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 carbsHi 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?
are you feeling ill at all? Cold coming on or similar?
What was your level 5hrs after eating?
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.
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?
What is your usual insulin to carb ratio?
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.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
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.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.
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.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.
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.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.
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 !!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.
Hi. All meters should meet the a spec of +/- 15% at 'any' BS levelThe 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.
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 5.6Hi. All meters should meet the a spec of +/- 15% at 'any' BS level
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