30/70 to modern regime

[iHs]

Get an insulin pen that has 0.5u increments on the doseage. If you were using a ratio of 1u to 8g of carb and eat 30g, then you would need 3.6u which on a 0.5u pen would be 3.5u and not 4 or 3u. This does help quite a lot.

 

[iHs]

Thanks for all the advice here guys. I have another quick question here:

So this morning I took my bolus at 9:30 had porridge etc and then went to gym at 10:30 for an hour and a half all good
THEN back at 12:30 ready to eat and levels around 4, question is is it ok to take a second bolus jab within 3 hours with food? I don't want to wait more then a hour and miss that 'golden hour' after training to take carbs and protein.

With the old 30/70 after training I just ate and based the carbs around the BG level after training didn't think twice about it, boom bang shabam all good!!!

Look up Accounting for Unused Insulin on Google. It's by Gary Scheiner and explains how to calculate a bolus dose within 3hrs of eating a meal.

 

[O_DP_T1]

@iHs cheers mate just found this http://static.diabetesselfmanagement.com/pdfs/pdf_2253.pdf most usefull!!!

 

[Shiba Park]

Don't all T1's do this irrespective of the regime they are on???

This is not intended as a patronising post so I hope it's received in the manner it's intended.

I think the replies you are getting are based on what you stated in your original post; you've just changed from a mixed insulin to MDI, so you have a completely new learning curve ahead of you. With the flexibility this combination offers come a whole load more variables to consider - not least because you can!

I suspect from one of your more recent posts that you have just discovered that a session at the gym with a bolus at it's peak potency have a bigger effect than anticipated. This happens even with the perfect theoretical ICR. Accounting for it is part of the 'matching insulin to carbs'. It's not patronising to say this, however it massively underplays the detail that needs to be considered to do this effectively...

So, please don't post rude comments to people like @catapillar, but soak up the tremendous knowledge that is shared so freely in this forum.

 

[O_DP_T1]

Ok soooo I have yet ANOTHER question hope someone can help....

Currently I take my Basal (Lantus) between 7-8pm every day and during the days things are relatively good, however come 5pm onwards my levels begin to rise even if I don't eat (today hit a 14 usually gets to about 8-10), I can only assume that this because the background insulin is running out.

Now the question is do I

A) Take a couple of units extra Lantus
B) Keep the dose as is and take the Lantus a couple of hours later say 9-10pm (not sure if this will just put the rise back a couple of hours)

thanks

 

[SueJB]

Still finding my feet a little with the new regime and I can totally understand the frustration of O_DP_T1 (and others I suspect). I have dipped in and out of this forum for a while as I get slightly frustrated by the preachiness of some of the contributors on here when all people are doing is asking for a bit of guidance...Having managed my T1 for 30 years VERY well, clearly I'm familiar with carb counting and acutely aware of how I feel with my BG and the impact changes of dose, timing, exercise, food, emotions etc could all have. Having people tell me I need to match carbs to insulin...***, you don't say. I hope those who are newly diagnosed and come here for help are cut a little more slack and sympathy... There appears to be a bit of an assumption that 'well I do it this way, so obviously you should to'...forgetting that we're all unique and managing T1 is, as a result, a bit of art as well as science.

Anyway...rant over.

When I switched over I got told by the dietician to do 1 unit of Novorapid per 10g of carbs. That seemed quite low to me and after only a couple of days with BG consistently >12 I too doubled the dose. So a typical day (no cycling) I take 6-8 with breakfast (2 slides of wholegrain toast with butter) and if I have lunch or snacks (morning or afternoon; quite rare to be honest - I tend to live on coffee) I count carbs and inject. I'll need to reassess that when the weather improved and I cycle to work again (1 hour / 16 miles, plus I also cycle another 5 miles in the evening to/from the station).

Following advice above I have switched and split my Lunctus 50/50 to a morning and evening dose, taking 12 units on each occasion. I am still finding myself a little high in the mornings (12BG today) and looking at my libre history I can see that it rises quickly 3-4 hours after bed and then the climb rate levels off. Should I look to adjust the 50/50 split to a 40/60 as I am more active during the day?

Not sure if others experienced this when first switching over, but I am probably having a touch too much carbs to correct a slightly lower BG level. For example, whereas on 30/70 I'd have a couple of biscuits before bed if my BG were heading lower than planned I think on the new regime, I only need 1 or even half a biscuit or smaller glass of orange juice. The fear (after 30+ years on the previous regime) remains of a night time hypo but this needs to be revisited, because the effects of the new regime are different. I'm going to see how that impacts things over the next few days, if there is any low(er) BG as I head to bed. And if someone says I shouldn't be going low as I head to bed if I'm carb counting....

Thank you for the rant and for the infoalthough I'm not sure what it all means. What is the 50/50, 30/70? The DSN hasn't mentioned this. Feeling very lost

 

[O_DP_T1]

A 30/70 insulin type is a pre mixed insulin where 30% of it is fast acting and 70% is background insulin it's delivered as one shot usually twice a day, so there is no notion of basal/bolus.

It is quite an old system tbh I was put on in the late 70's and been on it until very recently.

 

[scotteric]

Ok soooo I have yet ANOTHER question hope someone can help....

Currently I take my Basal (Lantus) between 7-8pm every day and during the days things are relatively good, however come 5pm onwards my levels begin to rise even if I don't eat (today hit a 14 usually gets to about 8-10), I can only assume that this because the background insulin is running out.

Now the question is do I

A) Take a couple of units extra Lantus
B) Keep the dose as is and take the Lantus a couple of hours later say 9-10pm (not sure if this will just put the rise back a couple of hours)

thanks

Many people find this because the truth is Lantus only lasts 24 hours at very high doses. You could try splitting your dose by taking half in the morning and half at night to get more consistent coverage. You could also try switching to Levemir which lasts about 12 hours at small doses, so it is easier to split like this without overlap.

 

[knipster]

sadly not..........I know a few T1D's in real life that have been diagnosed for at least 7 or 8 years and have not been on carb counting courses, and don't really know about I:C ratios , pre-bolusing , etc.

That's crazy! I started carb counting while still in hospital, how on earth do you stay at decent ranges without carb counting??

 

[himtoo]

That's crazy! I started carb counting while still in hospital, how on earth do you stay at decent ranges without carb counting??

i agree -- it is crazy ... but having been a member on the forum for a few years I have definitely encountered new members given no advice and let out into the wide world with no carb counting advice , and I know real people in my wider community that have experienced the same.

 

[Rox000]

My daughter has been on the same regime 30/70 novomix for 3mths now...its way to restrictive for us in that im restricting carbs she has no social life no correction doses if she spikes and generally no quality of life. Respect to those who find it works for them. But when being diagnosed with something that is lifelong such as t1diabetes looking at alternative options are something im interested in doing.
I have read 'how to think like a pancreas'recommeded by the good ppl here and oh my lord how many doors has it opened for me. well worth a read...

 

[O_DP_T1]

I was on the 30/70 for 30 plus years until a couple of weeks ago.

 

[Rox000]

i guess its quite true in that not everyone adapts to one mould. its surely true on this forum..thanx for your reply