New to Novo Rapid

I always eat at 5 on a week day but at the weekend I eat at between 7 and 8. I found that if I didn't have anything to eat I would be hypo by 6 so I always have something to eat at 4 normally a 10g snack but if I'm really hungry I will have something bigger with a small amount of novorapid. This seems to work fine for me hope this helps.

Hello,

i dont take my Novorapid unless I am eating something that I know will spike my BG's.
I dont have set times either and I carb count to make sure that I am taking the right dose.

has your doctor given you an specific amount that you have to take per meal or have they told you to adjust according to your carbs?

it's all a bit of trial and error to begin with but it soon becomes clear.

A food diary always help and that way you can see what you have eaten, how many units you took and what the effect was afterwards.

Good luck
x

xmas said:

So u would have 4 meals and 4 rapid injections yes and this is fine

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This is what I would do, but as others have said, it is quite important to get a feel for how much carbohydrate you're eating and how much insulin covers it. There are plenty of sources online where you can find out the amount of carbs in food.

If you haven't been told any ratios, I think the normal way to start off is to assume that it's one unit of insulin for 10g carbohydrate. 10g carbohydrate isn't very much. For example it's an egg-sized potato, a tablespoon ful of pasta, or a very small apple.

Your ratio however could be very different from this and you're only going to know by testing it out. I think the best advice was given by Lezzles when she said to write it all down. This helps you look back and see patterns. For example if 4 hours after a meal your blood sugar is the same as it was before the meal, that means you took the right amount of insulin. If it's significantly lower, you took too much, if significantly higher, too little. By significant I mean more than one mmol/l.

It's very bad that the doctor didn't answer your questions, but you have found a brilliant resource here and if you keep asking the questions I'm sure you'll get the support you need.

xmas said:

thanks for the replies, im in thailand now and i just felt i was rushed in the hospital with the doctor

i was very high 22 after fasting all night (see other thread on here) and she changed me to lantus and rapid and yes ive come down very quick but my eyes have gone bad as in i cant see my phone or newspaper very blurred i hope this goes back to as it was before as my eyes were better when i was sky high, is this normal ???

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I think it took about two weeks for my eyes to go back to normal when I was first diagnosed. I think it's because when your blood sugar's high it alters the viscosity of the fluid in the eyes which makes it hard work for the eye muscles to accommodate to changes in distance. I just found everything blurry, but it all settled down after a week or two.

If you go up or down overnight and you've not eaten before, your Lantus needs changing. If you go up or down within a few hours of eating and taking Novorapid then that needs changing and not your Lantus.

Hi Xmas

If you test your bg levels and you find that they are low then you need to eat something sweet to raise them up to a bg level of at least 6mmol. You will then also need to eat a small amount of carbohydrate like a biscuit to make sure that your bg doesn't start to fall again 2-3hrs later. Not sure what type of sweets are available in Thailand but get something that resembles the appearance of Jelly Babies. Usually 3 Jelly Babies will quickly lift most people out of the hypo feeling so that they can then decide whether they should eat some longer lasting carb like a biscuit etc if they are not going to eat a main meal. If a meal is going to be eaten fairly soon after the hypo then no need to eat the biscuit.

Regarding SamJB's msg.... everything about adjusting bolus insulin and also adjusting basal to get the best effect on your bg levels can probably be found from reading the book - Think Like A Pancreas so see if you can buy it or borrow it from someone.

I'm all for people writing all their bg levels down on paper, plus insulin injected, times, carb eaten etc but unfortunately many of the bg meter manufacturers are not up to speed with the basal/bolus consept so I suggest that as you are using Lantus, phone Aventis and ask them to send you one their bg monitoring diaries. These are not perfect but are large enough to enable you to enter more information into the data area. Other than that you could phone Accu Chek and ask them to forward you a pump bg monitoring diary which will have columns for basal, bg, carb value, bolus, correction bolus. These diaries are free of charge so you should be able to get them ok. Basal/bolus is very much like using an insulin pump anyway........

Insulin to carbohydrate ratios are all figured out by testing bg levels every 2.5hrs and adjusting the bolus insulin so that your bg levels stay within what is considered to be a healthy range ie 4mmol - 7mmol before you eat your main meals and then no higher than 8 - 10mmol 2.5hrs later (this will then mean that you wont have to eat a snack) but if bg level is 10mmol then you should adjust the bolus insulin and inject 0.5u more when you eat your main meal that preceeded that bg level. The book will explain things to you a bit better and you will find out how to adjust your bolus and basal insulins correctly.

Any more help needed ?????? ask away we've all been where you are so dont worry.....

Gosh.... I clearly forgot to mention the need to get hold of some Glucogel. Glucogel is a must for everyone to have in their cupboards and until you get your overnight bg levels sorted a bit better... have some Glucogel near to your bed so that you can just grab it untwist the nozzle and have some.. Pay attention to the instruction leaflet and take notice of the word - buccal... This means that the gel can be absorbed through the gums and cheek lining if need be.... Glucose tablets can also be bought but dont taste wonderfully nice and the lucozade ones are a bit hard to chew up so something like Jelly Babies is probably better.... If you set an alarm to go off on your mobile about 1hr before you find yourself having low bg levels, then that will enable you to test, and eat a biscuit if need be rather than wait another hour and then find that you need to have some fast acting glucose.

Good luck... make sure you get anough bg teststrips as you will need plenty of them while you go through the process of adjusting the bolus for what you eat etc.........

Hi Xmas

Go into Boots and ask them where you could buy some bottles of liquid glucose. Some supermarkets will sell it for cooking cakes etc. Also icing sugar should be able to be bought by the packet which is fairly fast at lifting bg levels up. Even jam or lemon curd spread is good. Just look at the food labels to see how much carb is contained per 100g weight or per teaspoon and how much glucose/sugar is in jams etc. 1tsp of table sugar is 5g carb so if you mix some up every night in a small amount of warm water so it disolves then you could use that in a mug. 2tsp sugar will be ok to treat most lows but if bg is lower than 3mmol then use 3tsp sugar just to make sure you lift out of the hypo fairly ok.

a packet of Walkers is about 12g carb per packet ready salted so yes you can eat them as long as you can work out how much bolus you will need to use to cover the carb. Crisps do contain some fat though so just keep a check on your bg levels............

Read up on the forum all about alcohol and how it affects bg levels for diabetics. My advice is only drink a very small amount of it if you need to on social occasions and definately dont allow yourself to get blind drunk.. Many people suffer fairly high bg levels and then dreadful hypos through drinking too much booze which usually comes on when people are fast asleep...... Save your money and save your health and dont drink... We only have 1 liver so love it with all your might and look after yourself.....

xmas said:

also i forget to say i cant buy Glucogel or glueose tablets here even boots dont have them !!! but i have a friend coming out next week and will bring me some

buy say if i went down to 3.5 which i have a couple of times this week well in fact one was 3.2 how much sugar should i have to get back

i panicked before and i think i had to much

i had half a tin of coke and a kit kat then about 15 minutes little a ham sarnie and a couple of biscuits is this to much or to little

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The usual advice on treating hypos is to take 15g of fast acting carbs and test again after 15 minutes. The quickest acting carbs are usually those in liquid form - so a full sugar soft drink will do it - you don't need very much - about 150-200 ml. Any sugary sweets will do as well although chocolate is not much good because of the fat content.

As for whether what you took was too much, it's hard to say while you are adjusting your insulin doses - for me that would be way too much but it depends on whether you've still got active insulin in your system. Did you test again later to see what effect that little lot had on your levels? It's best to wait after taking the fast acting carbs before eating anything else which might slow down their effect. That can be difficult because your body is telling you you need to eat something, but you want to try and avoid a rebound high.

When I was on MDI and it wasn't time for a meal I would follow up the fast acting carbs with an oatcake to keep me level, but more if I realised I had hugely overestimated my insulin requirements. Now I'm on the pump I find I don't need to do that any more.

Good luck with this, it must be very difficult with nobody out there to talk to, but I hope you can work it all out.

Each Glucotab contains 4g of carb so to get 15g of carb you would need 4 tablets .
How much you actually need depends on your own metabolism , how low you are and what caused the low.
I very rarely need to take 15g but it is best to play safe at the beginning and you'll gradually learn how much you need to take.

Whether you need to have 15g of longer acting carbs afterwards depends on what caused the hypo and how long it is before your next meal. ie if it's caused by too much insulin on the past meal and you've still got a couple of hours before the next one you might need it. Similarly for safety in the middle of the night it's better to err on the side of caution.
If the hypos caused by a walk on a hot day and you're now slumped in front of the TV then it's a different matter and you might not need to eat the longer acting carbs.
Again it's a matter of play safe and gaining experience of what works for you.