Hi my sugar seems to be high lately i have my background which is 30 x 2 and at lunch today I had 14 carbs which was 28 units of novorapid which I felt was a large amount but after 2 hours I tested my self and was 16.7 what is a maximum amount any of you have had to cover a meal?
Type 1 Novorapid dose?!?!
- Thread starter GJT71
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I assume you mean you had 140g carbs - 28 units of novorapid for 14g carbs sound very high.
However, as has been said by many people, many times, "we are all different".
It is not particularly useful comparing (or advising) insulin doses.
If it works for you, it is the right dose for you.
Regarding your high BG reading 2 hours after eating, was it just high after eating or is it high throughout the day?
I ask because your basal need may have changed. There are many reasons for this - stress, weather, illness, ...
However, as has been said by many people, many times, "we are all different".
It is not particularly useful comparing (or advising) insulin doses.
If it works for you, it is the right dose for you.
Regarding your high BG reading 2 hours after eating, was it just high after eating or is it high throughout the day?
I ask because your basal need may have changed. There are many reasons for this - stress, weather, illness, ...
Hi Helen I’ve been on insulin since 1984 and was very stuck in my ways with 50 background and 12 novorapid for each meal but recently it’s all gone mad I was admitted Boxing Day with dka which I’ve never had before since I’ve been home I’m really struggling to control my levels I’m now carb counting 100% and doing 2 to 1 all in all today I e had 67 units of novo yesterday was 92 the lowest my sugar has been today is 10.7 I understand everybody is different and I know I eat a high amount of carbs but I’m very active and never had a problem with my weight and that is the food I enjoy so I was just wondering what amount of units others was having?
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Are you saying that you're having 2 units of insulin for every gram of carb? That is a lot, but people vary enormously with their carb to insulin doses. Some possible reasons for increasing need of insulin for the same carbs
1) overused injection sites so not all the insulin gets through
2) gone off insulin or faulty insulin pen
3) illness (eg a urinary tract infection which might be asymptomatic).
4) you're becoming carb intolerant and developing T2 as well as T1 (OK, this one is unlikely, I hope, but it does happen, particularly if you've got T2 in your family tree.)
I'm sure there are lots of other possibilities but I'm out of ideas for now.
Good luck.
Thanks for your reply but I’ve used fresh injection sites new pens etc etc
is there a recommendation for maximum amount of novorapid in a day as I’m really worried and can’t get an appointment until the end of next week 
rmz80
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I was never keen on testing at 2 hours after injection as that will be the peak sugar level (16 sounds about right) I tested at 4 1/2 hours after and aimed to get fast insulin dosage to get me back to fasting level. PS I was told to do that on first starting with insulin by diabetes nurse.
PS I changed my meal times to get at least 3 good fasting levels a day. This meant however not snacking between meals. The lunch I split into 2 meals 4 ½ hours apart (10 am and 2:30 pm) to get a fasting reading and use less fast insulin
PPS There doesn’t seem much point testing at 2 hours as much will depend on carbs eaten. I reckoned the time for me as; Glucose 40 min, Sucrose and Fructose about 1 hr 10 min, Starch about 2 hours, Fibre about 24 hours
PS I changed my meal times to get at least 3 good fasting levels a day. This meant however not snacking between meals. The lunch I split into 2 meals 4 ½ hours apart (10 am and 2:30 pm) to get a fasting reading and use less fast insulin
PPS There doesn’t seem much point testing at 2 hours as much will depend on carbs eaten. I reckoned the time for me as; Glucose 40 min, Sucrose and Fructose about 1 hr 10 min, Starch about 2 hours, Fibre about 24 hours
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Hi. You say you haven't a problem with your weight but can you let us know your BMI as it sounds like you may have some insulin resistance?
Hi my bmi is 22.5 I’m worried also about insulin resistance which is why I would love to find out people’s maximum dose
kitedoc
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You keep mentioning 'background' insulin bu
The whole idea of testing at about peak glucose level after a meal is to ensure that the peak level is in normal range. Anything above that has the risk of causing long term damage. And of course that level depends on what carbs are eaten (and to lesser extent protein). Knowing that peak figure helps one to adjust insulin dose and timing, food intake or both. to bring that peak down, modify it to a reasonable level. Testing 4/1/2 hours after a meal does not help you guess the peak or the graph preceding.
kitedoc
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Hi @GJT71, to summarise somewhat: trying to stay with pure fact: And as a TID, not as professional advice or opinion:
You say you are set in your ways. But not many of us would consume 140 g of carbs in one meal. You say there are no weight problems and quote a BMI of 22.5.
Also if my arithmetic is correct you have been diagnosed with T1D and been injecting insulin for 34 years.
you are concerned about knowing how much Novorapid you can safely inject but insist on high carb meals.
And the dosage of insulin injected by pen per day, depending on food intake is: 60 + 67 = 127 Units.
And you say the insulins are new, pens are new. The injection sites are fresh. And you are feeling fine.
Your weight and insulin dose could suggest possible insulin resistance.
And your troubles seemed to start about Xmas time with a first time admission with DKA and you have not been able to return to your usual doses of insulin, or ,presumably, past insulin to carb ratios.
Questions: What is the 'background' , insulin I presume, you are taking?
What were your insulin to carb ratios before Xmas.?
What has your blood pressure been before and since Xmas.?
Do you have the results of your blood tests some time before and since your admission to hospital?
Any HBA1C results from last year and this year??
What is the composition of your typical meals and the counted carb amounts, and protein and fat content??
Do you snack in between meals and if so what foods and how many carbs/protein and fat??
Are you prescribed any other medications and take any over-the-counter things or other substances?
What is your usual activities/exercise and how do you cope with that food and insulin-wise.?
Was there any conclusion reached by your hospital doctors about why your DKA happened?
In hospital or since has anyone assessed your injection technique?
I apologise for the list but to gain a full picture the answers would help.
Of course you are under no obligation to divulge any or all of it.
But to give you a suggestion for an interim solution until everything is known and sorted (which may take some further tests if your doctors think so)
1) Cut down your carbs. That seems to me to the simplest way and requires your doctor's input and discussion about food intake and insulin doses, ratios. as there is a risk of hypos if not done carefully. It is a strategy not a sentence!!
The mantra: reduce carbs (which means up protein and fat) rather than up up the Novorapid
The story about the truck stuck under the bridge?
either you cut away the underside of the bridge for more height, or you let some air out of the tyres.
2) and choose entirely new sites where you have never injected before. I have been injecting insulin for 52 years and know there is scar tissue which is not always easy to feel but which, if I use a particular length cannula/needle, I am likely to hit that tissue and have unreliable absorption of insulin.
Of course I am only suggesting these things, and it is a decision between you and your doctor via a phone call.
Still further checking and work to do about why things happened and about what is happening now.
Best wishes with your deliberations.
The Forum has resources if you need further info on things and of course to answer your queries !!
You say you are set in your ways. But not many of us would consume 140 g of carbs in one meal. You say there are no weight problems and quote a BMI of 22.5.
Also if my arithmetic is correct you have been diagnosed with T1D and been injecting insulin for 34 years.
you are concerned about knowing how much Novorapid you can safely inject but insist on high carb meals.
And the dosage of insulin injected by pen per day, depending on food intake is: 60 + 67 = 127 Units.
And you say the insulins are new, pens are new. The injection sites are fresh. And you are feeling fine.
Your weight and insulin dose could suggest possible insulin resistance.
And your troubles seemed to start about Xmas time with a first time admission with DKA and you have not been able to return to your usual doses of insulin, or ,presumably, past insulin to carb ratios.
Questions: What is the 'background' , insulin I presume, you are taking?
What were your insulin to carb ratios before Xmas.?
What has your blood pressure been before and since Xmas.?
Do you have the results of your blood tests some time before and since your admission to hospital?
Any HBA1C results from last year and this year??
What is the composition of your typical meals and the counted carb amounts, and protein and fat content??
Do you snack in between meals and if so what foods and how many carbs/protein and fat??
Are you prescribed any other medications and take any over-the-counter things or other substances?
What is your usual activities/exercise and how do you cope with that food and insulin-wise.?
Was there any conclusion reached by your hospital doctors about why your DKA happened?
In hospital or since has anyone assessed your injection technique?
I apologise for the list but to gain a full picture the answers would help.
Of course you are under no obligation to divulge any or all of it.
But to give you a suggestion for an interim solution until everything is known and sorted (which may take some further tests if your doctors think so)
1) Cut down your carbs. That seems to me to the simplest way and requires your doctor's input and discussion about food intake and insulin doses, ratios. as there is a risk of hypos if not done carefully. It is a strategy not a sentence!!
The mantra: reduce carbs (which means up protein and fat) rather than up up the Novorapid
The story about the truck stuck under the bridge?
either you cut away the underside of the bridge for more height, or you let some air out of the tyres.
2) and choose entirely new sites where you have never injected before. I have been injecting insulin for 52 years and know there is scar tissue which is not always easy to feel but which, if I use a particular length cannula/needle, I am likely to hit that tissue and have unreliable absorption of insulin.
Of course I am only suggesting these things, and it is a decision between you and your doctor via a phone call.
Still further checking and work to do about why things happened and about what is happening now.
Best wishes with your deliberations.
The Forum has resources if you need further info on things and of course to answer your queries !!
rmz80
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The subject of when to test is an important one to resolve. The idea of adjusting fast insulin to get back to fasting level (without over correcting) would be my concern. A reading of 16 at 2 hours would for me be not a problem as this will only last a few minutes. Secondly; meters are not particularly accurate above 7. I would however try to keep any meter readings to below 15 if continuous.
kitedoc
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How do you know a high reading will only last a few minutes when we are talking at a possible peak at the 2 hour mark of say, 7 mmol/l above normal range ? The injurious time is from when the level grew higher than 9 til when if dipped back below 9 mmol/l.
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rmz80
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There is no guidance in the instruction leaflet for NovoRapid as to which approach to take. I shall write to the manufacturers (Novo Nordisk) with our comments and hopefully post a reply next week.
kitedoc
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Thank you for undertaking that. I guess it is like trying to fit a curve on a graph of insulin action to that of the glucose whilst the interaction between the two takes place.and Damned if you are too high in BSL in one place and too low in another !!
rmz80
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Depends on if your meter was bought after June 2018 (ISO 15197:2015 implementation date). Could be +/- 20% if older. Also they are only accurate 95% of time provided they are calibrated (which few people do) and test strips are stored correctly. I've had a test strip read 13.5 with two subsequent readings of 5.6
