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Number of daily injections

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Abo2000

Member
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Hi all I hope everyone is staying healthy and safe

I’m on Lantus in the morning 16U and NovoRapid pre meal

I have a question or two: I currently am on 5/6 injections a day. 1 from Lantus in the morning and 3 prior to every meal with an injection an hour after my meals if I have some protein in my meal.
Firstly is 5/6 injections a day normal for this sort of insulin regimen? If not then what do I need to change? Is my basal insulin too low maybe (I’m not too sure what basal insulin actually does I can’t understand) ?
Secondly I saw previous posts with people saying they don’t always inject for protein, my question is how? Whether I eat it alone or with fats or with carbs my glucose still goes up high 4 hours later?

Thank you in advance for your help!
 
I’m on 30 units of tresiba & novorapid with meals. Your lantus is a long acting insulin which keeps your sugars level for upto 24hrs, so it’s really important part of your medication.

I don’t take insulin for proteins, I count the carbs and Inject for that. So I would only inject once per meal which means on average 4 injections per day. If I’ve miscounted carbs or just simply having a bad day I may need to take corrective doses of novorapid so sometimes i may need to inject a lot more than 4 times.

With novorapid I’m sure you should only be taking it for the carbs you eat.
 

Thank you! But I’ve tried even increasing my insulin:carb ratio and I just end up going too low. I’m almost 100% certain it’s the protein that makes my glucose go up 4/5 hours later, I saw it online and it made a lot of sense because whenever I have protein my glucose goes up later.
So I don’t know how to solve that??
 
Like @Maco I'm on Tresiba (25.5U at the moment) and Novorapid, people generally find they only need to cover protein in the absence of carbs in a meal so first thing I would ask is are your ratios correct and is your basal correct, have you performed a basal test recently?
xx
 
Reactions: ert

Hi, thank you, I’m not sure what a basal test is? I think my basal might be too low to be honest because my fasting glucose level stays at about 9mmol/L
 
Basically for a basal test you make sure your bloods are in range and stable, say 4-7mmol. Take your lantus & then don’t eat, keep checking your levels and see if they stay within range. If they do your lantus dose is correct, if it raises your not taking enough and if it drops your taking too much.
 
I’d start with the basal test & adjust accordingly, that could be your issue. Honestly I’ve never heard of taking insulin for protein
 
Hi. I have 5/6 injections per day similar to you. Probably worth adding that the main function of Basal is to balance the continuous background output of glycogen (glucose) from the liver
 
Abo2000 said:
https://www.diabetesnet.com/diabetes-tools/insulin-dose-guide/how-to-bolus-fat-protein/

If you get a chance to read this let me know what you think
Click to expand...

That’s a good read, have you done the online BERTIE course? If you haven’t I’d recommend doing it, it’ll certainly help with working your basal rates & understand how to take your quick acting insulin. It’ll probably take you a couple hours to complete & you get a certificate at the end. If you ever decide you want to go onto pump therapy your clinic might accept Bertie instead of a Dafne course
 
I'm on novorapid and Lancaster.
usually 6 injections a day (at least)
1 of Lantus.
3 novorapid before meals
Plus couple more for corrections, or snacks etc.
 
Maco said:
Honestly I’ve never heard of taking insulin for protein
Click to expand...
I'm surprised you haven't, many find that in the absence of carbs they have to take a reduced dose for the protein content as in the absence of carbs it does also turn to glucose in the body albeit a smaller percentage and at a much slower rate so finding in a protein heavy carbless meal they would have to inject sometime after to account for it, of course if you don't research or haven't had carbless meals then you might not know but it does happen so saying you haven't heard of it doesn't mean it doesn't happen/isn't needed xx
 

I never said it doesn’t happen or isn’t needed, just that I’ve never heard of it & certainly never been told about it from anyone at my clinic. Which is surprising because they know I go to the gym 7 days a week and drink one carbless protein shake after the gym and another around 30 minutes before bed. 25grams of protein per shake and honestly I’ve never had to Inject once for it.

Other than my protein shakes there’s nothing in my diet that’s carb free so maybe that’s why I’ve never been told to inject for anything other than carbs. I do mention it been briefly mentioned on the Bertie course about protein but can’t really remember what was said xx
 
I take split doses of Lantus which helps with reducing the spikes so much and take 3 or 4 doses of Novarapid a day which may include 1 or 2 correction doses. Don't find Lantus that good. Seems to peak at around 6-7 hours which isn't what a long acting insulin is supposed to do and only last for around 12-16 hours. Novarapid is ultra slow at kicking in. Take an hour before food normally and sugars still rise quickly and Novarapid can last upto 5 hours. Peaks around 2-3 hours after taking it. No wonder I have extreme difficulty controling my diabetes.
 
Abo2000 said:
Hi, thank you, I’m not sure what a basal test is? I think my basal might be too low to be honest because my fasting glucose level stays at about 9mmol/L
Click to expand...

Your levels could be going up because of your basal rather than the protein. I'd expect most boluses to be running out after 5 hours so if your basal isn't enough your levels would go up then.

My clinic told me that I only need to bolus for protein if I don't eat carbs, one reason why I go low carb rather than keto because life is hard enough just counting carbs.

I do probably inject 6 times a day because I take one lantus, injections before meals, then often have to have a correction dose, particularly in the early hours of the morning to avoid a dawn phenomena spike. But my insulin needs and ratios vary quite a bit by time of day and activity level, so I have to tweak my dosages accordingly.

Abo2000 said:
https://www.diabetesnet.com/diabetes-tools/insulin-dose-guide/how-to-bolus-fat-protein/
Click to expand...
That's interesting. Sort of consistent with not worrying about protein if you're not on a high protein diet such as a keto one?

Have you considered asking for a pump rather than having so many injections?
 
When I was on mdi 5 to 6 injections was not unusual

The first thing that is needed is to get the lantus correct.. lantus should keep your bg level without food or exercise

Basically if on a regular day with a skipped meal your bg still rises there is not enough lantus

Once the basal(lantus)is right it’s easier with the bolus often not needing corrections

I always had bolus before bed so the night time fast was a reasonable indication of how my basal was

When I started insulin my dsn and me discussed how/when to increase the basal dose I was advised 2 unit increase every day until my bg was about 7 in the morning. And this worked quite well

Was anything similar discussed for you?

I wouldn’t recommend just increasing your dose without discussing with your care team as they can be a bit funny about it if the didn’t recommend it.
 
If you are eating fatty foods. The fat in foods takes time to break down & after a few hours this can make your blood sugars rise but not so much just after you have eaten it. Pizza for example. This is what I have found anyway.
 
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I take 2 pig/ pork (thank you mr pig you are a holy CREATURE and should be honoured)insulin jabs daily .The clinic said to me we have a huge breakthrough 5,even 6 jabs a day is a huge advance REALY.I did try the synthetic ,analogue,or Human insulin for a while it nearly killed me.They blamed me not the insulin typical response from them big pharmacy,hospital clique medical clique but it was the pig who came to help me and I will never forget that.So that's my angle on thing on this particular item.1 JAB A DAY HUGE ADVANCE 4 TO 6 NO ADVANCE.
 
Hi
My view is good natured and light hearted and works for me....
Nearly 50 years ago when first diagnosed the needles were the size of a dart and I was just 6 years old.
Today the needles are 4 mm long !!!
I couldn't give a **** how many I take as they don't hurt and because you are spreading the doses you take less insulin in one go.
I recall taking 2 enormous injections a day with 50 units plus ..ouch...
Life is a breeze these days everything is better and as long as i'm in range, oh I have a libre to help whereas in the old days you tested your urine with a colour coded chart, I don't care how many times I inject.

Good luck everyone

Tony
 
Thanks so much for your honest reply TONY,its best we agree to disagree as multiple daily jabs is just no advance.I too had needles like bolts and urine tests ,but its not about any pain on injection...Its the constant thinking I must jab,must jab never goes away I mean people need a break from this constant Diabetic mindset .Timeout without having to constantly obsess over ***k*** Diabetes and The DIABETIC Clique on the many Diabetic forums.Please excuse the stars everything is fine these days ROSE TINTED GLASSES .
 
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