I'm new to insulin, can anyone give me any pointers?

[angelbite11687]

Hello there, a couple of months ago I was put onto lantus and told to adjust my dosage until my morning glucose was in good range. Im also on 2000mg glucophage and 320mg gliclazide daily too.

The nurse has just started me on novorapid as my morning numbers are still at 15mml before food and peak into the high 20s after food.
I've been told to start at an initial 6 units with every meal with a goal of no more than a 2mml rise after two hours. My question is how do I account for a correction dose to get my glucose into normal range on waking and for stability through the day. I'm so over this disease.

 

[xfieldok]

Have you changed your diet?

 

[ert]

As you've just started insulin, you may need to wait a week or so to see where your numbers end up, before making too many changes, as blood sugars tend to come down gradually. I recommend that you start by checking your basal dose buy skipping a meal or eating a carb-free meal to see if your blood sugars holds a line. Follow your DN's advice until you get this right. You should also record a diary of your waking, bedtime, before meals and five hours afterwards finger-prick blood sugars, how much insulin you are dosing and what your carbohydrate count is each meal. Once you have 4-5 days of data, send it into your DN for dosing advice.

It's also important to ask your DN about your own correction dose. Correction doses should be taken with your next meal, and if you're not on any other medication, usually start with the calculation 1 U will drop your blood sugar 2-3 mmol/l. As you're on other medication, contact your DN for clarification.

Injected insulin has a fixed curve, so if you eat normally, you can not achieve the no-more-than-2 mmol/l rise as stated by your nurse (unless you go low carb.) What's important is that your blood sugars return to what they were 5 hours after eating.

Good luck asking more questions of your DN. I hope you get your blood sugars sorted soon.

 

[Antje77]

how do I account for a correction dose to get my glucose into normal range on waking and for stability through the day.

The amount of insulin we need for a correction dose is highly personal. Some of us may need 1 unit to get down from 20, others need 30 units or more.
Can you ask your nurse for guidance on corrections?

Correction doses should be taken with your next meal

Do you mean you can't correct unless you are eating? I've never heard that, and I correct all the time without food. I also prefer waiting until I'm dropping from my correction before eating again.
So again, something to talk over with your nurse, as obviously Ert and I have gotten opposite advice ourselves.

 

[Fawbs89]

Hello there, a couple of months ago I was put onto lantus and told to adjust my dosage until my morning glucose was in good range. Im also on 2000mg glucophage and 320mg gliclazide daily too.

The nurse has just started me on novorapid as my morning numbers are still at 15mml before food and peak into the high 20s after food.
I've been told to start at an initial 6 units with every meal with a goal of no more than a 2mml rise after two hours. My question is how do I account for a correction dose to get my glucose into normal range on waking and for stability through the day. I'm so over this disease.

Hi I take novorapid and levirmir

I've been diabetic since I was 14 and I'm 31 now. Personally I would say its really not as easy as saying just take 6 units. You need to factor in the tablets you are taking too... What if you have a low carb breakfast or a breakfast where you need more than 6 units. I actually think it's ridiculous yo just say take 6 units. For example I have 30 grams of porridge with a splash of honey and peanut butter for my breakfast and I take 8 units of novorapid sometimes 10... It varies person to person. Lifestyle, weight ect

 

[Fawbs89]

The amount of insulin we need for a correction dose is highly personal. Some of us may need 1 unit to get down from 20, others need 30 units or more.
Can you ask your nurse for guidance on corrections?

Do you mean you can't correct unless you are eating? I've never heard that, and I correct all the time without food. I also prefer waiting until I'm dropping from my correction before eating again.
So again, something to talk over with your nurse, as obviously Ert and I have gotten opposite advice ourselves.

I agree I correct all the time without eating. If I check and I'm a bit high I will correct.

 

[masonap]

I guess part of the answer depends on whether you are type 1 or 2.
I’m type 2 and I’ve been on insulin for about 5 years. I moved to a low carb way of eating and my levels are now somewhere between fantastic and incredible. If you haven’t started to reduce your carbs you should start now, before you do damage to your body. Read product labels, look at the total carbs (not sugar, sugar is a carb and is already included in the total). It’s hard to give you advice but for example a yogurt pot for me has to be under 10g of carbs, if it’s more I will skip it. Cut out bread, rice, pasta, potatoes, and anything made with flour or sugar. I think you will find that butter, cheese, cream, eggs, meat, veg, etc are the good things you should be eating. Watch out for fruit, I know people say it’s natural but once you’re diabetic any form of sugar is bad for you (even honey).

 

[ert]

The amount of insulin we need for a correction dose is highly personal. Some of us may need 1 unit to get down from 20, others need 30 units or more.
Can you ask your nurse for guidance on corrections?

Do you mean you can't correct unless you are eating? I've never heard that, and I correct all the time without food. I also prefer waiting until I'm dropping from my correction before eating again.
So again, something to talk over with your nurse, as obviously Ert and I have gotten opposite advice ourselves.

The advice to only correct with your next meal is from DAFNE. They're obviously playing it safe to avoid stacking insulin. Which is probably good advice to someone starting out.

 

[angelbite11687]

Thanks everyone, I'll speak to my nurse and see what she says, she has said to go low carb which I'm doing, but it's scary starting out on a rapid insulin and suddenly being told to adjust my dose, it really hasn't been explained, I don't know about how to adjust to carb load or anything. It's very daunting

 

[DCUKMod]

Thanks everyone, I'll speak to my nurse and see what she says, she has said to go low carb which I'm doing, but it's scary starting out on a rapid insulin and suddenly being told to adjust my dose, it really hasn't been explained, I don't know about how to adjust to carb load or anything. It's very daunting

Angelbite, the following link was designed for those living with Type 1, but many Type 2s, using on insulin have founf it beneficial in a few areas. It's a free resource and once you have signed up, you can dip in and out to take things at your own pace.

I don't envy you trying to get the balance right with diet, tablets and injections, but in your shoes, I'd be inclined to take it steady and try to understand each step of the way, rather than bash on through and still not really understand what's going on.

Fingers crossed for you. I hope your call with your team is helpful.

https://www.bertieonline.org.uk/

 

[Type1jobo]

Hi rebecca I’m kind of in the same boat regarding your situation. Hope you are ok

 

[TashT1]

I would echo that Bertie online is a great resource for learning about carb counting & adjusting insulin.

It’s quite common to have a fixed dosed at first until you become more confident & then you can start to play around. It can also take a few weeks to see your levels come down & that isn’t a terrible thing.

As others have said, test & record everything. You might find 6u is enough based on time of day, what you eat & your activity level but eventually you might want different ratios for the time of day.

Take a couple of hours & work through the Bertie course, you will feel a lot better informed.