Wil Dubois

If it isn't one thing with diabetes, it's another — from trying to figure out our dosing needs to cross-over with other ailments to how we feel about sharing our D-issues with loved ones and others in our lives. We at the 'Mine are here to support you, especially each Saturday with our weekly in-depth advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and educator Wil Dubois.

This week, as we wind down the year, Wil's addressing some "straggler" queries from the mail bag... which we thank you all for keeping full!Ask D'Mine Mail Bag


{Have questions of your own about diabetes? Email us at [email protected]}


Billy, type 1 from Texas, writes: I'm just writing to say thank you!! Back in '62 when I was first diagnosed, I remember overhearing my family doctor tell my mother that I would not be able to live into my 30s. I was 12 at the time. I'm not quite 12 anymore... well, please don't ask my wife about my emotional age!  ;-) But I am happy and healthy. I have just read some recent research studies about how we (type 1s) feel alone socially... Really?! No duh!!  Well, I don't feel alone anymore, thanks to you.

[email protected] D'Mine answers: Thanks, Billy, you just made my day. The great thing about this gig is I don't feel alone anymore, either.


Ruth, type 1 from South Carolina, writes: Medicare letter received today says my Novolog is no longer covered in 2014, and I'll need to change to Humalog. Do I need to change how I use it in the pump? 

[email protected] D'Mine answers: Nope! It's always vexing when the powers-that-be force us to change brands, but the action curves of these two insulins are pretty much the same. They both have virtually the same onset time, peak, and duration. It's like changing from Cheer to Tide to do your laundry. The soap is technically different, but either one will get your clothes clean.

Of course, as we are complex biological organisms, not washing machines, there will be some small differences, and you'll probably need to tweak your pump settings going forward. But there's no universal advice for me to give you when switching between the big two fast-acting insulins: Some folks might need a little more, some might need a little less, and others make no changes at all. Your D May Vary.

Oh...Wait. Then there are those people like fellow diabetes blogger Sarah Kaye who's written about her Humalog experiences just not panning out at all. So I probably should have qualified what I said by adding soHumalog from Novologmething like, most folks see little difference...

That's not to say that switching brands is something that can work for everyone with diabetes. There are those who report one insulin variety just doesn't work the same way — one example that comes to mind is fellow diabetes blogger Sarah Kaye who's written about her  not panning out... But again, keep in mind that YDMV.

Either way, it's scary changing, and you'll be hyper alert to speed bumps in your diabetes control, so my advice is to ramp up your testing and keep a food log on your last few weeks on the old insulin. This will give you an up-to-date baseline so you can see where you're really at prior to the change over. Keep it up for the first few weeks on the new juice. This way you'll be making changes based on some real data and avoid falling into the trap of blaming the new insulin for something that may not be not it's fault.


Carrie, type 2 from California, writes: I have type 2 diabetes and lithium-induced decreased renal function with eGFR 32, and CR 168 (measures of kidney function). Can you suggest a combined diabetes/renal diet that would feature  1,500 calories  and 40 grams of protein a day?

[email protected] D'Mine answers: Good Lord, no. I am soooooooo NOT qualified to answer this question. It's way above my pay grade. You need to find a Certified Diabetes Educator of the Registered Dietitian variety. You should check with your nephrologist to see if they have someone they like working with, but if not, you can search for one yourself here. This is a zip code-searchable database hosted by the NCBDE, the folks that certify CDEs. To test it out, I first ran a search for my zip code but came up blank, as there are no CDEs for a hundred miles, the maximum search radius. So next I picked out a San Francisco zip at random—hello 94122!—and boom, a ton of CDEs popped up.

What I like about this particular list is that it features a little "about me" section the CDE can fill out. TheySearching For CDE don't all do it, and many of them who do are rather clinical and dry, but some of the CDEs give us a peek into their souls. It's sort of like speed dating, you can get a quick feel for whether or not this is the educator for you. For instance there was one who says she's patient and compassionate, another who talks about her missionary work, one who's D-folk like us, and still another who has family members with diabetes but personally enjoys mountain biking. I won't be seeing her anytime soon. Oh, and then there's one pitching annual health retreats in Hawaii and Italy (nice little tax deduction there), one who speaks Chinese, and one who volunteers for Dogs4Diabetics. The NCBDE site does not specify credential (RN, RD, Pharm, etc.), but many of the listed educators, especially the dietitians, include this info in their mini-bios.

Happy hunting!


Jane, type 1 from Florida, writes: A week ago I was operated on for a detached retina.  Since then, I have been taking Pred Forte drops three times a day. Within a day my blood glucose, which has been under steady control, has gone wildly out of control, regardless of the units I take and the food I consume or exercise I do. Have others experienced this craziness, and what alternative treatment options are available?

[email protected] D'MPred-Forte-Eye-Dropsine answers: The eye drops are a steroid, a class of drugs that are the number one ass-kickers when it comes to elevating blood sugar. Adding a steroid to blood sugar is like pouring lighter fluid, kerosene, paint thinner, and gasoline onto drought-parched prairie, throwing fifteen matches into the grass, and then dropping napalm on top of the whole affair.

Right. You get the picture. A difficult fire to put out with one measly vial of insulin.

The good news for you is that you only need to take the eye drops for a few weeks while your eye heals. This won't be a permanent therapy. I don't honestly know if there are alternatives, but a detached retina is serious businesses. I'd take what the doctor ordered with a chaser (or two or three or five) of insulin and just ride it out. Once the eye drops are finished, your blood sugars will return to normal.



Carmen, type 2 from Montana, writes: I have PCOS (Polycystic Ovary Syndrome) and diabetes. Some people have said I may have a more difficult time controlling my BG levels due to the PCOS, but how do I tell the difference? If I'm taking my meds, but my BG is still off, it could be something I ate or stress or anything else.

[email protected] D'Mine answers: It's hard to define "difficult" when it comes to diabetes control, as all diabetes control takes a lot of effort. In your case, having PCOS makes you more insulin resistant than a type 2 without PCOS, and, of course, type 2s are pretty insulin resistant in the first pltype 2 diabetes medsace. Most women with PCOS take metformin, which in addition to being a mild insulin sensitizer, is also an effective treatment for the PCOS itself.

But you are right, you can't really tell the difference between you and anyone else. All you can really do is know if your therapy is doing the job most of the time or not. If you are taking all your meds and your blood sugar is generally above target, then you know your meds aren't robust enough for the combo of diabetes and PCOS, and your therapy needs to be ramped up. If your sugar only occasionally spikes, then food or stress is the more likely culprit.

I've said it before, and I'll say it again: Diabetes is enough. In a Just Universe we'd be immune to all else, including the common cold and mosquito bites.

Oh well, we don't live in a Just Universe.  But at least we're not all alone...

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.
Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.