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	<title>Comments on: Travel States side, Insulin timings?</title>
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		<link>http://www.healthdiabetes.info/travel-states-side-insulin-timings/comment-page-1#comment-5228</link>
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		<pubDate>Sat, 27 Feb 2010 19:14:20 +0000</pubDate>
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  In article &lt;49esg6$...@bigguy.timeplex.com&gt;, White_Ch...@timeplex.com (Chris White) writes: &lt;br /&gt; &lt;br /&gt;= &#160; &#160; &#160; Hello People. &lt;br /&gt; = &#160; &#160; &#160; This is my first time on internet so please be gentle with me &lt;br /&gt; =in the event of any Faux-pas. &lt;br /&gt; = &#160; &#160; &#160; My wife has recently, 1.5 months ago, has been diagnosed as &lt;br /&gt; =insulin dependant. She currently jabs herself once per day with 12-16 &lt;br /&gt; =U&#039;s, normally 0900. &lt;br /&gt; &lt;p&gt;Er, from the numbers you give, she is NOT insulin-dependent. &#160;She&#039;s using &lt;br /&gt; exogenous insulin, but she&#039;s not [yet] insulin-dependent. &lt;br /&gt; &lt;/p&gt;&lt;p&gt;= &#160; &#160; &#160; I&#039;m relatively sure it&#039;s 100% slow acting insulin. &lt;br /&gt; &lt;/p&gt;&lt;p&gt;OK. &#160;That fits with NIDDM (non-insulin-dependent diabetes mellitus) using &lt;br /&gt; insulin, or not-yet full-blown IDDM (i.e., one way or another, she&#039;s still &lt;br /&gt; producing substantial amounts of endogenous insulin). &#160;She is NOT what&#039;s &lt;br /&gt; commonly described as insulin-dependent. &lt;br /&gt; &lt;/p&gt;&lt;p&gt;= &#160; &#160; &#160; We are traveling to Los Angeles End of this week and I&#039;m &lt;br /&gt; =looking for anybody with advice and experience. I&#039;ll set out my &lt;br /&gt; =rough idea for the schedule, BUT I am fully open to critism. &lt;br /&gt; =0915 10 u&#039;s insulin. &lt;br /&gt; =0940 Lightish Breakfast &lt;br /&gt; =1200 Snack &lt;br /&gt; =1415 lunch on flight &lt;br /&gt; =1800 sandwich provided by self Time US 1000 &lt;br /&gt; =2200 8 U&#039;s Jab &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; time US 1400 &lt;br /&gt; =2220 Sandwiches on Flight &lt;br /&gt; =2330 Land &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160;Time US 1530 &lt;br /&gt; =US Time 1900 Evening Dinner &lt;br /&gt; = &lt;br /&gt; =I&#039;d welcome comments with respect to this. &lt;br /&gt; &lt;/p&gt;&lt;p&gt;Er, you haven&#039;t given us anywhere enough information. &#160;Well, maybe you have, &lt;br /&gt; sort of, but not explicitly. &#160;You&#039;ve got these &quot;Time US&quot; things here, and other &lt;br /&gt; times, but YOU HAVEN&#039;T TOLD US WHERE YOU&#039;RE STARTING! &#160;OK, let&#039;s try to figure &lt;br /&gt; it out. &#160;You say you&#039;re coming to LA. &#160;Your schedule says that it&#039;ll be 15:30 &lt;br /&gt; in Los Angeles (I guess; you say US 1530. &#160;You DO know that the United States &lt;br /&gt; spans at least seven time zones don&#039;t you?), and that that corresponds to 23:30 &lt;br /&gt; your local time. &#160;Let&#039;s see now, that&#039;s a difference of 8 hours, with Los &lt;br /&gt; Angeles being earlier than your home time zone. &#160;Sounds like you&#039;re probably &lt;br /&gt; from Great Britain or thereabouts, if I recall correctly (and I may well not). &lt;br /&gt; At any rate, let&#039;s look at the scedule, in terms of your starting time: &lt;br /&gt; &lt;/p&gt;&lt;p&gt;&#160; &#160; &#160; &#160; =0915 10 u&#039;s insulin. &lt;br /&gt; &#160; &#160; &#160; &#160; =0940 Lightish Breakfast &lt;br /&gt; &#160; &#160; &#160; &#160; =1200 Snack &lt;br /&gt; &#160; &#160; &#160; &#160; =1415 lunch on flight &lt;br /&gt; &#160; &#160; &#160; &#160; =1800 sandwich provided by self &lt;br /&gt; &#160; &#160; &#160; &#160; =2200 8 U&#039;s Jab &lt;br /&gt; &#160; &#160; &#160; &#160; =2220 Sandwiches on Flight &lt;br /&gt; &#160; &#160; &#160; &#160; =2330 Land &lt;br /&gt; &#160; &#160; &#160; &#160; =0300 Dinner &lt;br /&gt; OK, you&#039;re talking about being up for more than 18 hours. &#160;I&#039;d guess that a &lt;br /&gt; normal schedule (it would&#039;ve been nice if you&#039;d told us what the normal &lt;br /&gt; schedule is; without knowing that, it&#039;s hard to guess how the schedule should &lt;br /&gt; be modified) would be something like: &lt;br /&gt; &#160; &#160; &#160; &#160; =0915 10 u&#039;s insulin. &lt;br /&gt; &#160; &#160; &#160; &#160; =0940 Lightish Breakfast &lt;br /&gt; &#160; &#160; &#160; &#160; =1200 Snack &lt;br /&gt; &#160; &#160; &#160; &#160; =1415 lunch &lt;br /&gt; &#160; &#160; &#160; &#160; =2000 dinner &lt;br /&gt; &#160; &#160; &#160; &#160; =2200 8 U&#039;s Jab &lt;br /&gt; &#160; &#160; &#160; &#160; =2300 snack &lt;br /&gt; If my guesses are correct, then chances are that the evening injection&#039;s &lt;br /&gt; going to be a bit late for the sandwiches and a bit early for the dinner. &lt;br /&gt; Between the two, I wouldn&#039;t expect any major problems. &lt;br /&gt; &lt;/p&gt;&lt;p&gt;However, I *DO* perceive (and remember, perception and reality aren&#039;t always &lt;br /&gt; the same thing) what seems to be a rather fundamental problem here, viz. a &lt;br /&gt; misunderstanding of what you should be looking at. &#160;Look, one day of high blood &lt;br /&gt; sugar levels is not likely to have any significant adverse affects. &#160;Same for a &lt;br /&gt; couple of days of odd levels. &#160;What you should (in my opinion) be looking at is &lt;br /&gt; avoiding hypoglycemic episodes (no, they&#039;re not likely to have any detrimental &lt;br /&gt; permanent effects, either, but the headaches are a real bitch, and if they &lt;br /&gt; sneak up on you, they CAN cause problems). &lt;br /&gt; &lt;/p&gt;&lt;p&gt;From what you&#039;ve told us of your wife&#039;s situation, it seems likely to me that &lt;br /&gt; what you might want to do is, on the day you&#039;re flying, take the morning &lt;br /&gt; injection as usual, delay the evening injection until as long before dinner as &lt;br /&gt; it normally is, and thereafter go onto your normal schedule (in local time, of &lt;br /&gt; course). &#160;Clearly, from the fact that your wife is injectin only 18 units per &lt;br /&gt; day, she&#039;s still producing a substantial amount of endogenous insulin (well, &lt;br /&gt; unless she weighs about 70 pounds or less, another detail you left out, but I &lt;br /&gt; suspect she weighs a bit more than that). &#160;It that&#039;s the case, then you&#039;ve got &lt;br /&gt; a fair amount of leeway in your choice of amount of insulin to inject and &lt;br /&gt; timing for the injections. &#160;But, in my opinion, anyway, for a one-shot (pun &lt;br /&gt; intended) deal like this, you want to avoid low blood sugar more than you want &lt;br /&gt; to avoid high blood sugar. &#160;That means you want, more or less, to base your &lt;br /&gt; injection strategy more on meals yet to come rather than meals past (sorry, but &lt;br /&gt; it being this season, and having already made one pun, I can&#039;t resist the &lt;br /&gt; sort-of pun there). &lt;br /&gt; &lt;/p&gt;&lt;p&gt;Meanwhile, I&#039;d advise you to try to learn more about what the logic underlying &lt;br /&gt; your wife&#039;s usual injection schedule is. &#160;Once you understand that, figuring &lt;br /&gt; out how to modify it for special circumstances gets a lot easier. &lt;br /&gt; --------------------------------------------------------------------------- &lt;br /&gt; I &#160;try &#160;very &#160;hard &#160;to say exactly what I mean. &#160;I&#039;d appreciate it if you&#039;d &lt;br /&gt; bear that in mind and not try to &quot;interpret&quot; &#160;my &#160;posts &#160;to &#160;fit &#160;your &#160;own &lt;br /&gt; preconceived notions if I&#039;m posting in a serious thread. &#160;Remember: &#160;If you &lt;br /&gt; throw a strawman into a heated debate, flames are likely to be the result. &lt;br /&gt;
  
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		<content:encoded><![CDATA[<p>In article &lt;49esg6$&#8230;@bigguy.timeplex.com&gt;, <a href="mailto:White_Ch...@timeplex.com">White_Ch&#8230;@timeplex.com</a> (Chris White) writes: </p>
<p>= &nbsp; &nbsp; &nbsp; Hello People. <br /> = &nbsp; &nbsp; &nbsp; This is my first time on internet so please be gentle with me <br /> =in the event of any Faux-pas. <br /> = &nbsp; &nbsp; &nbsp; My wife has recently, 1.5 months ago, has been diagnosed as <br /> =insulin dependant. She currently jabs herself once per day with 12-16 <br /> =U&#8217;s, normally 0900. <br /> 
<p>Er, from the numbers you give, she is NOT insulin-dependent. &nbsp;She&#8217;s using <br /> exogenous insulin, but she&#8217;s not [yet] insulin-dependent.  </p>
<p>= &nbsp; &nbsp; &nbsp; I&#8217;m relatively sure it&#8217;s 100% slow acting insulin.  </p>
<p>OK. &nbsp;That fits with NIDDM (non-insulin-dependent diabetes mellitus) using <br /> insulin, or not-yet full-blown IDDM (i.e., one way or another, she&#8217;s still <br /> producing substantial amounts of endogenous insulin). &nbsp;She is NOT what&#8217;s <br /> commonly described as insulin-dependent.  </p>
<p>= &nbsp; &nbsp; &nbsp; We are traveling to Los Angeles End of this week and I&#8217;m <br /> =looking for anybody with advice and experience. I&#8217;ll set out my <br /> =rough idea for the schedule, BUT I am fully open to critism. <br /> =0915 10 u&#8217;s insulin. <br /> =0940 Lightish Breakfast <br /> =1200 Snack <br /> =1415 lunch on flight <br /> =1800 sandwich provided by self Time US 1000 <br /> =2200 8 U&#8217;s Jab &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; time US 1400 <br /> =2220 Sandwiches on Flight <br /> =2330 Land &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Time US 1530 <br /> =US Time 1900 Evening Dinner <br /> = <br /> =I&#8217;d welcome comments with respect to this.  </p>
<p>Er, you haven&#8217;t given us anywhere enough information. &nbsp;Well, maybe you have, <br /> sort of, but not explicitly. &nbsp;You&#8217;ve got these &quot;Time US&quot; things here, and other <br /> times, but YOU HAVEN&#8217;T TOLD US WHERE YOU&#8217;RE STARTING! &nbsp;OK, let&#8217;s try to figure <br /> it out. &nbsp;You say you&#8217;re coming to LA. &nbsp;Your schedule says that it&#8217;ll be 15:30 <br /> in Los Angeles (I guess; you say US 1530. &nbsp;You DO know that the United States <br /> spans at least seven time zones don&#8217;t you?), and that that corresponds to 23:30 <br /> your local time. &nbsp;Let&#8217;s see now, that&#8217;s a difference of 8 hours, with Los <br /> Angeles being earlier than your home time zone. &nbsp;Sounds like you&#8217;re probably <br /> from Great Britain or thereabouts, if I recall correctly (and I may well not). <br /> At any rate, let&#8217;s look at the scedule, in terms of your starting time:  </p>
<p>&nbsp; &nbsp; &nbsp; &nbsp; =0915 10 u&#8217;s insulin. <br /> &nbsp; &nbsp; &nbsp; &nbsp; =0940 Lightish Breakfast <br /> &nbsp; &nbsp; &nbsp; &nbsp; =1200 Snack <br /> &nbsp; &nbsp; &nbsp; &nbsp; =1415 lunch on flight <br /> &nbsp; &nbsp; &nbsp; &nbsp; =1800 sandwich provided by self <br /> &nbsp; &nbsp; &nbsp; &nbsp; =2200 8 U&#8217;s Jab <br /> &nbsp; &nbsp; &nbsp; &nbsp; =2220 Sandwiches on Flight <br /> &nbsp; &nbsp; &nbsp; &nbsp; =2330 Land <br /> &nbsp; &nbsp; &nbsp; &nbsp; =0300 Dinner <br /> OK, you&#8217;re talking about being up for more than 18 hours. &nbsp;I&#8217;d guess that a <br /> normal schedule (it would&#8217;ve been nice if you&#8217;d told us what the normal <br /> schedule is; without knowing that, it&#8217;s hard to guess how the schedule should <br /> be modified) would be something like: <br /> &nbsp; &nbsp; &nbsp; &nbsp; =0915 10 u&#8217;s insulin. <br /> &nbsp; &nbsp; &nbsp; &nbsp; =0940 Lightish Breakfast <br /> &nbsp; &nbsp; &nbsp; &nbsp; =1200 Snack <br /> &nbsp; &nbsp; &nbsp; &nbsp; =1415 lunch <br /> &nbsp; &nbsp; &nbsp; &nbsp; =2000 dinner <br /> &nbsp; &nbsp; &nbsp; &nbsp; =2200 8 U&#8217;s Jab <br /> &nbsp; &nbsp; &nbsp; &nbsp; =2300 snack <br /> If my guesses are correct, then chances are that the evening injection&#8217;s <br /> going to be a bit late for the sandwiches and a bit early for the dinner. <br /> Between the two, I wouldn&#8217;t expect any major problems.  </p>
<p>However, I *DO* perceive (and remember, perception and reality aren&#8217;t always <br /> the same thing) what seems to be a rather fundamental problem here, viz. a <br /> misunderstanding of what you should be looking at. &nbsp;Look, one day of high blood <br /> sugar levels is not likely to have any significant adverse affects. &nbsp;Same for a <br /> couple of days of odd levels. &nbsp;What you should (in my opinion) be looking at is <br /> avoiding hypoglycemic episodes (no, they&#8217;re not likely to have any detrimental <br /> permanent effects, either, but the headaches are a real bitch, and if they <br /> sneak up on you, they CAN cause problems).  </p>
<p>From what you&#8217;ve told us of your wife&#8217;s situation, it seems likely to me that <br /> what you might want to do is, on the day you&#8217;re flying, take the morning <br /> injection as usual, delay the evening injection until as long before dinner as <br /> it normally is, and thereafter go onto your normal schedule (in local time, of <br /> course). &nbsp;Clearly, from the fact that your wife is injectin only 18 units per <br /> day, she&#8217;s still producing a substantial amount of endogenous insulin (well, <br /> unless she weighs about 70 pounds or less, another detail you left out, but I <br /> suspect she weighs a bit more than that). &nbsp;It that&#8217;s the case, then you&#8217;ve got <br /> a fair amount of leeway in your choice of amount of insulin to inject and <br /> timing for the injections. &nbsp;But, in my opinion, anyway, for a one-shot (pun <br /> intended) deal like this, you want to avoid low blood sugar more than you want <br /> to avoid high blood sugar. &nbsp;That means you want, more or less, to base your <br /> injection strategy more on meals yet to come rather than meals past (sorry, but <br /> it being this season, and having already made one pun, I can&#8217;t resist the <br /> sort-of pun there).  </p>
<p>Meanwhile, I&#8217;d advise you to try to learn more about what the logic underlying <br /> your wife&#8217;s usual injection schedule is. &nbsp;Once you understand that, figuring <br /> out how to modify it for special circumstances gets a lot easier. <br /> &#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212; <br /> I &nbsp;try &nbsp;very &nbsp;hard &nbsp;to say exactly what I mean. &nbsp;I&#8217;d appreciate it if you&#8217;d <br /> bear that in mind and not try to &quot;interpret&quot; &nbsp;my &nbsp;posts &nbsp;to &nbsp;fit &nbsp;your &nbsp;own <br /> preconceived notions if I&#8217;m posting in a serious thread. &nbsp;Remember: &nbsp;If you <br /> throw a strawman into a heated debate, flames are likely to be the result. </p>
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