On one shot a day there is no insulin left in the blood in the morning and thus one needs the quicker beef Neutral insulin mixed with the morning Isophane shot to fill the gap. Later in the day, if the BG goes too hi, for various reasons, it takes far less neutral to reduce the BG but normally the Isophane will continue its action thus reducing the blood sugar without a bolus neutral injection.
Also, I take the same dose of Neutral every morning whether the BG is hi or low. If low then eat a small breakfast. If hi eat nothing for breakfast. Adjust the food, not the insulin. {once you have determined the right dose}. Also, one needs to understand that the Isophane turns into basal at night to keep the blood glucose in a normal range while sleeping (after dinner thru the night hours). If one does something like dancing after dinner, then a bed snack is usually needed.
Eating more than your normal diet will require a bolus Neutral shot, @ the meal to give enough insulin to cover the extra food consumed. Be careful, as you dont want to cause a needless hypo in 2-3 hours. Understand that the Isophane is still working to take care of the lunch & supper meals. Also realize the blood glucose (bg) after a meal nearly always raises to 250-300 but comes down without another shot. Plus never go to bed with a normal bg reading because youll have a hypo while you sleep. Try for a 225 before bed to awaken with a normal blood glucose.
Examples of handling:
*EXAMPLE 1: 200bg at 9AM: No breakfast. Only coffee + a cracker to satisfy the empty acid stomach.
I take the 60% Isophane with 40% Neutral to bring the BG to 100 by 11 AM to 12 PM = (2-3 hours).
* EXAMPLE 2: 70bg at 9AM: I take the 40% Neutral with the 60% isophane just before eating 5 min. oatmeal (w/2 saccharine) mixed w/raisins & a teaspoon of peanut-butter for breakfast. One still needs the 40% Neutral (or whatever amount suits you) to quickly ad insulin to the blood for the beginning of a normal day. There is rarely a need to take more Isophane unless you plan to have a large supper. But if the morning bg is over 250 then 1-2 extra units of Neutral may be necessary to allow lunch at 11:30 to 1 PM.
EXAMPLE 3: 500+- bg after supper because the meal was too big. Go dancing & take Neutral to bring the bg down in 2-4 hours. Depending on how the insulin works for you. In my situation it reduces the bg by 65-70 points per unit of neutral in 3-4 hours after an 8th or 9th hour dinner. You must figure the units of neutral and how much you need for your size, weight and activities.
Expected. MATH: 500bg-125 desired bg=375needed reduction while asleep.
Math: 375 bg divided by 65 bg probable reduction per unit =5-6 units of Neutral needed. (The formula should be the same but the units may change depending on ones size, weight, health, exercise and other drugs.
I have found the combo of 40% Neutral + 60% Isophane Beef/Bovine insulin every morning to be the magic formula. Assuming you are an otherwise healthy individual and not on other drugs. Variations may be different for different life styles and amounts of exercise. As for me, when I am active I merely eat more to serve both the activity and the insulin. If you are on other drugs, you must discover how they affect the insulins action.
Below I have included a diet suggestion that will suit the 1 shot a day with mild exercise. The blood glucose should stabilize to 8-8.9 A1c. This is not intensive therapy, thus, once you become familiar with the insulin action you should have few hypoglycemic insulin reactions and not have to worry about bolus injections to control hyperglycemia.
Understanding the main causes of insulin reaction (hypoglycemia) can avert the monster pretty well and with beef there is nearly always a warning unless you have allowed the bg to be too low too many times in a short period of time (2-3days). The main causes of hypos are: too much insulin, not enough food, more than normal exercise, missing a meal, other drugs & alcohol, ignoring the symptoms of the hypo, a change of health condition, & just variables of being a brittle diabetic. But dont fret, beef insulin offers a nearly normal life. Far more stable than what synthetic insulin offers. We will never be normal so dont expect it.
8-8.9 A1c allows one to feel pretty good almost all the time. Tight control is deadly for the brittle type one diabetic. Normal blood glucose is a must before meals but spikes after meals. This is a necessary formula to keep going without a hypo for us brittle diabetics. Do not keep your A1c any lower than 7.7 or you will damage the nervous system, eyes, kidneys, etc. Thats a kind ah cover all statement so if you need help with this easy life style just email & I will help you. It is wonderfully different than the life that is offered by any synthetic insulin.
If you need a larger diet then increase diet & insulin accordingly. I am a very small person and eat according to my size and activities. Keep in mind the basal need is always there even if you eat nothing. Meaning you need insulin weather you eat or not. The more you eat the more insulin is needed to cover the calories. Except when one is sick and cant eat. Then drink a lot of water but continue the insulin with many blood glucose tests Neutral insulin in small doses thru the day adjusting for hi or low.
The difference in beef insulin activity is going to delight you. Beef insulin is the only insulin that offers one shot a day as an option giving fair to good control, not tight control. For the Juvenile Type One, tight control should never be on the agenda. Tight control usually/frequently causes hypoglycemic unawareness, which causes nerve, eye and kidney, etc. damage and an overall grumpy person.
OK, I can hear your doctors disgust,,,, but believe me, for the juvenile type one, otherwise healthy diabetic 8 to 8.9 A1c is the only way to live a near normal life. So you go to 300 occasionally after a meal. Dont panic the beef will kick in to reduce the blood glucose to 1-200 without doing anything except allowing the Isophane/Neutral morning shot to perform for you. Depending on the time of day the 300 blood glucose reading might occur. If its before bed then youll need a tiny shot of Neutral. I would take 2 units of neutral if I were 300bg before bed. Remember Im only 51 tall.
Any change in insulin must be accompanied by frequent (every 2 hours) blood glucose and daily urine ketone tests. Keep a chart so you can see a pattern and adjust the dose up or down. Be sure to eat enough natural carbs or the ketones might cause a yuck feeling. Ketones are dangerous weather from hi or low blood sugar (eat a few natural grain crackers (Wasa, RyVita, etc) weather hi or low and drink plenty of water). Bg should be 70-150 before eating a meal. If its to hi wait till it comes down. Bg should rise to from 200-275 from 1-3 hours after a meal.
This scenario is mandatory until you stabilize and become accustomed to how the insulin feels for the different situations of ones life style demands.
You should feel the lows before they get too low (70bg) so you can take care of them before they zap you. However, if you are accustomed to a doctors prescription of 6 to 7.9 A1c (should be 8 to 8.9) you will need to keep the BG over 70 so you begin to feel it when the BG begins to drop below 70-80. For a brittle diabetic, a 6 A1c is a prescription for frequent hypoglycemic reactions and nerve damage, without a possibility of keeping the bg above 70. Again, a very pleasant insulin by comparison to any of the erratic synthetics including Lantus (see article).
The hardest part will be in forgetting all that you have been indoctrinated with concerning life style via todays status quo. Life on beef insulin is pleasantly different than todays synthetic insulin directives for life. Just write to me at
Try to keep the BG above 70 because to many below 70 readings will interfere with the ability to predict hypos. Causing poor hypo warnings (hypoglycemic unawareness - hu). It is best to allow the bg to be a little hi while you are trying to determine the correct dosing and diet.
The following is my diet.
850-1250 calorie diet (geared to the Beef Isophane + Neutral action)
9AM w/shot 60% Isophane & 40% Neutral
This is my schedule w/beef insulin determined as close as possible.
If you need more calories, thats fine, just keep the diet balanced and timed to the action of the insulin. If you are taller you'll need more calories. I'm only 5'1"
Logic the 40% Neutral is starved at 11-1 oclock.
Logic the 60% Isophane is starting.
Logic the morning Isophane&Neutral will bring down the bg before lunch.
BG will/should rise to 250-300 after lunch. Take no insulin for this.
The AM shot will cover the meal.
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DINNER 4-5 PM (bg 80-150)
2 carb servings 160
4 lean protein (or 3 prot. +1/2 c milk) 220
~ veggies-no butter 40
1 fruit 40
TOTAL CALORIES 460
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BEDTIME SNACK Rarely.
Have up to 150 calories if bg is less than 200.
Cereal and milk if bg is 70-125 before bed.
NOTE: You do need to understand Isophanes Basal action at night before you can accurately figure when you need a bed snack. Dont be alarmed if a low blood glucose level awakens you at 3 to 5 AM from the shot you took in the morning IF you needed but failed to eat a bedtime snack or exercised more than normal.
If one needs to stall a meal, 1 banana fills the gap in timing perfectly & doesnt throw off the next meal. But dont eat more than 1 small banana daily.
Unlike the synthetics a low will probably wake you up when the bg drops to approximately 55-60. As there are no synthetic insulins that last 24 hours for the Juvenile type one diabetic, you will be delighted with the beef insulins calm, slow, regular, forgiving normal 24 hour action.
I hope you will aim for an 8-9 a1c as 6-7 is disastrous. Forget the bad rap the endo might give you as no brittle diabetic should maintain tight control, EVER. If you do you are asking for diabetic complications of all types including a wrecked nervous system otherwise know as neuropathy. Also, forget the bad directives of the ADAs DCCT trial.
NOTE: I am 51 and weigh 126 pounds loving mild activity like dancing, house/yard work, and inspecting and showing homes for sale. I am 63 years young. My directives are from 59 years of successful living with this monster called diabetes.
Larger or smaller people need to adjust the insulin and food according to their size, activity and health.
