Making an Insulin Correction chart for type 1

[kitsunerin]

Hey all,

I have had diabetes for about 12 years (type 1) but my control has never been very good. I am trying to turn this around. I was never properly educated about it and am not even sure how much insulin I am supposed to be taking. I am on lantus 32mg and humalog with meals.

My bloods are all over the place and can run from 3-32 at any time. Recently I've often been in the 20-28 range and feeling ill. I need to know how much insulin to take, as when I do, it runs me low so I'm obviously doing things wrong...

I want to make a rough chart of how much correctional insulin to take but I don't know how to start... I've heard of the 1 unit of insulin vs 10g carbs (or something to that effect) but I can't find anything on correctional insulin.

If anyone has any links or other resources, they would be very much appreciated.

Thanks!

 

[Engineer88]

basic start is 1u to 2 mmol drop but that only works for the humalog (dont try and use lantus to correct!) you really need to test that though.

 

[kitsunerin]

Alright, that's a good start! I'll try that and see how it goes! And yeah, I only take lantus once a day in the morning

 

[tim2000s]

If you have no idea what you are doing, then I'd suggest two things.

1. badger your diabetes clinic team to get on DAFNE. YOu sound like you need the help.

2. Work though this - it will help you understand carb counting: http://www.bdec-e-learning.com/

Then there are some more sources of information below to help you get yourself on an even keel:

http://integrateddiabetes.com/basal-testing/ to help you get your lantus levels correct

This work sheet is great for working our correction factors and insulin sensitivity factors: https://www.uclh.nhs.uk/PandV/PIL/P...ets/Correcting a high blood glucose level.pdf

If you have been running in the 20-28 range you are likely to be highly at risk of Diabetic Ketoacidosis (DKA) - have you been testing your ketones? If not then I'd suggest that a trip to A&E may be in order if your BG levels remain in the 20s.

 

[kitsunerin]

I'm on the waiting list for DAFNE, but haven't heard anything further Initially they referred me to DESMOND by accident so the mix-up made things a bit slower.

Thanks so much for the resources too! I'll read through them! Thanks for the advice!

 

[Daibell]

Hi. As you probably realise, having correction doses should be needed only occasionally once you can get your insulin reasonably balanced. There are, of course, some people who have the less common forms of diabetes that will never be easy to control. Yes, you must seek guidance on adjusting your insulin. This normally means getting the Basal right first and then finding the best ratio for your rapid. The normal guidance for the Basal is to aim for a fasting reading in the range 5 - 7mmol. There are many NHS guidance leaflets on the web for insulin correction and Tim2000s has given you a link for the UCLH one. I'm assuming you are carb-counting for your meal-time Rapid. I would try to smooth your carb intake during the day if you can, have a low-carb diet as discussed a lot on this forum and have low-GI carbs with enough fat and protein to smooth carb absorption.

 

[TorqPenderloin]

Nailing down your insulin:carb ratio is not easy. However, it's much easier with the right information and the right tools.

Most people in the UK don't have a CGM (Dexcom) but that has been the single most helpful tool in figuring out my own C:I ratio

The accu-check Aviva expert is also a very helpful tool. Again, it's not cheap but here in the US the meter is free but the test strips cost money. It's almost worth having without the strips because you can input carb ratios and it will tell you how much insulin you need to correct as well as a wealth of other information.

The old fashioned way- in addition to the above mentioned, I test manually at specific times of the day. My diet is also pretty consistent day-to-day as well. I keep handwritten logs of when I test, what the result was, and any additional notes such as what I ate the night before.

Thoughts: I'm currently focusing on getting my basal/bolts insults EXACT. I was previously doing 15unit basal injections 2x a day, and 1 unit: 30g carbs for bolus insulin. However, I've since dropped that to 12units (levemir) twice a day and no bolus insulin at all (I correct using exercise).

 

[noblehead]

For a correction dose you can also use the Rule of 100 (do Google for a full explanation), this works to some degree but the higher your bg levels the more insulin resistant we become so if your levels are extremely high then the Rule of 100 will be worthless .

Do join up to the BDEC site that Tim has linked to above, you should also purchase the book Think Like a Pancreas by Gary Scheiner, it covers most aspects of type 1 diabetes management and is really a good book, in the mean time @kitsunerun you need to make contact with your diabetes team asap and work on getting them bg readings down, do this today if possible.

 

[kitsunerin]

Thanks again for all the info! I have been seeing my diabetes team but they left me without care for over 6 months because I moved from Wales to England and there was a lot of waiting on my (huge) medical files. They finally started to see me a month or so ago. I do have the diabetes nurses number though so I will contact her!

I really should be in control of this all, I'm 30 next year and I've been in denial as I was diagnosed right in the middle of my GCSEs and I've just never come to term with it. I need to start...