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Type 1 Diabetes
Insulin changing help needed
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<blockquote data-quote="EllieM" data-source="post: 2204249" data-attributes="member: 372717"><p>We're not allowed to recommend doses, but we can talk a bit about regimes.</p><p></p><p>It sounds like you have always been on a mixture of short and longer acting insulin, so as to minimise your injection number. Unfortunately this results in a regime where you have to have fixed amount of carbohydrates at fixed times of day, and gives you very little flexibility to cope with high (or low) blood sugars. (I was on this for my first 15 years of T1).</p><p></p><p>A basal/bolus regime typically requires 4 injections a day: one basal or long acting (eg lantus), which lasts in the background for 24 hours, and bolus or short acting insulin which you take before meals. The advantage of doing this is that you can adjust your basal to keep your levels steady during the day (and night) when you are not eating, and use the short acting bolus insulin to compensate for meals. This allows you both to eat when and how much you like (midnight snack or skip a meal, no problem) and to adjust your long acting insulin so that your blood sugar in the morning is the same as your levels before bed. This is probably the most common regime for T1 diabetics, at least in the last 20 years.</p><p></p><p>Insulin pumps: probably not the way to go if you're nervous about injections because you have a needle permanently connected, requires quite a lot of effort to get the doses right, but people who use these often have the best control of their diabetes, because they have the most control over how much insulin is injected. Apparently 40% of US T1s use pumps, though UK usage is only about 12% (figures in 2016).</p><p></p><p>Honestly, I'd recommend a basal bolus regime if you can tolerate the injections - can you take advise on injection technique to see if they can be made less painful???</p><p></p><p>As regards to your original dosage question, can you contact your diabetic team/doctor? Really they should not give you insulin without instructions on how to modify it if your levels are too high or low, or contact details so that you can ask for help. Can I ask which country you live in, as medical practice does vary by country....?</p><p></p><p>Good luck.</p></blockquote><p></p>
[QUOTE="EllieM, post: 2204249, member: 372717"] We're not allowed to recommend doses, but we can talk a bit about regimes. It sounds like you have always been on a mixture of short and longer acting insulin, so as to minimise your injection number. Unfortunately this results in a regime where you have to have fixed amount of carbohydrates at fixed times of day, and gives you very little flexibility to cope with high (or low) blood sugars. (I was on this for my first 15 years of T1). A basal/bolus regime typically requires 4 injections a day: one basal or long acting (eg lantus), which lasts in the background for 24 hours, and bolus or short acting insulin which you take before meals. The advantage of doing this is that you can adjust your basal to keep your levels steady during the day (and night) when you are not eating, and use the short acting bolus insulin to compensate for meals. This allows you both to eat when and how much you like (midnight snack or skip a meal, no problem) and to adjust your long acting insulin so that your blood sugar in the morning is the same as your levels before bed. This is probably the most common regime for T1 diabetics, at least in the last 20 years. Insulin pumps: probably not the way to go if you're nervous about injections because you have a needle permanently connected, requires quite a lot of effort to get the doses right, but people who use these often have the best control of their diabetes, because they have the most control over how much insulin is injected. Apparently 40% of US T1s use pumps, though UK usage is only about 12% (figures in 2016). Honestly, I'd recommend a basal bolus regime if you can tolerate the injections - can you take advise on injection technique to see if they can be made less painful??? As regards to your original dosage question, can you contact your diabetic team/doctor? Really they should not give you insulin without instructions on how to modify it if your levels are too high or low, or contact details so that you can ask for help. Can I ask which country you live in, as medical practice does vary by country....? Good luck. [/QUOTE]
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