Optimising Insulin Dose

hyposkimmer

Newbie
Messages
4
I live a complicated but fairly interesting life. When I am at home, I can with some precision calculate the nutritional content of my food intake, but things get more difficult when eating out, attending business dinners, travelling abroad, dealing with emotionally fraught family situations etc.

At present I am trying to meet three objectives:

1) to lose about 7 or 8 kilos weight - for general health reasons and also in order to reduce pressure on my lower joints (I have already had one hip replacement operation)

2) To get fit after several sedentary years and a heart bypass operation (I am 71)

3) To get my Blood Sugar under tight control.

To achieve these, I am using three main tools: Strict control of food content and quantity, Exercise, Insulin Injection with pretty frequent monitoring of Blood Sugar, Weight, Waist Measurement, Carbohydrate Intake, and Glycaemic Loading.

Because of my rather inconsistent lifestyle, I am trying to develop a computer algorithm that, given: {a blood reading, an estimate of exercise about to be undertaken, an estimate of food intake expected, and personal details such as my weight}, Will give me a recommended dose to get me through the next 12 (or so) hours

I hope that this will enable me to achieve tighter control than hitherto.

One parameter that I have yet to work on is a target BS level just clear of hypo with a small safety margin. I would welcome any views as to the right margin to aim for. Obviously the accuracy and resolution that the algorithm is capable of, affects the margin that I must aim for. Also there are bound to be biological factors that will tend to increase margin at the expense of control accuracy.

I would particularly welcome a collaborator on my Algorithm Project. I do not have any medical qualifications, but am an engineer with a great deal of curiosity and a scientific background.

I am already having some success, My BS is consistently 1.5 points lower than when I started my project, Hypos are now virtually non-existent and extremely slow starting and shallow if they do occur. My daily dose of Insulin is more stable, but the ratio of AM to PM dose is more difficult to get right than I expected.

I look forward to any input from members.

As a come-on, I suppose that as well as being useful to me, others may also be interested in using an accurate method of living with low sugar and zero hypos. Certainly I think it should be possible to do better than the NHS seems to offer.
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
Hi, Welcome
I've just read your posting . Am I right in thinking that you are on a twice daily mixed insulin regime? (you mention a dose lasting 12 hours)
If so, I think it would be very difficult to work out an algorithm to take account of all the variables involved but others with more experience of the regime might be able to give some suggestions.
Many (most??) people use a basal/bolus regime adjusting mealtime boluses at each meal. This makes it easier to take exercise etc into account.
 

hyposkimmer

Newbie
Messages
4
Thanks for your suggestions. You are right. I take a dose of Mixtard 30 before breakfast and another before dinner. I tend to work out a likely day's menu and exercise regime in advance; then I measure my blood. Then I 'guess' how much Daily Insulin will be needed to match these inputs. I then make another guess as to what proportion of the Daily Insulin will be needed in the AM dose, and by subtraction arrive at an estimate of the PM dose required. To simplify things, my exercise calculation is based on a somewhat subjective scale from 0 (Lying around in bed all day), to 10 (A ten mile fast walk including hills). Most days, I am in the 3 to 5 zone, but recently having been ill with a bacterial infection, I have been in the 0 to 1 region.

The PM vs AM dose calculation that I have been using is based on when I expect the exercise to be carried out, and how my food nutritional content (particularly carbohydrate) is spread during the day. It has been a failure. In fact if I take 60% of the dose pre-breakfast and 40% pre-dinner, I achieve much better results. It is also clear from the data that I have gathered that GL correlates better than does simply using Carbohydrate intake.

My problems probably arise from my not having a detailed knowledge of the Mixtard chemical reactions, and I think that that is where I shall direct my efforts next.

Regards

Hyposkimmer
 

totsy

Well-Known Member
Messages
3,041
Type of diabetes
Type 1
Treatment type
Insulin
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i was on novomix for a few yrs and after begging my dr i am now on basal bolus which has helped me no end, maybe think about changing insulin :D and welcome to the forum
 

hyposkimmer

Newbie
Messages
4
Thank you for your advice.

In the end, I will probably take the route that you recommend. In the short term I shall continue my research into the various parameters and their interactive correlations. I feel that I am making progress, but that could be an illusion.

Regards

Hyposkimmer
 

hanadr

Expert
Messages
8,157
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Essentially, the only way a T1 can keep tight on minimal insulin, is to cut carbs right back. If you are already doing that, you're as near as it gets.
I'm sure Bernstein has something to say on this. I'd definitely recommend you read him.
 

hyposkimmer

Newbie
Messages
4
Thank you Hanadr,

Yes I am following a minimum carbohydrate diet - at least until I achieve the weight loss that I have set as my target. In fact I have only about 1 kilogram to go, so I am about to ease up a little. Obviously I will want to keep my low sugar level but at a different level of control - more insulin, or more exercise. I intend that my algorithm will be able to accommodate a reasonably wide range of inputs without losing accuracy. I hope it will be possible and if it is difficult, so much the better - I enjoy intellectual problems.

Kind Regards

Hyposkimmer