Correction Dosing of Humalog

[Jill-O]

Can folks explain this to me?

I am recently off a premix and on Lantus at night and Humalog before meals. Sometimes, I eat more carbs than "planned" (per the dosing directions pre meal of my doctor) and would like to correct, or take more before the meal but I do not know how to start adjusting, or correction with the Humalog.

I have ordered John Walsh's book Using Insulin and a carb counting book that addresses (I think) insulin usage. Though I do know carb counting from the perspective previous low carb dieting... But, I have not received these books yet.

As always, I welcome your experience, insight and guidance.

[ant hill]

Hello Jill, There is no hard and fast way to do an correct bolus and that's the idea to test and see that you are in the right way however you have the knowledge to count your carbs and also find your ratio of carbs = insulin and test 2 hours after your last bite of your meal.
As for the Basel see the fasting tests as that's an idea of how the log acting insulins work.

[Jill-O]

Thanks, Peter!

My fasting number is always bad. It was 170 this morning, and that, urgh, is "good" for me as it's often over 200 even though it's good (100-120) before bed most nights.

I don't know how much of this issue is the basal, and how much of that is the DP?

You know, I honestly wonder if I am SMART enough to have this disease (or rather to control it).

Jill

[owlyn]

IMO, you need to work with ah endo to get the Lantus right. My a.m. fastings were running the same as yours, and he increased my Lantus by about 12% but as you know, everyone is different. I take my Lantus once a day when I wake up. It is largely just educated guessing for a few weeks to get the Lantus correct. Everyone starts out with too little and works up from there.

Once you get that working well, you then need to figure out your carb to insulin to bg ratio. This also takes a few weeks and careful documentation of what you eat, exercise and bolus and frequent bg checking. My ratio is around 1 u insulin = 15g carbs = 30 points bg, which is allegedly pretty average.

[Alice]

I try to "resist" corrections until about an hour or more after first bolus. That gives the insulin enough time to rise and, from experience, you can trend whether you will need more.

When I eat difficult meals to judge (last night's mexican food)...I purposely take a moderate dose knowing when I get home and shortly after, I'll check to see if I'm going to need more later. Then I take a second bolus (really a planned split) 1-2 hours later. Definitely after 3 hours, I correct.

When I over-guess an original dose, I hate the bad lows that come along...so this is my conservative way to deal with big starchy restaurant meals. Especially pasta which takes hours to burn out.

If I'm far out enough from original bolus (3 hours), I subtract 100 from my meter number and bolus for that difference. In my case, 1 unit Humalog for about 70 points. I increase to 1 unit for 50 points on meter if I'm really high...we tend to need more with higher corrections than low corrections.

[BlueSky]

To be able to bolus correctly for different amounts of carbo and to correct high blood sugars, you need to work out your insulin:carb ratio and insulin sensitivity factor. John Walsh explains very well how to do this, so read the book. But bear in mind that it was written for type 1 diabetics, who are typically insulin sensitive and for whom this mechanistic approach generally works well. As a T2, your insulin resistance changes the numbers and can make calculating these coefficients more difficult. This is why doctors often use sliding scales with T2 patients. Having said that, John Walsh's approach should still work for you. You will also need to test your basal rate, which I think is explained in the book. If it isn't search the forum for info on it. Good luck! ;)

[TenderVittleS]

Say if I'm 2oo I'll take 2-3 units to correct. Sometimes though nothing happens and that starts to piss me off.