Corrections

[ElkBond]

As discussed previously on this forum it appears most people are more comfortable with hypos versus hypers.

So I am just wondering how everyone deals with the hypers? When would you consider correcting a hyper with insulin?

Any other methods people use to bring the BG down?

The other day I was rising quite highly so I went for a very casual jog about the place, ended up taking myself down from 8. something to the lows 4s... very effective! Although I think I got a bit carried away.

I am still adjusting doses, especially my background Lantus. Has anyone had an experience with creeping BG all day (i.e. background wasn't strong enough). Did you correct frequently? How did you cope?

 

[himtoo]

anything over 8.5 is too high for me and I would look to correct in some way ( exercise , correction )

i struggle to keep to my so called rule but in terms of how I feel -- that is the number i try to work to as a max

 

[ElkBond]

My main issue at the moment is that my bodies insulin (Honeymoon Period) is on overdrive in the mornings and most of the afternoon. I wake up many times a night to a low BG. Today I struggled to get it above the mid 4s all day. No matter what I did it just kept dropping. But in the eves my Lantus wears off as its so little now then creeps up. Currently sitting on 9.7, been creeping since 10pm (Lantus at 10:30). I have gave myself 1 unit to try to slow it and even jogged around my flat a little!

In contrast, yesterday I had perfect 5s all day! Can't win!

 

[RuffsTheShake]

I am OK with correcting but sometimes I forget that I need more insulin for corrections when I'm quite high >12 than when I am a little high >8. A little high depending on what I am doing I may go for a walk to lower it, quite high I definitely take a correction dose ASAP. I record when and how much insulin so I don't forget and check my bgl level pretty regularly.
I really dislike being high so sometimes I will take too much insulin wait until it's within normal levels and then eat to prevent a hypo it just gets me back in range quicker but maybe not something to recommend... I am pretty sure I am not in the honeymoon and my basal is decent now so it's relatively easier to predict (unless sick etc etc).

 

[azure]

I correct when necessary (generally when over 8 but it varies depending on the circumstances)

I don't wait to correct at the next meal - I correct when I see the higher sugar. I don't like being high longer than necessary. The only time I'm cautious about correcting is before bed.

I know my correction ratio and it usually works very well. But if I'm higher than 12, I need a little more to get back into range.

Other methods I use are going for a walk or doing some exercise, or even some vigorous housework : D

 

[ElkBond]

My mindset is :

4.5-5s = ideal,
6s = ok, but try to get a bit of movement,
7 = start considering bolus depending on the next reading
8 or Upwards Arrow on CGM past 6 = Seriously get moving or jab now!

After 8 I tend to get a bit stressed, despite me knowing it makes it worse.

Edited missing sentence

 

[Kristin251]

I correct with a half unit when I am over 115. It lowers me to about 85 without food and i don't feel it. i am very sensative to insulin and fluctuating sugars either way so this is more delicate for me. I too prefer to do it away from a meal and correct as soon as possible and keep bs as steady and even as possible.

 

[Mep]

thanks for posting... interesting. I've never had any one advise or show me how to correct with insulin. I've attempted it a few times myself though and it is hit and miss. I try and correct at meal times instead and sometimes it works and other times it doesn't. Like one time I corrected a sugar level of 13 with 4 units of insulin when I was work and about to leave for the day... I walked 10 mins to my car and then tested at 5.7 which I thought was a sudden drop so I quickly had some quick acting carb before I jumped in my car thinking I'd be ok until I got home. Well I just made it off the main road heading to my place when I started to full on hypo from that correction... I pulled into my drive and thought my house was moving towards my car so slammed on my brake. I tested at 3.7. Other times I can give myself 8 units or more and hardly get much difference.. I don't know how it works when I keep getting different results. So is there some formula that you guys all use? I'd be interested to know how you do this. Where I live there is no education for insulin dependant diabetics other than for type 1's (I'm not allowed to attend DAFNE here). I would be interested to know how this is supposed to work. So far for me I just guess how much bolus I need. I don't like being over 8 either but I tend to get those levels later in the day which is why I think my lantus dose wears off. I should add that I seem to need more insulin than my type 1 friend does.. she uses a lot less. I have insulin resistance though and I think that is probably why I need more. I'm currently bolus'g about 45 units on average per day and 13 units of lantus. I'm about to go back to 12 though which is what my endo wants me on... but I'm not convinced it works for me especially when I'm sick.

 

[ElkBond]

Its a guessing game with corrections for me also, sometime a 2 unit will take me down nicely, other times at the same level a 1 will bring me down to a low BG.

 

[claire1991]

I correct for anything over 7.5 and don't wait until meal times as there is often a large gap in between my meals.
I do find that, similar to others, if I'm above 12 I need a higher correction to bring it back down again. Also, being on the pump, if I'm still not starting to come down after my correction then I will increase my basal rate as well by some 50% until it is 'normal' again.

The only time I don't correct is if it is high after a hypo but still under 10mmol.

I think everyone is different when it comes to corrections and you just have to do what works for you!

Best,
Claire x

 

[Robinredbreast]

One DSN, at the hospital told me not to correct in between meals, as it would still be in my system at the next meal time and so I have ended up hypo (and they are concerned about hypo's) so to leave it until my next meal. But..............I have corrected and use a tiny amount, also some exercise helps too.
This is what works for me.
Best wishes RRB

 

[azure]

I have a correction ratio that my very knowledgeable pump trainer worked out for me 12 years ago. Before that, I was on MDI and needed more insulin to correct.

If in any doubt, always err on the side of caution and take less insulin than you think you might need. Better to run a bit high than risk a serious hypo.

 

[iHs]

I always use the 100 Rule to try to figure out my correction factor as it works reasonably well. For mdi users as apposed to pumpers......Most but not all pumps will have an IOB feature to them which will work out how much of a bolus for food or correction is still active to allow for the pumper to deduct the IOB from the next bolus or to eat something to use up any IOB due to miscalculation of the carb bolus due to bg levels getting to the target before 4hrs has gone by. For mdi, it's a case of not correcting too early with insulin or to use an IOB calculator which is available online ... Accounting For Unused Insulin.

 

[tim2000s]

I've always corrected rather than waiting as I'd rather not end up in a position where my foot falls off, which is something non-D people tend to forget when talking about not correcting because you'll have IOB. I'm currently running HAPP with my x-Bridge set up so it will be interesting to see what the open loop APS says about what I think are good correction levels and carb ratios.

 

[noblehead]

As discussed previously on this forum it appears most people are more comfortable with hypos versus hypers.

From a personal perspective I'm not comfortable with either @ElkBond

With regards to corrections, much depends if there's still IOB, if I'm above target and still have IOB then a 20-30min walk can be as effective than giving a correction dose.

 

[Kristin251]

I prefer to correct in small doses between meals. Now it also depends on what you ate in your last meal how much insulin be effective. FOR ME if I had a high fat meal my correction will be much less effective. If it was higher carb it could plummet me. There is no 'set' dose because there are all sorts of variables. I know for me that 1/2 unit away from food will drop me 20-30. However if I had a high fat meal or have a small fat snack ( few nuts) it will drop me much less. I eat the same macros at every meal and I am vlc so I now have a system.

I never thought I'd say this but I am actually struggling now with the opposite problem. I am taking 1/2 unit with meals and only 1 unit lantus and still going low. About a month ago I reduced a lot of fat and obviously have become far more insulin sensative. I knew fat mattered before but it is very clear now how much it matters. I really don't like eating to feed insulin but not sure how to go about correcting this. I need insulin with meals but can't take less than 1/2 unit. I guess I will add a few more veggies and see if that helps

 

[ElkBond]

From a personal perspective I'm not comfortable with either @ElkBond

With regards to corrections, much depends if there's still IOB, if I'm above target and still have IOB then a 20-30min walk can be as effective than giving a correction dose.

Ahh yes! Sorry @noblehead! I try avoid both aswell!

 

[Robin_H]

I constantly run high, especially in the morning, for example this morning two hours after waking and before eating my reading just now was 10.6. I use the Aviva Expert system which worked out a correction on top of the carb calculation for breakfast, which should bring me back down to a reasonable level.
I was diagnosed in October 2015 following DKA and pancreatitis and STILL haven't managed to fix a basal dose which gives a waking reading of 9 or lower (typically it's 9-11) which I'm finding increasingly frustrating. My nurse switched me to Tresiba, for which I had high hopes but it isn't making much of a difference to the morning reading but is stabilising my daytime readings which are reasonable, usually at the higher end of the acceptable range. I was previously on A dose of Levemer twice the size of the Tresiba over two doses and had to regularly correct with NovoRapid also.
I have very little worry over hypos - I would say I have experienced two or three mild episodes since diagnosis. Interestingly once I get into readings of 5s is when hypo symptoms kick in for me. I suppose we will all be different in that respect.

 

[pinewood]

I correct at 7.5mmol and above.

To be honest I've never really felt that insulin staking is a big risk; for me I find that it doesn't make a huge amount of difference. I'm always conscious of how much active insulin I've still got on board but I find NovoRapid is definitely completely out of my system by 3 hours and injecting within 1 hour of a previous injection doesn't make much difference.

As others have said, when my levels are in double digits my correction dose is increased; for me it essentially doubles.

 

[Mep]

I prefer to correct in small doses between meals. Now it also depends on what you ate in your last meal how much insulin be effective. FOR ME if I had a high fat meal my correction will be much less effective. If it was higher carb it could plummet me. There is no 'set' dose because there are all sorts of variables. I know for me that 1/2 unit away from food will drop me 20-30. However if I had a high fat meal or have a small fat snack ( few nuts) it will drop me much less. I eat the same macros at every meal and I am vlc so I now have a system.

I never thought I'd say this but I am actually struggling now with the opposite problem. I am taking 1/2 unit with meals and only 1 unit lantus and still going low. About a month ago I reduced a lot of fat and obviously have become far more insulin sensative. I knew fat mattered before but it is very clear now how much it matters. I really don't like eating to feed insulin but not sure how to go about correcting this. I need insulin with meals but can't take less than 1/2 unit. I guess I will add a few more veggies and see if that helps

You're mentioning about half a unit... is that a special pen you use? I've only ever had full unit pens. It looks like i use a lot more insulin so not sure if half a unit dosage would make any difference for me. Maybe it's something that is used when you're very sensitive?