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Humalog mix correctional doses

Jacquelineann

Jacquelineann

Well-Known Member
Messages
66
Type of diabetes
Type 1
Treatment type
Insulin
Hi
I am on morning and evening Humalog 25 mix and lunchtime Humalog 50 dose, plus Metformin. Can anyone tell me how to apply a correctional dose of insulin please? In fact can anyone tell me how to calculate the amount of carbs I should eat in relation to units of Humalog mix injected? Because my medics certainly can't :-(
 
A morning injection of Humalog mix 25 is supposed to last throughout the day until the evening dose. I'm puzzled why you're injecting at lunchtime.
 
I was told 8 units of humalog 25 in the morning, 10 of humalog 50 at lunch and 8 of humalog 25 with dinner. These doses are way too high and I don't take anything like that much, but should I be taking one larger dose at breakfast? Wouldn't that give me too much rapid action insulin?
 
Hi Jacquelineann

you posted again while i was writing
humalog mix25 and humalog mix 50 are not really insulins that are designed for taking correction doses.

the very nature of these insulins is such that they are designed to be used in a fairly rigid routine of eating and injecting at the same times every day.

if you used either of these as a correction you would be stacking insulin and would leave yourself vulnerable to lows at unexpected times in relation to your daily life.

as to insulin to carbs ratio first have a read of the attached link which explains in detail how mixed insulins work and who they are suited to.
http://dtc.ucsf.edu/types-of-diabet...pies/type-2-insulin-rx/sliding-scale-therapy/

we would need to know the doses you are taking , pre meal and 2 hour post meal test results , and how many carbs you are eating per meal to help make any sense of it for you.
 
using the doses you have posted
8 units mix25 in the morning is 2 units fast acting which is in theory about 20 grams carbohydrate
10 units mix50 at luch is 5 units fast acting and therefore about 50 grams carb
evening dose as brekkie
 
Jacquelineann said:
I was told 8 units of humalog 25 in the morning, 10 of humalog 50 at lunch and 8 of humalog 25 with dinner. These doses are way too high and I don't take anything like that much, but should I be taking one larger dose at breakfast? Wouldn't that give me too much rapid action insulin?
Click to expand...


I'm afraid none of us are medically qualified to give advice on how much insulin you should take @Jacquelineann, appreciate when you say that your medics have been unhelpful but they are the best people to advise on such matters.

If your just under the care of a Dr's surgery for your diabetes care then ask for a referral over to the hospital diabetes clinic as they are more adapt at dealing with type 1 related issues, if your wanting an insulin regime where you can adjust your doses more easily around meal-times then do ask about basal/bolus.
 
I'm on Humalog mix 25 too and through adjustments I now inject 10 units in the morning and 10 in the evening and this keeps me fairly stable throughout the day and night. I manage to keep within my target range of 5.0 -8.5mmol. I eat about 80g of carbs per day and this seems to match the insulin dose. This regime was agreed with my Diabetic team and you really need to be guided by them. What I have said is only an example of how I'm coping, which may not suit you at all.
 
himtoo said:
using the doses you have posted
8 units mix25 in the morning is 2 units fast acting which is in theory about 20 grams carbohydrate
10 units mix50 at luch is 5 units fast acting and therefore about 50 grams carb
evening dose as brekkie
Click to expand...
 
Thank you all for your replies. One of the main problems is that I am in Spain and the medical system is different here. I don't think the medics are unhelpful, but by their own admission they don't know much about diabetes so I am having to work out a lot by myself. This is interesting that basically I should cater for the fast acting percentage of the dose in the amount of carbs I take per meal. I had been doing that and was having severe hypos and therefore it seemed logical to me that I should also be "catering" carbo-wise for the slow acting percentage. To simplify - if I have 4 units (in total) humaglog 25, I need 4 "units" (10-15grms each) of carbs. But maybe not? I will read the link that has been kindly posted and see if I can get anywhere with it. I actually would much prefer a basal/bolus regime. It will be the 4th different treatment I have received and they may be getting a tad fed up with me, but I have to get this right.
 
taking @noblehead ' s response on board -- this information is based on my experience of taking mixed insulins for many years.

you are correct in that part of the carb needs to come out of the longer acting part of the dose but the main meal at dose time is the fast acting part.
it is really difficult to be exact as factors including your weight and physical activity are part of the equation.

one of the main ways I accomplished my regime was to eat little and often

so breakfast , mid morning snack , lunch , mid afternoon snack , dinner , and finally bed time snack
this was a diet that was quite rigid -- not so much in terms of EXACTLY what was eaten but definitely exact in terms of measured ( weighed ) amounts of carbohydrate ar fairly rigid times.

for example i ate the exact same breakfast -- no variance for about 12 years
and the exact same 1/2 sandwich ( with the same amount of butter and mayonaise ) with the same weight but different meat every bedtime snack for the same 12 years
 
himtoo said:
taking @noblehead ' s response on board -- this information is based on my experience of taking mixed insulins for many years.

you are correct in that part of the carb needs to come out of the longer acting part of the dose but the main meal at dose time is the fast acting part.
it is really difficult to be exact as factors including your weight and physical activity are part of the equation.

one of the main ways I accomplished my regime was to eat little and often

so breakfast , mid morning snack , lunch , mid afternoon snack , dinner , and finally bed time snack
this was a diet that was quite rigid -- not so much in terms of EXACTLY what was eaten but definitely exact in terms of measured ( weighed ) amounts of carbohydrate ar fairly rigid times.

for example i ate the exact same breakfast -- no variance for about 12 years
and the exact same 1/2 sandwich ( with the same amount of butter and mayonaise ) with the same weight but different meat every bedtime snack for the same 12 years
Click to expand...
Thank you himtoo - that's brilliant. Snacks suit me and am also very capable of sticking to the same old thing for at least two meals a day so I may, finally, get this to suit me! I shan't throw in the towel just yet! Thanks everyone very much for your help. It's so easy to get discouraged!
 
Jacquelineann said:
Thank you himtoo - that's brilliant. Snacks suit me and am also very capable of sticking to the same old thing for at least two meals a day so I may, finally, get this to suit me! I shan't throw in the towel just yet! Thanks everyone very much for your help. It's so easy to get discouraged!
Click to expand...

Out of interest why not do bolus basal?
 
Simply because my poor doctor is exasperated with me anyway and he started me on Metformin, then gave me Metformin and Lantus, then Metformin and Humalog 50 once a day as I recall - maybe it was twice - and now this combination, although I did ask for basal/bolus. He freely admits he knows very little about diabetes. Not hugely reassuring but it's not a precise science even if you are the living pin cushion. Hard to expect someone else to grasp the complexities of your body even if they did study it in medical school. I think he thought the mix would be much easier for me but it's accuracy I am after, not ease. If I have no joy following the advice of himtoo above then I'll ask again :-)
 
If you are completely dependent on insulin then a basal/bolus would help you tremendously................i know me saying that doesn't help you now though.......

is a basal/bolus regime possible...........
 
Jacquelineann said:
Simply because my poor doctor is exasperated with me anyway and he started me on Metformin, then gave me Metformin and Lantus, then Metformin and Humalog 50 once a day as I recall - maybe it was twice - and now this combination, although I did ask for basal/bolus. He freely admits he knows very little about diabetes. Not hugely reassuring but it's not a precise science even if you are the living pin cushion. Hard to expect someone else to grasp the complexities of your body even if they did study it in medical school. I think he thought the mix would be much easier for me but it's accuracy I am after, not ease. If I have no joy following the advice of himtoo above then I'll ask again :)
Click to expand...

Hi Jacquelineann,

I use Humalog Mix25. I take 12u in the morning and a variable dose in the evening depending on meal size. With these doses I am always high after lunch unless I take a couple of units of rapid acting insulin (Humalog Lispro). If I were to up my breakfast dose to get over lunch then I'd have serious hypo's mid morning.

This has been working well for me for the past 6 months or so and is possibly another way of doing things. It was recommended by my hospital, but as per general forum rules I am not advocating that you change your regime without professional advice.

I am seeing medics in mid-July and may change to basal/bolus which I'm told offers a bit more flexibility.
 
novorapidboi26 said:
If you are completely dependent on insulin then a basal/bolus would help you tremendously................i know me saying that doesn't help you now though.......

is a basal/bolus regime possible...........
Click to expand...
It could well do. Happy to say that having followed the advice of himtoo (THANK YOU himtoo!) the last 24 hours figures have been much more stable. But a basal/bolus regime does sound good. I'll bear it in mind, thank you
 
urbanracer said:
Hi Jacquelineann,

I use Humalog Mix25. I take 12u in the morning and a variable dose in the evening depending on meal size. With these doses I am always high after lunch unless I take a couple of units of rapid acting insulin (Humalog Lispro). If I were to up my breakfast dose to get over lunch then I'd have serious hypo's mid morning.

This has been working well for me for the past 6 months or so and is possibly another way of doing things. It was recommended by my hospital, but as per general forum rules I am not advocating that you change your regime without professional advice.

I am seeing medics in mid-July and may change to basal/bolus which I'm told offers a bit more flexibility.
Click to expand...
Thanks for that - it will be really interesting to see what happens mid July. I would like more flexibilty but just today I am delighted to have found - thanks to the advice from himtoo! - something which is giving me some control here. It's a minefield. My father was type 1, diagnoses in his 20s and died at the age of 89. He managed his condition so well that I honestly though diabetes was a bit of a pushover! Ha! (He was a doctor - I guess that helped a bit)
 
Hello @Jacquelineann

Twice daily insulin injections are easy to comply with but their mode of action in controlling bg levels is very dependant on eating carbohydrate in quantities on a frequent basis like every 3hrs to keep bg levels maintained within healthytarget ranges like 6mmol before eating a main meal and adjusting the carb to allow a rise of about 8.5mmol 2-3hrs later Some diabetics get a bg of about 7.5mmol and unless they eat a small snack, they can go a bit hypo before the next main meal is due. So to get the best out of twice daily jabs, testing bg is essential so that carb can be adjusted. Is it restrictive?. Well it depends on how much food you like to eat in one go. I used Humalog Mix 25/75 from the mid 80's until 2002. I asked to change to bolus basal thinking that mylife would be much better but all it did was cause me to have a lot more hypos as I had no guidance about calculating the bolus insulin using a ratio. I only found out about ratios through reading msgs on the forum and registering with BDEC. Would you be ok with doing an injection at lunchtime and bedtime?
 
My reaction is that you need to move to Basal/Bolus; typically Levemir and Novorapid. Your current insulin regime sounds very strange to me and I wonder what the GP's strategy is? As you say he accepts he knows little about insulin, I would ask again to go Basal/Bolus and if neceesary ask to be referred to someone else. NICE now suggests Levemir as the default Basal and NovoRapid is by far the most common rapid. Mixed insulins are really for T2s with diabetes that isn't very advanced or for people who can't cope with more than 2 injections per day. I'm on Basal/Bolus and most days have only 3 injections.
 
I'd be fine with that. Actually I inject with every meal as it is. However my main worry is hypos as last week I had a very severe one and in fact have always had a tendency to go low. It's lack of guidance which has been the problem here - but the advice I am getting on this forum is a lifesaver :-)
 
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