new to novolog

cdpm said:

I began novolog on the 1st of sept. 4 u with each meal
how does a person know when they would need more
units with a meal then the 4u?
based on pre meal or post meal numbers?
or is it based on a higher carb meal?
and
how does a person convince their nurse that post meal
numbers are important? that numbers in the high high 100's
are still damaging? and that an a1c of 8 is not good?
my goals are to reach 70-90 for fasting and less then
130 after a meal
I also use lantus and am at 20u but my morning fasting
is still running near 135
any help or comments would be appreciated

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I suggest you ask to see a different nurse, because if you are having trouble convincing him or her of basic stuff, there's probably not much you can do to change their skills/knowledge.

The following article may answer your insulin questions. If not, let us know:
http://www.phlaunt.com/diabetes/15478720.php

cdpm said:

hi
I read it a few times but it didn't quite answer my questions.
I'm kind of on my own with this as I don't have a dr just walkin
ones and the time between nurse appts, is 2-3 months in which I still have
all these high numbers but I do have "permission" from the prescribing
dr to adjust the insulin
and I read several articles about bolus and adjusting it and seem to only find
ones relating to matching carbs or adjusting insulin when starting with only the 1 meal
neither seem to apply to me
I understand and adjust my basal insulin but need a little more help
with the bolus adjustments to achieve a reasonable post meal result

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The T1s should be able to help you with that, but I'm sure they will also suggest you register with a GP practice and also ask to see your DSN sooner than the 2-3 months because you need help, and you are entitled to it.

There is a DAFNE course people get sent on, which teaches them how to manage their insulin in the way you want to. There is also an online course or you could ask your DSN to teach you. I think there is a book about it - again, the T1s will know what to suggest.

Basically the way they describe it is they take their pre meal BG and the carbs in their meal in grams, and apply a ratio and the result is the number of units to inject. The ratio depends on various factors and is usually worked out in conjunction with your DSN.

We don't have many T2s on MDI insulin and I can't remember who they are but these T1s may be able to help @noblehead @Spiker @himtoo @urbanracer

Keep your carbs low, that will help you find your way and sort out ratios. Avoid takeaways, pizzas, pasta as fat plus carbs is a nightmare to bolus for. Tons of low carb recipes online. Then, if you wish, up them a little along with your Novolog. A lot of us just eat low carb as a way of life to keep control.

Ali