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Type 1 Diabetes
What happened with my BG levels?
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<blockquote data-quote="Deleted Account" data-source="post: 1548109"><p>I am a little confused. </p><p>Lantus is a long acting insulin which us used as basal and typically taken once or twice a day. My understanding is that our basal needs are not dictated by what food we eat so I had never heard about carb counting for Lantus. It is used to "mop" up the glucose our liver "drips" out throughout the day and usually lasts for 23 to 25 hours.</p><p>Novorapid is a short acting insulin which is usually taken with each meal which is why we carb count. For simplicity, we usually assume one insulin to carb ratio throughout the day but sometimes it differs. NovoRapid usually last for about 4 hours but the peak is near the start which is why we may test 2 hours after eating.</p><p></p><p>So what I am thinking is</p><p>- until now, you have been advised not to take NovoRapid with your breakfast. This may be because your insulin to carb ratio in the morning is very low. You may need to start taking some NovoRapid with breakfast ... but may be at a lower ratio to the rest of the day.</p><p>- you seem to be carb counting for your Lantus. This seems counter-intuitive as it is usually a fixed amount (which may vary slightly due to illness, stress or exercise). The Lantus you take with (but not FOR) brerakfast may not be enough. This may be because you are eating less carbs for breakfast so calculated a different dose. If you can find any notes from when you were first prescribed Lantus, this may give you a hint as to how much you should be taking. Or your needs have increased. This is less likely as your pre-breakfast BG is ok. </p><p></p><p>I think your best bet is to talk to your local diabetes team. </p><p>If they are not available, take a small amount of NovoRapid with breakfast and increase it gradually. If it was me (and I am not a medical practitioner), I would start with a ratio of 1 unit to 20g carbs and do lots of testing. This is easiest to adjust if you stick to the same breakfast everyday. </p><p></p><p>My last suggestion is to find out your correction ration (maybe called something like Insulin Sensitivity Ratio) so you can correct if your BG gets too high. Take care with this and always remember the NovoRapid which may still be in your system for 4 hours after injecting - this is called insulin on board or IOB.</p></blockquote><p></p>
[QUOTE="Deleted Account, post: 1548109"] I am a little confused. Lantus is a long acting insulin which us used as basal and typically taken once or twice a day. My understanding is that our basal needs are not dictated by what food we eat so I had never heard about carb counting for Lantus. It is used to "mop" up the glucose our liver "drips" out throughout the day and usually lasts for 23 to 25 hours. Novorapid is a short acting insulin which is usually taken with each meal which is why we carb count. For simplicity, we usually assume one insulin to carb ratio throughout the day but sometimes it differs. NovoRapid usually last for about 4 hours but the peak is near the start which is why we may test 2 hours after eating. So what I am thinking is - until now, you have been advised not to take NovoRapid with your breakfast. This may be because your insulin to carb ratio in the morning is very low. You may need to start taking some NovoRapid with breakfast ... but may be at a lower ratio to the rest of the day. - you seem to be carb counting for your Lantus. This seems counter-intuitive as it is usually a fixed amount (which may vary slightly due to illness, stress or exercise). The Lantus you take with (but not FOR) brerakfast may not be enough. This may be because you are eating less carbs for breakfast so calculated a different dose. If you can find any notes from when you were first prescribed Lantus, this may give you a hint as to how much you should be taking. Or your needs have increased. This is less likely as your pre-breakfast BG is ok. I think your best bet is to talk to your local diabetes team. If they are not available, take a small amount of NovoRapid with breakfast and increase it gradually. If it was me (and I am not a medical practitioner), I would start with a ratio of 1 unit to 20g carbs and do lots of testing. This is easiest to adjust if you stick to the same breakfast everyday. My last suggestion is to find out your correction ration (maybe called something like Insulin Sensitivity Ratio) so you can correct if your BG gets too high. Take care with this and always remember the NovoRapid which may still be in your system for 4 hours after injecting - this is called insulin on board or IOB. [/QUOTE]
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