How much insulin to inject?

[lizzie31]

Hi,

I know this may sound silly but can anyone give me a guidance on how much insulin to inject with meals, I have been a type 1 diabetic for 21yrs but never really been told how much insulin to inject, I usually just guess but this sends me high and low. I am on Novorapid and lantus. For example I have 2 slices of burgen bread in the morning and will inject between 5 and 10 units dependent upon what my sugar level is before I eat. I am due to see a new doctor shortly but before I do I just wanted to get some advice.

Many thanks

Liz

 

[jopar]

You do surprise me, as surely when you were first diganosed you would have been on the restricted carb regime or what was often termed carb exchanged regime, where you carbs per meal, snack where matched to your insulin intake!

If you are seeing your doctor I would asked to be put onto there carb counting course, if you'll lucky they will do the DAFNE course, or they may have one that they've created themselves (generally not quite as good as DAFNE)

As you need to know whether your background is set correctly to cover the day, then you can work out from what you are doing now, basically work out the carbs amount in your meal and divid by the injection you would normally have had... then work from there you will need to take a lot of BG readings at the right times, so that you can then worked out what is what etc

 

[lizzie31]

Thanks Jopar, I have heard a lot about the DAFNE course and think I would really benefit from a course like that, I do find it so frustraing that I just don't know how much insulin to take. To be honest I was 10yrs old when first diagnosed and it was lines in those days!!, my mum and dad were quite strict with me and used to make me control my diet, I then left home at 18 to go to uni and it all went down hill from there and to be honest I really can't remember what I used to do. It has only been recently that I have had a health scare and understand I have to be a lot more controlled!!.

 

[Chewitt]

Hi I'm on nova rapid aswell so I'll try and help, bear with me it's a bit long winded, most of everything you eat as you know contains carbs and 10grams of carbs will raise your sugar level 2-3 mmls. To counteract that 1unit of nova rapid will lower your sugar level 2-3 mmls so, for, every 10grams of carbs do 1unit of nova rapid. On most food look on the nutritien list it will show how much corbohydrates per 100g and how much per serving of what ever it is your eating. Just an exaple a kit Kat chunky has around 40g of carbs per bar so that is 4 units of nova rapid if you wanted to eat one. A bowl of cereal for exaple you will need to weigh to help you, mesure out 100 grams into a bowl and on the box It will give you a carbohydrate amount for 100 grams, say for example 60g that's 6units. Everyone however is different because of metabalism and fitness etc so this is the guideline I was given.
1 unit of nova rapid will lower your sugar levels 2-3 mmls
10grams of carbs will raise your levels 2-3 mmls
For every 10g of carbs do one unit of insulin.

When doing exercise you will need to reduce your insulin aswell, for relativly strenuous exercise reduce your insulin around the 10% mark however test more frequent.

Sorry for the spelling I hope this helps.

 

[lizzie31]

Many thanks Chewitt, I will certainly try this out.....this is the most advice I have had on how much insulin to inject in 21yrs!!!

 

[noblehead]

Lizzie,

As Jopar has stated already, without doubt you would benefit immensely from the DAFNE course. I did the course last year, and despite having had diabetes for the last 28 years, I learnt a great deal of knowledge that I had never been told previously. Ask your DSN about this course, you will not be disappointed!

Nigel

 

[Chewitt]

When you see your doctor next also speak to them about possibly changing your background insulin to "levamir" the problem with lantus is that you begin after a number of years to loose your hypo awareness and in my experience lantus ("glargine" I think I was on) was causing me to go down to 1.8 bedew I was feeling the syptoms of a hypo. "lantus" is relativly new but it's proven to bring back your hypo awareness and help stabalise your levels more. What sort of levels are you getting in the mornings and evening and how many units do you inject of lantus and when? Might be able to help with that too.

 

[Debloubed]

Hi Liz,

As everyone has already said, do your best to get on a DAFNE course asap! the course is called 'INSIGHT' where I live and there are lots of other similar ones, including one you can do online. Carb counting changed my diabetic life as prior to that, like you, I had never been taught about exchanges even though I am 25 years in and I used to stick to the same dosage of insulin no matter what I ate. It amazes me I have got this far with zero problems.

Guess work will get you so far but if you nail the carb counting, you're onto a winner :lol:

 

[caspararemi]

Hi Liz,
I'm posting in sympathy - when I was diagnosed 14 years ago I was on to injections a day (Humulin M3 or something), then 3 years ago moved onto lantus plus Humalog at meals, but the nurse just 'guessed' what I'd need to take (she split my total daily dose with the 2 pens, half of it it the lantus, the other third divided between my 3 meals!). I'd never, until recently, been told it should change depending on the carbs you eat. I'm now signed up for a carb counting course and I've done the online version to get the basics right - anyone can do it at http://www.bdec-e-learning.com/