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When does the extended dose start working? Is it immediately or one hour after the bolus?

July 25, 2012
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My daughter has been ill twice recently and I’ve had to increase her insulin significantly. Should I be concerned? Is there anything you recommend I do?

January 3, 2012
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After two years on Lantus and Apidra, my daughter’s blood sugars are usually elevated. Adjusting the Apidra by a unit causes either highs or lows and I am at a loss. Are her insulin doses not commensurate to her needs/weight?

June 21, 2011
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Here, in Colombia, I can get only one vial of lispro per month, but I may need to use more to combat highs. Can I use Regular for the times I run out of lispro?

March 4, 2011
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What is your recommended rule of thumb for converting to an injections strategy in the event of a pump failure and a replacement pump is not available for, say, 48 hours?

November 30, 2010
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Other than pregnancy, what are the possible reasons for a very sudden increased insulin requirement? I have had type 1 for seven years and my diabetes has been stable for years.

November 23, 2010
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On NPH and NovoRapid, my daughter often has unexpected highs and lows. Would her blood sugars be more stable if she were on Levemir?

October 20, 2010
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Can insulin be degraded in blood and ECF which become a reason for its decreased effectiveness? How do abnormal levels of HBA1c effect oxygen levels and results thereof?

October 5, 2010
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Since an early July seizure, our daughter has been much more sensitive to insulin. We now have to give her diluted insulin. Have you heard of such sensitivities before?

September 27, 2010
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My daughter experienced a honeymoon in February 2010. In the past month, she has again needed to reduce her insulin drastically. What do you think is going on? Her diabetes team plans to do some testing and is considering putting her on metformin to see if this helps manage her blood sugars.

July 27, 2010
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Since I started taking insulin, I have been experiencing edema, which is not being helped by diuretics. What do you suggest?

July 15, 2010
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The doctor suggested switching my son from NPH and Regular to NovoLog and Lantus. Is there a way to continue the old regimen and get better control? Might the lack of exercise be contributing to poorer control? Which is better: Lantus or a pump?

July 14, 2010
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My daughter was just diagnosed and I am concerned about having to limit her carbohydrates drastically to avoid blood sugar spikes. Is this normal? Will I ever be able to give her more than five grams of carbohydrates at a time?

June 8, 2010
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Diagnosed a month ago, my son was having many lows so the endocrinologist changed his insulin-to-carbohydrate ratios, the ones for breakfast and lunch drastically. Why would he make such drastic changes? I am now concerned about highs.

June 8, 2010
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Is it possible that extra insulin can interfere in filtration from micro-vessels and from liver, kidney, etc. and cause some problem because it is a big molecule and exogenous insulin can be bit odd for body’s normal handling?

March 31, 2010
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Since a stomach bug a week ago, my son has needed no insulin to cover the foods he has consumed and has had in range blood sugars. He is still getting Lantus, but I need to reduce this, too. Is this common after an illness?

March 15, 2010
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When our grandson comes to visit, we have to call his parents for insulin dosing guidance. Is there a formula for determining the dosing?

February 18, 2010
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What is the suggested formula for calculating a return to MDI from pump therapy either for short term in cases of pump failure and for longer term return to MDI?

January 22, 2010
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Can long acting insulins cause downregulation of insulin’s receptors due to their prolonged and continual exposure in comparison to short acting insulin due to decreased insulin oscillations and degradation?

December 19, 2009
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Diagnosed with type 2 two years ago, my doctor now suspects I have LADA. Should I consider adding another medication to my metformin? Should I consider taking insulin?

November 16, 2009
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