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Correction doses and one for the girls!

B

blackie2711

Member
Hi guys I was just wondering if anyone can answer a couple of questions please.

Just had my first appointment with dietician which was very informative I have to try matching my Novarapid with my carbs. What I was wondering if I underestimate and find at the next mealtime im quite high in my reading do I increase ny dose to correct this and also if i were to snack in between meals say for instance have a bun (know I shouldnt) but not always perfect! do I inject to cover this?

For the girls sorry guys!
On a different topic this is only my 2nd period from I have been diagnosed. Last one was just after I was diagnosed in hospital it was fine had another one then on 11th July - grand 28 days in between another arrived on Friday 18 days from the last and omg never ever had one so heavy! Anyone think this could be related to diabetes never had any problems before!
Also finding high readings all weekend!

Thanks!! :?
 
Yes, in theory, you should have insulin every time you have carbs..unless you are having them to treat aa hypo. I take into account what my BG is, to wiork out my dose. I know that 1 ul of insulin, this will bring my BG down by 3 mmol approx, so have to do the maths.


As for periods, it is not unheard of, as your body gets used to better BG, thatit impacts your cycle somewhat. I used to find that I need about 20% more insulin at that time of the month too...but for some reason, I seem to have grown out of this after having children.

the joys eh?
 
You can experiment to work out what your insulin correction dose is. Everyone is different so 1 unit of novorapid will lower your bg reading by a different amount to someone else. Correction doses can also vary depending on the time of day. The other thing that will affect your correction dose is when last you injected insulin and how long that insulin remains active for you. The length of time the insulin is active for you can also be worked out by injecting and then testing every hour until your reading stops falling. Once you know how many mmol/l 1 unit of novorapid drops your reading by then you can work out how much you need depending on what your reading is. Be careful that you don't end up stacking insulin by giving corrections too soon after the last injection. If you snack inbetween meals, not ideal, you can inject some novorapid to cover the snack. Or stick to low or no carb snacks, then you don't need to inject to cover them.

This is how we worked out the amounts for my daughter. She had a carb free evening meal (omelette, salad and sugar free jelly), then she had nothing to eat until we were finished testing. It didn't worry her because she was off to bed and didn't need to eat again until breakfast. We made sure she had a high blood glucose of around 13 to 14 mmol/l by reducing the insulin from her previous meal (lunch). Also, you want to make sure your basal is correct before working this all out. The last rapid acting injection had been 5 hours before (at lunch) and she hadn't had any carby foods since that last injection. Also make sure the last carb meal is not one like pasta which can affect the blood sugars for a longer period of time. After the evening meal do the BG test to get your starting reading. It must be a highish reading otherwise you may go hypo. Inject 1 unit of novorapid and then start testing every hour for 5 hours or until your BG no longer drops. The starting reading, say 13 mmol/l minus the end reading e.g. 8 mmol/l will tell you how much on average 1 unit of novorapid will reduce your BG. In this example it's 5 mmol/. Now you know how much insulin you need to inject to get your BG back to target. At the same time you've also worked out how long the insulin is active for you. If the BG stopped falling after 4 hours, then you know it's active time is 4 hours. This will help you to avoid insulin stacking. For example, you inject with your snack and 2 hours later you test and your reading is a little high. You know that the insulin injected with your snack still has another 2 hours of active time so it's best not to correct otherwise in another 2 hours you may end up with a hypo because you've stacked your insulin. Better to wait 4 hours until you know all the insulin has worked out of your system and then if you're still too high you can calculate more accurately how much extra insulin you need as a correction dose.

Working it out like this will give you a starting point for correction doses. Time of day can affect this a bit so you may find that mornings need a little more and mid-afternoons need a little less correction. But at least you have somewhere to start at. The other thing I forgot to say earlier that can also affect correction dose is how active you've been before or after the correction. Do the experiment on a fairly normal activity day for you.

As for periods, I have no idea as we haven't reached that stage yet with my daughter. But I have read that a period can affect BG readings so the higher readings are no surprise.
 
I worked out my daughters correction dose similar to how sophia did above.
She has not started periods yet so no help there.
 
A lot of women find that periods affect their BG, in either direction. Or maybe a rise for a few days before, then drops again once bleeding starts. You'll need to test frequently and find your own pattern. That is, don't believe doctors who tell you what will happen as though its fixed by law - everyone's different. Diabetics are more likely to be irregular, apparently. Personally I've noticed different menstrual patterns (or lack of) with various insulins, but its impossible to prove the insulin's really the cause as opposed to just me getting older. Can't say about the heaviness, I was diabetic well before mine started.
 
Thanks everyone this information all helps for someone new in the game you are all so generous with your time giving replies!!

Can you tell me how I would check if im on the correct amount of basul insulin and also what amount of carbs in the day you would class as low carbing?
 
Re-reading your first post I've realised too that you're quite newly diagnosed. Bear in mind that you may still be in the honeymoon phase so the numbers you work out now may change until you're completely out of the honeymoon period.

To see if your basal is correct you need to do some fasting tests. Rather than try to fast for an entire day it's probably better to fast over a number of days choosing a different time of day to test on each of the days. During the fasting you don't really want to do any exercise other than walking around the house and you want to try and get your blood glucose in a good range so there's no need for making any corrections. If you've had a hypo don't do a fasting test that day. If you've needed to correct your BG then leave the fasting test for another day. If you're desperate to eat something whilst doing the fasting tests you could have a no carb snack.

So maybe the first day you fast over breakfast time up until lunchtime. Take a reading every hour from waking. You want to see if your BG stays around the same when you haven't eaten and injected Novorapid. Your BG may move a little but what you want to see is no big rise or fall. I'd say you want to stay within 2 mmol/l either way of your starting reading. Eat normally for the rest of the day from lunchtime onwards.

Day two have breakfast but skip lunch. Do a test at lunchtime and make sure the reading looks fairly good, not too high or low needing a hypo treatment or a correction. If the readings are too far out leave fasting for another day. Take a reading every hour until late afternoon or evening. Same as before you want to see a steady BG reading throughout the afternoon. Eat your evening meal as usual.

Day three, have breakfast and lunch. From late afternoon onwards start testing every hour until late evening. It's difficult to skip the evening meal so maybe allow yourself a no carb snack in the afternoon and have some sugar free jelly or something like that to get you through the evening. Have a very late evening meal before bed, you may want to set your alarm for 2 to 3 hours after that meal to make sure your readings are not too low.

What the results should show you is that mostly your BG stays within range for the duration of the day without any significant shifts either way. It's probably not going to be a perfectly flat profile but it should look fairly steady. If you are noticing a significant climb or fall in BG then you may need to make some adjustments to your basal insulin. Either less or more or if you're not already doing so perhaps you need to split the basal into two injections per day. As you're newly diagnosed I don't recommend you making these changes without first discussing with your diabetes team, show them the results and get their help with the decision. You may also want to do these fasting tests more than once just to make sure you didn't do it over an off day where your readings weren't doing what they usually do. If you're still honeymooning it may be too early to do this sort of adjusting, speak to your diabetes team and see what they think.

I'm not sure what the answer to the low carbing question is as my daughter doesn't do what I consider low carbing. She eats at the lower end of the recommended daily allowance for a child her age.
 
Hi there,
I also don't low-carb so can't help with that - there are threads on here about what counts as low carb though, a quick trawl through those will no doubt give you an idea of others' opinions on it.

Re basal insulin: SophiaW gives good advice. You could also try checking your blood in the middle of the night to see what is going on then.
HOWEVER - if you aren't feeling as dedicated as all that (and I never feel dedicated enough to miss food or sleep), the main things that will let you know you're on the wrong dose are waking with night hypos, or blood glucose rising after your short acting insulin has run out. Eg if you eat at 12noon with an insulin that lasts 4 hours, and your blood sugar is 5.6 at 4pm but 10.8 at 7pm (and you've not eaten in the meantime) then your basal's probably too low. Equally, if you eat at 12noon and your bg is 5.6 at 4pm but 2.1 at 7pm, (and you haven't been exercising or drinking alcohol in the meantime) your basal's probably too high.

Hope that helps...?
 
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