Dosing Question! Forum newbie : )

[HelloItsMe]

Hi everyone!

I'm new to the forum and would really love to hear from you guys about dosing. I know that everyone is different and no two diabetics are the same but I really feel like I'm on a huge amount of insulin and this in turn is making me worry about weight gain etc.

I've only recently (like, in the past week) had properly controlled blood sugars since I was diagnosed at 11. This has obviously brought a whole host of compilations already but at least now, I've made a change and really want to try!

To give you an idea: I'm 23, female, around 140lbs and 5'8". Type 1. Last HbA1c is ....bear with me.... 103. :'(

Right now, with fairly good control (except morning reading sometimes) I am taking on average 8U Novorapid in the morning, 8U with lunch and 8U at dinner (sometimes a tiny bit more) 6U with a snack later on and then 28U of Levimir at night.

I may need to up the Levimir more, as I'm getting readings like 13-15mmol in the morning sometimes. Ugh

In the past week, I have really slashed my carb intake to very little (man, those sugar withdrawals were rough!) but I've noticed that I've already started to pack on weight from the up in insulin. Between both of those, my motivation is tested and I could easily reach for some chocolate :/ BUT I've turned over a new leaf and want this to work out as best I can... But don't really want to have to weigh loads as this would do nothing for my outlook/confidence/motivation to control my levels.

Also... How are we meant to exercise when right after you have to eat so you don't faint?! It cancels out all the work! How is weight lost safely? Haha. I am not obsessed about this, but I want to go about as healthily as possible

Phew, that was long. Thank you so much for reading this far if you have, it's tough when I can't really run this by anyone. If anyone was comfortable enough to pop up their doses so I can just get an iiiiidea I'd really appreciate it.

Looking forward to jumping into the forum and helping where I can, thanks in advance!


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[jack412]

As a T2, weight is controlled by carb intake. Lchf diet is worth looking at, with bolus for protein needed and fat if your keen on tight control
If needed even the Atkins induction diet can be done

Can you bolus to allow bg for exercise, so you don't go low? It would work like a liver dump, wouldn't it?

 

[HelloItsMe]

Thanks for your reply Jack412, I think I mentioned above but I'm actually type one

Oh dear, That's all very confusing. I've no idea what you mean by liver dump or taking insulin for protein etc. ahhhh,....

 

[jack412]

The T1 will be on in the morning and there are some T1 low carb dieters who can share their opinion or how some also low carb for better BG control
I think the T2 dieters are also worth looking at, as they tend to do a lot of their management by diet

I don't know but I was thinking if you could not fully bolus for the meal prior to exercise and allow the carbs what would be in a snack to be left to burn that
Would that stop you going low?

 

[Patch13]

Hi. Firstly I don't think the insulin you are taking looks like huge amounts and is a little less than what I was on before the pump / LCHF.

However, reducing your carbs will reduce your need for so much insulin and may help you to loose weight. I say may help due to the fact that my weight hasn't really changed doing LCHF (however I am within an acceptable weight range, but wouldn't mind losing a few extra pounds). However the thing that has changed is my blood sugar levels. They used to swing between high and low and now are in an acceptable range nearly all of the time. That makes low carbing worth it!

One thing I would recommend is taking a little less insulin on days you exercise. I used to reduce my basal (this was my lantus) when I knew I was exercising. I also used to sip on lucozade when working out (since LCHF I haven't found the need to sip lucozade though). However you will have to work out what is best for you through trial and error and lots and lots of testing!

A website that might help with exercise and controlling blood sugar levels is runsweet- google it.

Another questions then just ask! Hope that helps


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[noblehead]

As Patch says your not on high doses of insulin so don't worry about that. To get your morning readings down you need to split your levemir dose, it only lasts around 18 hours max so most people find they need to split dose this insulin, your diabetes nurse will advise you on how best to go about this.

As for exercising, make sure you reduce your previous bolus dose to allow for the exercise, depending on the duration and intensity you might have to do this by 25-50%, if your exercising everyday and for prolonged periods then you might have to reduce your basal insulin by up to 50%.

Take a look at Runsweet for some tips and advice on exercising with type 1 diabetes:

http://www.runsweet.com/

 

[Nicko2K]

I work out too n usually just go for it lol, if hypo sets in usually need a drink by then anyway so just have something full sugar & 10 min break. Dunno if just me but find it easier to come up a little rather than trying to drive BG down without insulin.

WhOop nearly forgot to smile

:-D

Type 1 Diabetic: (Novorapid/Levemir) Diagnosed 2014: Extremely handsome: Always smiling

 

[HelloItsMe]

Thanks @jack412! I think that's a good start, with a smaller bolus just before a bit of exercise

 

[HelloItsMe]

Thank you @Patch13. I'll definitely check it out!

It makes sense, I just hate having to pre-plan everything way ahead of time like that. It's a little of putting, like it takes the spontaneity out of exercise, you know? Guess I'll have to get out of that mind set

 

[HelloItsMe]

@noblehead thanks for the reply! I'm going to check out that website, for sure.

Splitting the Levimir sounds like a good option, I'll bring that up on Wednesday at my clinic.

It'd be great to be able to pull down the insulin levels with exercise like that!

 

[HelloItsMe]

@Nicko2K You have a great attitude

Thanks for the reply, I am a little afraid of hypos,.. I totally shutdown and get so dizzy with cold sweats. But it's a worthy risk at this point after running high for so long

 

[noblehead]

@noblehead thanks for the reply! I'm going to check out that website, for sure.

Splitting the Levimir sounds like a good option, I'll bring that up on Wednesday at my clinic.

It'd be great to be able to pull down the insulin levels with exercise like that!

Or you could change to lantus which is another basal insulin, in most cases this just needs to injected once a day and it's often the case that you need less of a dose when taking lantus than you do with levemir. When I briefly changed over to levemir from lantus my DSN warned me that I'd need to inject a good third more, as it happened I doubled the dose and still couldn't get my levels under control with levemir, hence the reason why I changed back .

Try and exercise regularly, exercise makes us extremely sensitive to the insulin we inject which is a good thing if you want to reduce your insulin doses, I can eat a meal that is highish in carbs and still take little insulin if I'm exercising afterwards

 

[Nicko2K]

@Nicko2K You have a great attitude

Thanks for the reply, I am a little afraid of hypos,.. I totally shutdown and get so dizzy with cold sweats. But it's a worthy risk at this point after running high for so long

Oh maybe not for everyone then, am past caring to be honest lol. As long as BG low am happy. Can soon pick up a hypo they like clockwork on another note however the other members give much more valid advice than me lol

Type 1 Diabetic: (Novorapid/Levemir) Diagnosed 2014: Extremely handsome: Always smiling

 

[JacHibbert]

Hi everyone!

I'm new to the forum and would really love to hear from you guys about dosing. I know that everyone is different and no two diabetics are the same but I really feel like I'm on a huge amount of insulin and this in turn is making me worry about weight gain etc.

I've only recently (like, in the past week) had properly controlled blood sugars since I was diagnosed at 11. This has obviously brought a whole host of compilations already but at least now, I've made a change and really want to try!

To give you an idea: I'm 23, female, around 140lbs and 5'8". Type 1. Last HbA1c is ....bear with me.... 103. :'(

Right now, with fairly good control (except morning reading sometimes) I am taking on average 8U Novorapid in the morning, 8U with lunch and 8U at dinner (sometimes a tiny bit more) 6U with a snack later on and then 28U of Levimir at night.

I may need to up the Levimir more, as I'm getting readings like 13-15mmol in the morning sometimes. Ugh

In the past week, I have really slashed my carb intake to very little (man, those sugar withdrawals were rough!) but I've noticed that I've already started to pack on weight from the up in insulin. Between both of those, my motivation is tested and I could easily reach for some chocolate :/ BUT I've turned over a new leaf and want this to work out as best I can... But don't really want to have to weigh loads as this would do nothing for my outlook/confidence/motivation to control my levels.

Also... How are we meant to exercise when right after you have to eat so you don't faint?! It cancels out all the work! How is weight lost safely? Haha. I am not obsessed about this, but I want to go about as healthily as possible

Phew, that was long. Thank you so much for reading this far if you have, it's tough when I can't really run this by anyone. If anyone was comfortable enough to pop up their doses so I can just get an iiiiidea I'd really appreciate it.

Looking forward to jumping into the forum and helping where I can, thanks in advance!


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Before going my pump around 18 months ago, I was on 44 units of levimer (split in 2 doses breakfast 14u and bedtime 30u as my BG kept rising late afternoon). Meals varied - carb ratio 1:3 at breakfast, 1:5 midday and same for evening meal. Since going on the pump my basal rate (levimer equivalent) is now around 28u but this depends on exercise. Everyone is different, so it is whatever works for you.
If you're high in the morning it could be the dawn phenomenon where BG rises around 3am. If that is the case (do a few early morning tests - pain in the bum but may be worth it) as you may be able to switch to an insulin pump.
I was diagnosed at 3, and am now heading for 46 !! After some rebellious teenage years (I had purple hair and a motorbike at 17 so you get the picture) things calmed down. Since going on my pump HbA1c is now 5.9 not sure what that is in new money. I bike to work most days (now pedal power and a less colourful hairstyle) and reduce my basal rate to compensate for this.
Diabetes is a challenge - so is life. Keep at it and you'll see what can be achieved.

 

[HelloItsMe]

Thanks for your kind words! It's such a struggle for me in general these days, but I'm not giving up just yet!

 

[QuirkyBit86]

Those are not high doses. I'll also sip some Lucozade if I know I'm going to do something to lower my blood sugar, not just exercise. Probably not as good as lowering insulin as it'll only giving a short boost to blood sugar levels. I have done this and found I had a hypo a couple of hrs later.

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[Lezzles]

Hi,

i have started on the Low Carb High Fat Diet and within a week found good results with my blood sugar.
I try and aim for 40g a day which is pretty low but possible, but if i am having a down or bad day then i will allow myself to go to 100g.
I find i am never hungry and I stop eating before 7pm every night and wake up with normal BG.
I find that i need very little insulin to control my BG, I try and eat my carbs in the morning and lunch and have mainly protein based meal at night.
I walk a few miles a day and dont hypo.
I think with the LCHF diet it takes a lot of will power and dedication in the first few weeks but will help with the insulin intake and slow or stop the weight gain.
It helps me to plan and be prepared.
I got a helpful link on here:

http://www.dietdoctor.com/lchf

Good luck x

 

[donnellysdogs]

I have found that since having berries and onken yogurt for my breakfast I can have perfection basically for my levels whilst doing 6 hours gardening...

I am however on a pump, even with pump exercise could really throw me.. And I used to eat half a yumyum pre gardening and the other 1/2 2-3 hours in.

I dont bolus for the 3 dessert spoons of berries or the 4 dessert spoons of yogurt...but it keeps my levels well n truly good...


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[Fairygodmother]

Hi HelloItsMe,

Have you done a Dafne course yet? I did one last year and it answered all the questions you've raised. It gives you so much more control over your life with Type One, how you might react in different situations, what basal bolus doses suit you, how to calculate what to inject for eating and so much more. You sound pretty much in control already; I thought I was, but wish I'd known what I know now when I was diagnosed 45 years ago: life would have been even sweeter (not in a carb way)!

 

[Nyxks]

@HelloItsMe like other's have said your not on a high dosage at all, some of us are on much higher dosages of insulin then that daily. I take 100 units of lantus at night n wake up at mmol 4 each morning because of it, rest of the day I'm around mmol 6 and I take a sliding scale of humalog (average 10 units with a meal and various with snacks if i have one), but my carb to insulin ratio is 1:5 so its a bit high do to also having insulin resistnace, which is annoying on many levels since it can equal weight gain if not watched (I've not pcos, so it adds to the weight issue and I'm post menopaual so again weight gain is easy weight loss not so much).