[DeusXM]

Humalog, 5-9 units per meal now, bout a month ago it was more like 9-16. Lantus 18 units in the evening.

[webpundit]

What is better?

-More Lantus at bedtime and lesser Humalog dosage?
-More Humalog with meals and lesser Lantus at bedtime?

I just was speculating which was lesser of the 2 evils.

[Mick]

I take 15.5 units of Lantus at 10:30pm, and Novolog via a refillable pen (the Novopen Jr.), at the rate of 1 unit for every 15 grams of carbs eaten, and 1 unit for every 50 mg/dl I wish to lower blood glucose levels. I don't necessarily inject at certain times, or certain amounts for certain meals. I won't bother taking an injection of less than 2 units, so if I'm faced with eating less than 30 grams of carbs, or a need to lower my glucose by less that 100 (or any combination of the 2...) then either I'll just skip the food, eat less, or forget it until I need a total of 2 or more units. Sometimes I just skip injections and food, especially at lunch (or lack of lunch)! Sometimes, I just want to eat (Sunday football games...) and so I'll eat and inject as the games go on.

webpundit--DO NOT EVER think that you should adjust your basal dosage (Lantus) the same way as you do your bolus (Humalog). Your need for humalog changes depending on what you eat, what you test, and how much activity you get. Your need for Lantus--your basal dosage--does NOT change much, if at all, and is based on your baseline metabolic rate, body fat vs. muscle mass, and total body weight. Your basal dosage does not cover your food, it covers the release of glucose from your liver which powers metabolic processes between meals and throughout the night. The best way to figure out if your basal dose of Lantus is perfectly matched to your basal needs is to spend a full 24-hr period fasting and refraining from bolus insulin while testing continuously during the day and night. If your glucose level stays relatively level, you are right on. If it rises, it means you're taking too little Lantus, and if it falls, it means you are taking too much Lantus. That's the current "best method" for testing correctness of basal dosage.

Michael
Type 1 since 1965

[Collette]

rzrbks, im gonna stay as i am until my appointment on the 23rd with my consultant when i shall ask about carb counting so i can recieve all the relevant info and monitoring etc. with not being on my insulin for long this time round, i dont wanna take any chances of changing my routine.

In the past when ive taken my insulin, my levels have been pretty consistant and ive eaten properly, just things in moderation.

[HeatherP]

Mick's right - adjust your Humalog first. It takes a couple of days to judge if your Lantus dosage is correct or needs to be adjusted.

I am a firm believer in the theory that if you eat "like you're supposed to" 95% of the time, then the other 5% doesn't count so much.

I would strongly encourage you to look into carb counting! It will give you a great deal of dietary freedom, and quite possibly help you w/ saying "no" to sweets.

As I've posted before, if I allow a small amount of "goodies" once in a while, I find it much easier to say "no thanks" the other 95% of the time.

Nowadays, Diabetes does not mean you can't have any sugar at all. You can buy books on the subject, but the best way to learn is to go see a dietician for several ono-on-one sessions, and it'll be so much easier to learn and figure out your individual insulin to carb rations.

I truly wish you the best,
HeatherP

[Andrea]

What form of insulin are you on and how much? and what do you use to take it?

I am on a pump so i only use Humalog. I have a basal rate that varies from 0.7 to 1.0 units per hour (depending on the time of day) and my insulin to carb ratio is 1:17, so my boluses at each meal or snack vary, based on the number of carbs that i consume. For a correction dose i take 1 unit to lower my blood glucose level by 3.75 mmol/L or 67 mg/dl.

Guess i should be grateful i only have to do it twice a day!

I would disagree with you here, Collette. The more often you take insulin, the more flexible you can be with your lifestyle and eating habits and the easier it is to actually keep your blood glucose level in your target range. Your other thread about wanting more control makes more sense to me now that i know that you are only on an intermediate acting insulin only twice a day. **(For those of you in north america or elsewhere, Humulin I is the same as Humulin N or NPH)**

I would encourage you to set up an appointment with your endocrinologist to talk about updating your diabetes treatment plan. You need to talk about more flexible insulin regimes as well as meal planning. I agree with Heather and the rest that carb counting is the way to go. The links that Heather posted are good ones. Once you understand the concept, an appointment with your dietitian might help determine how to adjust your current meal plan.

There is nothing (including castor sugar) that you should have to completely remove from your diet, just because you have diabetes. You should be able to eat everything (in moderation) by watching the quantities and injecting the appropriate amount of the appropriate type of insulin to cover the carbs. Ask your endocrinologist and/or dietitian about DAFNE (dose adjustment for normal eating).

What is better?
-More Lantus at bedtime and lesser Humalog dosage?
-More Humalog with meals and lesser Lantus at bedtime?

There is no one answer to this question. It depends on the person. The correct answer is the dose of each of these that maintain your blood glucose levels as close as possible to your target ranges as much of the time as possible.

Lantus can and in fact needs to be adjusted until the right basal amount is found. Once that is done, then very little further adjustment is usually needed. As Mick said, skipping meals is the best way to test this. If you skip a meal and your blood sugar goes up anyway, you likely aren't taking enough Lantus - and vice versa. The most important glucose level to check lantus doses is the fasting one. After your Lantus dose is properly adjusted for you, then start playing with your Humalog (insulin to carb ratio) to fine tune it to your needs.

Andrea

[webpundit]

Mick, Heather & Andrea,

Thanks for your replies! It's amazing how much I've learned here in the forums over the past month or so...it's seems like much more in the 9 yrs I've had diabetes!

I will definitely try the skipping-a-meal test to check on how efficacious my Lantus dosage is.


Cheers!
WP

[Musqua]

Hi Collette:

My name is Heather W. I am on glargine which is another name for lantus. I take 49 units at bedtime. I use the pen which I find very handy. All you have to do is dial in the units and inject yourself. I have been on this type since being dx. about 1 1/2 years ago. I guess that I am luckiwer than others in that I haver just the one type and only have to inject once a day. I am a type 2 .

Heather W. (A Canadian friend) :

[lgvincent]

I like the insulin pen but I don't like the price.

[Collette]

Lowell, how much is it over where you are then? We are lucky in the UK, we get it free on the NHS.