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"Think Like a Pancreas"

C

chocoholic

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I started reading this book a while back and got side-tracked and started reading something else. Having now gone back to it and started on the chapters about setting basal/bolus insulins, it makes very interesting reading. I tried matching insulin to carbs at the beginning of my changeover to an MDI regime but because I'm on very small amounts, I ended up asking and waiting several months for a half-unit pen for the Novorapid.Well, since I've had that and have been able to get more 'supposedly' perfect matches with carb. to insulin ratio, I have come to realise that the ratio I'm on is not working and the tables given in the aforementioned book would seem to agree with me. I did wonder. I think, in this interim period, I've been second-guessing how much I really need to inject but I always thought I was having more than the ratio that was given me.
I feel my head is swimming again and every time I read and re-read what I should be doing, it seems to go in one ear and out the other. When the changeover was done,my new insulin was given me with doses set but now I've read about getting the background insulin right before tackling the Novo. I think it's going to take me a while to sort out what is what.
I feel like you need to be a mathematician to work it all out, especially when you have to somehow work out how the ratio can change over the day or according to hormone levels, exercise etc.
What makes it harder is that when I asked for more test strips, whilst I assess what different foods do to me, I was told no because I could become obsessive about testing. :roll:
I feel as if I'm doing a bad doggy-paddle........desperately paddling away and not getting anywhere.
I think I need to go back to square one and work out if my Lantus is right and then slowly work out the Novorapid from scratch again.
Is it just me or has anyone else found it so hard to work out dosages when changing to MDI regime?

P.S. I bought myself Gary Taubes book today....."The Diet Delusion". Reminder to self.......don't start dipping into that until 'Think Like a Pancreas' is finished. It's a bad habit of mine.....dipping into a new book that looks interesting before finishing an already started book. :oops:
 
hya hun,
i bought that book too as i was struggling to adjust at first to basal bolus, it took me a while and i still have the odd blips but i did restart with the lantus after reading the book, got that sorted and now im doing ok,my latest hba1c had gone to 5.9 so well pleased but im with u on how hard it is at first :D
 
Choccy tell them you're getting depressed by not knowing whaat's going on. It Might work. they aren't worried about your mental health, just their budget. Try challenging them on it.
 
Hi choc

Im not MDI yet so it may as well have been in latin, but at least Im armed (and dangerous likely, according to my DNS). :lol:
The interesting thing for me was that he made virtually no reference to premixed insulin and said that snacking was a no no for diabetics cause of the up and down of the bg when you eat. Both of which apply to me.
Still with a1c must be doing something right and I continue to will my pancreas to KEEP GOING for a bit longer . Good to know theres something in his calculations etc cause Ive asked to be considered for DAFNE when I move over but doubt this will be timeous so will def use the book for reference

L
 
The trick is to get the basal right first, once you got a good grip on the basal then it is much easier to work out your carb to insulin ratios for each meal exercise etc...

One of the reasons that 'think like a pancreas' doesn't deal with pre-mixed insulin is because the book is based on the basal/bolus regime, the problem with pre-mixed insulins is that it's regieme is based on injecting insulin and partly due to having to feed the insulin thats been inject through out the day, so creates quite a regimental regime and lacks the flexibilty of basal/bolus regime.

But keep with it, and has time goes on, you get the basal sorted and you should find that the rest slots in nicely, and you find it easier to indenify when and where and what insulin might need adjusting to suit,,
 
Like Choccie

I also haven't been given any guidance at all in accurately adjusting my basal and bolus insulins. The doses were worked out for me by my consultant when I first changed to MDI and I've just guessed using trial and error along with BG testing 5 or 6 times a day to work out how much insulin I really need.

Not sure whether I should also buy the book as sometimes I find myself going a bit hypo through injecting too much bolus as a way of correcting and calculating meal bolus in one jab :? This Excel spreadsheet looks fairly good though:-
http://www.integrateddiabetes.com/tools.shtml
 
i wasnt told what to do except for change basal to 2/3 of what it was and start bolusing 1 unit for 10g carb, with the help of my collins carb counter ive sussed out what i need, i have a few blips if im more active etc but my hba is a lot better with basal bolus :D
 
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