Is it okay to vary insulin doses on a daily basis?

[mon]

Hello,
Since reading this forum I have been changing my diet to cut out refined carbs, of which I was eating a lot of, to bring down my very high blood sugar levels. This seems to be really working for me which is excellent! However eating less carbs means I am also getting a lot of hypos now. I am monitoring my blood sugars levels constantly to see what my insulin requirment is and can see that it has come down a lot from what it was before- and can be very different depending on what I eat for each meal.
I was wondering whether most Type 1s will alter the dose of insulin they inject dependant on the meal they eat or do you always stick to the same doses of insulin every day and work your food intake around that?
For example, at lunch if I ate a chickpea and pumpkin curry I might take 7 units of novorapid, but if I ate a chicken salad this would be way too much insulin so I might bring it down to 5.
Looking at my results over the past couple of weeks I can see that I am taking very varying amounts from day to day, to try to tailor it adequately - one morning i might take 9 units for breakfast (with porridge), but the next day it might be 4 (with omlette)
I have generally been advised to stick to a plan of the same units of novorapid for breakfast / lunch and dinner and if I make any changes to do it gradually, so im a worried that it might be a really bad idea or maybe even dangerous to vary the doses on a day to day basis like this?
Does anyone have any advice on this?
and if you dont vary insulin how can you be flexible with what you eat?
p.s I am keeping the lantus at night the same at 16 units
I hope this makes sense! thanks very much for any advice!

 

[hanadr]

I don't use insulin, but I'm married to a T1 and I know that once you get the basal right, you SHOULD vary the bolus to match your meal. thus change every meal, not just every day.

 

[phoenix]

I vary it, I certainly take into account exercise before or after and pre meal blood glucose levels but I do find that keeping a regular pattern of meals as far as possible seems to help overall glucose control This doesn't stop me going out to a restaurant eating a very different meal or having just a snack if I'm not really hungry. I just try not to do it everyday.
(I have a pump which only uses rapid insulin, most days I use around 24units in total but there are some days when I have used as little as 18 and others when I've used 30)

You do need to carefully count the carbs and know how much insulin to take for each 10gm of carbs. Eating a fixed amount at each meal and adjusting your insulin so that you have good control can help you determine what your personal insulin/carb ratio is (and it may vary according to time of day). Then you will be able to vary your dosage with more confidence. What isn't a good thing is making guesses which if wrong can result in too much insulin and a hypo or too little and a hyper which then needs correcting.
The NHS has a course to teach you how to do this (DAFNE) you should ask your DSN or doc about it. There is a basic online version (from the hospital at Bournemouth so quie legit) which could help give youthe basic knowledge , http://www.bdec-e-learning.com/
The one thing it may not help with is mainly protein meals. Personally, I find that such meals need insulin and I find the amount needed seems to vary considerably... eggs for example seem to need far more than they should. This is one of the reasons I do eat some carbs at each meal ...though normally, not over refined ones.

 

[totsy]

i too vary my insulin, some days i may have none except my basal, it also depends on whether im going to be very busy, basically if i eat no carbs i dont inject bolus, you should inject to what u eat not eat to what u inject

 

[Jen&Khaleb]

My 2 and a bit year old gets his novorapid varied, dependent on the meal. I don't change the long acting until I have to and do this over several days. His long acting is going up over time as he grows (not really an issue for adults). If he is ill and not wanting to eat I'll lower the long acting dose but I still end up with hypo problems. I also follow the trend he has at the time. At the moment he is needing more insulin in the morning and much less at night.

Take care, Jen.

 

[Dillinger]

Hello,

If you are having hypos then you are taking too much insulin (of course ! ) so it is important that when low carbing you should lower the short acting accordingly. There is no problem at all with this as long as you keep your eye on the ball and test regularly until you get everything under control.

I've found that on a pretty low carb diet hypos seem to become a thing of the past whilst at the same time maintaining good blood sugar levels.

One of the liberating things about a basal/bolus insulin regime is that it removes the old tyranny of having to eat to your insulin (which is the opposite of how our bodies respond to glucose).

By the way, I used to think that porridge was a pretty good breakfast option; blood sugars seemed to be fine at lunch but when I test an hour or so after eating the stuff the bloods were through the roof, so I haven't touched the stuff in ages; so have a look at how it affects you. Continental cheese and cold meat is the option I've gone for...

Dillinger