My Mom Is A Brittle Diabetic

[MomsLittleGirl20]

Hi,
My Mom (46yrs) was diagnosed a Brittle Diabetic. She has been taking Lantus at night and she dreads taking it because it causes her to scream from the burning in her arm. She uses the smallest needles available for the pen. Her diet is very limited and on a daily basis she usually eats about 2 bowls of cucumbers with vinegar and a bit of olive oil and some type of protein, such as chicken or salmon. Her sugar is never consistant. Sometimes her sugar level reads 430, 525, 290 and so on through out the day and sometimes hits way low around 50. It is troubling to see my Mother struggle with this.
If anyone could possibly have any tips on how to avoid the burning of the Lantus I would greatly appreciate any information. She has recently gone to the doctor and gave her no alternatives or prevenative info on the burning and also uped her units from 40 to 60.
If there is any information you have at all on the Lantus  and/or diabetes in general, I thank you.

[JDRF-Team-RL]

Hi MomsLittleGirl.  I'm not a medical professional, just the parent of a child with diabetes.  Thank you for caring enough about your mother to ask questions like this.

There are lots of factors that go into blood glucose scores, everything from stress to exercise can have an effect.  It's much more than just the foods that a person eats.  As long as your mother maintains a good diet combined with exercise and proper monitoring and adjustments, the scores should come back into range.

As for the burning of the shots, does she only use one injection site?  Or does she change where she gives shots?  Legs and stomach are two good areas to give shots.  Continuing to give shots in the same location can build up scar tissues and make it more painful.  My brother is also Type 1, he also uses Lantus, and he primarily uses his stomach for injection sties because he says it's less painful.  There are also several different techniques to giving shots.  Is she injecting too quickly?  That much insulin being pushed into the skin too quickly can also cause pain.  We've also done things with my daughter to make it less painful, such as keeping a spoon in the freezer, and right before she gives a shot she puts the spoon on the site where she's going to inject.  It numbs the site just enough and just long enough to prevent the pain.  Try those suggestions and let us know if it helps.

[MomsLittleGirl20]

Hi RL,
Thank you for the information.
Well, in regards to the injection site, my Mom has been using her arm, as her Doctor told her that by using your stomach, the fat tissue can cause the insulin to not be released into the body properly, causing it to not work as well. Also, my Mmom has tried all three injection sites, Leg, Arm, and Stomach. She bruises so easily in those areas, but not as badly in her arm. The Endo Doctor also told her that if her sugar levels are not reading well, he will continue to up her doages of the insulin.
Thank you for your information. Also, I wish the best for your brother and your daughter!
Thanks again,
Mom's Little Girl

[JDRF Volunteer CDB]

You don't say if your mom has a lot of body fat, but it seems unlikely given her diet and her high blood sugar. If she doesn't, I don't see why her doctor would discourage giving shots in her abdomen. My daughter's doc, who is a highly respected endocrinologist, encourages giving shots all around the abdomen area, which is mostly where my daughter does it. The arm is often more sensitive.

The frozen-spoon idea is a great one-- thanks for the tip!

[JDRF-Team-LRS]

I'm another volunteer here and I wonder if your mom keeps her vial of Lantus in the refrigerator.  Extra bottles should be kept refrigerated, but the vial of insulin we are using for daily doses should be kept at room temperature.

I've heard from others who use it, that Lantus burns a lot when it's injected cold.

You mom should really work with an endocrinologist and/or certified diabetes educator to help her gain better control over her numbers.  They'll never be perfect.  Type 1s always need 2 types of insulin -- one to cover the baseline needs. Lantus is an example of an insulin that covers baseline, sometimes called "basal" insulin.  We also need insulin to cover the carbohydrates we eat at meals & snacks.  Type IIs sometimes use a combination of insulin and oral meds; some Type IIs use just insulin; others use just oral meds; still others can gain control with diet & exercise.  The point is, needs differ across individuals, and for each of us, our needs change over time.

Encourage your mom to work more closely with her medical team.  Perhaps she'd welcome your going with her to her appointments.  You could help by asking questions of your own and listening carefully to what the professionals are saying.  After the appointments, you'd be able to discuss specifics with her.

[JDRF Team SGG]

I am a type 1 diabetic who uses Lantus, and I don't notice any burning, no matter where it is injected. Perhaps the first suggestion is one she should try, slowing down the actual push of medication into her injection site. She is taking a large dose of Lantus, and if she slows down how she pushes the plunger, it will keep the bruising from being as bad, for the insulin can be absorbed into the tissue better than when it is pushed too quickly and causes a bubble of sorts. I also have been told that the abdomen is usually one of the best spots to inject... most endocrinologists encourage their patients to use this area because the insulin is absorbed quicker there.

I am guessing from your mom's doctor's comment about fat tissue being a problem that your mom is overweight. If so, she probably is a type 2 diabetic who has been put on insulin, and so is being CALLED a type 1 diabetic. Type 2 diabetics are usually overweight, and the problem is not an immune system disorder as in type 1 diabetes, but is instead a problem with insulin resistance, for fat tissue is insulin-resistant. So too much fat tissue can cause real problems with insulin efficiency. If your mom is indeed overweight, she can probably solve some of her problem (the high insulin dose causing bruising) by losing weight. Less fat tissue means less insulin resistance and therefore a smaller insulin dose. This might also help the numbers to stabilize. I wish her the very best.