I'm injecting 4 times a day at the moment but sometimes I'll do a quick check and find I'm 12-13 ish and was wondering whats stopping me haveing additional injection just to bring the level down a bit ?
Additional Injections
- Thread starter dingbat
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Hi dinbgbat.
What exactly are you injecting. What type of Insulin ? Dose ?
This is the T1 area but your profile shows you as a T2 ? Did you post in the wrong area :?:
Helps with any answers you might get if all the information is correct.
What exactly are you injecting. What type of Insulin ? Dose ?
This is the T1 area but your profile shows you as a T2 ? Did you post in the wrong area :?:
Helps with any answers you might get if all the information is correct.
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Yes it would be helpful if you clarify what treatment you are on as your profile says you are type 2 and on oral meds.
As a type 1 on insulin I rarely inject to correct except in times of illness, over-lapping insulin injections (quick acting insulin is active for 4-5 hours) can cause hypo's and we are told to avoid this practise and include a correction dose on top of your normal dose at the next meal, it's much easier to try and find out why your bg is running ''12-13 ish'' and rectify it than to include a extra insulin injection.
Nigel
As a type 1 on insulin I rarely inject to correct except in times of illness, over-lapping insulin injections (quick acting insulin is active for 4-5 hours) can cause hypo's and we are told to avoid this practise and include a correction dose on top of your normal dose at the next meal, it's much easier to try and find out why your bg is running ''12-13 ish'' and rectify it than to include a extra insulin injection.
Nigel
apologies but the profile I out of date and I'm unsure how to update it. I'm now injecting 4 times a day , meals (5 units) nova rapid and at night 15 units slow release glargine (?). doc says keep increasing the slow one until morning levels are 4-6 but that scares me cos I think I'll drop very low for the rest of the day.
Thanks for that, so can we assume you are still a Type 2 just injecting Insulin or, have you been re-diagnosed as a Type 1 ?
It would be helpful to us so that we can decide whether to move your post or not ? :?
It would be helpful to us so that we can decide whether to move your post or not ? :?
I'm not on oral meds now and I've had to inform dvla but no one has actually said I'm type 1. bg runs from 8 to 14.hope that helps
Hi DB.
Had a feeling that was the case.....you are T2 and you use Insulin. That does not make you a T1.
The reason you had to tell the DVLA was because you are using Insulin, a legal requirement. No problem here.
As for Bg levels, that really needs a balance between what you are eating and the Insulin dose. Hopefully our Insulin users will be able to give you the benefit of their own experience.
I will move the post into the T2 area now we know what the facts are. Thanks for your co-operation.
Had a feeling that was the case.....you are T2 and you use Insulin. That does not make you a T1.
The reason you had to tell the DVLA was because you are using Insulin, a legal requirement. No problem here.
As for Bg levels, that really needs a balance between what you are eating and the Insulin dose. Hopefully our Insulin users will be able to give you the benefit of their own experience.
I will move the post into the T2 area now we know what the facts are. Thanks for your co-operation.
Yes it's called insulin glargine (trade name lantus). Having morning (fasting) readings of 4-6 is nothing to be worried about, you won't drop too low the rest of the day because what you eat will raise your blood sugar.dingbat said:
I was told to do correction doses if my blood sugar is high, and not wait until the next meal. But try to get the insulin right in the first place like Nigel says!
I've found the amount of insulin I have to use for both meals and correction doses depends on the time of day, some times the long lasting insulin is more active (though I'm on levemir, I think lantus lasts longer?) so I need a smaller dose.
Thanks for the replies. I think I thought I knew what I was doing , now I'm not so sure. Maybe its time to rethink !!
dingbat said:
It is all a bit trial and error I am afraid! I was told to do corrections if I needed to...you need to have an idea about how much injecting 1 unit f novorapid will reduce your blood sugar. For me, 1 usint, drops me abot 3 mmol/l...so I would not do a correction bolus unless I was over 10. i am however, type 1, and was reasonably confident that my long term insulin was more or less correct...so, I gues, as Nigel says, it would be betterto make sure your glarine is correct, beofre doing any correcting...however, if you find yourslf with a high BG (especially over christmas, when there can eb some hidden carbs, you may need a correction dose. Please, please please though, be very careful...it is better to do a tiny extra dose...and then do another 1 a couple of hours later, than to give yourself too much and go hypo.
that's inrcedibly useful because I have no idea how many carbs need so much insulin to drop so much in blood sugar levels or how many minutes excercise will make this much difference. I know w'ere all different but there must be a rough guide somewhere. I've stopped cycling as much because I don't know much I need to eat to last a certain time or distance.
dingbat said:
Until you find through trial and error exactly what your TDD is (Total Daily Dose) you wont know exactly how much 1u of bolus will make yr bg drop by.
Best thing is to use 1u correction to make bg level drop by 2mmol and use a slightly higher target to correct to. So if yr bg level is 12, aim to calculate to a target of 8 which leaves you with a difference of 4. 4 divided by 2 equals 2. So yr correction dose will be 2u plus your calculation insulin to carb ratio. As a very very rough guide Dingbat until you can work things out a bit more accurately, use the carb ratio of 2u to 10g carb at breakfast and then see what yr bg level is 2hrs later. If its somewhere near where you should be all ok. If its higher then you will need to use a different ratio such as 2.5 or 3u to 10g.
phoenix
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Hi Dingbat, t
I've just skipped through your previous posts. Whether you are T1 or T2, It seems that you are at last getting an appropriate treatment. It maybe worth asking your consultant about your diagnosis. Have a look at this page and see if you relate to it.
http://www.locallada.swan.ac.uk/faq.html
There is some info on correction factors here:
http://www.diabetesnet.com/diabetes_con ... z18MTbVrAx
whilst the '1800' rule is very much a starting point it suggests that someone on 30units a day has a correction factor of 1u insulin to drop glucose levels by 60mg/dl (that's 3.3mml), I certainly think that any experimentation must start from the cautious.
There is also if you follow the links a page on carb factors, though as it says, it is if there is some insulin being produced it's more difficult .
Personally I would again be a bit more cautious :the 2 u to 10 carbs suggested by IHS would for me be far too much and would have been when I was on 30units a day when I left hospital (I actually now take less).
What I did initially was to carefully count the carbs in my meals, keeping to similar amounts for each type of meal for a while (ie if you have 40 for breakfast, have 40 everyday for a while, if you have 60 for lunch , do the same every day). This means there is one less variable, if you eat different amounts , it's more difficult to see what's happening. You can be flexible when you know a bit better whats happening.
Record the pre and 2 hour and next meal levels. You will soon see the results of your 5 units for these meals. You can then work out whether to adjust the insulin up wards or downwards. Alter things cautiously (with your Nurses 'permission') You might find you need more insulin to carbs at certain times of day (I use 1u-11g carbs for breakfast, 1u-12g carbs for lunch and 1-15g carbs for dinner)Many people with T2 use more insulin than this but you certainly aren't on a high dose at the moment .
Of course our lives aren't totally static and the carb factors are just 'best fit'.On days when you cycle you will probably find you need less insulin for carbs than on days when you sit down at the computer all day. You may find that you have to adjust for this.
The other very important thing is your basal. This isn't meant to cover the carbs in food, but to enable the use of the glucose released naturally by your body during the day. If your levels are rising during the time inbetween meals and overnight (ie when it's 3 hours of more since your meal)
It maybe because the basal dose is too little. if glucose levels are falling during these times then it's too high. Again this needs adjusting in small increments and it is normal to wait 3 day between adjustments. (again check with your nurse)
I've just skipped through your previous posts. Whether you are T1 or T2, It seems that you are at last getting an appropriate treatment. It maybe worth asking your consultant about your diagnosis. Have a look at this page and see if you relate to it.
http://www.locallada.swan.ac.uk/faq.html
There is some info on correction factors here:
http://www.diabetesnet.com/diabetes_con ... z18MTbVrAx
whilst the '1800' rule is very much a starting point it suggests that someone on 30units a day has a correction factor of 1u insulin to drop glucose levels by 60mg/dl (that's 3.3mml), I certainly think that any experimentation must start from the cautious.
There is also if you follow the links a page on carb factors, though as it says, it is if there is some insulin being produced it's more difficult .
Personally I would again be a bit more cautious :the 2 u to 10 carbs suggested by IHS would for me be far too much and would have been when I was on 30units a day when I left hospital (I actually now take less).
What I did initially was to carefully count the carbs in my meals, keeping to similar amounts for each type of meal for a while (ie if you have 40 for breakfast, have 40 everyday for a while, if you have 60 for lunch , do the same every day). This means there is one less variable, if you eat different amounts , it's more difficult to see what's happening. You can be flexible when you know a bit better whats happening.
Record the pre and 2 hour and next meal levels. You will soon see the results of your 5 units for these meals. You can then work out whether to adjust the insulin up wards or downwards. Alter things cautiously (with your Nurses 'permission') You might find you need more insulin to carbs at certain times of day (I use 1u-11g carbs for breakfast, 1u-12g carbs for lunch and 1-15g carbs for dinner)Many people with T2 use more insulin than this but you certainly aren't on a high dose at the moment .
Of course our lives aren't totally static and the carb factors are just 'best fit'.On days when you cycle you will probably find you need less insulin for carbs than on days when you sit down at the computer all day. You may find that you have to adjust for this.
The other very important thing is your basal. This isn't meant to cover the carbs in food, but to enable the use of the glucose released naturally by your body during the day. If your levels are rising during the time inbetween meals and overnight (ie when it's 3 hours of more since your meal)
It maybe because the basal dose is too little. if glucose levels are falling during these times then it's too high. Again this needs adjusting in small increments and it is normal to wait 3 day between adjustments. (again check with your nurse)
Thanks everyone for the comprehensive replies, much appreciated. im very impressed with the bdec site, I didn't realise info like that was out there, Im going to have a serious go at carb counting, at the very least roughly.
one problem is hypos, I've had a couple when I've been out and I'm soooo wary of injecting too much or doing too much excercise. hopefully I'll get better control of that.
last question i promise.. do we know how long does the effects of quick acting insulin last ?
one problem is hypos, I've had a couple when I've been out and I'm soooo wary of injecting too much or doing too much excercise. hopefully I'll get better control of that.
last question i promise.. do we know how long does the effects of quick acting insulin last ?
This lists the action profiles of novorapid (scroll down the page): http://www.novonordisk.co.in/documents/ ... brands.asp
And Lantus: http://www.lantus.com/hcp/comparison.aspx
And Lantus: http://www.lantus.com/hcp/comparison.aspx
Hi Dingbat
Although Lantus is meant to last 24hrs, many people who just inject it once a day at night will find that at best its effect will only last about 16hrs. You can test this by waking up at breakfast time with a bg level within a normal range and then dont eat any breakfast and miss off the bolus. You will find yr bg level will start to elevate within about 2hrs and you'll then start to question Lantus's profile. Its for that reason why people start to inject Lantus or Levemir twice per day and by doing so use slightly less in the way of bolus insulin and hopefully have less hypos.
Its not at all uncommon for people using Lantus once a day to have to use a lot more in the way of bolus insulin but everyone is different and there is no accurate calculation that can be used so that is why people have to use trial and error and just test bg levels about 6 times a day so that they can find for themselves their ideal bolus ratio. The 2u:10g carb that I mentioned was just a very rough guide so it will only be by you testing that you will get to find out if its too much, ok or too little. Whichever way, the bolus can be adjusted. Try for a little while to keep the amount of carb that you eat the same each day, so if you eat 2 weetabix and milk (30g carb) for breakfast, then keep to eating that each day. It will then make it easier for you to adjust your bolus insulin up or down. Make sure you get a good bg monitoring diary and write down yr bg levels, the amount of carb that you eat at each meal time (incl a snack) and the amount of bolus insulin you inject. Once you start to get bg levels that are about 5-7mmol before a main meal and then about 8-9mmol 2hrs later, you'll then know that the bolus insulin is correct for that meal time. So if you inject 5u of bolus and you eat 30g carb and yr bg levels are all ok, then the ratio will be 1u:6 (30g carb divided by 5u bolus). Just to add a bit more complication to it all, you will also find that you will need to use a different ratio for all your other main meals.
Although Lantus is meant to last 24hrs, many people who just inject it once a day at night will find that at best its effect will only last about 16hrs. You can test this by waking up at breakfast time with a bg level within a normal range and then dont eat any breakfast and miss off the bolus. You will find yr bg level will start to elevate within about 2hrs and you'll then start to question Lantus's profile. Its for that reason why people start to inject Lantus or Levemir twice per day and by doing so use slightly less in the way of bolus insulin and hopefully have less hypos.
Its not at all uncommon for people using Lantus once a day to have to use a lot more in the way of bolus insulin but everyone is different and there is no accurate calculation that can be used so that is why people have to use trial and error and just test bg levels about 6 times a day so that they can find for themselves their ideal bolus ratio. The 2u:10g carb that I mentioned was just a very rough guide so it will only be by you testing that you will get to find out if its too much, ok or too little. Whichever way, the bolus can be adjusted. Try for a little while to keep the amount of carb that you eat the same each day, so if you eat 2 weetabix and milk (30g carb) for breakfast, then keep to eating that each day. It will then make it easier for you to adjust your bolus insulin up or down. Make sure you get a good bg monitoring diary and write down yr bg levels, the amount of carb that you eat at each meal time (incl a snack) and the amount of bolus insulin you inject. Once you start to get bg levels that are about 5-7mmol before a main meal and then about 8-9mmol 2hrs later, you'll then know that the bolus insulin is correct for that meal time. So if you inject 5u of bolus and you eat 30g carb and yr bg levels are all ok, then the ratio will be 1u:6 (30g carb divided by 5u bolus). Just to add a bit more complication to it all, you will also find that you will need to use a different ratio for all your other main meals.
