Fear of injecting to much insulin

Pota said:

I have heard about putting gel in the mouth, but i dident think it was that effective, it is you say? Is it as effective as swallowing?

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No, it's not as effective as swallowing. But if you cannot swallow, or cannot digest, or may vomit back up, it's better than nothing.

It's hard to remember to do during a hypo, but I try to chew or swill and get the saliva working, before I swallow. I particularly do this if I also feel nausea.

Pota, AndyS is right, you must not be doing correction doses 1 and 2 hours after a meal. The advice I was given is:

- Don't do any tests before 2 hours after a meal
- Only do a 2 hour test if you can resist the temptation to give a correction dose. The main purpose of a 2 hr test (for a Type 1 diabetic) is to check for hypos.
- Do a test after 4 hours, and if your BG is high, then you can do a correction dose.
- Keep in mind there is still some insulin active at 4 hours, so don't correct too strictly


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Pota said:

Are you saying that for example if im injecting 4IE to a meal... can be less hard to stop if i go low, than example injecting 2IE on the same meal... and 2 after 1 hour..(totalt 4 IE)?

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It's OK if you want to inject some of the bolus dose later, but this should be your calculated bolus dose. It should never be a correction dose based on any blood sugar readings in the 0-4 hours after the first bolus injection.

Pota said:

Are you saying that for example if im injecting 4IE to a meal... can be less hard to stop if i go low, than example injecting 2IE on the same meal... and 2 after 1 hour..(totalt 4 IE)?

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Hi Pota,

I'm not say I exactly follow what you are asking so let me try with an example instead in the form of a series of log entries, I am assuming 1UI:10g CHO ratios and for correction that 1UI = -2mmol/l PLEASE NOTE: This is for example purposes ONLY and I do not recommend anyone take these numbers as fact, we are all different and you need to work out these relationships for your own body:
Breakfast (07:00):
BG - 5.2
Food - 50g CHO
Inulin - 5UI

Mid Morning (10:00)
BG - 6.9

Lunch (12:30)
BG - 5.8
Food - 40g CHO
Insulin - 4UI

Mid Afternoon (16:00)
BG - 9.8

Dinner (18:30)
BG - 9.4
Food - 40g CHO
Insulin - 4UI + 2UI ( Here the +2 is your correction)

Mid Evening (20:30)
BG - 8.4

Bed Time
BG - 6.1

Hopefully you can see that in the mid afternoon I did not correct but rolled that correction into the dose at dinner time. This allows you to have a more graceful drop instead of your BG spiking and crashing which will wear you out and probably has you feeling awful.
If you are consistently seeing something like you having to correct at dinner time then this tells you that your lunch time ratio of 1UI:10g CHO is not quite right.
In this example I would work it all backwards by taking the correction I added at dinner, adding it to my lunchtime dose then divide back, like this:

Lunch was 4UI to cover 40g but I had to correct +2 at dinner, this means I should have taken 6UI at lunch.
So my new lunch time ratio should have been 1.5UI : 10g CHO.

The nice thing about correcting with a meal is that your system is dealing with the food and your sugars will come down a little more gently, though it may take more than two hours.

For me I find that I have lunch at 12:00 and even at around 4pm my sugars can still be 2 to 4 mmol/l more then I am aiming for, but usually by 6pm they have come back down to where they should be and I do not need to correct.

Does this help you understand what I am trying to say?

Spiker said:

Pota, AndyS is right, you must not be doing correction doses 1 and 2 hours after a meal. The advice I was given is:

- Don't do any tests before 2 hours after a meal
- Only do a 2 hour test if you can resist the temptation to give a correction dose. The main purpose of a 2 hr test (for a Type 1 diabetic) is to check for hypos.
- Do a test after 4 hours, and if your BG is high, then you can do a correction dose.
- Keep in mind there is still some insulin active at 4 hours, so don't correct too strictly


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One additional test I was told to take due to DVLA rules.
- Test before driving a car and ensure that you are above 5mmol/l
- Test every 2 hours when driving and take food if required.

One side question. Are you taking too many carbs? There is a view that athletes need loads of carbs, but beyond a certain amount it's food for energy you need and fats and proteins can also provide energy thru ketosis. I know I'm being simplistic here but remember that carbs are only one source of energy and too many will cause large blood sugar swings when using insulin. I always carry 'cheap and nasty' glucose tablets with me and they will do the job if any hypo isn't too advanced.