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<blockquote data-quote="Scott-C" data-source="post: 2025525" data-attributes="member: 374531"><p>Hi, [USER=502486]@rupertl[/USER] , as you've been dx'd T1, I assume you've been put on insulin straightaway, presumably two types, a slow acting "basal" insulin to cover background needs, and a fast acting "bolus" insulin to inject with meals?</p><p></p><p>If that is the regime you are on, then the gp is wrong, and the consultant is right.</p><p></p><p>That is because the fast acting bolus insulin you take for meals will typically last for about 3 to 5 hours.</p><p></p><p>There are differences between different types of insulin but generally speaking, they get to work in about 20 mins, reach peak action in about 45 to 90 mins, and wear off over 3 to 5 hrs. As you can see from the timing ranges, there are broad margins, it's not a definite science, and it varies widely between individuals and on meal types and many other factors.</p><p></p><p>Bearing in mind that they tend to have an overall effect of 3 to 5 hrs, what they are trying to figure out in these early days is how to get you into a situation where you check your bg just before the meal to see what level you're at, take the injection, then if the amount of the dose and amount of food are correct, the level about 4 hours later when the insulin wears off should broadly match and leave you where you started. If they don't it'll give your team pointers on adjusting the dose.</p><p></p><p>The advice to test after 2hrs is incorrect as it will tell you nothing about what effect that injection is having on you in the remaining 2 or so hours of action, so you will have no idea whether the dose was about right or not at the point it matters, which is when it wears out.</p><p></p><p>Where you are after 2 hrs doesn't really matter in these early days. As time goes by you'll maybe learn some more sophisticated techniques to correct inter-meal, but forget about that at this early stage. </p><p></p><p>If though, you feel hypo (bg too low) at any time before 5 hrs is up, then definitely test.</p><p></p><p>I suspect your gp is more accustomed to treating T2, but the biology and factors to be taken into account are completely different for the two conditions.</p></blockquote><p></p>
[QUOTE="Scott-C, post: 2025525, member: 374531"] Hi, [USER=502486]@rupertl[/USER] , as you've been dx'd T1, I assume you've been put on insulin straightaway, presumably two types, a slow acting "basal" insulin to cover background needs, and a fast acting "bolus" insulin to inject with meals? If that is the regime you are on, then the gp is wrong, and the consultant is right. That is because the fast acting bolus insulin you take for meals will typically last for about 3 to 5 hours. There are differences between different types of insulin but generally speaking, they get to work in about 20 mins, reach peak action in about 45 to 90 mins, and wear off over 3 to 5 hrs. As you can see from the timing ranges, there are broad margins, it's not a definite science, and it varies widely between individuals and on meal types and many other factors. Bearing in mind that they tend to have an overall effect of 3 to 5 hrs, what they are trying to figure out in these early days is how to get you into a situation where you check your bg just before the meal to see what level you're at, take the injection, then if the amount of the dose and amount of food are correct, the level about 4 hours later when the insulin wears off should broadly match and leave you where you started. If they don't it'll give your team pointers on adjusting the dose. The advice to test after 2hrs is incorrect as it will tell you nothing about what effect that injection is having on you in the remaining 2 or so hours of action, so you will have no idea whether the dose was about right or not at the point it matters, which is when it wears out. Where you are after 2 hrs doesn't really matter in these early days. As time goes by you'll maybe learn some more sophisticated techniques to correct inter-meal, but forget about that at this early stage. If though, you feel hypo (bg too low) at any time before 5 hrs is up, then definitely test. I suspect your gp is more accustomed to treating T2, but the biology and factors to be taken into account are completely different for the two conditions. [/QUOTE]
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