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Post by agedhippie on Apr 19, 2024 10:53:17 GMT -5
Afrezza is a meal time insulin, Levemir is a basal insulin. You cannot replace Levemir with Afrezza as they have different roles. You got me thinking about basal versus bolus last night. I started to do some research but it was painful to find what I was looking for. What I wanted to know is if the pancreas essentially leaks insulin (basal) and somewhere it stores some of the leaking basal for a mealtime bolus. Is there an insulin bladder in the pancreas? Or are there some beta cells that hold on to their insulin and then release on demand? I assume all insulin is created equally and it is a simple matter of “background” versus bolus. I am absolutely certain that is too much of an oversimplification, but wondered if it was a directionally correct understanding (or perhaps just hopelessly wrong). You pretty much have it correct. Insulin is held in vesicles which are small sacks so not unlike lots of tiny bladders. These are attached to the plasma membrane when they are needed and the membrane is de-polarized. Thi is largely of academic interest to me as a T1 since my immune system ate the lot! The full mechanism is still not entirely understood because there are so many moving parts. Your body steadily consumes glucose even is a resting state. To provide that energy it releases a steady stream of glucose which provokes the pancreas to release a matching stream of insulin. That is your basal glucose supply. That glucose release isn't constant, it's highest just before dawn, and lowest around 2am at night. Injectable basal insulin is a trade off between those two points which is why night time hypos happen (if you inject at about 7pm then all of that insulin should be out of your system by midnight although that varies from person to person.) There isn't a big margin for error as a T1 on overnight insulin. When you eat your glucose level rises and more vesicles get coupled to the plasma membrane and release their insulin. This is the result of the electrolytic change produced by that rise. |
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Post by sayhey24 on Apr 19, 2024 15:12:28 GMT -5
Come on man! Her problem is control. Especially when playing tennis. She is not getting Levemir any more but she can probably use something like Tresiba and not try and control her highs and lows with the basal. Thats afrezza's job after she eats and then its gone. ... This is discussion is beginning to feel like that old saying, if you have a hammer everything looks like a nail. Afrezza will not solve her problem at all. This is nothing to do with eating, it's to do with the interaction between basal insulin and exercise. When you exercise your body burns glucose but your basal insulin still takes the same amount of glucose so there is a deficit and you go low. What she is doing is using Levemir because it is the shortest lasting basal insulin (it lasts about 12 hours) so on days when she is going to play tennis she can take less basal insulin that morning and go back to normal that night (if she was a non-diabetic this would happen automatically). Tresiba would be the worst possible choice for her as it is the longest lasting of all basal insulins, she wants an intermediate basal like Levemir. It will be interesting to see if VDex can help her. Lets see what they say. Lets see if she is actually using the Levimar has the hammer and with afrezza and a smaller dose of Tresiba she can actually address the issue better. I am pretty sure Ginger Vieira discusses this in one of her articles. |
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Post by agedhippie on Apr 19, 2024 22:12:11 GMT -5
It will be interesting to see if VDex can help her. Lets see what they say. Lets see if she is actually using the Levimar has the hammer and with afrezza and a smaller dose of Tresiba she can actually address the issue better. I am pretty sure Ginger Vieira discusses this in one of her articles. As a T1 you cannot do that because you will have insufficient insulin at night which will be problematic. You will also have to take Afrezza every two hours while you are awake. What Ginger may have been talking about is that people tend not to do basal testing regularly and end up using their basal to partially cover meals and taking less RAA. That's generally a bad idea. Ginger was probably saying take the right amount of basal and bolus instead which often ends up being less basal and more bolus. Commonly people run into this when they switch from MDI to pump because endos make you basal test to get the numbers on the pump right. |
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Post by mytakeonit on Apr 26, 2024 1:27:24 GMT -5
I know that I said that I'd never post again ... but, I just had a remembrance of my daughter being born. When my wife was pregnant with my daughter ... I talked to my daughter while being close to my wife's belly. We had already named her because we knew that she would be a girl. When she was born and I was carrying her to the nursing room ... I talked to her and ... she looked at me with wide eyes ... so I knew that she recognized my voice. That was amazing !!! The nurses told me that they see that a lot.
So, don't be a stranger to your unborn child.
But, that's mytakeonit
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