Weight-Based and Insulin Dose

[azizdhl]

Hi guys,

For someone that was diagnosed with type 1 diabetes for 18 years, she wight 42kg and take a total of daily insulin 13 units ( 7 Lantus + 6 novorapid ), which means 0.3 insulin per kg of body wight.. she usually test 5 to 8 times and also have Freestyle libre and her BG most of the times is around 100. So now she read that total daily insulin must be 0.5 insulin per kg or more and she is afraid that it may developed a ketoacidosis because she only took 0.3 insulin per kg,

1. Is that a rule to follow? (0.5 per kg or more)
2. and does anyone took a little insulin does like her?
3. and is it good that her body need a little insulin or there is a problem with that?

 

[tim2000s]

1. Is that a rule to follow? (0.5 per kg or more)
2. and does anyone took a little insulin does like her?
3. and is it good that her body need a little insulin or there is a problem with that?

1. No. The rule to follow is whether she is getting in-range glucose results.
2. There are a few people out there. Insulin needs vary.
3. There are no issues with the amount of insulin she needs. A lower number usually suggests that there is some level of residual beta cell activity.

 

[azizdhl]

1. No. The rule to follow is whether she is getting in-range glucose results.
2. There are a few people out there. Insulin needs vary.
3. There are no issues with the amount of insulin she needs. A lower number usually suggests that there is some level of residual beta cell activity.

after 18 years of having a type 1 diabetes, is there a chance that beta cell may be a little bit active?
is there any lab test to do to make sure of that?

 

[tim2000s]

after 18 years of having a type 1 diabetes, is there a chance that beta cell may be a little bit active?
is there any lab test to do to make sure of that?

The usual test is a c-peptide test, and yes, even after 18 years, people can still have beta cell activity.

 

[EllieM]

Hi guys,

For someone that was diagnosed with type 1 diabetes for 18 years, she wight 42kg and take a total of daily insulin 13 units ( 7 Lantus + 6 novorapid ), which means 0.3 insulin per kg of body wight.. she usually test 5 to 8 times and also have Freestyle libre and her BG most of the times is around 100. So now she read that total daily insulin must be 0.5 insulin per kg or more and she is afraid that it may developed a ketoacidosis because she only took 0.3 insulin per kg,

1. Is that a rule to follow? (0.5 per kg or more)
2. and does anyone took a little insulin does like her?
3. and is it good that her body need a little insulin or there is a problem with that?

My mother, who died in 2012 aged 78 after 55 years of diabetes, was on a fairly similar dose although heavier. (probably same dose per kg). Low insulin doses are fine if they keep your blood sugar where you want it to be. You can always do some urine tests for ketones if you're worried, but I can't see why you would be.

 

[Deleted Account]

There are many things which affect our insulin needs such as insulin resistance, insulin production, how much we exercise, how many carbs we eat, ...

Whilst there may be guidelines/rules of thumb to estimate total insulin needs these are only guidelines used for estimates.

The important thing, as others have stated, is what are her BG levels like. If they are in the "correct range" (e.g. https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html), the chance of complications due to diabetes are greatly reduced regardless of how much insulin is being injected.

 

[Daibell]

You need to use the glucose meter to decide how much insulin to inject and not use weight tables as they are merely a guide. The Basal may need a slight tweak and the meal-time Bolus should be adjusted by carb-counting to suit the carbs in the meal. Come back if you need more guidance on that.

 

[Shiba Park]

Hi guys,

For someone that was diagnosed with type 1 diabetes for 18 years, she wight 42kg and take a total of daily insulin 13 units ( 7 Lantus + 6 novorapid ), which means 0.3 insulin per kg of body wight.. she usually test 5 to 8 times and also have Freestyle libre and her BG most of the times is around 100. So now she read that total daily insulin must be 0.5 insulin per kg or more and she is afraid that it may developed a ketoacidosis because she only took 0.3 insulin per kg,

1. Is that a rule to follow? (0.5 per kg or more)
2. and does anyone took a little insulin does like her?
3. and is it good that her body need a little insulin or there is a problem with that?

Even HCP's get too hung up on 'rules'. As others have said, the results say this is spot on.
I think people that are sensitive to insulin are treated with suspicion; I use less per kg than that, my consultant endo just repeated my GAD test because of this... still positive!

Shiba.