How many insulin shots do you take a day?

[Rob43]

Hi, My doctor has put me on four insulin shots a day. Three before meals and one at night before bedtime. What worries me is the real bad BG lows because I live alone and if I got into coma there is nobody to help me.

Thanks, Rob

[Jill-O]

Hey, Rob --

I do the same as you. And, I know I worried a lot when I first started on insulin and then again when I changed from a premix to the 4x like you are now. Just keep an eye on yourself, test a lot, make sure you have glucose tablets around close (or some kind of soda / candy). Hopefully you'll do about like I did and get more and more at ease based on how you feel and your test numbers :)

Jill

[Rob43]

I'm thinking about going to another doctor at St Thomas Hospital in Nashville for a second opinion about my diabetes and with all these insulin shots. My doctor here in this small town must have aleast 10,000 patients.

Rob

[xMenace]

Your confidence will grow over time.

My critical times are middle of the night, late afternoon before supper, and the hour before lunch. I've had very bad experiences napping.

I can't guarantee your liver will always pull you out, but it does do a hellava job! I suggest you make your quarters as safe as you can: basically make it as drunk proof as possible. You're more likely to get injured stumbling around or convulsing than go into a coma.

Get an alarm with multiple settings. I use my cell phone. If I go to bed in doubt about my BGs or take a nap, I set multiple alarms to get me up at regular intervals to test, usually every two hours. It has saved my butt.

Go through a pre-bedtime routine to assess your likelyhood of going low. I can't give you any details, but make it a habit. Most of my bad ones were due to me making lame assumptions that if I thought hard about, I probably would have handled differently.

Learn your hypo symptoms. I'd even get someone to supervise me dropping low intentionally so I could experience them. Most of us have no need of this, but you don't have the luxury of family or partner support. If you are old like me, it won't help your sleeping hypos.

[Rob43]

My doctor has told me this is one reason to be married. :D Living alone can have it's down side. What about a device called First Alert so I can wear a botton on my wrist for me to get for help when I need it. My diabetic aunt has this. Someone told me diabetic comas you cann't move and talk. Is this true?

Thanks, Rob

[NoraWI]

Quit worrying! You have a good doctor. Sounds like you are on an MDI regimen. The bad doctors put their patients on one or two shots of a mixed insulin each day. And that doesn't work!

Learn how to match your premeal bolus insulin shots to your premeal BG plus the carbs you are planning to eat. Your evening basal shot can be taken in the morning avoiding the worry of a middle-of-the-night low. And all through your initial adjustment period, test, test, test.

[morrisma]

When I was on MDI, I took 2 shots of ultra-lente morning & evening and as many humalog shots as meals or high bgs required - averaged 4 a day I'd guess.
Mike

[Funnygrl]

I voted based on when I used to take shots. It varied, but I took 2 basal a day and 3-5 based on what I was eating and correction.

Taking more shots a day actually LOWERS your risk of having bad hypos. Instead of relying on unreliable long acting insulin to peak when you need it to, you're taking very short acting insulin exactly when you need it.

Type 2s, even those on insulin, aren't at a high risk of having severe hypos. Testing a lot will help you avoid severe lows.

Yes, get a second opinion, it's a good idea. But I doubt the opinion will differ much. The way your doctor has you doing things is pretty standard.

[JediSurfer]

I take a minimum of 5 shots a day but this can increase depending on whats going down on that particular day. Other times if I'm not eating well I might only have three. So I suppose a minimum of 2 Lantus shots and the rest as and when needed.

[grace girl]

I chose 5...I take lantus 2x daily, and if I eat three times a day then I total 5...some days it's less, some more.
I understand your concerns, I felt the same way when I went to more than 2 shots a day. You gain confidence as you go. Don't be afraid to test OFTEN, for that's how you'll learn how it's all working for you.
And it's true, you are less prone to hypos with more shots. My life was a nightmare all the years I only took two...since I switched over to this method I've got the hypos down to 1 or 2 a week, sometimes less, and I generally know when it will happen.

[owlyn]

I didn't see a choice for "too many", or, "more than I'd like".

[JediSkipdogg]

I push my bolus button about 8 times a day, so do I get a vote? LOL

With that said, with modern insulin it's alot harder for you to suddenly drop for no reason. Lantus/Levemir has a pretty flat profile. If you are on Apidra/Humalog/Novolog then test right before bed and think on how long ago the last shot was of one of those. That will help to determine if you should drop lower overnight or not. If you think you might, set an alarm and wake up 2 hours later to test.

One key thing to remember with insulin is you should test EVERYTIME before you inject and then right before you go to bed. It's just a safety measure.

[Dewey]

When I was on multiple daily injections, I took as many as 6 per day. Is there a friend or someone you could have check on you from time to time? I also thought of those dogs that can sense lows, but not sure if that idea appeals to you or if you can have dogs where you live.

[ant hill]

I generally have 5 sometimes 6 or 7 depending what's available to eat but the size of me tells to say no and to take insulin accordingly. :( But hey I have an affair with Levemir. :D

[Rob43]

Quit worrying! You have a good doctor. Sounds like you are on an MDI regimen. The bad doctors put their patients on one or two shots of a mixed insulin each day. And that doesn't work!

Learn how to match your premeal bolus insulin shots to your premeal BG plus the carbs you are planning to eat. Your evening basal shot can be taken in the morning avoiding the worry of a middle-of-the-night low. And all through your initial adjustment period, test, test, test.


What is a MDI regimen?

Rob

[Rob43]

When I was on multiple daily injections, I took as many as 6 per day. Is there a friend or someone you could have check on you from time to time? I also thought of those dogs that can sense lows, but not sure if that idea appeals to you or if you can have dogs where you live.

Hi, I have two dogs now that stay with me in the house.

Rob.

[shabbie]

rob, i felt scared just like you when i first started on mdi (multiple daily injections), i too live alone.

i just had to make sure that i manage my BG's in a sensible manner, eventually i learned what my insulins would do for me, after a while i relaxed into it.

you will learn that insulin is the best thing for managing your D, and it is long term, you just need to learn what you can about it...and take it easy on yourself ;)

EDIT: i forgot to mention that pre-pumping i would take up to 8 shots per day, wasnt sure if i qualify to vote of not though ;)

[owlyn]

MDI = Multiple Daily Injections. If you are a Type 1, you should either be on MDI or a pump.

[Emm]

Rob, others have already said it really, but 4 shots or more means better control and you're LESS likely to have troubles with lows. Of course, when you first change you'll have to keep a close eye on things, but once you have your dosages sorted out it should be good for you.

[Alice]

I checked (6) on MDI...some days as little as 4...some days more...depends on corrections, snacks and split boluses...which I do for dinner quite a bit.

[UpNorth]

Most days i take 6 injections... I split mealtime doses quite often :T

[DCaplinger]

When I first replied to this, I was on one shot a day at bedtime. Since then, I am now up to 4 - 5 shots per day.

Regards,

[rzrbks]

Depends on the day with me, can be as little as two ot three, could be as many as 8+ ---------depends on whether I'm feeling Piggy about food that day or not.

Normal is 5 or 6.


JediSkipdogg

I push my bolus button about 8 times a day, so do I get a vote? LOL

Hah, the Truth is out, Jedi Really is just a button pusher.:D

[shiftzor]

I was alseep when i voted :o, i only choose 3 because i had only done 3 shots that day (missed breakfast) normaly i would do 4 + corrections if needed. ;)

[BriOnH]

I don't have a specific quantitive routine as to how many shots I will have in a day. I always have at least one (my lantus) but if I don't eat the next day, or I am exercising all day long all I need is that one. If it's a heavy eating day I can give up to three shots per meal.

On average I would have to guess 6 a day.

[KCP]

to be honest i dont really have a hard and fast amount either. its at least two (split Lantus) and then whenever i eat something that i know will affect my sugars.. which could be up to 6 times a day maybe more

[azzkikr3d]

Hi, My doctor has put me on four insulin shots a day. Three before meals and one at night before bedtime. What worries me is the real bad BG lows because I live alone and if I got into coma there is nobody to help me.

Thanks, Rob
Rob

What my Specialist prescribed was that I should devide the bolus(Long acting) that I take in half and inject one in the moring and one at night. That way it is more controlled. Give it a try.

[MissLynn]

Rob, I am on 4-5 insulin shots a day, 1 lantus which was supposed to be at night ( but like you that idea scared me, so I simply changed it to in the morning, which for me I take mine as soon as I wake up, or if I go to bed late.. depending) and I also have Novolog before meals, this I adjust as to what I am eating so that I can now keep from spiking. ( hot **** been runnin a solid 129 the last two days and I want a cookie lol) what I have found as for the fast acting insulin is that I'll drop 10 points with every unit I use, so I adjust accordingly. The lantus doesnt peak, it stays steady throught its active time ( 24-36 hours) Since you dont have someone who can help in case of a severe low, I'd switch the base insulin to the morning time, and just let your Dr know. Test before bed, usually if you go to bed a few hours after eating and your numbers look good, you should be ok, or atleast thats been my experience, I've never dealt with an extreme or severe low ( thank god) Good luck to you.
Lynn

[stlduckhunter]

For those that are truely taking 4 or more "shots" a day, why aren't you on a pump to smooth out some of these bumps? Sorry, I am not trying to hijack the thread.

[Stuboy]

I originally chose 4 shots, but that's changed,

It's more like 6-7 shots a day now.a minimum of 5 anyway.

[Emm]

For those that are truely taking 4 or more "shots" a day, why aren't you on a pump to smooth out some of these bumps? Sorry, I am not trying to hijack the thread.

For me, it's because it's not an option. Pumps are rare and very expensive in New Zealand. *sigh* I would if I could - I think - but I'm fine with MDI :)

[ant hill]

For me, it's because it's not an option. Pumps are rare and very expensive in New Zealand. *sigh* I would if I could - I think - but I'm fine with MDI :)

It's the same here Emma, I cannot afford one myself.

[Penny]

For those that are truely taking 4 or more "shots" a day, why aren't you on a pump to smooth out some of these bumps? Sorry, I am not trying to hijack the thread.

Two insurance providers ago (The union keeps changing us), I was told I am too old and they would not pay any of it. I have not tried with the current one, but cost is a big issue with me.

[Gary_W]

For those that are truely taking 4 or more "shots" a day, why aren't you on a pump to smooth out some of these bumps? Sorry, I am not trying to hijack the thread.

I do a minimum of 5 a day, 6 is the most usual at present though it can be up to 8 or 9 if it's a weird day. Struggling a little at the moment due to Lantus splitting being a little on the tricky side, but in the great scheme of things I keep reasonably well. Until recently, MDI kept me absolutely A1 and I hope it can again once the Lantus is sorted.

In the UK, only around 1 in 50 type 1's have a pump. I am led to believe that the number is around 1 in 10 for most of the rest of Europe and around 1 in 4 / 1 in 5 in the USA.

Over here, it very much depends on where you live as to how easy it is to get access to a pump. I am looking into it, and will soon know how many hoops I have to jump through to get one; it is starting to look attractive due to my basals being a lot harder to manage now than they once were and basal management is certainly more flexible on a pump than it is with MDI. The number of shots as such would not make me change, as pumping has its own problems (i.e. plumbed into a bit of plastic tube 24/7). Both management methods have good and bad bits. Well, they both have bad bits in varying degrees as I'm sure we'd all rather do without, but trying to put the positive spin on here as reality bites and we must choose the lesser of the evils for our personal needs ;)

Pumping is not something that is even mentioned to your average T1 over here (put it this way, no-one ever mentioned it to me when I was constantly feeling grim and had an average HBA1c of 8+, so possibly 'qualified' in terms of NICE guidance). It adds a huge expense over and above MDI. This is a fixed, measurable cost and is ongoing in terms of consumables. It can be argued that the potential reduction in long term complications from pumping (your average person keeps better on a pump than on MDI, though there are exceptions) will save the health service money in the long run. When you ask a business manager in the NHS to choose between a real, quantifiable saving NOW and a 'potential' saving in 20 years time when it will be some other manager's problem, they'll choose plan A every single time unless forced into plan B by other factors.

Gary

[stlduckhunter]

I didn't mean to hit a nerve, and I guess I should consider myself lucky. Even though I believe there is a lot to be desired about the health care/insurance system in the US, it is a shame that most health care world wide is simply cost-driven versus need and quality of life.

[Gary_W]

I didn't mean to hit a nerve, and I guess I should consider myself lucky. Even though I believe there is a lot to be desired about the health care/insurance system in the US, it is a shame that most health care world wide is simply cost-driven versus need and quality of life.

No nerve hit; just trying to fully answer your (very reasonable) question :)

Everything is cost driven. I currently have a very good job and, if I lived in the US, I would have pretty killer medical insurance. For this reason, my needs would probably be better served in the US than here for my current situation.

Difference is, when I'm old, poorly and unable to get decent medical insurance, the care over here will be the same (assuming they don't drastically reform the NHS which is always highly possible). It's not perfect, but I do rather like the fact that anyone can access it based on need vs finance. Private medical insurance over here still gets you seen quicker but only for certain things. If you keel over due to a heart attack or renal problems then they will cart you to an NHS hospital and you will be helped, irrespective of your financial status. Some people completely abuse it and some people get denied treatment that (in another country with medical insurance) they would get straight away, but no system is perfect.

Gary