How Much Insulin Do I Take?

[pancratic]

Hi Folks,

I thought that I would pop into your forum to see if anybody can help me out with a dilemma I have.

I was diagnosed with Type 2 diabetes about 14 – 15 years ago and have been on insulin for the past 10 years and take a 30/70 mix. Up to now my Hba1C readings have been in the high 7s to mid 8s and I’ve plodded along injecting 60 units in the morning and 60 in the evening. However, matters have changed recently.

In order to support my wife, who needs to lose a lot of weight for an operation, I have also decided to curtail my food intake and have lost some weight, which generally means that the amount of insulin that needs to be taken can become less. This is what I cannot work out.

So that I can try to get a grip on this problem I have started to weight the food for each meal and, using a program on the Internet, I am able to calculate the number of carbohydrates consumed with each meal. Therefore, using my last blood reading, adding in the amount of carbs taken, I should be able to calculate how much insulin to take to give me a 5 to 7 reading the next time. However, depending on what insulin I take, my next reading is either high or I have a hypo.

Are there any mathematicians amongst you? I feel that there must be some sort of an equation here on the lines of :- (a + (b/10))/c = e, whereby a = the last blood reading; b= the number of carbs in the meal; c = the amount of insulin taken and e the next reading. If I take an example from the log I am keeping then a = 7.8; b=67/10 (based on the theory that 10 grams of carbs will increase bloods by 1 point) c = 50 units and e = 8.9 (the next reading).

Now even I can calculate that 7.8 + 6.7 (total bloods rise) divided by 50 does not equal 8.9. It equals 0.29. So there must be another factor (d) that influences this calculation but I am not sure how to work it out. Can anybody help please?

Basically what I am asking is :- if my blood readings before a meal are 7.8 and I eat 67 grams of carbs, which will make my blood level 14.5, how many units of insulin do I need to take to get my next level between 5 and 7. I think on the above example, if I had taken 60 units of insulin it would have been lower that 8.9. However, I have taken a high dose before and ended up having the start of a Hypo.

Here are some more examples from my log if anybody feels like playing around with figures.

A= 6.6: b=44; c=40; e=6.1

A=7.3: b=38: c=50: e=8.1

A=9.2: b=4: c=40: e=6.5

Any help on this would be gratefully received.

Regards.

Pancratic

 

[jack412]

I would see your nurse and ask about going onto a separate basal and bolus insulin, this may let you have a stable background and you bolus for the carbs in any given meal,

as to weight loss, these sites helped me
http://www.dietdoctor.com/lchf it’s a long page and a video

http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm For me, the more carbs we eat the more carbs we want. they don’t give up easy.

http://lowcarbdiets.about.com/od/lowcarb101/a/firstweek.htm

http://www.lowcarbdietitian.com/blog/carbohydrate-restriction-an-option-for-diabetes-management


blood testing

http://www.phlaunt.com/diabetes/14045524.php

http://www.homehealth-uk.com/medical/blood_glucose_monitor_testing.htm

food counting

http://www.myfitnesspal.com/


Newcastle diet aims in 8+ weeks to mimic the rate of ~70% remission, for surgery T2

“It is now clear that Type 2 diabetes is caused by abnormal fat storage. Research on how this may be reversed is available. “click that link on this page http://www.ncl.ac.uk/magres/research/diabetes/

http://www.diabetesforecast.org/2010/mar/weight-loss-surgery-and-type-2-diabetes.html


American diabetic association ( http://www.professional.diabetes.org/)

http://www.professional.diabetes.org/admin/UserFiles/0 - Sean/dc132042 FINAL.pdf

Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes;

therefore, goals should be individualized; fat quality appears to be far more important than quantity.

In people with type 2 diabetes, a Mediterranean-style, MUFA-rich eating pattern may benefit

glycemic control and CVD risk factors and can therefore be recommended as an effective alternative to a lower-fat, higher-carbohydrate eating pattern.

 

[Nuthead]

Welcome. I am on humulin m3. 18 units am and 8 units pm. Was on 35 and 25 units a few months ago. I was advised to adjust dose by 10% at a time. So the idea is to drop the dose and reduce your food intake slowly over a couple of weeks or so. Your weight will have an effect on your dose and this makes it tricky to calculate. Sam with exercise. Mixed insulin is supposed to be a constant dose with a constant carb intake. Don't know of any other way. There is a formula for dose depending on weight but it's only rule of thumb starting point. Sorry can't remember where to find it. Best to consult your diabetic nurse..

 

[pancratic]

Hi there,

Many thanks for your responses.

I have read some of the links posted by Jack 412 and I like the idea of a low carb diet but the high fat does appear to be a contradiction for weight loss.

I did read recently that eating more fat does help the insulin be absorb better but also there were articles on Free Fatty Acids which apparently promote insulin resistance. Many of these articles are written by professional and aren’t always easily understood. I think what I need is “Fat and Carb Eating For Dummies”.

At my last meeting with my Diabetic Nurse I produced a chart of my blood readings taken every hour over one day. I did this to see what relationship there was between Carbs and Insulin. To my surprise there was no large spike after my breakfast of 91 carbs (50 units of Insulin on a Blood Reading of 6.5) and the readings kept coming down over the day and rose slightly at my evening meal of 6 carbs (7.7 BR on a dose of 45 units Insulin). However, at about 9-30 in the evening the Blood Reading were down to 2.4 and the start of a Hypo which I corrected by a can of regular Coke.

Looking at the chart, I am keeping, I have been at that level before (same Bloods, same Carbs) and have taken slightly more Insulin with no effects. This is what I cannot understand. I am retired now and my life is probably dull and boring but with this there are lots of constants. I have the same food for breakfast, the same type of sandwich for lunch and only my evening meal varies. Likewise my activity during the day is visiting the supermarket and watching TV in the evening. No proper exercise except mowing the lawn every two weeks. Therefore, with all those being constant only my evening meal carbs should alter my Blood Readings!

My Diabetic Nurse has suggested coming of the mixed Insulin but as that would mean extra jabs during the day I am not that keen.

I have spoken to a few “Healthcare Professionals” and none can answer the question on how much Insulin will reduce my Blood Glucose by 1 unit. They all say “it depends”. I am sure there must be someway to calculate it for an individual, if not generally. Like what Nuthead said, I was told that I should keep my doses level and make sure I took enough Carbs to match the dose. I should not play about with the dose without consulting the Doctor. But as far as I can see increasing Carbs could lead to increasing calories which leads to increase weight.

I am sure there must be a way of getting the dosage right to keep you in the 5 to 7 range. At the moment every thing just appears to be guess work.

I am going to give the LCHF diet ago after Christmas,

Anyway onwards and downwards

Regards

Pancratic

 

[Nuthead]

WOW.. 91 carbs for breakfast.I'm having around 10ish. There's a carb and insulin reduction opportunity.

 

[pancratic]

WOW.. 91 carbs for breakfast.I'm having around 10ish. There's a carb and insulin reduction opportunity.

Hi Nuthead - sorry I've not replied sooner.

It probably sounds a lot, well I suppose it is a lot, but it is only made up of a bowl of cornflakes (37), a toasted hotcross bun (37), a cup of coffee and the milk (17) used on these items.

I've looked at other alternatives but porridge is only a few carbs less and a hotcross bun is less than two slices of toast. There appears to be more carbs in skimmed milk that semi skimmed.

Besides trying the LCHF diet in the new year I don't know what alternatives there are.

Regards

 

[Nuthead]

Hi Nuthead - sorry I've not replied sooner.

It probably sounds a lot, well I suppose it is a lot, but it is only made up of a bowl of cornflakes (37), a toasted hotcross bun (37), a cup of coffee and the milk (17) used on these items.

I've looked at other alternatives but porridge is only a few carbs less and a hotcross bun is less than two slices of toast. There appears to be more carbs in skimmed milk that semi skimmed.

Besides trying the LCHF diet in the new year I don't know what alternatives there are.

Regards

I think you need to think about your food choices. For breakfast I normally have full fat Greek total yogurt or similar make. With a few berries and a small sprinkle of granola. Always have full fat milk. Bacon and eggs tomatoes and mushrooms on the menu tomorrow .almost no carbs..Before diagnosed I could get through a bowel of cereal and four rounds of toast with marmalade piled on. We have to adjust. Easy to say and hard to do. Need to think carbs= suger=bad health in the future for a diabetic.

 

[Daibell]

A few things. Your nurse is right; you need to move over to the Basal/Bolus regime. You appear to be eating too much (sorry). Set the carbs right down to below 200gm/day and quite a bit less if you can. You will see your weight go right down and so will the insulin units. With Basal/Bolus you will have much better control and can worry less about weighing food. Ignore the LCHF quoted in some posts as it may mean LowCarb but it doesn't mean HighFat but enough fat. To make up for the low carbs just increase protein and fat but don't go mad. Carbs are the main contributor to weight gain not fat and certainly high blood sugar. Fats slow the absorption of carbs.

 

[NoSugarBabe]

What is the max. amount of Humulin M3 that I can take?

I cannot find ANY info - even in the Humulin M3 leaflet! I was given in July 2014 when I started taking this insulin - that tells me this.

I am not due to see the diabetic specialist doctor till February 2015, 3-4 months away. And need to know an answer to this query way before then.

MY HISTORY OF MEDS: I was first started on insulin a year ago in October 2013 (after diet, then pills & then Victoza injections, or a mixture of all these types, didn't do the job of sufficiently reducing my BMs). That insulin was Levemir. Then, as that too wasn't sufficiently reducing my BMs, I was put on Humulin M3 in place of the Levemir. That was in July this year (2014).

MY DOSAGE DATA: re Humulin M3: I started (July 2014) on 18 units in the morning and 12 units in the evening. I have gradually (2 units at a time) increased this till my BMs lowered. Those 2-units increments were following the advice given over the diabetic clinic's telephone advice line (with the diabetic clinic nurses). My pre-brek BM is thus now roughly near to what it should be - it's approx. in the 7s (sometime the 8s), on average - although it can be higher sometimes.
The rest of the day is less easy to guage/record, but is generally way too high.
BTW it was tricky finding that out too (i.e were the pre- & post-meal BMs too high or not)!! This was something else I had been given NO! information about by the NHS! :-(
In the end, after searching here & at Google, I found a handy webpage at this super website:
www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html.
BTW, does anybody else find it ironic that the most helpful advice & attitude is found at this website & others, not at/via the local NHS clinic?!?! Grrrr!! ,-)

IMHO the diabetic specialist will, like as not, deem the BMs to still be out of control, & so will put me on a different insulin at the next appointment, or change me onto a middle of the night dosage. Or both: ha-ha (not!) ,-)
But till then I believe I might need to increase 1 or both of the dosages of Humulin M3 still further . . . ?

But I do not know if it is safe/advisable to do so as there is little guidance info to be found anywhere re how HIGH a dosage - either accumulated over the day or just 1 dosage (of the a.m. or p.m.) - I can/should take. Hence my query here!

Any advice??

 

[Totto]

Hi there,

Many thanks for your responses.

I have read some of the links posted by Jack 412 and I like the idea of a low carb diet but the high fat does appear to be a contradiction for weight loss.

I think what I need is “Fat and Carb Eating For Dummies”.



Regards

Pancratic

If you are looking for Fat and Carb eating for Dummies who want to control weight and blood sugar this is what you are looking for: http://www.dietdoctor.com/lchf

 

[Nuthead]

What is the max. amount of Humulin M3 that I can take?

I cannot find ANY info - even in the Humulin M3 leaflet! I was given in July 2014 when I started taking this insulin - that tells me this.

I am not due to see the diabetic specialist doctor till February 2015, 3-4 months away. And need to know an answer to this query way before then.

MY HISTORY OF MEDS: I was first started on insulin a year ago in October 2013 (after diet, then pills & then Victoza injections, or a mixture of all these types, didn't do the job of sufficiently reducing my BMs). That insulin was Levemir. Then, as that too wasn't sufficiently reducing my BMs, I was put on Humulin M3 in place of the Levemir. That was in July this year (2014).

MY DOSAGE DATA: re Humulin M3: I started (July 2014) on 18 units in the morning and 12 units in the evening. I have gradually (2 units at a time) increased this till my BMs lowered. Those 2-units increments were following the advice given over the diabetic clinic's telephone advice line (with the diabetic clinic nurses). My pre-brek BM is thus now roughly near to what it should be - it's approx. in the 7s (sometime the 8s), on average - although it can be higher sometimes.
The rest of the day is less easy to guage/record, but is generally way too high.
BTW it was tricky finding that out too (i.e were the pre- & post-meal BMs too high or not)!! This was something else I had been given NO! information about by the NHS! :-(
In the end, after searching here & at Google, I found a handy webpage at this super website:
www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html.
BTW, does anybody else find it ironic that the most helpful advice & attitude is found at this website & others, not at/via the local NHS clinic?!?! Grrrr!! ,-)

IMHO the diabetic specialist will, like as not, deem the BMs to still be out of control, & so will put me on a different insulin at the next appointment, or change me onto a middle of the night dosage. Or both: ha-ha (not!) ,-)
But till then I believe I might need to increase 1 or both of the dosages of Humulin M3 still further . . . ?

But I do not know if it is safe/advisable to do so as there is little guidance info to be found anywhere re how HIGH a dosage - either accumulated over the day or just 1 dosage (of the a.m. or p.m.) - I can/should take. Hence my query here!

Any advice??

Hi.m3 is a mix of fast and slow acting insulin. It should be used as a fixed dose and a constant carb/suger intake. Now saying that, when I was on chemo I was taking 35 units am and 25 pm. Now on around 18 am and 8 pm.I do adjust this ether way by a couple of unit's depending on my bg reading or if I know I'm going to be eating higher carbs, such as a meal out. Sometimes a bit more even. I have never come across a max or min dose. I take enough to allow me to drive legally but not go to high. Beware of your diet/ carb intake. Hope this helps.. my bg is around 7 to 8waking. 5.5ish before lunch. 5 to,6.5 before tea and anything between 5 and 7 before bed.