How To Lose Weight I
We start 2015 with a new series – How to Lose Weight. Probably what many people wonder about this time of year. First and foremost, any rational weight loss program starts with a thorough understanding of what causes weight gain in the first place. What is the Aetiology of Obesity? We’ve spent the previous year discussing this question in substantial detail. There was the 41 part series of posts entitled “Hormonal Obesity”. You can review it here – starting with post 1. You may also review our 11 part series entitled “Calories” to review why calories do not actually cause weight gain. The four part Exercise series reveals why exercise, while healthy and beneficial, is a relatively minor part of weight loss. I am aware that reviewing over 50 blogs (about 50,000 words) may not be the most fun you have this new year, but hey, are we here to lose weight or have fun? Once we understand that insulin is the key player in the development of obesity, we can begin to treat it. Insulin causes obesity so the key to the treatment of obesity is to lower insulin. Obesity is not a caloric imbalance, it is a hormonal imbalance. Obesity is a disease of too-much-insulin. Therefore, the treatment is to lower insulin. This, of course, is easier said than done. It is not simply a matter of lowering calories, or lowering carbohydrates, or lowering sugar or lowering processed foods or or increasing fibre or increasing fruits and vegetables. No, it is a matter of doing all of these things that decrease insulin levels. There are two main factors that lead to increased insulin levels. The first factor is the foods that we eat. Certain foods tend to raise insulin more than others. There are also foods that protect against insulin spikes. This is the question which we obsessively thin Continue reading >>
Long Term Travel And Insulin Effectiveness
Long Term Travel and Insulin Effectiveness So I going on a backpacking holiday in a months time, traveling from Perth, Australia to Lima, Peru, then around places in South America for about 2 months or so. Several problems however relating to me being an insulin dependent Type 1 Diabetic however. For reference, I use Apidra Solostar and Lantus Solostar disposable pens. First off, travel time from Perth to Lima will be around 40+ hours. Im planning to pack all my insulin I need for the trip into a FRIO style bag when on the move, then refrigerate the unopened insulin again on arrival at each hostel I will be staying at. During my trip, I will be moving from hostel to hostel, which will mean that sometimes, my insulin will be exposed to temperatures above normal refrigeration levels. My question is -** will the constant moving from place to place reduce the effectiveness of my insulin?** Documents relating to my insulin say that it can be kept unrefrigerated at temperatures below 25 degrees celsius for up to 28 days, but do not detail whether this is constantly unrefrigerated or whether once you take it out, it can only last 28 days before it starts to lose effectiveness. If Im moving the insulin in a out of a fridge every few days/week, will this lengthen the 28 day period? Sorry for the long post, but Id love to hear some experiences from others on this. Once you open the pens they do not recommend putting them back in the refrigerator Ive never understood why, and have often done it anyway-- but the 28 day recommendation is based on being at room temperature the entire time. Ive used pens of novolog well beyond that, probably to about 45 days at room temperature without ever noticing any reduction in effectiveness. I have never been able to actually get any strait ans Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Comparative Effectiveness and Costs of Insulin Pump Therapy for Diabetes
- Can Diabetes Be Reversed? Study Claims Weight Loss And Cutting Calories Cure Condition, Even In Long-Term Patients
How Long Does Insulin Last Once It's Been Opened?
A fellow caregiver asked... My mother has type 2 diabetes and needs help with her insulin injections. After I open a new bottle, how long does insulin last for, how should I store it, and how do I know whether it's gone bad? Expert Answers As a general rule, most bottles of insulin are good for 28 days once they're opened. Of course, how quickly a person goes through a vial is highly individual. Some may go through a bottle in a week or two. Others, on a lower dosage, may not use all the insulin within four weeks. But the drug's stability and potency is only guaranteed for 28 days. Opened insulin pens typically last 14 days, though some last only 10 days. If you're uncertain, check with your mother's pharmacist to find out how long her insulin should last. When either of you opens a new vial or pen, make a note on the calendar -- and note the date when you'll need to throw out any remaining insulin. It's best to store an opened bottle of insulin at room temperature, even though manufacturers often recommend refrigeration for opened containers. It's usually less painful to inject insulin when it's at room temperature than when it's cold. Store unopened insulin vials and pen cartridges in the fridge, though, where they should last until their expiration date. Insulin shouldn't be exposed to extreme temperatures, so don't leave it in the car, next to the stove, in the freezer, or in the bathroom. If the bottle freezes, it must be discarded. Two typical signs that insulin has gone bad: poor performance and unusual appearance. If your mother is following her treatment plan and her glucose levels stay stubbornly, inexplicably high, her insulin may have lost its potency. Insulin that's cloudy when it's supposed to be clear or that contains particles, crystals, or small clumps Continue reading >>
12 Myths About Insulin And Type 2 Diabetes
Insulin facts vs. fiction When you hear the word “insulin,” do you picture giant needles (ouch!) or pop culture portrayals of insulin users with low blood sugar (like Julia Roberts losing it in Steel Magnolias)? Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment. The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you. Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes. Diabetics always need insulin Not necessarily. People with type 1 diabetes (about 5% to 10% of diabetics) do need insulin. If you have type 2, which includes 90% to 95% of all people with diabetes, you may not need insulin. Of adults with diabetes, only 14% use insulin, 13% use insulin and oral medication, 57% take oral medication only, and 16% control blood sugar with diet and exercise alone, according to the CDC. The point is to get blood sugar—which can be a highly toxic poison in the body—into the safe zone by any means necessary. Taking insulin means you’ve ‘failed’ “This is a big myth,” says Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trial unit at the Albert Einstein College of Medicine, in the Bronx, N.Y. “Many people who try very hard to adhere to a diet, exercise, and lose weight will still need insulin.” The fact is that type 2 diabetes is a progressive illness, meaning that over time you may need to change what you do to make sure your blood sugar is in a healthy range. Eating right and exercise will always be important, but medication needs can vary. “A large percentage of people with ty Continue reading >>
Insulin Actions Times And Peak Times
A good way to improve your glucose levels is to track the peaks and drops in your glucose , so you can figure out why they happened and how to correct them. Once you identify glucose patterns (they ARE there!), you also want to understand when each of your insulins is active and when they typically stop lowering your glucose. This helps you adjust your doses or food intake to stop unwanted ups and downs in your readings. The table below shows the start, peak, and end times for various insulins with some explanations and typical uses for each. When Does My Insulin Peak and How Long Does It Last? designed to peak, covers meals and lowers high BGs Humalog , Novolog and Apidra insulins currently give the best coverage for meals and help keep the glucose lower afterward. Their glucose lowering activity starts to work about 20 minutes after they are taken, with a gradual rise in activity over the next 1.75 to 2.25 hours. Their activity gradually falls over the next 3 hours with about 5 to 6 hours of activity being common with these insulins.Although insulin action times are often quoted as 3-5 hours, the actual duration of insulin action is typically 5 hours or more. See our article Duration of Insulin Action for more information on this important topic. In general, "rapid" insulins are still too slow for many common meals where the glucose peaks within an hour and digestion is complete within 2-3 hours. The best kept secret on stopping post meal spiking is to eake the injection or bolus earlier before the meal and to eat slower low glycemic carbs. Regular insulin still carries its original name of "fast insulin" but its slower action often works better for people who take Symlin or for those who have gastroparesis (delayed digestion). It is also a great choice for those who Continue reading >>
Insulin Use Tips
Before each use, take a moment to inspect the insulin prior to drawing it into the syringe; clear insulins should appear not discolored and clear; suspended insulins should be uniform in their cloudiness.  Do not use the insulin if: The bottle looks frosted.  Clear insulin that looks discolored or has turned cloudy, contains particles or haze.  Cloudy insulin that appears yellowish or remains lumpy or clotted after mixing.  See Insulin problems for more information about "bad" insulin. Damaged Insulin: Insulin that is getting too old, or has been dropped or shaken or mishandled, or exposed to a lot of light or heat, will be less effective than before. Freezing  destroys the molecules of ANY insulin; any that has either been frozen or is suspected of having been frozen should not be used. Insulin which has been frozen will not be able to do an effective job of controlling blood glucose.  Check for discoloration or floating objects in the insulin -- it may also be contaminated. It's also possible that the new or newer vial from the pharmacy may be flawed. If you've recently started it and are having problems, this might be the case. Taking down the lot number and getting a new vial that has a different batch/lot number should take care of this. Frosted insulin: If insulin is subjected to temperature extremes, such as freezing or overheating, the insulin can precipitate  on the vial's walls, giving it a frosty or frosted appearance. Another term used to describe this is flocculation.  In the photo above, the insulin vial on the right is a visual example of what a frosted vial would look like. You can see the precipitated insulin clinging to the sides of it. The problem seems to be a particular one with R-DNA/GE/GM NPH Continue reading >>
Does Insulin Really Only Last 28 Days?
it can lose its potency, but thats not til after its exp. date located on the bottle itself... so my pharmacist says. by the way, i wish i could get 1 bottle to last 28 days, lol. i swear my pump uses more insulin than my car does gas. I use 100 units a day for 30 days or 3 vials of insulin per month, but my pharmacy fills a 90 day prescription and I end up with 2 months worth of insulin that go past the 28 day mark. I figure if I can get a script for a 30 day supply at another pharmacy it would be better in the long run. It is true that insulin becomes less effective with time, and it also depends on how sensitive you are to that particular insulin as to it's length of time it will last. I would rather it be a 28 day supply than a 60 day because of the effectiveness factor. I truely is NOT worth the risk of ketones or DKA in my opinon. Good luck to you though. In the US (as it has been explained to me) a drug MUST hold its effectiveness for ONE YEAR AFTER THE PRINTED SELL BY DATE. Of course this does mean that you need to store it under the proper conditions. I have gone well beyond the 28 days even with pump insulin use and been fine---and I had an entire shipment of insulin go "bad" during WINTER shipping and almost went crazy worrying what was WRONG with me before we figured out that it was not in fact ME it was bad (probably formerly frozen) insulin. And yeah what IS it with the pumps consumption???? LOL!!!! I use WAY LESS than I did before and have a very low basal and the thing eats the drug like an opium fiend!!!! And I do NOT toss the cartridges if I am changing a set up---either re-cycle the canister (don't tell MiniMed on me please!) or you can withdraw almost ALL of the insulin with a syringe thru the top if you are careful and aim thru the area where the c Continue reading >>
- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Only 2 Ingredients and You Can Say Goodbye to Diabetes Forever! No More Medications and Insulin!!!
- Eat Carbs Last to Reduce After-Meal Blood Sugar Spikes?
The Insulin Resistance Diet Protocol
Understanding the cellular mechanisms of insulin resistance helps us choose more effective therapeutic interventions for the treatment and prevention of prediabetes and type 2 diabetes. Insulin resistance is present in individuals who are obese and those with diabetes mellitus. Several studies have found that an insulin resistance diet protocol and exercise can alter insulin signaling pathways and delay the onset of insulin resistance. It’s estimated that the number of diabetes sufferers in the world will double from about 190 million to 325 million during the next 25 years. (1) It’s obvious that we need to pay more attention to our lifestyle habits and make some changes. An insulin resistance diet, similar to a diabetic diet plan, helps you lose excess weight and regulate your insulin and blood glucose levels in order to reduce your risk of developing prediabetes and diabetes. Insulin Resistance Diet Research suggests that the primary cause of insulin resistance is excess weight, especially excess fat around the waist. Fortunately, weight loss can help the body respond better to insulin. The Diabetes Prevention Program and other large studies indicate that people with insulin resistance and prediabetes can often prevent or delay developing diabetes by changing their diets to follow an insulin resistance diet, along with losing weight. Here are seven ways to start eating an insulin resistance diet. 1. Limit Carbohydrates Research published in Diabetes, Metabolic Syndrome and Obesity suggests that monitoring carbohydrate intake, whether by carbohydrate counting or experience-based estimation, remains a key strategy in achieving glycemic control. Although all carbohydrates can be incorporated into carbohydrate counting, for good health, carbohydrates from vegetables, Continue reading >>
Beware Summer Extremes With Insulin
Living with diabetes blog With summer arriving in Minnesota and many other places, I'd like to talk about how to manage insulin storage in extreme temperatures such as this season brings. A number of years ago, I met with a client who used a rapid insulin pen for meal dosing. She shared with me a story of how she attended the county fair on an exceptionally hot day, and had placed her insulin pen in the back pocket of tight jeans and walked around the fairgrounds all day. She used the pen for covering meals eaten at the fair, and her blood sugars were running higher than normal, but she related this to all the junk food. The next day her blood sugars continued to run high and when she took her (rapid) insulin, it didn't seem to affect her blood sugar level at all; in fact, it was like she was taking water instead of insulin. She wondered if the heat had affected her insulin, so she switched to a new insulin (disposable) pen, and soon after her blood sugars started to drop. Has this or something similar happened to you? I looked at insulin manufacturers' websites and found that for the majority of all types and brands of insulin, the maximum temperatures recommended are as follows: Opened room temperature insulin should not exceed 86 F (30 C) with the exception of Lantus, which should not exceed 77 F (25 C). Most manufacturers of insulin recommend discarding insulin if it exceeds 98.6 F (37 C). Other non insulin diabetic injectable medications: Glucagon and Byetta should not exceed 77 F (25 C). Symlin should not exceed 86 F (30 C). Avoiding potential problems Temperatures exceeding manufacturer's recommendations for insulin/medications Store your insulin in the refrigerator, in an insulated case or cooler with a freezable gel pack, or use a cooling wallet. Cooling wallet Continue reading >>
Information Regarding Insulin Storage And Switching Between Products In An Emergency
en Español Insulin Storage and Effectiveness Insulin for Injection Insulin from various manufacturers is often made available to patients in an emergency and may be different from a patient's usual insulin. After a disaster, patients in the affected area may not have access to refrigeration. According to the product labels from all three U.S. insulin manufacturers, it is recommended that insulin be stored in a refrigerator at approximately 36°F to 46°F. Unopened and stored in this manner, these products maintain potency until the expiration date on the package. Insulin products contained in vials or cartridges supplied by the manufacturers (opened or unopened) may be left unrefrigerated at a temperature between 59°F and 86°F for up to 28 days and continue to work. However, an insulin product that has been altered for the purpose of dilution or by removal from the manufacturer’s original vial should be discarded within two weeks. Note: Insulin loses some effectiveness when exposed to extreme temperatures. The longer the exposure to extreme temperatures, the less effective the insulin becomes. This can result in loss of blood glucose control over time. Under emergency conditions, you might still need to use insulin that has been stored above 86°F. You should try to keep insulin as cool as possible. If you are using ice, avoid freezing the insulin. Do not use insulin that has been frozen. Keep insulin away from direct heat and out of direct sunlight. When properly stored insulin becomes available again, the insulin vials that have been exposed to these extreme conditions should be discarded and replaced as soon as possible. If patients or healthcare providers have specific questions about the suitability of their insulin, they may call the respective manufacturer a Continue reading >>
How Long Should Insulin Be Used Once A Vial Is Started?
Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>
Weight Loss With Insulin Resistance: Diet Tips And Strategies
According to the World Health Organization, the prevalence of diabetes has risen significantly over the last 30-plus years. In 1980, just 4.7 percent of the world's population had diabetes, but by 2014 this figure had soared to 8.5 percent. This means approximately 422 million people were living with diabetes in 2014. These astounding statistics do not take into account the additional number of people with prediabetes or insulin resistance. In this article, we take a look at what insulin resistance is and what its relationship with body weight is. How might being overweight lead to insulin resistance and what can be done to lose weight? What is insulin resistance? Insulin resistance leads to a condition known as prediabetes, which means that a person's blood sugar level is high, but not high enough to qualify as diabetes. Having insulin resistance is a warning that, without intervention and effective lifestyle changes, someone with prediabetes may go on to develop type 2 diabetes. Sugar (glucose) is the body's main source of food energy. People obtain it from the food they eat. After food is broken down in the body, the sugar enters the bloodstream. In order to use it as energy, the body's cells need to "pick up" the sugar. Insulin, which is a hormone produced by the pancreas, helps this happen by moving the sugar out of the blood and enables it to enter the body's cells. Insulin maintains blood sugar levels, ensuring they are not too high or too low. However, when blood sugar levels are persistently high, the body's cells stop responding to insulin as effectively. This is known as insulin resistance. When insulin resistance occurs, sugar is unable to enter the cells as successfully, and too much remains in the bloodstream. Higher levels of sugar in the blood place a de Continue reading >>
Comparative Efficacy And Potency Of Long-term Therapy With Glipizide Or Glyburide In Patients With Type 2 Diabetes Mellitus.
Comparative efficacy and potency of long-term therapy with glipizide or glyburide in patients with type 2 diabetes mellitus. Department of Medicine, The University of Tennessee-Memphis 38163, USA. BACKGROUND: Long-term studies on the comparative efficacy and relative potency of glipizide and glyburide are sparse and controversial. METHODS: In a randomized prospective trial, we compared the effectiveness and relative potency of glipizide and glyburide over a 15-month period in 18 patients with type 2 diabetes mellitus (DM2) (9 on glyburide and 9 on glipizide) who were unresponsive to diet therapy. Glycemic control was assessed using 4 methods: 1) quarterly fasting plasma glucose (FPG), and 2-hour postprandial plasma glucose after a standard breakfast; 2) insulin and glucose response to Sustacal (test meal) challenge every 3 to 6 months; 3) quarterly hemoglobin A1c; and 4) intravenous glucose tolerance testing every 6 months to measure first and second phase insulin secretion. Patient characteristics were similar in each treatment group. RESULTS: Similar doses of glipizide (11 mg/day) or glyburide (10 mg/day) resulted in comparable reduction of FPG and hemoglobin A1c and increase in first phase insulin response to intravenous glucose tolerance testing. There was greater reduction in FPG and 2-hour postprandial plasma glucose with glipizide than with glyburide in 6 months. Contrary to the Physicians' Desk Reference, but consistent with another short-term study, our long-term study demonstrated that glipizide and glyburide are equipotent at similar doses in controlling hyperglycemia in DM2. CONCLUSIONS: Glipizide and glyburide are effective in controlling hyperglycemia with similar doses in DM2. Glipizide exhibits greater reduction in FPG and 2PPG at 6 months. Additional s Continue reading >>
Nine Things That Improve Insulin Sensitivity: Accelerate Fat Loss & Build Muscle Faster!
Insulin sensitivity is SO important for fat loss because when you are insulin resistant, the body is much more likely to store the food you eat as fat. Insulin resistance also produces inflammation in the body, causing a whole bunch of health problems that any sane person wouldn’t want to deal with. Besides making it nearly impossible to lose significant amounts of body fat or pack on muscle, poor insulin sensitivity has all of the following negative effects: • It reduces athletic performance. • It inhibits sleep and makes you tired. • It slows recovery from training or injury. • Muscle soreness and pain are more severe. • It leads to diabetes if you don’t fix it. • It raises triglycerides and increases heart disease risk • It leads to a boatload of other health problems—you’ve heard the misery suffered by diabetics (sleep apnea, nerve problems, gut issues, eye and feet problems, and so on). Don’t worry! There are simple everyday things you can do to improve insulin sensitivity and optimize everything about your life. This article will give you a quick run-down on how insulin works and what you can do NOW to improve it. What Insulin Is & Why It Matters Insulin is a hormone that is secreted by the pancreas. When you eat a meal, your blood glucose (sugar) rises after you digest the food. Insulin goes into action, binding with your cells in order to store the glucose either in muscle as glycogen (the energy source for the muscle) or as fat. If you are healthy, the body “prefers” to replenish glycogen first, only storing excess glucose as fat if glycogen stores are topped off. When you develop insulin resistance, the cells aren’t readily binding to insulin. The body has to pump out more insulin to get the high blood glucose that’s circulating Continue reading >>
Can Insulin Lose It's Effectiveness?
Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. I use both Humalog and Levemir. I have been having higher readings lately in my BG and was wondering if my formula needed a change. Or what was wrong. Today I opened a new batch of Humalog in the pen form. Usually I use a syringe. The new insulin really worked and put my BG at the numbers I needed. Has anyone ever found that the last of a vial of Humalog (or any other) insulin did not seem to work for them....or as well? I do leave it out til it is gone and do not refrigerate as that is what the directions say. It was good til 2013. I use both Humalog and Levemir. I have been having higher readings lately in my BG and was wondering if my formula needed a change. Or what was wrong. Today I opened a new batch of Humalog in the pen form. Usually I use a syringe. The new insulin really worked and put my BG at the numbers I needed. Has anyone ever found that the last of a vial of Humalog (or any other) insulin did not seem to work for them....or as well? I do leave it out til it is gone and do not refrigerate as that is what the directions say. It was good til 2013. If it's left out too long, it will lose it's effectiveness. How long was it left out at room temperature? Unrefridgerated it will last about a month (actually a little shorter). Refridgerated it's good until it's exparation date. All of the info you need should have been with the documentation that came in the box. What I need to do is write down the date I opened it and see if it lasts or goes over the 30 days expected for effectiveness. I just wasn't watching how long it lasted. Different amounts on different days according to the ca Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Comparative Effectiveness and Costs of Insulin Pump Therapy for Diabetes
- Type 2 diabetes breakthrough: Scientists create first pill that not only STOPS the condition in its tracks but also helps patients lose weight - and it could be available on the NHS within 3 years