Insulin doses

tinka21

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Lantus 24 units first thing morning
Novorapid 8 units per meal 3x day

How do I work out how much to increase insulin units to the meals im eating, these are the doses my Diabetic nurse set for me, she did say I could tweak the rapid to suit but not by how much so to speak.
Any advice appreciated.
 

EllieM

Moderator
Staff Member
Messages
9,209
Type of diabetes
Type 1
Treatment type
Insulin
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Hi @tinka21 , I just gave your post a hug because I can't believe how inadequate the advice from your DN is.
Are you counting carbs at all?
As a T1. who produces none of her own insulin, I have a ratio of so many units for so many carbs, but individual ratios are massively variable (some people need 1 unit for 20g , others need 1 unit for 1g).

As a T2, you may or may not be producing your own insulin (T2s typically start out overproducing but long term high blood sugars reduce your insulin production). So in theory you should be able to tweak your insulin amounts to make your blood sugar go back to normal before your next meal, but this is a question your DN should answer for you.

Good luck.

ps Having said that, maybe some insulin dependent T2s can give you better advice,
 
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NicoleC1971

BANNED
Messages
3,451
Type of diabetes
Type 1
Treatment type
Pump
Lantus 24 units first thing morning
Novorapid 8 units per meal 3x day

How do I work out how much to increase insulin units to the meals im eating, these are the doses my Diabetic nurse set for me, she did say I could tweak the rapid to suit but not by how much so to speak.
Any advice appreciated.
IF you pop into the thread currently on page 2 of recent posts entitled Bolus and meals or somilar, the OP has attached a file which illustrates the relationship between dose of insulin and carbs eaten with your carb:insulin rations.
The poster was struggling because their fasting and pre meal bg levels were high but assuming you are 'in range' at these times then the next step is to calculate how many carbs you could eat to match that 8 units e.g. if you ate 40g. carbs would you be back in range again after 4 hours?
For type 1s we are often started on 10g per unit for example but the key pathology of type 2 is insulin resistance hence you've been started on 8 units because your injected insulin is working harder to push energy into your cells alongside your own insulin which hasn't been able to keep up with the demand.
SO I'd start with establishing how your basal insulin/meds are working by checking where you are when you wake up then if you tend to eat similar things each day, start with calculating the carb content of each meal and see how your 8 units tackles it.
The less carb you eat the less insulin you will need. If you can eat less carb in general this will help you reduce your need for insulin (in may people). in other words you will become less diabetic.
Linking to Carbs and Cals where you can see typical carb counts for average UK food which is a bit easier and very visual for those who struggle with small print on food labels like me!
https://www.amazon.co.uk/Carbs-Cals...keywords=carbs+and+cals&qid=1639666004&sr=8-1

Good luck
 

Fenn

Well-Known Member
Messages
1,405
Type of diabetes
Type 1.5
Treatment type
Insulin
Hi, I am classified by my hospital as T1 but believe I am in fact somewhere in between 1 and 2 so feel slightly able to answer your question, with the understanding I am not trained, just went through this as a T2 on insulin.

It’s all about finding your insulin ratio, for example, if I ate a meal of one large potatoe at 64 grams of carb, and my ration was 1 to 1, I would need to inject 64 units, if 5 to 1, 32 units, 10 to 1, 6.4 units (or rounded to 7).

So all you gotta do is work out what your ratio is by trial and error, this might mean eating the same meal or meals until you figure it out.

Now if that sounds easy, it’s just not! Really really not lol, if you eat butter on your potatoe the carbs are slower, if you have a virus brewing, even one you will never know you have, if you are menstrating (be hard for me lol) if the wind is blowing in the wrong direction, your exercise changes, even what I eat today seems to effect tomorrow’s bg, it’s almost impossible to get it right, then as a T2 you may well be producing insulin naturally that will work or not depending on god knows what.

I am lucky in a sense as I don’t produce any natural insulin so it’s more predictable.

This all becomes easier if you eat low carb, if the potatoe was 64 and you ratio is xx, imagine how much easier the steak is, you don’t need to know your ratio for the steak, ignore it! Isn’t that great (not strictly true but almost true as protein morphs 20% of itself into carbs but close enough for now).

I’m sorry if I misunderstood your question or made things more confusing, best of luck.
 

Fenn

Well-Known Member
Messages
1,405
Type of diabetes
Type 1.5
Treatment type
Insulin
Just reread your post, 24 seems a high starting dose, I was started on 2 units at bedtime, I was told that adjustments should be made in increments of 2 but to wait for a few days after an increase before doing it again as it can take time, this was for slow acting not novo, novo is trickier and the carb ratio is best if you can, test test test or get a libre, hypos are terrible things.