Carb counting

[Hampshire Hog]

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 ?

 

[EllieM]

is there any other way of bringing the morning levels down ?

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

 

[Hampshire Hog]

Thank you , I will have a chat to my nurse about it .

 

[Daibell]

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.

 

[Hampshire Hog]

Thank you for your information, I will discuss it further with my diabetes nurse

 

[CharlottePatten]

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

 

[MarkMunday]

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.