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Insulin Dose Regulation

Amadeus

Newbie
Messages
3
Hello everyone;
I have a litte issue about Insulin, so I think maybe you can guide me.
My mother (female age 52) have diagnosed with Type 2 and start using insulin. However, fasten blood glucose level won't drop below 150 mg/dl (8.33 mmol/l) and after the meals most likely 250 mg/dl (13.88 mmol/l).

What would you do when your BG is so high ? Take more insulin is fix the problem ? Or when should you take EXTRA dose of insulin (She's using Homolog %25)

Thank you so much for your time.
 
Hi Amadeus and welcome to the forum :) Some insulin users will be along soon and answer your questions. On this forum we use mmol/l not mg/dl as this is a UK site so I have converted your figures for other members to understand: Divide mg/dl by 18 = mmol/l.

150 mg/dl = 8.3 mmol/l
250 mg/dl = 13.9 mmol/l
:)
 
Thank all of you. I'll use mmol/l from now.

I've already talked a endocrinologist, but I don't trust doctors in general. It would be invaluable if any of you could share her/his experence.
 
Not sure how long your Mother has been diagnosed so I will go ahead and offer you the Basic Advice my pal Sue and I usually hand out to newly diagnosed. The information in there should help sort a few things out. If not new.....it can still help.

However I would agree with copepod you should discuss things with your HCP as well. Advice from Members of the Forum with their own experiences can be very helpful.......especially as many of us have had bad advice from HCP's. At least we can see what other's experiences are and make our own minds up. That's what any Forum is for.......help and advice.

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Ken / Sue
 
if the sugar level,is about 8 before meal,and 13 after meal,and normal should be ~4-5,you need to inject (8-5=3,13-5=8. 3+8=11. 11:1,4=7,85.) 8 units of insulin.before meal.if sugar level will be 4-5 before meal,need to let 5.5-6 units of insulin for same amount of food.5-10 min before meal.but your mum"s insulin is different.this is recomend. for short action isnulin like apidra or novorapid.
 
Amadeus said:
Hello everyone;
I have a litte issue about Insulin, so I think maybe you can guide me.
My mother (female age 52) have diagnosed with Type 2 and start using insulin. However, fasten blood glucose level won't drop below 150 mg/dl (8.33 mmol/l) and after the meals most likely 250 mg/dl (13.88 mmol/l).

What would you do when your BG is so high ? Take more insulin is fix the problem ? Or when should you take EXTRA dose of insulin (She's using Homolog %25)

Thank you so much for your time.

Hello

Because your mother is using Humalog Mix 25 which is biphasic in its action, it is regulated by eating food containing carbohydrate at set times during the day. How much food that needs to be eaten is found out by testing bg levels. Most people get control by eating 'little and often' and not just eat 3 times a day. The reason why your mother's bg levels are higher than they should be (is this 2 hours after or less?) is because she has eaten too much carbohydrate for a meal so she will need to eat less and this should then make her bg levels drop to a safer level. How much less can only be determined by the bg tests that she does. It is common for people to eat approx 6 times a day using biphasic insulin but the carbohydrate is varied so that food balances the insulin's effect on bg levels.
 
I'm very grateful to you for all your help.
It seems like I have make her a less carb diet. I feel very lucky to find a community like yours
 
Hi

Just remember to tell your mother to test her bg levels before she eats, then 2-3hrs after and use those readings to adjust the amount of carbohydrate that she eats. Once she has found her ideal amount of carb that she needs to eat for each meal so that her bg levels are at good targets, then she will be a lot better :)
 
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