know financially you can't afford the fast acting like humalog
and novolog
those are also abt $58 a pop... and only good for 30days.. and if you have a
high
resistance, then you're looking prolly at 2 pops a month.

Regular you can get at wallyworld for $17 a pop.. syringes i've no clue if
you can
get without a script.. those run $22 for 100.. i do NOT suggest getting the
cheap ones
those have more bent ones and bend easier then the more expensive ones.. not
the
thing to skimp on.

Post by Hi_Therre

Post by RK
Have you increased your exercise? That might help.

I generally walk 2 miles in the morning and 2 miles at night.

hmmmm

well good luck.. keep asking.. and trying .. something is bound to work..
but bitching
I know dont help much.. except make your bg go higher.

[Guy]

I suggest you do a search of MHD archives for past post on
"Liver dumps".

I am reasonably sure mine come from the body sensing
"starvation" Some people do think that some diabetic
drugs do damage certain liver functions in some
patients..

Your problem is that there is several issues here. Not easy to
sort out. An "up to date" Endow might be an excellent idea.
Guy

[Hi_Therre]

Post by Guy
I suggest you do a search of MHD archives for past post on
"Liver dumps".
I am reasonably sure mine come from the body sensing
"starvation" Some people do think that some diabetic
drugs do damage certain liver functions in some
patients..
Your problem is that there is several issues here. Not easy to
sort out. An "up to date" Endow might be an excellent idea.
Guy

I call it a liver dump since it is a spike when the food intake is
only cheese. I have excellent control over the BG's except for this
damn morning spike. It just keeps getting the best of me.

[oldal4865]

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. . . .(snip). . .
The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. . . .(snip). . .

Today's dump of 163 is the highest reading I've seen in

Post by Hi_Therre
a long time.

. . .(snip). . .

Post by Hi_Therre
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. . . .(snip). . .
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville. There has to be a solution to
controlling the morning explosion of BG's.

Some comments:

1. Lantus is not a "fast" insulin, it is actually the slowest of the
non-beef type insulins around.. It will do a fine job on your fasting bG,
but only help a bit on any PP bG. How much it helps probably depends on
your level of Insulin Resistance, the number of remaining beta cells, how
much you shoot, and how fast it absorbs in your particular brand of
subcutaneous fat. (In some folks, it will generate a double-dose at 2 to
"N" hours after injection [where N is a number between 2 and 12] ).

Lantus dribbles insulin into your blood slowly. In some folks, it
dribbles for 19 hours after a shot, in other folks, 34 hours, and in yet
other folks, everything in between. If you are one of the slow
absorbers, you get a double dose (yesterday's dose plus today's) for a
while, starting sometime around 2 hours after you shoot.

Take at bedtime to work on morning sugars. It has a ~2 hour lag (YMMV)
before much of anything happens.

2. Any of the "fast" insulins would do a job on that PP explosion if you
used them right. If you used the "slowest of the fast insulins", i.e.
Regular, you would have to shoot early and give it time to work before
eating. The ultra-fast insulins, Humalog, Novolog and Apidra cost
twice as much but don't need much of a lead time before eating.

3. Although Glipizide does come with liver warnings, AFAIK one of the
side effects of liver damage is a build-up of glipizide in the blood so that
a small dose acts like a large dose, i.e. you start having low blood sugar
episodes. Actually, to me, your experience suggests that your liver is
working fine, you just wish it wouldn't work so fine (i.e. dumping too
much glucose at inappropriate times).

I have read that the general T2 condition of high Insulin Resistance will
also cause the liver to become Insulin Resistant. AFAIK, that is one of
the causes of inappropriately timed liver dumps. Metformin fights that
effect, but daily exercise and eliminating abdominal fat does an even better
job. (twice as good by one estimate)

Insulin-in-the-blood suppresses some liver dumps. Injected insulin will
both remove bG and suppress some of the liver dumps at the same time.

4. Keep in mind that Dr Bernstein and Dr. Hayden assert that your beta
stimulator med, Glipizide, acts to accelerate the death of your remaining
beta cells. Dr Bernstein favors prescribing fast and slow insulins instead
of beta stimulators for his patients.

The veterinarians aren't too happy with beta stimulators like Glipizide
either, for about the same reasons that Dr. Hayden discusses in his papers
on amyloid polypeptoids and beta cell death, i.e.

http://www.marvistavet.com/html/body_glipizide.html

". . . .One of the most important cautions with the use of this medication
is that by increasing the release of insulin, glipizide also increases the
secretion of other proteins in the pancreas. It is generally protein
deposition in the pancreas that caused the diabetes mellitus in the first
place, thus the use glipizide may lead to progression of pancreatic
destruction. For this reason, we recommend glipizide as a last resort when
insulin administration cannot be given or for a select few cats who are
sensitive to insulin secretion. . ."

5. Endo's are in short supply. Any doctor who is also a "diabetologist"
would be a great help to you. The CDE at the diabetes centers in your
regional hospitals might have some idea of which docs to approach if you
can't get in to see an Endo. Actually, around here, the CDE do most of
the day-to-day insulin management after some doc decides which prescriptions
to write.

Some phone numbers in your area:

http://diabetesplanner.com/diabetes_education/find_educator.asp?state=AR

Regards
Old Al

[Hi_Therre]

Post by Hi_Therre

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. . . .(snip). . .
The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. . . .(snip). . .

Today's dump of 163 is the highest reading I've seen in

Post by Hi_Therre
a long time.

. . .(snip). . .

Post by Hi_Therre
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. . . .(snip). . .
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville. There has to be a solution to
controlling the morning explosion of BG's.

1. Lantus is not a "fast" insulin, it is actually the slowest of the
non-beef type insulins around.. It will do a fine job on your fasting bG,
but only help a bit on any PP bG. How much it helps probably depends on
your level of Insulin Resistance, the number of remaining beta cells, how
much you shoot, and how fast it absorbs in your particular brand of
subcutaneous fat. (In some folks, it will generate a double-dose at 2 to
"N" hours after injection [where N is a number between 2 and 12] ).
Lantus dribbles insulin into your blood slowly. In some folks, it
dribbles for 19 hours after a shot, in other folks, 34 hours, and in yet
other folks, everything in between. If you are one of the slow
absorbers, you get a double dose (yesterday's dose plus today's) for a
while, starting sometime around 2 hours after you shoot.

I just threw Lantus in the posting since it is the only insulin name I
know. I have no idea what it does other than it is insulin and you
guys mention it a lot.

Post by Hi_Therre
Take at bedtime to work on morning sugars. It has a ~2 hour lag (YMMV)
before much of anything happens.

I used to take the orals in the morning, but in April I saw the
fasting starting to rise to above the 105 mark. So I switched the
glipizide and 2 metformin to bedtime, and now the fastings are in the
60 - 80 range. Since April the explos

Post by Hi_Therre
2. Any of the "fast" insulins would do a job on that PP explosion if you
used them right. If you used the "slowest of the fast insulins", i.e.
Regular, you would have to shoot early and give it time to work before
eating. The ultra-fast insulins, Humalog, Novolog and Apidra cost
twice as much but don't need much of a lead time before eating.
3. Although Glipizide does come with liver warnings, AFAIK one of the
side effects of liver damage is a build-up of glipizide in the blood so that
a small dose acts like a large dose, i.e. you start having low blood sugar
episodes. Actually, to me, your experience suggests that your liver is
working fine, you just wish it wouldn't work so fine (i.e. dumping too
much glucose at inappropriate times).

You hit the nail on the head with this one.

Post by Hi_Therre
I have read that the general T2 condition of high Insulin Resistance will
also cause the liver to become Insulin Resistant. AFAIK, that is one of
the causes of inappropriately timed liver dumps. Metformin fights that
effect, but daily exercise and eliminating abdominal fat does an even better
job. (twice as good by one estimate)
Insulin-in-the-blood suppresses some liver dumps. Injected insulin will
both remove bG and suppress some of the liver dumps at the same time.

Should I be on insulin in the mornings if these explosive liver dumps
continue?

I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

Post by Hi_Therre
4. Keep in mind that Dr Bernstein and Dr. Hayden assert that your beta
stimulator med, Glipizide, acts to accelerate the death of your remaining
beta cells. Dr Bernstein favors prescribing fast and slow insulins instead
of beta stimulators for his patients.
The veterinarians aren't too happy with beta stimulators like Glipizide
either, for about the same reasons that Dr. Hayden discusses in his papers
on amyloid polypeptoids and beta cell death, i.e.
http://www.marvistavet.com/html/body_glipizide.html
". . . .One of the most important cautions with the use of this medication
is that by increasing the release of insulin, glipizide also increases the
secretion of other proteins in the pancreas. It is generally protein
deposition in the pancreas that caused the diabetes mellitus in the first
place, thus the use glipizide may lead to progression of pancreatic
destruction. For this reason, we recommend glipizide as a last resort when
insulin administration cannot be given or for a select few cats who are
sensitive to insulin secretion. . ."
5. Endo's are in short supply. Any doctor who is also a "diabetologist"
would be a great help to you. The CDE at the diabetes centers in your
regional hospitals might have some idea of which docs to approach if you
can't get in to see an Endo. Actually, around here, the CDE do most of
the day-to-day insulin management after some doc decides which prescriptions
to write.
http://diabetesplanner.com/diabetes_education/find_educator.asp?state=AR

Thanks OldAl, I never knew our hospital St Marys had a diabetic class
and CDE's. The GP never mentioned it. That is one major problem with
Arkansas, we have to travel a long way for decent medical support.

[oldal4865]

. . . .(snip). . .
I used to take the orals in the morning, but in April I saw the
fasting starting to rise to above the 105 mark. So I switched the
glipizide and 2 metformin to bedtime, and now the fastings are in the
60 - 80 range. Since April the explos

Post by oldal4865
2. Any of the "fast" insulins would do a job on that PP explosion if you
used them right. If you used the "slowest of the fast insulins", i.e.
Regular, you would have to shoot early and give it time to work before
eating. The ultra-fast insulins, Humalog, Novolog and Apidra cost
twice as much but don't need much of a lead time before eating.
. . .(snip). . .>>
Insulin-in-the-blood suppresses some liver dumps. Injected insulin will
both remove bG and suppress some of the liver dumps at the same time.

Should I be on insulin in the mornings if these explosive liver dumps
continue?
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

By taking glipizide at bedtime, you are stimulating your beta cells to
release extra insulin during the night, perhaps for much of the night.
Hopefully, this technique does not send you too low at 3 a.m. (the time at
which most folks need the minimum amount of insulin).

Folks in my shoes (insulin shooters) are supposed to set our alarms and
test at 3 a.m. when we do anything which might increase our night-time
insulin supply. If you wish to continue the bed time glipizide, I
suggest you test now and then to see what is happening. (Our local endo
doesn't "suggest" during his training sessions. It's more of a look you in
the eye and demand)

My morning effect is very powerful also. I can jump 100 mg/dL between 4 am
and 7 am, and continue drifting up during the rest of the morning unless I
take positive action. Insulin therapy would suppress your morning
explosions but mostly because insulin always works to control bG for any
standard diabetic. It works well for me though I must attempt exercise
after breakfast as much as possible.

If I don't plan exercise, I have to shoot extra insulin and delay eating
after shooting in order to give the insulin a head start. In general,
that's burdensome.

I know a T2 on orals-only who eats breakfast, gets up from the table, and
takes a two-mile walk just about every day of the year. His late morning
bG are fine.

When I first discovered that I would have to shoot insulin, I just about
threw up. However, after the first day, it became trivial. Now one of
my control techniques is to shade my dose to avoid going low (low bG =
feel lousy) , and correct with extra shots later if I guessed wrong.
That means extra shots during the day but, as I said, I now regard
injections as trivial (as do most regular shooters).

The blood test hurts more! When you get really good at it, you can
actually perform an injection which is so painless that you have to stare at
the syringe to make certain you actually got everything right. When I
eat in restaurants, I inject through my clothes and therefore must use a
non-pain-free technique to make certain that the needle went where it was
supposed to go.

Regards
Old Al

[Jefferson]

Post by oldal4865

Post by Hi_Therre
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

As it has been said frequently on the diabetes newsgroups, it doesn't
hurt as much as pricking your fingers for blood glucose tests. I have
found that if I feel more pain, it is not a good place to inject. I now
do not force the needle until after it breaks the skin. Needles are
coated with silicon to make the easier to insert.

Post by oldal4865
If I don't plan exercise, I have to shoot extra insulin and delay eating
after shooting in order to give the insulin a head start. In general,
that's burdensome.

I injected 6 units of NPH one day last week at 10:30 AM and then went
mall walking for about 45 minutes. My blood glucose dropped to 62 mg/dl
by the time I got home to eat lunch. I expected the NPH to have a
slower reaction time. The exercise and insulin injection can be tricky.
It could be that the insulin in the vial was becoming more like regular
since there was not that much left in it. A t2 that is not insulin
dependent is different than a t1 when it comes to balancing things out.

Frank

[oldal4865]

Jefferson wrote in message ...

Post by Jefferson

Post by Hi_Therre
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

. . .(snip). . ..

I injected 6 units of NPH one day last week at 10:30 AM and then went
mall walking for about 45 minutes. My blood glucose dropped to 62 mg/dl
by the time I got home to eat lunch. I expected the NPH to have a
slower reaction time. The exercise and insulin injection can be tricky.
It could be that the insulin in the vial was becoming more like regular
since there was not that much left in it. . . .(snip). . .
Frank

Erratic NPH absorbence is a common complaint among NPH users. There
are worse NPH surprise stories out there, many of which involve waking up
surrounded by the EMS personnel who are working on you.

I sit in at a Pumpers Support Group Meeting. More than half of the
folks switched to pumping because for them, NPH was fast one day, slow the
next, and in general, full of surprises. Surprise-hypos are a lot
less welcome than Surprise checks-in-the-mail.

Regards
Old Al

[Hi_Therre]

Post by Jefferson

Post by oldal4865

Post by Hi_Therre
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

As it has been said frequently on the diabetes newsgroups, it doesn't
hurt as much as pricking your fingers for blood glucose tests. I have
found that if I feel more pain, it is not a good place to inject. I now
do not force the needle until after it breaks the skin. Needles are
coated with silicon to make the easier to insert.

Post by oldal4865
If I don't plan exercise, I have to shoot extra insulin and delay eating
after shooting in order to give the insulin a head start. In general,
that's burdensome.

I injected 6 units of NPH one day last week at 10:30 AM and then went
mall walking for about 45 minutes. My blood glucose dropped to 62 mg/dl
by the time I got home to eat lunch. I expected the NPH to have a
slower reaction time. The exercise and insulin injection can be tricky.
It could be that the insulin in the vial was becoming more like regular
since there was not that much left in it. A t2 that is not insulin
dependent is different than a t1 when it comes to balancing things out.

I am well aware that insulin useage is not a big deal. I'm just
venting at something since trying to control these morning explosions
are driving me up a wall without a consistent solution. I've been
through this before and solved it each time. But, this time the
explosions are nastier and more unpredictable than before. I will
also solve this, but at this point, I can't find the right combination
of whatever. Just takes time. And, boy do I like to bitch and
grumble. How I hate this god damned disease.

_____________________________________________
http://www.tcainternet.com/retired/index.html
Free Diabetic Software

[JHA]

Hi_Therre wrote:


boy do I like to bitch and grumble

Go ahead! That's what "support" is all about!

While we're grumbling WHEN WILL THEY GET THE DAMN GLUCOWATCH OR
SOMETHING LIKE IT WORKING? I WANT CONTINUOUS MONITORING!!!!!!!!!!!!!!

(Now that's high up on my "magic" list.

[Guy]

Post by JHA
boy do I like to bitch and grumble
Go ahead! That's what "support" is all about!
While we're grumbling WHEN WILL THEY GET THE DAMN GLUCOWATCH OR
SOMETHING LIKE IT WORKING? I WANT CONTINUOUS MONITORING!!!!!!!!!!!!!!
(Now that's high up on my "magic" list.

I have been screaming for years. Nothing yet. There
was one in Europe but silence recently. Will someone update
us. I am a bit paranoid but if strip cost was about three cents each
we might see one soon. Don't hold your breath. A digital record and
the proper software would be a big advance. That is if
the docs will use such a system.

I spent years trying to sell an automated classroom where the
student gave the instructor instant feedback. The pros
found every excuse to not accept it. it would give immediate
feedback on the instructors effectiveness.

I think a lot could be done with a digitized continuous record to
cure the WAGS.

[M***@AOL.com]

Post by Guy

Post by JHA
boy do I like to bitch and grumble
Go ahead! That's what "support" is all about!
While we're grumbling WHEN WILL THEY GET THE DAMN GLUCOWATCH OR
SOMETHING LIKE IT WORKING? I WANT CONTINUOUS MONITORING!!!!!!!!!!!!!!
(Now that's high up on my "magic" list.

I have been screaming for years. Nothing yet. There
was one in Europe but silence recently. Will someone update
us. I am a bit paranoid but if strip cost was about three cents each
we might see one soon. Don't hold your breath. A digital record and
the proper software would be a big advance. That is if
the docs will use such a system.
I spent years trying to sell an automated classroom where the
student gave the instructor instant feedback. The pros
found every excuse to not accept it. it would give immediate
feedback on the instructors effectiveness.
I think a lot could be done with a digitized continuous record to
cure the WAGS.

Who gives a shit what you think. Why not live in the 21st century
instead of the century past?

[Hi_Therre]

Post by oldal4865

. . . .(snip). . .
I used to take the orals in the morning, but in April I saw the
fasting starting to rise to above the 105 mark. So I switched the
glipizide and 2 metformin to bedtime, and now the fastings are in the
60 - 80 range. Since April the explos

Post by oldal4865
2. Any of the "fast" insulins would do a job on that PP explosion if you
used them right. If you used the "slowest of the fast insulins", i.e.
Regular, you would have to shoot early and give it time to work before
eating. The ultra-fast insulins, Humalog, Novolog and Apidra cost
twice as much but don't need much of a lead time before eating.
. . .(snip). . .>>
Insulin-in-the-blood suppresses some liver dumps. Injected insulin will
both remove bG and suppress some of the liver dumps at the same time.

Should I be on insulin in the mornings if these explosive liver dumps
continue?
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

By taking glipizide at bedtime, you are stimulating your beta cells to
release extra insulin during the night, perhaps for much of the night.
Hopefully, this technique does not send you too low at 3 a.m. (the time at
which most folks need the minimum amount of insulin).

Glipizide by itself reduced the fastings very little. The two
metformin at bedtime push the fastings down to about 65 - 80 range.
The GP likes the idea of glipizide at night, but he is concerned that
the merformin at night may give me hypos at night. But, so far, no
hypos. Since I also have chronic back problems, I probably would not
be able to discern the difference between a hypo and back problems. A
pinched nerve can fire off in many directions and symptons. It can be
a real bitch.

Post by oldal4865
Folks in my shoes (insulin shooters) are supposed to set our alarms and
test at 3 a.m. when we do anything which might increase our night-time
insulin supply. If you wish to continue the bed time glipizide, I
suggest you test now and then to see what is happening. (Our local endo
doesn't "suggest" during his training sessions. It's more of a look you in
the eye and demand)

You mean test at bedtime and at 3 AM? I've tested at 8 PM
sporatically recently to see if I was having BG explosions at times
other than in the morning. I think the BG's < 100. I don't remember
ever testing during the nightime, never saw any reason for it.

Post by oldal4865
My morning effect is very powerful also. I can jump 100 mg/dL between 4 am
and 7 am, and continue drifting up during the rest of the morning unless I
take positive action. Insulin therapy would suppress your morning
explosions but mostly because insulin always works to control bG for any
standard diabetic. It works well for me though I must attempt exercise
after breakfast as much as possible.

Insulin would definitely resolve the problem. But, it would also
create a bigger problem. The explosion does not always occur. Or,
the explosion is not that bad. The darn thing is all over the map.
There is no telltale sign when to use insulin or in what quantity. If
I used insulin and no explosion, I may end up with a nasty hypo and a
trip to the ER. I have now added a metformin at breakfast. Will see
if that will help reduce the explosions. Damn disease.

Post by oldal4865
If I don't plan exercise, I have to shoot extra insulin and delay eating
after shooting in order to give the insulin a head start. In general,
that's burdensome.
I know a T2 on orals-only who eats breakfast, gets up from the table, and
takes a two-mile walk just about every day of the year. His late morning
bG are fine.

I do the same, but no can do if my back hurts like a bitch. Then
comes the explosion. No simple solution.

Post by oldal4865
When I first discovered that I would have to shoot insulin, I just about
threw up. However, after the first day, it became trivial. Now one of
my control techniques is to shade my dose to avoid going low (low bG =
feel lousy) , and correct with extra shots later if I guessed wrong.
That means extra shots during the day but, as I said, I now regard
injections as trivial (as do most regular shooters).
The blood test hurts more! When you get really good at it, you can
actually perform an injection which is so painless that you have to stare at
the syringe to make certain you actually got everything right. When I
eat in restaurants, I inject through my clothes and therefore must use a
non-pain-free technique to make certain that the needle went where it was
supposed to go.

Isulin is in my future, but not something I yearn for.

The best solution to the problems you and I face is not to get
diabetes in the first place. There are no easy solutions to this damn
disease.

[None Given]

Post by Hi_Therre
You mean test at bedtime and at 3 AM? I've tested at 8 PM
sporatically recently to see if I was having BG explosions at times
other than in the morning. I think the BG's < 100. I don't remember
ever testing during the nightime, never saw any reason for it.

Here's a reason to try it.
from:
http://www.faqs.org/faqs/diabetes/faq/part2/
Subject: Why is my morning bg high? What are dawn phenomenon, rebound,
and Somogyi effect?

This section is written by Charles Coughran <ccoughran(AT)ucsd.edu>.

There are three main causes of high morning fasting bg. In decreasing order
of
probability they are insufficient insulin, dawn phenomenon, and Somogyi
effect (aka rebound). Insufficient or waning insulin is simple. If the
effective duration of intermediate or long acting insulin ends sometime
during the night, the relative level of circulating insulin will be too low,
and your blood sugars will rise.

Dawn phenomenon refers to increased glucose production and insulin
resistance
brought on by the release of counterregulatory hormones in the early morning
hours near waking. It happens in normal people as well as in diabetics; in
nondiabetics it shows up as measurably increased insulin secretion around
dawn. Dawn phenomenon is variable in strength both within the population and
over time in individuals. It can show up as either high fasting glucose
levels or an increased insulin requirement to cover breakfast compared to
equivalent meals at other times of day.

Somogyi effect refers to a rebound in bg after nocturnal hypoglycemia which
occurs during sleep with the patient not experiencing any symptoms. The
hypoglycemia triggers the release of counterregulatory hormones. Somgoyi
effect appears to be less prevalent than previously thought. While it does
occur, some episodes of hyperglycemia following hypoglycemia are actually
waning insulin levels following an insulin peak with medium acting insulin.
This can be difficult to sort out.

The best way to sort it out is to test every couple of hours from bedtime to
morning.

If your bg rises all, or much of the night, it is a lack of circulating
insulin.

If it is stable all night, but rises sharply sometime before you wake in
the morning, it is dawn phenomenon.

If your bg declines to the point of a hypoglycemic reaction, it is
*possibly* Somogyi effect.

You may have to test on several nights to nail the problem. Once you have
figured out the problem you and your doctor can discuss changes in your
insulin regimen to correct it. The answer depends critically on your
particular circumstances.

Mayer Davidson, in _Diabetes Mellitus: Diagnosis and Treatment_ (p 252 in
the
3rd edition) says that Somogyi effect rarely causes fasting hyperglycemia,
and cites studies.

[Guy]

Post by Hi_Therre
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

Worry about the other aspects of insulin but
the injection process becomes routine very
quickly. Any routine may crimp some life styles.

Just get competent advice on insulin startup.
Go slow and work your way up. You seem to
be one that can manage your situation Old
Al is a great source of info.

[Hi_Therre]

Post by Guy

Post by Hi_Therre
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

Worry about the other aspects of insulin but
the injection process becomes routine very
quickly. Any routine may crimp some life styles.
Just get competent advice on insulin startup.
Go slow and work your way up. You seem to
be one that can manage your situation Old
Al is a great source of info.

In the 2.5 years since DX, this damn disease has thrown me in a
thousand different directions. Each time, I've beat the damn Bastard
and I maintained control. I will again beat this God Damned Bastard.
The only difference between the recent explosions and prior
explosions, is they are presently more explosive and more
unpredictable. I don't like to lose.

[JHA]

I took Lantus at bedtime for a while to try and stop the really bad
morning spike I had. It did, but it also kept knocking me into
hypoglycemia in the middle of the night.

Now I'm on 3-5 units of Humalog at breakfast and at lunch. I've been
really pleased.

If you've never used insulin before, tyou might be pleasantly suprised
when you start. ("Pleasantly surprised" = "not as bad as you
expected.") Insulin needles are very thin--when I started I kept
bending the needle when I stuck it into the insulin vial!.

Sometimes when I inject I feel no pain at all and can barely tell
anything is happening. Sometimes it hurts enough to trigger a "darn!"
(rarely everything stronger).

If I could change things by magic, the pain from insulin injections
would be way down on my list--even below the pain from finger sticks,
and that's not all that high for me.

YMMV of course.

Post by Hi_Therre

Post by Hi_Therre

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. . . .(snip). . .
The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. . . .(snip). . .

Today's dump of 163 is the highest reading I've seen in

Post by Hi_Therre
a long time.

. . .(snip). . .

Post by Hi_Therre
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. . . .(snip). . .
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville. There has to be a solution to
controlling the morning explosion of BG's.

1. Lantus is not a "fast" insulin, it is actually the slowest of the
non-beef type insulins around.. It will do a fine job on your fasting bG,
but only help a bit on any PP bG. How much it helps probably depends on
your level of Insulin Resistance, the number of remaining beta cells, how
much you shoot, and how fast it absorbs in your particular brand of
subcutaneous fat. (In some folks, it will generate a double-dose at 2 to
"N" hours after injection [where N is a number between 2 and 12] ).
Lantus dribbles insulin into your blood slowly. In some folks, it
dribbles for 19 hours after a shot, in other folks, 34 hours, and in yet
other folks, everything in between. If you are one of the slow
absorbers, you get a double dose (yesterday's dose plus today's) for a
while, starting sometime around 2 hours after you shoot.

I just threw Lantus in the posting since it is the only insulin name I
know. I have no idea what it does other than it is insulin and you
guys mention it a lot.

Post by Hi_Therre
Take at bedtime to work on morning sugars. It has a ~2 hour lag (YMMV)
before much of anything happens.

I used to take the orals in the morning, but in April I saw the
fasting starting to rise to above the 105 mark. So I switched the
glipizide and 2 metformin to bedtime, and now the fastings are in the
60 - 80 range. Since April the explos

Post by Hi_Therre
2. Any of the "fast" insulins would do a job on that PP explosion if you
used them right. If you used the "slowest of the fast insulins", i.e.
Regular, you would have to shoot early and give it time to work before
eating. The ultra-fast insulins, Humalog, Novolog and Apidra cost
twice as much but don't need much of a lead time before eating.
3. Although Glipizide does come with liver warnings, AFAIK one of the
side effects of liver damage is a build-up of glipizide in the blood so that
a small dose acts like a large dose, i.e. you start having low blood sugar
episodes. Actually, to me, your experience suggests that your liver is
working fine, you just wish it wouldn't work so fine (i.e. dumping too
much glucose at inappropriate times).

You hit the nail on the head with this one.

Post by Hi_Therre
I have read that the general T2 condition of high Insulin Resistance will
also cause the liver to become Insulin Resistant. AFAIK, that is one of
the causes of inappropriately timed liver dumps. Metformin fights that
effect, but daily exercise and eliminating abdominal fat does an even better
job. (twice as good by one estimate)
Insulin-in-the-blood suppresses some liver dumps. Injected insulin will
both remove bG and suppress some of the liver dumps at the same time.

Should I be on insulin in the mornings if these explosive liver dumps
continue?
I know that insulin is in my future, but I dread the thought of
sticking myself with that damn needle.

Post by Hi_Therre
4. Keep in mind that Dr Bernstein and Dr. Hayden assert that your beta
stimulator med, Glipizide, acts to accelerate the death of your remaining
beta cells. Dr Bernstein favors prescribing fast and slow insulins instead
of beta stimulators for his patients.
The veterinarians aren't too happy with beta stimulators like Glipizide
either, for about the same reasons that Dr. Hayden discusses in his papers
on amyloid polypeptoids and beta cell death, i.e.
http://www.marvistavet.com/html/body_glipizide.html
". . . .One of the most important cautions with the use of this medication
is that by increasing the release of insulin, glipizide also increases the
secretion of other proteins in the pancreas. It is generally protein
deposition in the pancreas that caused the diabetes mellitus in the first
place, thus the use glipizide may lead to progression of pancreatic
destruction. For this reason, we recommend glipizide as a last resort when
insulin administration cannot be given or for a select few cats who are
sensitive to insulin secretion. . ."
5. Endo's are in short supply. Any doctor who is also a "diabetologist"
would be a great help to you. The CDE at the diabetes centers in your
regional hospitals might have some idea of which docs to approach if you
can't get in to see an Endo. Actually, around here, the CDE do most of
the day-to-day insulin management after some doc decides which prescriptions
to write.
http://diabetesplanner.com/diabetes_education/find_educator.asp?state=AR

Thanks OldAl, I never knew our hospital St Marys had a diabetic class
and CDE's. The GP never mentioned it. That is one major problem with
Arkansas, we have to travel a long way for decent medical support.

[Hi_Therre]

Post by JHA
I took Lantus at bedtime for a while to try and stop the really bad
morning spike I had. It did, but it also kept knocking me into
hypoglycemia in the middle of the night.
Now I'm on 3-5 units of Humalog at breakfast and at lunch. I've been
really pleased.
If you've never used insulin before, tyou might be pleasantly suprised
when you start. ("Pleasantly surprised" = "not as bad as you
expected.") Insulin needles are very thin--when I started I kept
bending the needle when I stuck it into the insulin vial!.
Sometimes when I inject I feel no pain at all and can barely tell
anything is happening. Sometimes it hurts enough to trigger a "darn!"
(rarely everything stronger).
If I could change things by magic, the pain from insulin injections
would be way down on my list--even below the pain from finger sticks,
and that's not all that high for me.

Magic and a Wish List is something we all need. I wish I didn't have
this damned disease. It's causing problems I never dreamed I would
have. This mornings Fasting = 45, yikkkkkkkkkkkkkkes.

_____________________________________________
http://www.tcainternet.com/retired/index.html
Free Diabetic Software

[Alan]

Post by Hi_Therre
For about the past two weeks I've seen a steady rise in my morning
BG's. The Fastings are always good. But, the 1PP breakfast is where
the trouble begins. The 1PP breakfast readings is what I call my
Liver Dump readings. Since last fall I've had about 3 oz colby cheese
to reduce the liver dump (1PP breakfast) readings. The graph on the
URL below shows my fastings vs liver dump (1PP breakfast) readings for
the past 90 days. I've been battling this liver dump problem since
last fall. My last A1c was 4.7, so the effects of the liver dump has
had a negligible effect on the overall BG's. But, that was before the
recent explosion in morning BG's.
http://wave.prohosting.com/ugleeeee/bg_blowout.jpg
The problem is for about the recent rise in liver dump readings have
risen dramatically to an alarming level. The worst part is that they
are staying above the 120 mark for up to 3PP breakfast. Up to maybe a
week ago, the lump dump would drop to <120 at the 2PP mark. Something
is pushing my liver to dump glucose and keep dumping for quite a
while. Or, my insulin resistance has gone through the roof. One day
the liver dump is very explosive, and the next day the dump is almost
nonexistent. Today's dump of 163 is the highest reading I've seen in
a long time.
I take 2 metformin and one Glipizide ER at bedtime to drive down the
morning fastings. This morning I added one metformin to see if it
will drive down the liver dump. If it doesn't work, I will just keep
increasing the morning orals until I max everything out. I've been
through this rise numerous times before, but, never to this level of
BG's.
I'm looking for a more definitive solution to the unpredicability of
this damn liver dump. What is I added a fast acting insulin like
Lantus just prior to eating breakfast? If the dump explodes, the
lantus should bring it down pretty quick. But, if the dump does not
explode, the Lantus may put be in a hypo and send me on a quick trip
to the ER. The liver dump is so unpredictable there is no easy
straight forward solution to controlling its nastiness. I'm running
out of solutions. I don't like seeing BG's exceed 100.
Could the orals I take and diabetes have damaged my liver? This idea
is quite scary.
Should I see an Endo? There are none in town. The closest Endo is
probably in Little Rock or Fayettville. There has to be a solution to
controlling the morning explosion of BG's.
_____________________________________________
http://www.tcainternet.com/retired/index.html
Free Diabetic Software

Hi Bruce

I'll just add these for my .02c:

1. Go for a walk or some other exercise after breakfast.
2. Time to try a different breakfast - can still be low-carb without
being cheese.
3. See the endo.

Good luck

Cheers, Alan, T2 d&e, Australia.
Remove weight and carbs to email.

[Hi_Therre]

On Mon, 04 Oct 2004 07:28:13 +1000, Alan

Post by Alan
Hi Bruce
1. Go for a walk or some other exercise after breakfast.

A good portion of the time my back hurts.

Post by Alan
2. Time to try a different breakfast - can still be low-carb without
being cheese.

I've tried every food imaginable. The fat in the cheese seems to work
the best.

Post by Alan
3. See the endo.

None in the area. Closest one is about 100 miles away.