changing to basal/bolus insulin

[pollyr]

Hi i am type 2 diabetic on insulin following an acute attack of pancreatitis. I currently take nova30 but may be changing to basal/bolus insulin to improve my control of hba1c. I know nothing about this type of insulin other than it is related to carb intake which i find daunting and wonder how i will cope with the carb counting and also any high or low readings. Wonder if anyone in a similar situation could help me out with any information or point me in the direction of help on the forum. Thank you .
pollyr

 

[azure]

@pollyr I'm Type 1 but started off on mixed insulin then moved to basal/bolus. Basal/bolus will give you more flexibility

You have one (or sometimes two) injections of long acting/basal insulin a day, and this should keep your blood sugar level in the absence of food. Then for meals (and sometimes snacks) you take a fast acting/bolus insulin to cover the carbs you're about to eat. If, say, you decided not to eat any lunch, you wouldn't have your bolus insulin as you're not eating.

Counting carbs isn't as hard as it sounds, so don't worry

 

[pollyr]

Thank you for your post Azure, it does seem a lot to take in and hope to learn what food does and doesn't work for me. For quite a while i have been chasing insulin with carbs to avoid low BS and am very interested in low carbing; not for weight loss but because i don't eat lots of food. Could you let me know if there is a list of foods and their carb value on this site. I have the Carbs and Cals bòok but there isnt an index and i find it hard going to look through each category for the items I want.
Thank you

 

[Jaylee]

Hi @pollyr ,

Both @azure & i are T1s though I do LC. Neither of us guys wouldn't like to misinform you..

What I can do, is tag in @satindoll . She recently started insulin....?!

 

[azure]

Thank you for your post Azure, it does seem a lot to take in and hope to learn what food does and doesn't work for me. For quite a while i have been chasing insulin with carbs to avoid low BS and am very interested in low carbing; not for weight loss but because i don't eat lots of food. Could you let me know if there is a list of foods and their carb value on this site. I have the Carbs and Cals bòok but there isnt an index and i find it hard going to look through each category for the items I want.
Thank you

There's no list of carb values here but there are other carb guides available. I have a Collins Carb Counter book, divided into sections.

Once you get your basal/bolus right, you shouldn't have to chase insulin with carbs so much

If you're dietician/nurse isn't aware you're low carbing, do tell them, and then you can get help with balancing your diet with your insulin.

 

[satindoll]

Hi @pollyr
Like you I was eating to feed my insulin, I found 1unit of my Insulatard insulin would take me down by 2m/ml on my meter, its important to know how much 1 unit will lower your BS, especially if you are on a restricted diet to begin with, so when they moved me onto Novo-Rapid with my meals I first worked on the assumption that the Novo-Rapid would work the same and luckily for me it does, but it took a lot of testing to confirm this so be prepared to do lots of jabbing,
Now my daily intake of insulin is;
5 units Insulatard on waking........1 unit Novo with my breakfast
1 or 2 units Novo with my lunch depending on what I'm having ie: 1 unit if having egg and bacon
5+ units Novo with my dinner depending on meal
5 units Insulatard before bed
This works for me BUT you will need to work out your own unit to meal needs, so do test before and after each meal, and keep a good record of what you had so you can refer back to it and adjust your units if needed, it does take a few repeated tests for regularly eaten meals to get a good idea of units, but once you have this information you should be fine.
One more thing to remember timing of the "with meal insulin" is important too, but this will come with practice.......hope this helps..........please feel free to PM me if I can help further.

 

[Interaud]

Sorry for hogging this, but PLEEEEEZZZEE can anyone tell me if being on HumulinM3 (after 3 years) is a good or "inconvenient" thing? Is it habit that keeps me with familiarity of insulin dosage , or if you were me, would you be looking at changing for a more versatile and normal lifestyle?

 

[satindoll]

Sorry for hogging this, but PLEEEEEZZZEE can anyone tell me if being on HumulinM3 (after 3 years) is a good or "inconvenient" thing? Is it habit that keeps me with familiarity of insulin dosage , or if you were me, would you be looking at changing for a more versatile and normal lifestyle?

It all depends on how good your numbers are, if your insulin is keeping your BG's steady without big highs or silly lows then I would stay with what you know......if it were that easy for me as a t2 then I would have grabbed it with both hands and been thankful.

 

[azure]

Sorry for hogging this, but PLEEEEEZZZEE can anyone tell me if being on HumulinM3 (after 3 years) is a good or "inconvenient" thing? Is it habit that keeps me with familiarity of insulin dosage , or if you were me, would you be looking at changing for a more versatile and normal lifestyle?

Would you like me to move your post to Type 1 @Interaud ?

There are a few Type 1s on mixed insulin but they may miss your post here.

 

[Chook]

Hi @pollyr

I'm a T2 and I used to be on a basal/bolus insulin regime - Lantus and Novorapid - and I used to use a lot of it. You will quickly get in to a routine, I used to take the Lantus at 8am and 8pm each day and the Novorapid about 10 minutes before eating. I never did get any advice from my DN or GP about carb counting - its something I learned to do for myself from reading websites and the back of packets.

I no longer use insulin (my own choice) but I am still 'officially' classified as an insulin dependant T2 and I have to keep both types of insulin in my fridge at all times just in case I find myself in a situation where I can't eat my strict low carb diet (like being admitted to hospital or similar).

I must admit I found the flexibility of the basal/bolus regime to be very useful once I got in to the swing of it. It means that you can skip meals or have a carb heavy meal - whichever you prefer - but it will help if you are good at maths.

 

[pollyr]

Hi @pollyr ,

Both @azure & i are T1s though I do LC. Neither of us guys wouldn't like to misinform you..

What I can do, is tag in @satindoll . She recently started insulin....?!

Hi and thank you for your help

 

[pollyr]

Hi @pollyr
Like you I was eating to feed my insulin, I found 1unit of my Insulatard insulin would take me down by 2m/ml on my meter, its important to know how much 1 unit will lower your BS, especially if you are on a restricted diet to begin with, so when they moved me onto Novo-Rapid with my meals I first worked on the assumption that the Novo-Rapid would work the same and luckily for me it does, but it took a lot of testing to confirm this so be prepared to do lots of jabbing,
Now my daily intake of insulin is;
5 units Insulatard on waking........1 unit Novo with my breakfast
1 or 2 units Novo with my lunch depending on what I'm having ie: 1 unit if having egg and bacon
5+ units Novo with my dinner depending on meal
5 units Insulatard before bed
This works for me BUT you will need to work out your own unit to meal needs, so do test before and after each meal, and keep a good record of what you had so you can refer back to it and adjust your units if needed, it does take a few repeated tests for regularly eaten meals to get a good idea of units, but once you have this information you should be fine.
One more thing to remember timing of the "with meal insulin" is important too, but this will come with practice.......hope this helps..........please feel free to PM me if I can help further.

Thank you

Hi @pollyr
Like you I was eating to feed my insulin, I found 1unit of my Insulatard insulin would take me down by 2m/ml on my meter, its important to know how much 1 unit will lower your BS, especially if you are on a restricted diet to begin with, so when they moved me onto Novo-Rapid with my meals I first worked on the assumption that the Novo-Rapid would work the same and luckily for me it does, but it took a lot of testing to confirm this so be prepared to do lots of jabbing,
Now my daily intake of insulin is;
5 units Insulatard on waking........1 unit Novo with my breakfast
1 or 2 units Novo with my lunch depending on what I'm having ie: 1 unit if having egg and bacon
5+ units Novo with my dinner depending on meal
5 units Insulatard before bed
This works for me BUT you will need to work out your own unit to meal needs, so do test before and after each meal, and keep a good record of what you had so you can refer back to it and adjust your units if needed, it does take a few repeated tests for regularly eaten meals to get a good idea of units, but once you have this information you should be fine.
One more thing to remember timing of the "with meal insulin" is important too, but this will come with practice.......hope this helps..........please feel free to PM me if I can help further.

 

[pollyr]

Your post has been very helpful, thank you. It does seem to be very involving and i have spent time this week looking at the advantages it ma give me, prior to seeing the specialist diabetic nurse next week. I would like to stay on the novamix 30 but bs control is not good and i would like to reduce my carb intake..

 

[pollyr]

Hi @pollyr

I'm a T2 and I used to be on a basal/bolus insulin regime - Lantus and Novorapid - and I used to use a lot of it. You will quickly get in to a routine, I used to take the Lantus at 8am and 8pm each day and the Novorapid about 10 minutes before eating. I never did get any advice from my DN or GP about carb counting - its something I learned to do for myself from reading websites and the back of packets.

I no longer use insulin (my own choice) but I am still 'officially' classified as an insulin dependant T2 and I have to keep both types of insulin in my fridge at all times just in case I find myself in a situation where I can't eat my strict low carb diet (like being admitted to hospital or similar).

I must admit I found the flexibility of the basal/bolus regime to be very useful once I got in to the swing of it. It means that you can skip meals or have a carb heavy meal - whichever you prefer - but it will help if you are good at maths.

Thank you chook for your post. I am trying to get around learning about carbs so i can make the change next week but am finding it quite a challenge. Am hoping to reduce carb intake overall but am not confident. Wiĺl see what next week brings.

 

[Chook]

A lot of people find the carb counting makes life more enjoyable than eating to suit the amount of insulin they are injecting.

You'll be fine - just ask on the forum if you have any questions.

You are definitely in the right place if you want to reduce your carbs.

 

[pollyr]

I will post my progress and think i will have loads to learn. Thank you

 

[Interaud]

Would you like me to move your post to Type 1 @Interaud ?

There are a few Type 1s on mixed insulin but they may miss your post here.

Thank you so much, and yes please. Sorry for delay in responding - your interest and help very much appreciated

 

[Interaud]

It all depends on how good your numbers are, if your insulin is keeping your BG's steady without big highs or silly lows then I would stay with what you know......if it were that easy for me as a t2 then I would have grabbed it with both hands and been thankful.

Thanks very much for your reply and best wishes