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From: Trish on 16 Jul 2008 15:02
I'm a thirty six year old woman newly diagnosed with Type 1. My doctor has
me on 7u of NPH at bedtime and 2 to 3 units of Humalog to cover meals. I've
just been reading horror tales of NPH and wondering what on earth these
seizures are all about!?! Also I'm very concerned with weight gain. I've
been a steady 135 for a number of years, run 15 km a week and have always
taken my health very seiously. I am scared that this new insulin regime is
going to cause me weight gain. Are there insulins that are better for weight
control than others?
Any discussion of these facts would be very helpful.

From: Robert Miles on 16 Jul 2008 16:19

"Trish" <u44880(a)uwe> wrote in message news:873f0bfa834b5(a)uwe...
> I'm a thirty six year old woman newly diagnosed with Type 1. My doctor
> has
> me on 7u of NPH at bedtime and 2 to 3 units of Humalog to cover meals.
> I've
> just been reading horror tales of NPH and wondering what on earth these
> seizures are all about!?! Also I'm very concerned with weight gain. I've
> been a steady 135 for a number of years, run 15 km a week and have always
> taken my health very seiously. I am scared that this new insulin regime
> is
> going to cause me weight gain. Are there insulins that are better for
> weight
> control than others?
> Any discussion of these facts would be very helpful.
>
I've seen more diabetics over on newsgroup alt.support.diabetes,
including a frequent poster with type 1.

I'm type 2 and not using insulin, so I can't offer much help with your
problems.


From: Tom on 16 Jul 2008 18:30
On 16 Jul, 20:02, "Trish" <u44880(a)uwe> wrote:
> I'm a thirty six year old woman newly diagnosed with Type 1.  My doctor has
> me on 7u of NPH at bedtime and 2 to 3 units of Humalog to cover meals.  I've
> just been reading horror tales of NPH and wondering what on earth these
> seizures are all about!?!  Also I'm very concerned with weight gain.  I've
> been a steady 135 for a number of years, run 15 km a week and have always
> taken my health very seiously.  I am scared that this new insulin regime is
> going to cause me weight gain.  Are there insulins that are better for weight
> control than others?
> Any discussion of these facts would be very helpful.

Hi Trish

Over many years I have been on (and off) NPH. As I write this, I am
back on NPH and have been for almost a year. I have been very
fortunate that anytime I have it as my medication I have never
suffered seizures etc. It can be a little unpredictable though, so
keeping a careful and constant eye on your sugar levels is important.

Seizures can occur when your sugar level drops to a very, very low
level. Any insulin can cause that though, not just NPH

Some people dislike NPH very much because if its unpredictability and
I fully understand that. I have been fortunate with it though and you
might be too.

If I can recommend anything it is to monitor your sugar levels closely
and get to know the insulin and how it works for YOU. If you wish to
stop using it then perhaps discuss your fears with your doctor and he
may suggest something like Levemir or Lantus as an alternative.

Tom
From: Alan Mackenzie on 17 Jul 2008 07:28
Trish <u44880(a)uwe> wrote:
> I'm a thirty six year old woman newly diagnosed with Type 1.

Sorry to hear that. Most important thing: DON'T PANIC!!! But you're not
doing that anyway.

> My doctor has me on 7u of NPH at bedtime and 2 to 3 units of Humalog
> to cover meals.

That's a very low dosage. For comparison, I'm taking about 45 units of
insulin per day. I've been T1 for 42 years. Probably your body is
still producing some insulin, just not enough.

> I've just been reading horror tales of NPH and wondering what on earth
> these seizures are all about!?!

They're about low blood sugar, technically know as hypoglycaemia. As BS
(the B stands for "blood" here, not "bull" ;-) sinks from the ideal
(~100), you get to a threshold, perhaps 50, perhaps 20, where the brain
stops working properly. Go much lower, and you can become unconscious.
It's really not very nice. What then happens is that the liver kicks
in, releasing massive amounts of glucose into the blood, and you wake
up with a ghastly headache, feeling generally unwell and delicate.

You really ought to get symptoms as BS drops below that critical point.
Some people (amongst them me) don't get decent symptoms when using NPH.
Although NPH supposedly works ~24 hours, for me it gave up after 7. The
other problem is that it can have a massive peak effect after ~5 hours.
I don't use NPH anymore (phew!). Apparently, though, it's fine for some
people.

You also ought to get some experience of a hypo - not an extreme one,
just one where you perhaps "accidentally" put in more than 2 or 3
Humalog, but in safe circumstances. You should get the symptoms and be
able to respond by swallowing glucose or sugar in some form.

> Also I'm very concerned with weight gain. I've been a steady 135 for
> a number of years, ....

What we would call 9 stone 9 pound in Britain, or 62 kg. in Germany.
"have been" 135. Does that mean your weight's been creeping up beyond
that in the last few days/weeks?

> ,.... run 15 km a week and have always taken my health very seriously.

Is that an "I have run (up till now)" or an "I (still) run"? It should
be the latter. But know what a hypo feels like (see above) and be ready
to handle it.

> I am scared that this new insulin regime is going to cause me weight
> gain. Are there insulins that are better for weight control than
> others?

Not really. You'll gain weight by eating more than you exercise off,
just like anybody else. In fact, you'll probably gain weight as you
approach middle-age, again just like anybody else. But, hey, that's a
few years off for you yet!

The trick is that you have to learn to adjust your insulin dose to fit
your life. If you're gaining weight, that means you're eating too much,
or exercising too little, so you'd cut your insulin dose so as to be
able to eat less or exercise more.

Sorry to say this, but your body will be giving up producing insulin
completely in the near future (maybe within 1 or 2 years, I don't really
know), so you'll have to inject a lot more. But you must take control
of this - your doctor must be relegated to the role of junior partner.

> Any discussion of these facts would be very helpful.

Best of luck. And, DON'T PANIC!!!

--
Alan Mackenzie (Nuremberg, Germany).

From: bgl on 17 Jul 2008 10:28
> Trish <u44880(a)uwe> wrote:
>
>> ,.... run 15 km a week and have always taken my health very seriously.

"Alan Mackenzie" <acm(a)colin2.muc.de> wrote in message
news:g5nadj$29dd$1(a)colin2.muc.de...
> Is that an "I have run (up till now)" or an "I (still) run"? It should
> be the latter. But know what a hypo feels like (see above) and be ready
> to handle it.
>

If you are still running, you may have to (if you don't already) learn to
carry stuff with you -- like your meter & glucose tablets, especially on
longer runs or if you are going more than a block or two away from home.
And learn to "test on the road" on long workouts as you learn how *your*
body
responds, as well as before & after runs. *Always* be ready with some
glucose source, as exercise can unpredictably suck up whatever's on board.

If you read articles about diabetic athletes, you can learn about how they
adjust their insulin & eating & "game day" routines & get some good ideas
you can use.
bj



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