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Insulin dose how do you calculate..Advice appreciated

M

Meehan84

Newbie
Messages
4
Type of diabetes
Type 1
Treatment type
Insulin
So Ive used the search function and read all I can.
I am a type 1 have been for 9 years and 3 months , I was diagnosed at 22.I have dealt with this 100% on my own bar doctor checkups every 3 to 4 months but they arent much help.They can tell the HBA1C what it is what is should be.Ive not spoke with another diabetic about how it is living with it ever no groups nothing.Ive basically had no help and it hasnt bothered me.I have posted on here 1 other time a few weeks ago.Its tume to get my dosage better if possible , there are suggestions but everyone is different I just went about it my own way.In the 9+ years I had no issue until April 2015 where I had a DK , I was sick with a vomiting bug (I work in a hospital) and woke up vomited went back to sleep woke vomited repeat woke up diarrhea vomiting I was dehydrated and there was no bringing my glucose levels down stomach spasms it was just horrible.Spent a week in Hospital.

Now Ive always just went about dosing insulin myself.Ive read about the 1 unit per 10g carbs but If I have a meal that has 50g of carbs veggies and protein 5 units just doesnt enough 10 units may not be enough.Maybe Im overdosing myself I inject whenever I eat and I usually eat anywhere from 5 to 8 times a day and they are mostly good size meals.
Night time insulin is becomming a pain too.I just want to know what other T1's do.Especially bigger guys that go to the gym.I go to the gym 4 to 5 times a week strenght training and I think Im doing it wrong insulin wise.Im in good shape currently 6'2 208blbs 15.5% bodyfat.

I would love to not be second guessing myself all the time with my Insulin and have it going smoothly as I type for example Im high again 14.2 I woke it was 8 had 60 carbs 42 protein 19 fat 14units of novarapid.
I at 1 hour ago.At night I find as well that I could be in a decent rang 7 to 9 and have 18 to 22 levimir a small snack but wake in the high teens.At the same time if I have the small snack the same levimir and 3 units of insulin I wake in a few hours under 3 and shaky , ye know that feeling.Its a constant struggle & I really want it in check better than it has been , I calculate that Im constantly walking around in a high maybe 9 to 14 but if I have the slightest bit of insulin I have a low within an hour.

Its like when I eat i need more insulin than most take to not be high , yet it can make me low.But If I have a bit less insulin I stay high anyway.Its becoming a pain in the ass.

Thanks for reading , excuse any errors in spelling etc... its high now and im gunna try to fix it.
 
Hi @Meehan84, there's a lot of info out there. Let me provide you with a couple of links to help you sort out your insulin.

This guide will hopefully explain the basics to get you going on how best to manage your insulin: http://www.imperialendo.co.uk/carb2012.pdf

To make sure your nighttime insulin is correct, use this link and follow the guide: https://mysugr.com/basal-rate-testing/

There is also an online course called BDEC which will help with carb counting and insulin dosing: http://www.bdec-e-learning.com/ - this is due to be updated soon.

There will shortly be a national on-line structured education course available, which will be added to the useful links page we have here: http://www.diabetes.co.uk/forum/threads/useful-tools-and-links-for-t1ds.88209/

Go and have a read of all of these things - they really help, and then please come back and ask us for more information or anything you don't get! We are all happy to help.
 
Hello,

So there are two things that you'll need to do in order to try and get things smoothed out again.

-Work out your carb:insulin ratio
-Work out your basal insulin requirements

500/total daily insulin needs is the starting point for your ratio. I find this a bit complicated though...

You're saying that you feel you're needing more Novorapid for meals. So how about trying 1:15 test before and after your meal. I'd leave it about 3 hours after eating to test though. This is in case you're levels don't come quick enough due to the type of meal you have eaten (high carb, high fat, low fibre, etc). Maybe try 3 meals at 1:15 and if that's still not working then gradually up it until it's sound.

Maybe first of all getting your basal sorted out would be better though. I've not long adjusted mine because of rebound morning highs and night time lows. I did cheat by using the Libre as it really made it easier for a novice like me. I couldn't recommend it enough for this task. It saves the need for waking up every couple hours during the night to test etc. The only issue is the cost, but IMO - it's well worth it.

What you've described in your thread about your Levemir was similar to what I was experiencing. I was waking with high BGL and thought I wasn't taking enough insulin. Where in fact, it was too much.

You may be dipping low during the night and then having rebound highs (liver pumping glucose into your blood stream as a natural low BGL response). This is sometimes hard to notice at night, especially if you're still in the 3mmol/L range as you don't tend to notice this low so much.

The other reason may be dawn phenomenon leading to your high morning BGL's. This is the body priming itself for the day on waking. A release of hormones just to add difficulty to the life of a diabetic!

This is an excellent guide for basal testing:

https://mysugr.com/basal-rate-testing/

The above is good but as you can see, quite time consuming. It is your best bet unless you want to use the Libre. Obviously cost is a major factor though.

I hope this answers some of your questions

Regards,
Grant
 
God sake Tim! I was busy typing that out
 
I really really appreciate that info.I'll look through it today.

Thanks Tim & you too Grant.
 
Hi. As others have said it's vital to get the Basal right first. It's easier with once-a-day which I'm on and a bit more fiddly with twice-a-day. Once that's right then it's much easier to adjust your Bolus carb ratio.
 
I would highly recommend the book "Think Like a Pancreas". I was in a similar position to you 1 year ago and this book answered a huge amount of my questions.
 
And I recommend Diabetic Athlete's Handbook. It will help you understand how to deal successfully with the various ways exercise can alter your insulin requirements.


Sent from my iPhone using DCUK Forum mobile app
 
I need to bolus for 1/2 my protein as protein really raises me. I cannot eat more than 3 oz at a time without having to split my bolus or correct after a few hours. Just something else to consider.

I am VLC due to the exact same thing you are going through. I could never get flat with carbs. I am less than 20 a day. Many do this but many don't.

To be clear, I had to greatly reduce my insulin.
 
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