Question about insulin doses

[Gareth94]

Your insulin doses are tiny in comparison to mine, I have been diagnosed for around a year and a half. Just about getting my head around it all.
Typical day I would have 46 levimir, split with 34 before bed and 12 in the morning. Sometimes my night dosage is still not enough.
Nova rapid I would typically have (depending on meals) around 40 units.
Just had my hba1c done and it was 48, down from 65 so I am relatively pleased with that.

 

[Gareth94]

Also having a no carb breakfast and still having highs at dinner, could this be due to your liver kicking out a boat load of glucose to kick start your body in the morning seen as though it's not getting it from the food?

Just taking a guess, dont know if this is a thing or not?

 

[tim2000s]

Don't forget that diabetics are more prone to gluconeogenesis than non-diabetics. If I don't bolus for an omelette I can trace a pretty quick rise in bg level, although with it taken as a split I find that I am fine.

 

[chl0ejasmine]

Also having a no carb breakfast and still having highs at dinner, could this be due to your liver kicking out a boat load of glucose to kick start your body in the morning seen as though it's not getting it from the food?

Just taking a guess, dont know if this is a thing or not?

My diabetic nurse told me we tend to need most insulin at breakfast because of how it rises. Diabetes is a dark art!

 

[Spiker]

My diabetic nurse told me we tend to need most insulin at breakfast because of how it rises. Diabetes is a dark art!

Yes that's often the case. The amount you need to correct the dawn rise though should be independent of what you eat. Unless you don't eat enough and that triggers a "liver dump".

Ideally you correct for the dawn rise using your basal dose(s).

 

[Spiker]

No not really Lucy, both protein and fat take a while to convert to glucose in the absence of carbs, for a cheese omelette/bacon & eggs breakfast I need to bolus 4 units of insulin in a split-dose otherwise my bg would be high before lunch, to compare my usual breakfast of porridge oats with seeds, berries, milk & yogurt I just need an extra 1 unit of insulin on top of the 4 I'd bolus for an omelette, it doesn't make sense but that is the way it is........

It does seem to be the case that at the low end of the carb spectrum there is a sort of minimum dose per meal, regardless of the carbs in it.

 

[noblehead]

It does seem to be the case that at the low end of the carb spectrum there is a sort of minimum dose per meal, regardless of the carbs in it.

Yes there does, I think most people find their insulin usage decreases as they lower their carb intake then it plateaus out, at what carb level that may be depends on the individual I would expect.

 

[chl0ejasmine]

Ate an omelette with bacon this morning and going to check between every 1-2 hours, will let you know what happens!

 

[himtoo]

This is what happens to me - I give about 4 units, the same amount of units I give with granola. Yet with the omelette I'll be higher than I would have if I ate the granola! So weird..

hi chl0ejasmine
with a bit of experimentation and your meter you can solve this !!!!,

footnote -- check every hour please

 

[chl0ejasmine]

I will thanks @himtoo!
Just did my 2 hour check and bs was 7, started as 5 but still not high

 

[himtoo]

I will thanks @himtoo!
Just did my 2 hour check and bs was 7, started as 5 but still not high

ok -- and you had an omelette ? and what bolus ??

 

[chl0ejasmine]

Checked again at 9:40 and going to at 10:40, was 7.3 and I didn't bolus anything. I put the carbs into my meter and it said give nothing @himtoo

10:40 result was 6.7

 

[himtoo]

cool -- so you have had an omelette this morning with no bolus and your bloods are staying pretty stable -- that is a question not a statement

 

[chl0ejasmine]

@himtoo Yep they've remained stable - sometimes when I used to have omelettes I'd ate a piece of toast maybe that's what made it unstable, my bs isn't very good with bread

 

[himtoo]

@himtoo Yep they've remained stable - sometimes when I used to have omelettes I'd ate a piece of toast maybe that's what made it unstable, my bs isn't very good with bread

hi again chl0ejasmine
i have had type 1 for 42 1/2 years and i am still learning all the time - and you are right -- at times it does seem like a dark art.

have you been on a DAFNE type carb counting course ?

 

[noblehead]

@himtoo Yep they've remained stable - sometimes when I used to have omelettes I'd ate a piece of toast maybe that's what made it unstable, my bs isn't very good with bread

Eat the omelette without the bread.

Your bg postprandial only went up by 2mmol which is very good indeed, especially as you didn't bolus for the meal, your very lucky

 

[Alanp35]

I had a 2 egg omelette for breakfast this morning. Tested 2 hours afterwards (as per) and had BGs of 4.7. Had to have 2 bikkies before I could drive to GP. There is little rhyme or reason at times so I just go with and manage whatever happens.

 

[chl0ejasmine]

@himtoo I'm being registered tonight actually to go on the DAFNE course in August - really looking forward to it! I was at the hospital for ketones in January and a diabetic specialist there said she learned so much even though she's a specialist!

@noblehead I'm really pleased, I felt really full up for the whole 6 hour gap between breakfast and dinner too. I don't want to eat eggs everyday - but its definitely given me more breakfast options which is great!

@Alanp35 Ah the pain of having to be 5 to be able to drive! Loved my omelette today and glad my bs did too!