Insulin

A lot of people are confused about how injected insulin works and how Serum insulin works.  This will explain the difference.  Serum insulin is created in the body to keep the blood/glucose as near normal as possible.  If you eat the proper foods it will keep the b/s normal most of the time and you will remain healthy.  Injected insulin is designed to bring down the b/g after a period of time.  This facility normally checks a persons b/g before meals.  There are variations in the schedule but  that is the starting point. What the doctor is aiming for is that the injected insulin will bring the b/g down to near normal by the time of the next meal.  That looks good if the patient participates and eats in such a manner that his b/g is near normal at the next meal  But in practice it leaves a lot to be desired because where the b/g was between those two periods is unknown.  How high the b/g went and how long it was there will depend upon the amount of insulin and how many carbohydrates the patient ate at and between meals. This  is the basic difference in how the injected and serum insulin works.  You could say Serum insulin works real time where injected insulin works over a period of time. 

Diabetes here

 My new place at the dining table now looks out towards the next table with two women about 70 ish overweight like most here.   Both are well kept and seem to desire to look their best.  In all the time here I have never seen them smile.  At the same table is another overweight woman considerable younger. She likes to make conversation and smiles.  Even though she has some serious diabetes problems.  I try to make conversation frequently when leaving or coming  to eat in order to be friendly.  Her promblem is she has perpherial neuropathy in her right leg dow near the foot.  Her diabetes has reduced the circulation in her leg to the extent she has developed a large red area.  I believe she may also have developed a sore.  The treatment she is undergoing now is to put hot packs on her ankle area.  I asked her today does she know what causes the condition.  She thought it might be one of two possibilities.  She has a Doctor appointment tomorrow I believe. She told me they have not told her what is causing the redness.  Previously I wrote about how the medical department here should sit people down and explain that if they do not control their eating habits what this lady has is in their future.  I've seen this in several people here.  the head nurse here commented once to me that many of the people with out of control diabetes are not interested in controlling their.  diabetes.  They are the ones who have problems that have manifested itself openly as the lady I am talking about here.  I wonder if they ever got the blunt truth told to them.  The lady here doesn't know her condition is the result of diabetes fueled by uncontrolled eating. So it is obvious she has never been told the truth. The doctors here make a show of treating them with more and more insulin.  Sometimes with both kinds of a total dose of over a hundred units. 



paths with everyoe living here.,,,,,,,

 Mary, the "Healthare worker" checked her B/G  at my request the other day and it was 383 mg/dl.  She is diabetic too need I say.  She had taken her insulin in the morning and had not eaten anything since.    Her doctor   prescribes one dose of slow acting insulin a day.  Obviously something is not working.  If I remember right one reason is she cant afford another more effective kind.  Now that is a good reason isn't it?  She has "insurance" through her place of work.   Things continued on a couple days and for some reason she was going to take another b/g test and she said she mentioned that here insulin was in the car.  Insulin in the car?  For Seattle we have had some hat days recently which meant the car had been reaching temps of well over a hundred many times.  No wonder the insulin was no good.  I asked here why the she kept it in the car and she said it said after opening it could be left out of the refrigerator.  Where in world did she read that? Obviously  she was going to re-read it again.  I wonder how long she has been doing this?  Like most diabetics who has a bad a1c she claims she did not remember what it was.  Can you imagine some doctor not trying to get to the bottom of why her a1c was so bad?  In my opinion a HMO doctor is just spending their time collecting their check when they allow this. How do you sort them out when this occurs? The good from the bad. She is not quite of SS age yet so has to pay the high co-pay fees of her insurance which is through Group Death oops I mean Group Health.   

Kay's blood test is back.

Click on picture for probably a full page pix.

I took Kay to the lab for a recheck of the potassium.   Don't expect necessarily a completely honest report by the doctor.  I think they minimize things in order not to alarm the patient.  But they said the potassium was ok.  But there is OK and then there is a real healthy OK.  They can consider what is healthy for a young person then there are readings that they consider healthy for an old person.  But you can die from the ok reading for an old person.  Like an a1c reading for a diabetic as an example. A healthy young person will get a reading of less than 5.0 a1c. But there is a wide range of what is OK for an older person according to doctors.  Actually it boils down to what the Dr figures he can manage without causing  the patient to died from an overdose of Insulin.  This is the result of the patient being totally ignorant of how to manage their own diabetes Expecting the doctor to do it for them.  But as the dr can not be there every time the patient takes a bite of something to adjust the mediction it s impossible for the Dr. to manage it.  That is the reason the doctors let the blood sugar run so high.  Medication prescribed to take care of  the b/g to a close tolerance makes it very easy to overdose and die from hypogylcemia.  In King county Washington State each year medics make over 4,000 emergency calls for overdosed diabetics. So you can see that doctors don't want to prescribe a close management of b/g for a pattient.  That HAS to be done by the patient.   Most of them can't do this.


The other day     MG/DL came back 92.  I was a little surprised because she was not supposed to be diabetic. Now 92 is not high for a diabetic. A non diabetic however should run under ninety, around 83/85. Doctors don't see it that way though.  But Kay had not eaten for a couple hours and if she was not diabetic her insulin should have brought it down to the normal diabetic. In other words 83 or 5.  But it was 92.  So as long as she was going in for a blood test anyway I asked the Dr, to take an a1c read. She was skeptical of course as the mg/dl was 92. But she humored me by ordering a test also.  Well, low and behold when the report came back the next day it was 6.2! That's higher than mine! Mine was 5.2 or 5.6 which I am real  unhappy about as I have had it 4.9 to 5.2. The doctor kissed it off as not bad enough to medicate which I agree with as Kay would be unable to help in her diabetes management. Kay had told me in previous years that her mother had diabetes which  I did't really know about. But I wasn't into those things in those days. 


This is probably why her GFI is where it is.  Her b/g is ruining her kidneys. So if I want to save Kay I will have to change her diet as her b/g is obviously going sky high from what she is eating now.  The problem now is to get her to eat what is not going to kill her.  Like this morning I made her a poached egg on toast in milk.  I don't think she ate more than a bite of egg.  The  rest of the day she has been snacking on things that will run  her b/g up where it should not be.  This new situation will require some thinking. 


 Bill Sheldon June 17, 1920. April 4, 2001. Four years in the 3rd Infantry Division WW2 His story. Find it at Four years in the 3rd Inf in WW2
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