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Injections

Bridie9408

Well-Known Member
Messages
115
I am just wondering is most type 1diabetics on 4 injections a day. The reason I ask is I have an appointment on 4th of February and I know my diabetic doctor will be asking me to consider going on 4 injections a day. If I am honest my blood sugars are a bit all over the place. At the moment I am on humalog mix twice a day. When you are on 4 injections a day do you have to eat after every injection. And what kind of meter do you have to use. I apologise if this question sounds silly.
 
When I was injecting (I am now on a pump), I would inject fast acting insulin every time I ate carbs and long acting insulin once a day.
This gave me the freedom to eat what, when and how often I wanted and helped maintain good control (except when I exercised ... but that’s another story and why I now have a pump).
 
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When I was young (a long time ago) I, like you, was on two injections a day. When I went to a new clinic in my early twenties they not only gave me my first glucometer (I said it was a long time ago ) but also suggested I'd find my life easier if I went on 4 injections a day: one long acting (basal) and 3 short acting (bolus) before each meal. In fact, you can have your bolus as often or as little as you like, depending on when you want to eat and how much you want to eat. So though it's technically more injections (assuming 3 meals a day) it's much more convenient, because you can freely adjust the times you eat and the amounts you eat. The one injection of basal insulin is designed to cover your needs when you're not eating, so theoretically you could fast all day and have no other injections.
As regards meters, anything is fine, you just need to know your level so that you can adjust your insulin/food intake.

Personally, I found it very liberating and never looked back. Still on basal/bolus regime today and it's been over 35 years since then.
 
Hi @Bridie9408, Perhpas think of it like TV stations. You have 2 at present but that limits your options. With say four TV stations you have more choice but the ned to use 4 rather than just 2.
Before going onto a pump 7 years ago, I spent 4 years on one mixed injection of insulin, 8 years on that twice daily, then 12 years on 5 injections per day of one older long acting twice per day and newer short-acting 3 times daily before moving to modern insulins 5 per day for 21 years. total of 45 years. I would never go back to mix insulins. Why two long acting insulins per day? That insulin, Levemir, gave me more flexibility than any other long acting insulin. Yes 5 instead of 4 injectons per day but flexibility was key.
The reason for the pump now? from 45 years to now 52 years on insulin? Even with building up 8 plus insulin injections per day I was still getting night time hypos and the use of pump solved that.
Enjoy the flexibility of 'more TV stations'.
 
As others already said, 4 injections is much better and much more convenient than 2 injections. I used Humalog Mix 25 for a few months and it was a better alternative than Mixtard 30 (I wasn't educated enough on what to expect so I was ignorant enough to have a BG down from 18 to 3.9 in 45 minutes!!!).
To be honest with you, when my nurse suggested (and this forum even before she did) basal bolus insulin, I was scared to death! I had an emotional attachment to my older insulin (silly it might sound but I had my smiles and tears using Mixtard 30) and I found the idea of taking insulin and sleeping very scary!! I was consumed by the idea of going hypo and not being able to recover. I was having a stressful time as I was the only one who supported this switch of insulin. Everyone around me went bananas when I changed. I still fought for it, although I was scared, and eventually started a steep learning curve. 1 year and 16 days after this switch, I never had such control over my diabetes. I never had such flexibility. I could easily go from 24 to 3 juat from taking a 2 flights of stairs. My mornings were so bad because of the spikes I used to see.
I can't even imagine seeing myself on Mixtard 30 or any premixed insulin anymore. They are very outdated for an active person and for someone who eats a lot of carbs. Premixed insulin might be good for someone going low carb (that's what I read somewhere not sure) but definitely not me. The change is very worth it.
Finally, my meter is Accu Chek Performa and I recently started using Accu Chek Guide. Both are extremely accurate.
 
Bridie9408 said:
And what kind of meter do you have to use.
Click to expand...
If you are in the UK then it needs to be one that your doctor will actually prescribe test strips for, I know at some point I was using Accu-check mobile cassettes but that got stopped cos it was too expensive so they refused to prescribe them anymore.
 
Over the years I have gone from 1 to 2 to 4 injections and while sometimes it can catch me out it is way more easy to control and gives you more freedom to choose your foods.

As for meters, well depends on where you are in the country it will be a finger prick device of some sort but if you can see if you can push for a Libre sensor they really can help

Good luck.
 
Hi. NICE now recommends Basal/Bolus as standard for T1s. It gives complete freedom to eat very much what you like and when you like. If I have tea-time snack of, say, 40gm carbs I may do an extra injection to cover that. BTW when I say you can eat what you like if you have too many carbs and inject the right amount of insulin you may start to gain weight as the body will just store any excess carbs so be aware of that.
 
Thanks everybody for all the replies. It has given me help to make up my mind. I feel the insulin I am on is ancient. The meter I use is accu chek mobile cassette.
 
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