Injections and food

[Bridie9408]

Hi I'm sorry if this seems to be a silly question but I am just wondering anyone that is on four injections a day do you have to eat after every injection. I am type 1 on humalog mix 25 and now have new doctor at my diabetic clinic who says I have to many low reading's and thinks I should inject four times a day. My low reading's range between 3.5 to 4.3 .I was on four injections years ago when I was pregnant and I feel it took up my whole day thinking about injecting and food. My previous doctor used to say there is nothing wrong with 3 or 4 if you can manage it. I am not sure what to think. My new doctor has reduced my morning and evening insulin and it has made bit of difference.

 

[SamJB]

With mixed insulin, you do need to have some carbs a couple of hours after injecting. I was on Novomix 30 a few years ago and needed to have a carby snack 2 hours after the morning injection. Regarding being comfortable in the 3s and 4s, I would never be happy in the 3s, I'd lose my hypo awareness and it's too close to dangerous hypos for me to be comfortable with. Most people class anything <4 as a hypo. Being in the 4s is ok, so long as your levels are stable, but I wouldn't drive if I was in the 4s as it's too close to hypo levels.

 

[Antje77]

Do you mean your doctor wants you to inject your mixed insulin 4 times a day or do they want you to switch to a basal/bolus regime (1 injection of long acting, 3 before meals)?

If on basal/bolus you can eat whenever you like but just inject before eating every time. So, yes, you have to eat after every injection, but that simply means you don't inject when you don't want to eat.

 

[Bridie9408]

Do you mean your doctor wants you to inject your mixed insulin 4 times a day or do they want you to switch to a basal/bolus regime (1 injection of long acting, 3 before meals)?

If on basal/bolus you can eat whenever you like but just inject before eating every time. So, yes, you have to eat after every injection, but that simply means you don't inject when you don't want to eat.

Thanks for your reply. The doctor wants me to switch but I am not sure what to. I just cut him of as soon as he mentioned 4 injections.

 

[Daibell]

Hi. NICE now recommends that all T1s are started on MDI which typically means 4 to 5 injections per with two different insulins. The daily Basal may be injected once or twice a day based on what you were told. The meal-time Bolus is used when you have a meal of more than, say, 20gm of carb. MDI makes control of BS much better and you can eat what you want when you want but does mean more injections.

 

[Circuspony]

I'm probably 6 times a day.

6am - inject my long lasting Tresiba and a separate injection of novorapid to cover 1st breakfast

10am - novorapid to cover 2nd breakfast

About 1pm - novorapid to cover lunch

Mid afternoon - novorapid for a snack

7pm - novorapid for dinner

I check bloods before bed at around 10pm and if they are over 10 may make a correction injection depending on what I had for dinner.

 

[Engineer88]

Thanks for your reply. The doctor wants me to switch but I am not sure what to. I just cut him of as soon as he mentioned 4 injections.

if you can get your long acting correct then you don't have to eat is the basic idea, then you only inject if you want to eat carbs or need to correct your blood sugar. its loads more flexible than the insulin you're on currently.

 

[Circuspony]

I'm probably 6 times a day.

6am - inject my long lasting Tresiba and a separate injection of novorapid to cover 1st breakfast

10am - novorapid to cover 2nd breakfast

About 1pm - novorapid to cover lunch

Mid afternoon - novorapid for a snack

7pm - novorapid for dinner

I check bloods before bed at around 10pm and if they are over 10 may make a correction injection depending on what I had for dinner.

 

[Bridie9408]

I'm probably 6 times a day.

6am - inject my long lasting Tresiba and a separate injection of novorapid to cover 1st breakfast

10am - novorapid to cover 2nd breakfast

About 1pm - novorapid to cover lunch

Mid afternoon - novorapid for a snack

7pm - novorapid for dinner

I check bloods before bed at around 10pm and if they are over 10 may make a correction injection depending on what I had for dinner.

Thanks everybody for your replies but I think I would never get the hang of that. I am from Northern Ireland and the clinic I attend is way behind rest of the UK.

 

[Bill166]

Hi Bridie9408,

I was diagnosed T1D 37 years ago, and put on a mixture of insulins. I well remember the hassles of needing to organise my world around needing to eat fixed amounts at certain fixed times, depending on the absorption rates of the insulins.

Moving to a basal-bolus regime with multiple injections a day was life changing. Suddenly I didn't need to eat at fixed times! If I wanted to skip a meal or eat late, no problem, you only need to inject when you want to eat. Eating in a restaurant when they give you something unexpected and you need more or less insulin to handle it? Just change the amount you take for that one meal. Travelling to different time zones? No problem. Catching a nasty bug and unable to eat for a day? No problem. It put me in charge of the condition instead of being a slave to the treatment regime. I couldn't recommend it more.

 

[Bridie9408]

Hi Bridie9408,

I was diagnosed T1D 37 years ago, and put on a mixture of insulins. I well remember the hassles of needing to organise my world around needing to eat fixed amounts at certain fixed times, depending on the absorption rates of the insulins.

Moving to a basal-bolus regime with multiple injections a day was life changing. Suddenly I didn't need to eat at fixed times! If I wanted to skip a meal or eat late, no problem, you only need to inject when you want to eat. Eating in a restaurant when they give you something unexpected and you need more or less insulin to handle it? Just change the amount you take for that one meal. Travelling to different time zones? No problem. Catching a nasty bug and unable to eat for a day? No problem. It put me in charge of the condition instead of being a slave to the treatment regime. I couldn't recommend it more.

Thanks Bill 166

 

[Circuspony]

Thanks everybody for your replies but I think I would never get the hang of that. I am from Northern Ireland and the clinic I attend is way behind rest of the UK.

It's seriously not that bad. I was only diagnosed last year and it just becomes routine. Time to eat? Then test and inject.

 

[Rokaab]

It's seriously not that bad. I was only diagnosed last year and it just becomes routine. Time to eat? Then test and inject.

Definitely agree with that, you do get used to it, I know there was issues when I changed from 2 injections to 4 a day, but then I was 15 at the time and hated the idea of more and well I was a teenager, but yeah I think I got used to it very quickly - worst thing was actually having to take my injections to school with me (hadn't had to with only 2 a day) !
Also means you don't have to watch the time as much, as you just take the bolus whenever you happen to eat, no matter what time it is