How to balance glucose level by humalog mix

[Zohaib]

I am taking humalog mix for past 3 weeks but am not able to balance my sugar levels. I have started to count my carbs and here is the average data for past week:
Note: All sugar readings are taken after carbs intake.

Carbs intake (g) Sugar
6 am Breakfast 33 103
9:30am Snacks 20 Hypo
12:15pm Lunch 45 220
5pm Snacks 15 Hypo
8pm Dinner 40 80

Kindly advise me how to maintain normal blood sugar plus how to take exercise into account when setting insulin dose?

 

[Zohaib]

I am taking humalog mix for past 3 weeks but am not able to balance my sugar levels. I have started to count my carbs and here is the average data for past week:
Note: All sugar readings are taken after carbs intake.

Carbs intake (g) Sugar
6 am Breakfast 33 103
9:30am Snacks 20 Hypo
12:15pm Lunch 45 220
5pm Snacks 15 Hypo
8pm Dinner 40 80

Kindly advise me how to maintain normal blood sugar plus how to take exercise into account when setting insulin dose?

I am taking 16 units in morning before breakfast and 10 units at night before dinner.

 

[azure]

@Zohaib On mixed insulin you need to eat the same amount of carbs at the same times. You should have been told how many carbs to eat per meal and snack.

Test your blood sugar before eating and two hours after the start of your meal. This will show you whether you're eating enough carbs or too many.

It's not clear from your above list how long after eating you tested.

Routine is everything when you're on mixed insulin - eat at the same times and the same amount of carbs.

 

[Chas C]

@Zohaib as mentioned you need to stabilise your carb intake and make it consistent, if your having mid meal hypo's you need to either decrease the insulin or increase the carbs in the previous meal.

Take care when balancing as the hypo's will give you a follow on high blood sugar that you need to ignore until you have fixed the cause for the initial hypo. Once you have done this over a good few days then you can concentrate on the next meal/hypo.

So start by counting carbs and working on one meal at a time, try this for a few days until your happy its looking ok then move to the next meal and repeat. Don't try to fix everything at once as it will just cause you to get in a mess.

 

[Daibell]

Hi. Are you a T1? Is there any reason you are on mixed insulin rather than Basal/Bolus? The latter involves more injections but gives much better control.

 

[urbanracer]

I am taking humalog mix for past 3 weeks but am not able to balance my sugar levels. I have started to count my carbs and here is the average data for past week:
Note: All sugar readings are taken after carbs intake.

Carbs intake (g) Sugar
6 am Breakfast 33 103
9:30am Snacks 20 Hypo
12:15pm Lunch 45 220
5pm Snacks 15 Hypo
8pm Dinner 40 80

Kindly advise me how to maintain normal blood sugar plus how to take exercise into account when setting insulin dose?

Hi @Zohaib ,

The following is a copy and paste of a response I gave to another member a couple of months back.....

So Iam using Humalog Mix25 with reasonable success (my last a1c was 6.8) but I've reduced my carb intake and I keep track of what I'm eating.

Using an insulin to carb ratio of 1:10, if I intend to eat 30g of carbs, I need 3 units of RA (rapid acting) insulin to keep my blood sugars under control. But only 25% of the insulin is RA so I need a total of 12 units with this meal - which gives me 3 units of RA and 9 units of LA (long acting). I need to to tweak this depending on my planned activity level and whether there is alcohol with the meal.

I find that if I try to eat roughly the same amount of carbs each day and inject the same amounts of insulin at the same times, I can keep fairly good control of my BG numbers. It does restrict spontinaiety a little, but it's a small price to pay.

I inject 12units every morning and don't go over 30g of carbs for breakfast. Depending on my activity levels I might need a biscuit mid morning to suppress a hypo. Lunch is a problem, because the RA insulin is spent after approximately 4 hrs so I often take a couple of units of RA insulin for this (or have an ultra low carb lunch). My evening meal is variable so I adjust the insulin accordingly based on my experience so far. But if I have 40g of carbs I'd need 16 units of insulin and then I'd hypo during the night.

It is always advisable to discuss any proposed changes in your insulin regime with your support team, unless you are supremely confident that you know what you're doing.

............hope you find this helpful.

Also, if you are new to insulin it can take a few weeks for the body to adjust.

 

[Zohaib]

@Zohaib On mixed insulin you need to eat the same amount of carbs at the same times. You should have been told how many carbs to eat per meal and snack.

Test your blood sugar before eating and two hours after the start of your meal. This will show you whether you're eating enough carbs or too many.

It's not clear from your above list how long after eating you tested.

Routine is everything when you're on mixed insulin - eat at the same times and the same amount of carbs.

I tested my sugar as per advice today and I got the following readings

Morning: 16 units
Fasting 92
After Breakfast 106

Evening: 10 units
Before 92
After Dinner 83

Are these readings ok?

 

[azure]

Those are very good readings @Zohaib but it depends on whether you're dropping further. Some of those readings are around 5mmol and that's great but if your blood sugar is still falling then you could have a hypo later.

Again, with your fasting reading - that's very good as long as you're not going low in the night.

I like to have a 'cushion' when I wake up so I prefer to be in the 5s or even low 6s. It's a balance between getting good results and avoiding going too low.

Here's the converter so you can see the units we use on this site (mmols):

http://www.diabetes.co.uk/blood-sugar-converter.html

.
,

 

[Zohaib]

Hi @Zohaib ,

The following is a copy and paste of a response I gave to another member a couple of months back.....

So Iam using Humalog Mix25 with reasonable success (my last a1c was 6.8) but I've reduced my carb intake and I keep track of what I'm eating.

Using an insulin to carb ratio of 1:10, if I intend to eat 30g of carbs, I need 3 units of RA (rapid acting) insulin to keep my blood sugars under control. But only 25% of the insulin is RA so I need a total of 12 units with this meal - which gives me 3 units of RA and 9 units of LA (long acting). I need to to tweak this depending on my planned activity level and whether there is alcohol with the meal.

I find that if I try to eat roughly the same amount of carbs each day and inject the same amounts of insulin at the same times, I can keep fairly good control of my BG numbers. It does restrict spontinaiety a little, but it's a small price to pay.

I inject 12units every morning and don't go over 30g of carbs for breakfast. Depending on my activity levels I might need a biscuit mid morning to suppress a hypo. Lunch is a problem, because the RA insulin is spent after approximately 4 hrs so I often take a couple of units of RA insulin for this (or have an ultra low carb lunch). My evening meal is variable so I adjust the insulin accordingly based on my experience so far. But if I have 40g of carbs I'd need 16 units of insulin and then I'd hypo during the night.

It is always advisable to discuss any proposed changes in your insulin regime with your support team, unless you are supremely confident that you know what you're doing.

............hope you find this helpful.

Also, if you are new to insulin it can take a few weeks for the body to adjust.

As per your advice I discussed my Insulin dose with my doctor today. He changed my dose to 14 units of humalog mix in morning and added 8 units of humalog plain in lunch.

 

[TheBigNewt]

Those sound like much improved readings. I'll second what @azure said about not dropping too far after the 2 hour reading was taken. That would imply a tad too much short acting at mealtime. I'm not familiar with mixed insulins. If you take 15 units total is that about 10 of the N and 5 of the R? Here mostly Type 2's take the mixtures not Type 1s.

 

[urbanracer]

As per your advice I discussed my Insulin dose with my doctor today. He changed my dose to 14 units of humalog mix in morning and added 8 units of humalog plain in lunch.

He hasn't given you the ok to vary it? Interesting approach.