FUDiabetes

Help pleaee

I am on a surf trip to Cosra Rica and I loop using an Riley link. Took the Rileylink surfing yesterday so no more omnipod for the rest of the week. I fochave a back up at home but have no basal insulin here. An suggestions for using my Humalog to control my sugar overnight? Thanksnin advance

Jeff

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Did you bring syringes with you? If not, run to a lical pharmacy and pick some up. Also, I’m not sure if that country requires prescriptions for insulin, but you need to get some long lasting insulin also.

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I have plenty of syringes. Already tried for some Basal insulin and struck out. About 3 hours from where I could get some. Last night I set an alarm for every 2 hours and woke up at 150. On surf days I try to get to about 225 before a session amd turn off my basal so as not to go low while out on the water. Guess I will just have to deal…Pura vida

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Is basal not available to purchase? It is much cheaper there than in the U.S.

Otherwise you gotta take small amounts of Humalog every few hours.

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I’d rather take the 6 hours round trip to get the insulin than have to wake up every 2 or 3 hours all night long. But either way works, so you get to choose what you prefer.

Your experience is a good reminder that we need to bring backups of everything, and preferably backups for the backups.

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Thanks @jeffsurfsncocktails for posting - let us know how it turns out and what you end up doing.

A couple of years ago, I did about 9 weeks of biking in Europe, taking a bunch of my dexcom and tandem pump supplies with me. I thought I would be super smart and send along ‘care packages’ to a few places I would stay on the trip - one in Denmark, and one in Italy. The packages contained more insulin and sensors / transmitters etc. I mailed them via USPS about 4 weeks before the trip.

So I get to Denmark and the hotel has no record of any package like that being delivered. No sweat, I have packed extra (and insulin use goes down when you’re doing that much exercising).

Three weeks later I get to Italy. You know what happened … no package. Actually, it had arrived in central italy but they felt that I was importing pharmaceuticals and so they would not release the package unless I paid a tax. This was all negotiated via the hotel front office people!

In the end I never got the ‘care packages’ during the trip - but both showed up back at their return address several months later!

And I had brought along insulin pens and an old-fashioned bg meter, so I went back to that regime for the last couple of weeks. Thank heavens for backup.

This brings up another point - while I am a huge dexcom/tandem fan, if you are doing hard traveling, pens and bg meters take up a lot less space and require less maintenance.

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It’s no fun, you literally have to take a small basal dose of insulin every 2-4 hours. It depends on how fast and how high you go. I can go to the 300’s in few hours with no insulin at all. I would drive the distance and get it over with to get a long lasting insulin if you’re going to be there for more than a couple of days.

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Sent a driver to pick up some Lantus. So I am good to go. Is the dosage the same as Levemir?

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Visit a local pharmacist, explain. Ask for Insulin NPH; TM’ed as Humulin N (Lilley) and Novolin N (Novo). It’s the same as Lantus, a slow release insulin, but no prescription required so far as I know in the mid to lower Americas.

The pharmacist will probably be able to help; she may have other approaches.

I generally end up in this position when I’m down there; I use an Omnipod and, despite the adverts, it doesn’t like repeated immersion. I do come prepared with a long acting insulin and I simply divide total daily basal by two and deliver it morning and evening. I use Lantus and, for me, it is somewhat peakiy and short acting (which is another reason for using NPH, but Lantus is free for me.)

If you haven’t done this before I suggest not doing your full basal; basal injections peak a while after injection and that can lower the blood sugar unacceptably. Apart from that I’ve found I get a good 1:1 conversion from my typical basal (12IU/day) on the Omnipod to good old MDI.

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For 10 years in the late 70’s and 80’s I survived strictly on intermittent Humulin injections.

As I recall my nighttime regime was to take a unit or 2 at bedtime and wake up 4-6 hours later for more.

This was long before MDI became a “thing”. I was working 12 hour shifts on the rigs in the arctic and couldn’t afford to have hypos

Good luck …

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Doses were identical for me.

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No, NPH is not the same as Lantus. NPH starts to take effect after 2 or 3 hours, has a significant peak around 7 hours after injection, and is all done after about 12 hours. Lantus has no significant peak, it releases about the same amount of insulin every hour for roughly 24 hours. (Sometimes a bit less; some folks split their lantus dose into halves given twice per day.)

But yes, NPH is readily available and can be made to work as a longer-acting insulin if necessary. But beware of timing the dose so the peak is in the middle of the night, it can cause a severe hypo while you’re asleep.

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True, although taken at 10 pm with a ~5 am peak could potentially work out perfectly…although still risky

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Ya, I was replying and then got delayed, and before I ended up posting it, he mentioned about getting basal.

So my reply was after Jeff said he tried to get it but basal was 3 hours away. I posted without reading the most recent comments.

Taking the small bits every few hours works, but as bkh said, it sucks doing it at night.

Backup for everything! A vial of Lantus or Levemir is such a small thing to pack.

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Not for me. I don’t think that’s what the insert say either (IRC) [EDIT: I mean the graphs, not the marketing speak wrapping them]; I don’t have one any longer because they give me the pens individually and I don’t get the info sheets. I’ve related my experiences before so I won’t go over them again but I didn’t see a significant peak with Novotard and AM injections despite doing them only once/24 hours.

My doc told me that Lantus lasts for longer than 24 hours and that I had to be careful about adjusting the dose because it takes several days to stabilize. That’s not my experience either. So far as I can determine most of this stuff comes out of some marketing department in Indianapolis. The best science money can buy?

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Thank you all for the help and advice. To sum it up…
My omnipod was working fine, the problem was my Orangelink went surfing and is now non functional so no way to communicate with it. Lesson learned tonhave back ups of everything. The Lantus is doing its job. About to go out for the morning session. I have mastered getting my sugar up high enough before I paddle out to avoid lows in the water. With no way to turn the Lantus off like I normally do with the pump we will see how it goes. Have glucose tabs in my board shorts just in case. PURA VIDA!!!



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Thanks for the update. Looks beautiful, especially when we are dealing with 10 degrees F and wind.

e

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I’m surprised that soaking it in tap water didn’t help; the assembly is very basic, no complicated connectors, so that makes it very easy to wash. Looking at it I’m pretty sure it will be trivial to pot it (encase it in potting compound, which makes it utterly, totally, waterproof under any conditions). It’s probably worth doing because the PCB is pretty much impossible to repair when it fails anyway.

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Just a note in case you are interested. I go out and snorkel for 2-3 hours at a time. I take GU energy gels with me for hypo treatment, my iphone in a Stash waterproof pouch so I can use the camera and a Libre Reader in a Stash pouch to read my Blood Sugars.

I wear a Dexcom as it’s more accurate and I won’t give it up, but I have a hard time getting it to read in the water. But a Libre you can scan and it works great in the water. So just for my snorkeling I self fund Libre’s to wear in the water. It’s been a game changer as now I stay out as long as I want and stop when I want too. And I can keep track of my Bg levels. If I need something when I am out there I just down some gel and stay out. I do use Skin Tac on my Libre and my Dexcom sensors to make sure they stay attached, I haven’t had to worry about my pods.

My iphone reads my Dexcom, but it doesn’t work underwater. But if you are surfing you probably are spending enough time above water to get readings. Both don’t work well in really cold water. I found Stash pouches have worked well to protect my electronics. I get great pictures and know my Bg levels!

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I keep Gels in my pocket just in case. I turn my basal off and try to get my sugar up to about 200 with no insulin on board as well. Generally after a two hour session I came back in and am sitting right around 80. I have a protein shake with 22g if carbs before and that usually gets my sugar qhere it needs to be. Have another one waiting in the car for recovery.

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