Questions about short acting insulin uses.

[marktype1]

There are 2 things bothering me about short acting (bolus) insulin.

1) Lets say I have a high blood sugar 2 hours after eating or even for an unknown reason, is it advisable or generally 'ok' to take some short acting insulin to lower the high blood sugar? (E.G. the other evening 2 hours after tea I was 16.2 and after taking 4 units of short acting Humalog, my sugars were back to 8.2). I do this quite often when I have a high sugar reading and occasionally it backfires on me and I go hypo which then becomes a nightmare for the rest of the day. What are the guidelines for this? The doctor simply told me not to do it, but I believe not treating a high blood sugar and staying high for several hours before next dose of insulin is really unhealthy.

2) As diabetics, we are told to avoid eating foods with high sugar content (chocolate, cakes, sweets etc etc). I have no interest in eating sweets, but I do love a good desert now and then. Does anyone else ever eat the occasional cake or chocolate // desert or even 'popcorn in the cinema', and then simply inject extra fast acting insulin?

Thanks guys, you are all amazing

 

[Daibell]

We are told not to stack insulin which means don't take more insulin whilst the last injection may still be working. Are you carb-counting as it sounds like you aren't? If I'm having the occasional suagry dessert I try to guess the right amount of carbs and Bolus for it. If I get it wrong I just live with it and try to make a better guess next time.

 

[Mrsass]

Yes & yes... As @Daibell just said we are told not to stack insulin, but if my bg was 16.2 2 hours after eating I would take a correction dose, especially if it was after my tea coz otherwise I'd be high all night!? Others may say different, but that's what I do.
And I take insulin to cover say a mid afternoon cake, but I'm on a pump so it does work it out for me if I put the carbs in. When I wasn't on the pub I still did both of these though.

 

[marktype1]

Yes & yes... As @Daibell just said we are told not to stack insulin, but if my bg was 16.2 2 hours after eating I would take a correction dose, especially if it was after my tea coz otherwise I'd be high all night!? Others may say different, but that's what I do.
And I take insulin to cover say a mid afternoon cake, but I'm on a pump so it does work it out for me if I put the carbs in. When I wasn't on the pub I still did both of these though.

Sounds good. So lets say I wanted to eat a bit of chocolate an hour after tea, would I be ok to inject more insulin to account for the carbs in the chocolate? Also, if I am taking humalog in accordance with carbs im eating, would it make a difference if it is sugar or slow acting carbs, aka do you still inject the same amount? Im sorry for all the questions but I am a little uneducated in this new basal-bolus regime im on.

Oh and how is the pump? Painful? I am considering maybe getting one because it seems like it will help me avoid highs. Maybe you could message me with your convincing words to get one haha! xxx

 

[marktype1]

So I did a test tonight for carb counting and insulin dosage.
Took a blood test an hour and a half after tea and it was 4.3.
I ate a bar of Dairy Milk plus 2 packets of crisps (just for the purpose of the test, wouldnt normally eat like this ha) which was roughly 43 grams of carbs. I took 4 units of insulin and an hour later my blood was 5.8

So it seems I should be taking around 1 unit per 10 grams and I CAN treat sugar intake the same in the way I treat standard carb intake.
I will do a few more tests and repost with more results.

 

[noblehead]

If you know your going to eat a piece of chocolate after your meal just include the carb content in your bolus dose for that meal, if your unsure about carb counting have a look at the following, its an on-line carb counting course similar to what is taught on the DAFNE course:

http://www.bdec-e-learning.com/

 

[marktype1]

If you know your going to eat a piece of chocolate after your meal just include the carb content in your bolus dose for that meal, if your unsure about carb counting have a look at the following, its an on-line carb counting course similar to what is taught on the DAFNE course:

http://www.bdec-e-learning.com/

Thanks man, will check this out. I am coming at it from a different angle though. If I felt like a piece of cake or something an hour or two after eating a meal, then can I treat it the same as counting carbs for a meal? I think I can as I have tried it tonight and it seemed to work quite nicely. Just getting into carb counting so its fairly new to me. I am actually looking forward to learning about the foods and how insulin works to burn the carbs.

 

[noblehead]

Thanks man, will check this out. I am coming at it from a different angle though. If I felt like a piece of cake or something an hour or two after eating a meal, then can I treat it the same as counting carbs for a meal? I think I can as I have tried it tonight and it seemed to work quite nicely. Just getting into carb counting so its fairly new to me. I am actually looking forward to learning about the foods and how insulin works to burn the carbs.

It's trial and error really and just because it worked tonight doesn't mean it will always work all the time, stacking insulin doses (taking bolus insulin doses close together) can lead to hypo's so you do have to be careful, as most quick-acting insulin can continue to work up to 4-5 hours after injecting.

 

[marktype1]

It's trial and error really and just because it worked tonight doesn't mean it will always work all the time, stacking insulin doses (taking bolus insulin doses close together) can lead to hypo's so you do have to be careful, as most quick-acting insulin can continue to work up to 4-5 hours after injecting.

Yeah of course, I have stated I will try it out a few times at different times of the day to make the results more reliable. I am just doing this to learn more about my insulin and how it affects me in relation to what I eat and my blood sugars. Experimentation is the only way to learn how to properly control diabetes I reckon. Even the hospital tell you its abut trial and error but with the hospital it always seems to take to long to have good results because they want you to change something slightly then come back after a few weeks with blood test evidence and they will make another slight adjustment, I suppose they are just looking out for you so you don't experience any drastic side effects. I have found lately that I need to fast track this attempt at achieving better results by experimenting each week and looking out for patterns. I have started monitoring EVERYTHING on a spreadsheet, including 7-8 blood tests a day plus changes in insulin, what I have eaten, experiments I have made and even things as drastic as changes in the weather etc (as I have found insulin works differently in hot weather as it does to cold weather).

Thanks for the input. As I said, I will keep posting new results from my little experiments

 

[Pudgem]

Yeah of course, I have stated I will try it out a few times at different times of the day to make the results more reliable. I am just doing this to learn more about my insulin and how it affects me in relation to what I eat and my blood sugars. Experimentation is the only way to learn how to properly control diabetes I reckon. Even the hospital tell you its abut trial and error but with the hospital it always seems to take to long to have good results because they want you to change something slightly then come back after a few weeks with blood test evidence and they will make another slight adjustment, I suppose they are just looking out for you so you don't experience any drastic side effects. I have found lately that I need to fast track this attempt at achieving better results by experimenting each week and looking out for patterns. I have started monitoring EVERYTHING on a spreadsheet, including 7-8 blood tests a day plus changes in insulin, what I have eaten, experiments I have made and even things as drastic as changes in the weather etc (as I have found insulin works differently in hot weather as it does to cold weather).

Thanks for the input. As I said, I will keep posting new results from my little experiments

Hi Mark, i'd be interested to see how you are recording all your testing info, and food intake etc. Did you just make a spreadsheet yourself, or find one online? I am trying to find a way that works for me for recording info which i can keep up for longer than a few days!! lol

 

[donnellysdogs]

Hi Mark

I always carb count but also don't take all my dose of bolus in one go. I.e I never know whether I will eat something else after my main meal.

So say for an example I may have just a salad with a fishcake (36g). I bolus for that.
On weekdays I rarely have anything else but walnuts and 2 sq of dark choc. I rarely include the 2 sq of dark choc in another bolus. However at weekends I may have a small torte bar (11-15g) or something up to 15g..(can't even think of anything else at the moment that I would have!). I bolus for this separately and it would be about an hour after my main meal.

I don't hypo from stacking.. But.......

1) I am a lowish carber person;
2) this has been my way of eating for best part of 50 years-30 years T1 so my body is used to it.
3) I'm on a pump for past 4+ years so I have really fine tuned basal rates.
4) I think the food that you are bolusing again for has a big impact on whether you may go hypo.. I don't eat crisps or chocolate or even 'proper' puddings....or at least very, very rarely when I go out with friends or family say ince every 3 months for a meal max.. So I don't think I'm totally tuned in to your food selections.

You need to be careful as other factors may unwittingly impact as to whether you go hypo or not.... Ie whether you are working, have been active, a weekend, been shopping, or had a drink etc.

Just be aware of all circumstances that could also factor in to the possibilty of readings being good or bad....

 

[marktype1]

Hi Mark, i'd be interested to see how you are recording all your testing info, and food intake etc. Did you just make a spreadsheet yourself, or find one online? I am trying to find a way that works for me for recording info which i can keep up for longer than a few days!! lol

I literally just created my own excel template. It's laid out very similar to a blood glucose diary but I have split it to monthly sections and have included notes and stuff. I could send you it if you want to see.