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Insulin Sensitivity Based On Weight And/or High Blood Sugar

Discussion in 'Type 1 Diabetes' started by paulpapa, Aug 23, 2016.

  1. paulpapa

    paulpapa Type 1 · Well-Known Member

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    Hi all,

    I was wondering if there are any tables that show the effectiveness of insulin for different weights or when our blood sugars are high. I'm trying to crack why I have high morning sugars and can never inject the right amount to bring it down. 4u hardly touches it (which DAFNE suggests as a max correction dose), but other times I go very low from a correction.

    Thanks

    P
     
  2. azure

    azure Type 1 · Expert

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    How high is your BS? I find that if mine's above 12 I need a larger correction dose.
     
  3. 1abRat

    1abRat Type 1 · Well-Known Member

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    Personally I find I need quadruple my usual correction dose in the mornings. I tend to split it so I have half when I wake up and then the other half 2-3 hours later mid morning once I've gauged how well the earlier correction worked.

    I'm very insulin resistant in the mornings and I find the best approach is to have a low or zero carb breakfast and try not to let it creep too high.
     
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  4. himtoo

    himtoo Type 1 · Well-Known Member
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    Hi there

    if you start by adding up your daily basal and all bolus doses in 1 day
    this will give you a TDD -- total daily dose

    so get your total daily dose for the last 4 days and then add them up and divide by 4
    this will give you an average TDD

    now take 100 and divide by TDD
    this result is the amount your blood sugar should reduce by giving 1u of fast acting as a correction dose.

    hope this helps a bit
     
  5. Juicyj

    Juicyj Type 1 · Expert
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    Hi there, just out of interest what are you eating from breakfast and what's your carb/insulin ratio in the morning, also when are you going high ?

    If you are waking high then you need to check your basal, so wake at 3am and test then, if you're going high from waking till lunch then your bolus carb/ratio would need reviewing.

    I am insulin resistant in the morning so have a low carb breakfast, otherwise with carbs on board I am high till lunch :confused:
     
  6. cath67plum

    cath67plum Type 1 · Active Member

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    I've had the same problem this morning. Blood sugar reading this morning 17.5. I had two slices of seeded bread toast and marmite for breakfast. Injected my correction dose: 1 unit brings it down 2 - 5 units given plus another 4 units for toast. Two hours later feeling **** :hungover: so test sugars - 18.4! So have given myself another correction dose but less than normally as don'y want to end up with hypo! I have housework to do and that often leads to a hypo especially vacuuming!!! :(

    It's all so complicated!!:banghead:
     
  7. azure

    azure Type 1 · Expert

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    I find delaying my breakfast can make me go high too. I need food and insulin first thing. If I do have to delay my breakfast, I either have a tiny bolus (without food) or a small amount of food plus bolus to keep my BS ok until I can eat.

    @cath67plum Yes, it's frustrating waking high like that as it can mess up the morning for hours. If you're generally waking high, you might want to look at your basal dose. If you normally wake up in range, but go high after breakfast, bolusing more in advance of breakfast can work wonders.
     
  8. noblehead

    noblehead Type 1 · Guru
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    Assuming you mean waking bg levels, I'm not sure what basal you inject but if it's levemir/lantus have you considered split-dosing to give you a better 24hr coverage?
     
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  9. paulpapa

    paulpapa Type 1 · Well-Known Member

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    Thanks for all the replies. I split my Levermir into two doses; one at 8am and 8pm of 25u each. I've recently lowered my dose to these levels as I was on 35 each time. I found I was more sensitive to the insulin and stopped taking the one daily, with dinner, Metformin as a consequence.

    I'm still trying to adjust my bolus insulin but I know that'll take time to get right. I just thought I had once again sorted the basal.

    @Juicyj I used to note at breakfast because of high blood sugars and didn't want food in me to compound the problem. After a week if doing DAFNE and having breakfast (around 40g carbs) I managed to get pretty good blood sugar readings, even after eating between 8 and 10, which for me is fantastic when I had been previously waking up 12-18.

    I was using the Libre but I'm away at the moment and can't get any new sensors shipped to me. Seeing a graph would help me know what was happening while I slept. I might get up tonight for a 3am basal test.

    Last night, four hours after dinner I was 16.5, took 6u Novorapid and then was 13.6 by the time I went to bed three hours later, so I thought I'll leave it as I still had a unit or two working. This morning I'm 16.8. It's annoying.
     
  10. Juicyj

    Juicyj Type 1 · Expert
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    Hello @paulpapa - is this a typical pattern at night and what did you eat last night ? Alot depends on what was eaten, if you are eating say a high fat meal at night then splitting your bolus over 2 hours would help alot, so taking say 2/3 before then a 1/3 an hour or so after eating, as fat slows digestion. Typically pizzas, curry work well with this type of bolus split. Also have your adjusted your carb/insulin ratio at night ? Getting your last reading in range will help you then to see what's going on in the night.

    I know it's frustrating but with a little work it will improve, perhaps write a food/insulin diary whilst this is happening to record patterns as you haven't got your libre ?
     
  11. paulpapa

    paulpapa Type 1 · Well-Known Member

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    @Juicyj I had a lamb shank and a few potatoes and two slices of garlic bread and I think I carb counted correctly but got the ratio wrong. Always a bit worried to do a big dose of insulin at night. It was particularly fatty like a curry which does make me go a little mad for a bit but I'll keep that in mind.

    I went to bed higher than I wanted to so its hard to tell really.

    I increased my basal by 2u this morning as I think I need it based on yesterday's readings.

    I'll try and carb count and increase my ratios if needs be today. I just did a lot of correcting with meals so I think my ratios are all a bit low.
     
  12. Juicyj

    Juicyj Type 1 · Expert
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    As mentioned by @noblehead do you take your basal once in the morning or do you split ?

    If your ratios are low then this is what's causing your issues - don't be afraid of adjusting, as long as you are eating/injecting say 4 hours before bed then you have a good window to watch what's happening with your BG levels before bed, I try and aim for about 5.5 to 6.5 before bed, it then helps you to see when waking if the overnight basal was working as it should or needs adjusting.
     
  13. paulpapa

    paulpapa Type 1 · Well-Known Member

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    I split it, 25u each time: 8am and 8pm. I'm going to try 2:1 ratio tonight and see what happens.

    Thanks. I'll try that. Spoke to the nurse and she said to do the same thing. Increase the ratio and see what happens.
     
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