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Insulin doses for simple carbs

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Sanober

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Not really knowing what's going on inside my Endocrine system!!!
I am getting a bit fed up that if i have a little bit of cake, biscuits or some milk choc my glucose level soars into the near 20s mark and i feel very symptomatic of hyperglaecemia.

I eat healthily and keep a daily diary. I am on small insulin doses. Should i inject extra to cope with these types of snacks?
 
Sorry, I must be missing something incredibly obvious here but why would you think that you shouldn't inject for those snacks?
 
These are just the type of foods that will send your levels up. Here is a protocol based on DAFNE for snacks http://medweb.bham.ac.uk/easdec/prevent ... snacks.htm
1cp=10g carb.

Personally I was too scared to do anything else than follow instructions when first diagnosed.One of those was no snacks, the French don't snack diabetic or not. The only time I have food between meals is if its before or after exercise. Got used to it now.
 
AMBrennan said:
Sorry, I must be missing something incredibly obvious here but why would you think that you shouldn't inject for those snacks?
Click to expand...

I asked if I need to inject 'extra' for those type of snacks. Also I'm newly diagnosed and on very small insulin doses. I'm not allowed to attend DAFNE for a year after diagnosis. I'm not full blown T1 so I've not been taught 1CP measures etc. I'm on set amounts of Novo for 3 meals a day and Lantus in the morning.

I really don't generally eat cake/milk chocs/biscuits (apart from w/meal d.choc digestives after dinner and my Novo dose seems to cover that ok) But on my little brother's birthday I had a little cake and I was 19.3 at 2 hours later...I had already injected to cover my dinner a couple of hours beforehand (at the time I was scared about injecting more because I didn't really get taught about extra dosing). I'm getting a bit braver and using 0.5 units here and there but it's not enough and takes hours to come down, I think I need to look at timing of main meal and when I last injected and when I have my next meal. I seem to be highly sensitive to sugary things :shifty:

Pheonix thank you very much, that's exactly what I needed to know - generally during the working day I stick to the 3 meals a day to be honest. However sometimes someone will bring in homemade baked goods and I do sometimes get fed up of everyone saying "Oh you won't be able to have these as they have lots of sugar" So the table is very useful to know to inject 1u per 10g snack - the timing of the snack, and next meal time etc because I worry I don't want to overcorrect and then hypo.
 
Sanober... you will need to inject extra if you eat sugary snacks.. If you are unsure of how you are going to react to the insulin then the best bet is to just increase your testing post injection.. I would suggest a +1 hour test + 1.5 hour test +2 hour test.. if you ever get a low reading say sub 5mmol/l then just do another test 10 mins later.. if the readings remain the same then test again after another 10 mins if thats the same then do a final test + 1/2 hour to check your levels are stable.. if they drop between the first and second test then eat some fast acting carbs like a glucose tablet and then test again 10 mins later.. this should allow you to 'catch' the hypo before it happens.
 
Many thanks Pneu - extra testing will definitely be in order.
 
As a suggestion I would say the best time to eat 'simple carbs' would be after your main meals as your food will slow down the absorption of your treat, you'd still have to cover with extra insulin mind.

I don't snack between meals and rarely eat cake, biscuits or deserts, the trouble with eating any form of carbs between meals and injecting to cover this is the potential to stack insulin doses, novorapid can be active for up to 4-5 hours after injecting and this can interfere with the next dose and cause postprandial hypo's.
 
I apologise, I seem to have mixed up the order of events in your signature in my head. Further, it's shocking that you didn't receive any information regarding carb counting at all (it's not DAFNE or nothing).
Edit to add: http://www.bdec-e-learning.com/ has a bit of useful information on carb counting
 
Hey Sanober!

I had no idea you were still on set amounts of quick acting. You must start carb counting and adjusting your Novo accordingly.

Start with 1 unit Novo to 10g carb and adjust from there. Err on the side of caution at first, but 0.5unit of Novo will only drop you by around 1.5 or 2 points, so decide what BG you are aiming for (I usually aim for 5.5). If you are 7 before you eat you need 0.5 units to bring you back to 5.5. Then work out how much carb is in what you're going to eat. If it's 20g, say, you need 2 units for that. Add the 2 units to the 0.5 units, so you'd inject 2.5 units. Get it?

If I were you, I'd start off with a slightly higher target e.g. 7 so that you have quite a big margin for error. You'll soon get the hang of it. If you can get a few days off work, that would help. Remember, if you do go a bit low, correct with small amounts of sugary carb. They will tell you 10g quick acting carb followed by 15 g slow acting carb - you will almost certainly need much less than that because with LADA your BG will blip significantly at small levels of carb -that's just trial and error I'm afraid. Test frequently.

As for the basal, that should just keep you level. So, if you're rising between meals or overnight, increase it 1 unit. If you're dropping, decrease it 1 unit.

Don't snack while you're learning this as it just confuses things. Get to grips with it and then you can start learning how to inject for snacks if you really want to, because it generally involves layering insulin which can require adjustment in the next dose.

I just ignored the DSN advice and started carb counting and adjusting the insulin doses myself. Once the DSN and consultant realised they couldn't stop me, they actually helped a lot and still do! I think they panic a bit that you won't cope with the inconsistency of LADA, but once they see you are, I'm sure they'll help.

Good luck. PM me if you need to.

Smidge
 
smidge said:
Hey Sanober!

I had no idea you were still on set amounts of quick acting. You must start carb counting and adjusting your Novo accordingly.

Smidge
Click to expand...

Hi there Smidge

You're right, they do sometimes get scared and err more on the side of caution. They've told me I'm insulin sensitive at this stage. Initially I was on 2u per main meal and I stuck to similar portioned main meals but I was going under the 4 mark on the glucose levels within 3hours. My Lantus seems fine as I had to do a couple of 3am tests and my glucose drops down to the 6 mark by this time even if I go to bed at levels of 13 odd (this is because they ask me to test before sleeping but I could have had a choc digestive or two about an hour before the test... so a bit of a dumb test but I suppose it's to check if the Lantus level is ok).

So I'm on 1.5u breakfast (which is always around 30-35g carbs)around 6.30am-7am.
(this is 0.5 to 10g or 1CP ratio - have I got this right?)

They set my lunch at 1.5u which again not too bad as this is usually around 30g (unless I go out for lunch to a cafe so my carb may be around 40g so I'll shove in 2u. However my lunchtime is 12pm one week and 1pm the other week and it alternates - it's when am on the later lunch I feel I need to nibble before it - normally a 10am regular soya latte does the job when am on 12pm lunch but I seem to want to nibble again around 11.30am when am on the later lunch...

After lunch, because I finish work at 5pm, sometimes 6pm - if my lunch is at 12pm I get nibbly around 4pm - a small banana, an apple, a couple of mini baby bells, or if I'm going to the gym after work a 10g of mini cheddar crisps or 3/4 crackers or 2 oatcakes sort me out. I don't bother covering as I seem to feel ok.

Dinner's 2u - although I always seem to need to have a couple of biscuits - dark choc digestives or 2 squares dark choc. For the biscuits I should perhaps add an extra unit. My morning reads come up around 8-9 usually. So this may give me the nicer 6-7 no.s -
Alcohol....I don't bother with any extra units then as that's when I do get nicer reads in the morning.

I just seem so sensitive if it's a simple carb a bit of cookie or milk chocolate (I rarely eat this kind of thing but you know, sometimes when it comes round it's hard not to resist!) It's the affect even a small bit has on my glucose and I become very symptomatic.

I'm getting a bit braver with adding extra shots here and there but 0.5u increments which as you've pointed out isn't making too much of a difference with the simple carbs. A 10g milk chocolate can send me soaring into near 15s- 20s. So is this where I should add 1u? Or easier not to eat them :yawn:

I think I need to ensure my own snack drawer is topped up adequately so I can reach for those instead of what's being passed around the office :lol:

Thank you for the tips - I think I know what I need to do now.
 
I am Type 1 and on Humilin M3 taking 19 at 8 ish and 8 at 5 30ish. I am trying to lower my carbs. I am reading Dr Biffras book Escape the diet trap. I have managed to get my nos lower and have had to lower my insulin intake to these levels. Most info on carb reducing is for T2's. I have not been on the DAFNE course is it a good idea for T's? I am 66 and was diagnosed at Christmas 2009. 8)
 
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