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How do you know if you've given the correct amount of insulin?

J

JonD_44

Member
Messages
8
Type of diabetes
Type 1
Hi all,

I'm not sure if there'll be a specific answer to this but here it goes.. How do you know if you've given yourself the correct dose of insulin? I always aim to be under 8mmol 2hrs after eating if you're over the recommended 9mmol after 2hrs, say they were 12mmol, would that mean you've had too little insulin and need more to correct it or has whatever you've eaten spiked your levels and you should leave them to come down?

Any insight to this would be great :)

Thanks

Jon
 
Hi @JonD_44 , It depends on what insulin regime you are on ... twice daily, MDI, pump etc. but for MDI and pump therapy in particular, you should have, or be able to calculate your Carb Factor - i.e. how many carbs to eat per 1 unit of insulin. This sometimes varies for different times of the day and for different people, but, for example I am on 1:8 (1 unit of bolus to 8g carbs) in the morning and 1:9 after that.
If I start with BG of 8mmols, I will know I have had the correct amount of insulin if I return to 8mmols 4 1/2 - 5 hours later (that's roughly how long the bolus remains active). If after eating my BG is greater 8mmols (e.g 10 mmols) I have not had enough insulin and if the BG drops below 8 mmols (e.g. 4mmols) I have had too much.
If you are worried about a peak after 2 hours, you first need to check where the BG is after 4 hours, and if it is back to normal, then it is more likely to be a bolus timing issue, and you should consider taking the bolus a little earlier before the food
 
Last edited by a moderator:
JonD_44 said:
Hi all,

I'm not sure if there'll be a specific answer to this but here it goes.. How do you know if you've given yourself the correct dose of insulin? I always aim to be under 8mmol 2hrs after eating if you're over the recommended 9mmol after 2hrs, say they were 12mmol, would that mean you've had too little insulin and need more to correct it or has whatever you've eaten spiked your levels and you should leave them to come down?

Any insight to this would be great :)
Click to expand...

Ideally if you get the insulin dose right (and correction dose if appropriate) your bg levels should be back in range once the insulin is exhausted, which for insulin's like Novo & Apidra is the around the 4 hour mark from injecting.

If you spike you could try injecting earlier to give your insulin more time to work before the food digests, most of us bolus prior to eating and the timings can vary going from personal experience, for most meals (except those that are high in fat) I bolus 20mins before.

@JonD_44, you might find the following link helpful:

http://www.bdec-e-learning.com/
 
Thank you for the replies.

So generally it seems best to wait until the insulin has completely worn off before taking more to bring down levels.

The reason I asked is because I went to a wedding on Friday and guessed how much insulin to take. My levels went up to 13.3mmol 3hrs after eating and I wasn't sure if it was the wrong amount of insulin or the chocolate fudge brownie with ice cream I had for desert! :D
 
Yes and No. With experience you can start to predict whether you have over or underestimated your dose, but the advice from most specialists generally appears to be do not correct between meals - wait until your next meal/bolus to apply corrections, especially as different foods cause peaks at different times. 2 great books to read on this are "Sugar Surfing", or "Think Like a Pancreas", as these perfectly explain the concept of micro-bolusing, which is applying small corrections if the BG is raising or dropping out of the target zone.
 
JonD_44 said:
I wasn't sure if it was the wrong amount of insulin or the chocolate fudge brownie with ice cream I had for desert! :D
Click to expand...

Now let me think.........................;)

Seriously though, at 3 hours postprandial most of your previous bolus dose would have been used up with maybe 15-20% still active (there are some graphs that explain this on the net), with bg that high I would correct but as @paulliljeros says the book he mentions have some great information on bolusing between meals.
 
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