1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2020 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Carb counting

Discussion in 'Type 1 Diabetes' started by Hampshire Hog, Jun 19, 2020.

  1. Hampshire Hog

    Hampshire Hog · Member

    Messages:
    7
    Likes Received:
    3
    Trophy Points:
    3
    Hi, relatively new to using insulin, I'm currently using a Humulin M3 quick pen once in the morning and again before my evening meal.
    My bg levels are higher in the morning than I would like, they drop to a good level during the day, but go up again over night , as I can't adjust my insulin to match my carb intake, is there any other way of bringing the morning levels down ?
     
  2. EllieM

    EllieM Type 1 · Well-Known Member

    Messages:
    2,462
    Likes Received:
    1,400
    Trophy Points:
    198
    You need to talk to your doctor/clinic/nurse about going on a basal/bolus regime

    basal - long acting insulin - typically taken once per day (sometimes twice) - covers your background needs when you aren't eating (eg overnight) - you can incrrease this to adjust your morning level
    bolus - take whenever you eat and also as a correction dose - typically peaks in less than a couple of hours and is out of your system by 5. It allows you to adjust your meal times, have snacks, miss meals etc etc.

    As long as you are not needle phobic (you'll have one daily basal injection plus a bolus for every meal/snack you eat) you should find this system a lot easier. You'll probably need to convince your team that you can count carbs because your bolus will be

    correction dose (if your levels are too high) plus so many units per carb eaten.


    Good luck
     
    • Agree Agree x 2
  3. Hampshire Hog

    Hampshire Hog · Member

    Messages:
    7
    Likes Received:
    3
    Trophy Points:
    3
    Thank you , I will have a chat to my nurse about it .
     
  4. Daibell

    Daibell LADA · Master

    Messages:
    11,409
    Likes Received:
    6,955
    Trophy Points:
    298
    Hi. As a T1 you should have been started on the Basal/Bolus regime. See the NICE T1 Diabetes Guidelines on the web which say this. Twice-a-day mixed insulin can be OK in the early days if you have predictable meals and some of you own remaining insulin but Basal/Bolus is better but does mean 4 or 5 injections per day.
     
  5. Hampshire Hog

    Hampshire Hog · Member

    Messages:
    7
    Likes Received:
    3
    Trophy Points:
    3
    Thank you for your information, I will discuss it further with my diabetes nurse
     
  6. CharlottePatten

    CharlottePatten Type 1 · Member

    Messages:
    20
    Likes Received:
    2
    Trophy Points:
    43
    What type of blood monitor are you using? Low will in fact cause higher levels after due to liver restores and often low blood sugars during the night/day correct the highs. Obviously monitoring carbs etc is very important as some food take longer to absorb and drinks are always faster to absorb so making sure your carb count is bob on is very important. Are you on just a fast acting insulin? I have T1D since the age of 2 and I'm on 2 doses of levemir and novorapid with carb intake. Think it's always best to know what is happening during the night as sometimes increasing insulin as the opposite effect, so if your using a Dexcom G5 or G6 then you will see a pattern but if not then maybe try testing during the night
     
  7. MarkMunday

    MarkMunday Type 1 · Well-Known Member

    Messages:
    224
    Likes Received:
    84
    Trophy Points:
    48
    Patients are often started on mixed insulin because they are still making much of their own insulin. But I agree, basal/bolus from the start makes more sense. You are still able to manage your blood glucose across the 24 hour cycle with mixed insulin, though.

    You can reduce your morning levels simply by increasing your evening dose. Humulin M3 is 70% Isophane and 30% Soluble insulin, so the effect will mostly be in the early hours of the morning. You may need to eat something before bed if the Soluble insulin brings you down too much.

    Here are the action profiles for Soluble (Regular) and Isophane (NPH). Use them to figure out how to close mismatches between insulin action and insulin requirement. You should stay in the target range 24 hours a day.

    [​IMG]
     
    • Informative Informative x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook