Flat line, but that's not the point

I had my first appointment at a new endo group since my previous endo passed away. One of the new patient forms they asked I sign was my consent to be seen by a Nurse Practitioner. I did not sign the form. If I wanted to see a Nurse Practitioner, I would have made my appointment with the Nurse Practitioner.


@Chris, I have read that many low carbers end up with giant spikes for 2-3 days when they switch back to a regular carb mode, then settle down again. Possibly this is what is hitting you?

I found this to be very informative:http://www.diabetes-symposium.org/index.php?menu=view&source=authors&sourceid=49&id=322.

It’s a pretty good overall review of what’s considered normal BG in healthy subjects. What I found enlightening were:

  1. Glucose excursions during daytime range from 55-160 mg/dl while night time tissue glucose is very stable.
  2. Tmax after a meal is around 45 minutes.

There are other good information in the presentation.

If one can achieve a delta of somewhere around 50 between pre and post prandial, then we would be similar to healthy subjects. For this study, they defined healthy subjects to be those with a mean age of 27.1, BMI 22.6 kg/m2. I wonder if insulin, and blood sugar results change as healthy subjects age. Metabolically, we all change as time goes by.


@Michel. I have been eating a regular carb diet 140-160g/day) for the past three days. My C/I for this period is back to about 0.6, and I have been taking almost 100 units of novolog/day. And spiking enormously after each meal.

It was fun, but now I’m back to low carb.


90-100g of carbs per day (which works for my son, and non-diabetic me), doesn’t look like what everyone else eats, but doesn’t feel too restrictive to me. Getting below 50g of carbs would be difficult.

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I tend to agree that staying below 50g carbs would be difficult and restrictive. My daily carb intake average around 60.

For all of you who take Afreeza, and are Afreeza experts, if you eat a “nasty” meal like Burger and Fries or Chinese/Japanese Food, lots of carbs and oil/fat/grease, the Afreeza works quickly and is out of the system in about one hour. How do you address the delayed increase? typically, I find that 3-4 hours later, there is a BG increase for me. So I’ve addressed these situations with small multiple doses spaced 1 hour apart after the start of the meal.

On a slightly different topic: Has anyone heard of intranasal insulin? I read about it in a paper that I posted on a different thread about alzeheimer and type 3 diabetes.

I tried snorting Afrezza powder, but it didn’t do much. It might work with more (I only tried a 4 unit dose). I plan to try it again with a bigger amount of powder. But I know that is not what the article was referring to. :smile:

I do something like this on days when I am doing intravenous.

Intravenous insulin runs through completely in well under an hour, so I need to use both normal subcu and IV at the same time. Roughly a 50-50% split works well for me.

This is similar to how it might be for Afrezza. Combining it with a normal injection at a certain time.

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For higher carb meals, l take 4u of Afrezza a little bit after staring the meal and then follow up with Humalog an hour after the meal. Based on past experience, if I know I’ll spike after a meal, then I’ll also take a few units of Humalog halfway through the meal and monitor things to see if I need a few more units 1-2 hours afterwards.

I rarely use the 8u Afrezza cartridges so I have been splitting them into 2u’s each. Thanks @mentat for the suggestion and great video showing how to do it!!

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Bummer :frowning:

But at least we know why. This was a very interesting episode for all of us. I am really sorry that it was not the start of a major remission!

12 posts were split to a new topic: Speeding insulin activaction: IM

I want to share this with the group:

It’s Entitled: Dr. Gary Fettke - ‘Nutrition and Cancer - Time to Rethink. He’s not an endo, nor is he an oncologist, but rather a surgeon and has had to ampute diabetics’ limbs.

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A post was split to a new topic: NYT: Hlow to push blood sugar

I still can’t get over intravenous insulin!


My way of thinking is this - all insulin needs to get into your blood to work. Insulin does not work when you inject it into the fat layer below the skin. It is only after it is absorbed in the blood where it does its magic.

So I am just cutting out the middle-man.

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Insulin in blood is the fastest, insulin in muscle is faster than in subq fat.

What length insulin needle do you use for IM, IV? I want to use the right tools for the right job.

My point was that insulin only works once it gets absorbed into your blood. It does not work in the muscle or fat. From those places it eventually gets absorbed into the blood, where it starts to work.

So the “eventually” part, the time you are waiting on it to get absorbed into the blood, that is the part that makes insulin so slow.

Does insulin work faster when accidentally hitting capillaries, ? Have you injected subcutaneously, only to find a small amount of blood? I think that I hit a small capillary- it’s blood.

As a follow up question, how about trying to target capillaries so that the insulin can work faster? Don’t we want insulin to work faster, and for the insulin to be out of our system faster?

It can work faster. Sometimes this is the goal, and others not. The problem is especially acute when you hit a large capillary with your Lantus and it goes straight into the bloodstream and hits you all at once. Really, it is just another tool in the chest of options.

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That’s rarely what I want. I want the insulin to reach my bloodstream at the same rate as the glucose from digesting what I ate. If my meal bolus entered my bloodstream all at once rather than oozing in over time, I’d have a severe low.


I’ve experienced this with Lantus! I switched to Tresiba and have not had any issues. A sigh of relief!

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