Quick Insulin Question

[ericw2000]

I've been a type 2 diabetic for over 10 years. About a month ago my doctor put me on Apidra, and I've been on Levimir for about a year. In the past couple of days I've reached a point where the insulin has started to work for me.

Anyhow, I had a low this morning, after breakfast, the first time ever with Apidra. Now at lunch time my blood glucose is 99, and I have a virtually carb free lunch (other than an apple) in front of me. Should I take a shot or no?

[Keezheekoni]

Do you count carbs or are you on a sliding scale? Most of us here are counting carbs and know our insulin to carb ratio. If you have that set, count the carbs in the apple plus whatever else you're eating and calculate your injection accordingly.

If you feel that Apidra is bringing you too low, then you may actually need to work out your Levemir dose before you change your I:C ratio.

[sugardumplin]

Keez- how do u figure out your insulin to carb ratio? is it different to everyone? i wanna know mine. Is that just for fat acting insulin users? i take lantus.

[Keezheekoni]

Yes, it's just for fast-acting users. To be honest, I don't know how to calculate it, my doctor gave me one to work with and it took me about 3 years to tweak it to where I have it now. I have different ratios for breakfast, lunch and dinner. Snacks are hit or miss depending on the fat and protein content...

I know a couple of members here who know how to do the calculations, maybe they'll chime in.

[xMenace]

basically eat the same meal for about two weeks. Adjust the dosage and timing until you get the profile you like.

[xMenace]

basically eat the same meal for about two weeks. Adjust the dosage and timing until you get the profile you like.

A big problem is the basal rate. Most assume their basals stay flat because their fasting number is ok, but that's a faulty assumption to make. Basals are often flat. but they can be very roller-coastery too. You can test this by performing another test after setting a rate. Eat the same foods again, but add 50% of the carbs. Instead of two slices of bread, eat three. If your BGs are fine, then your basals are likely flat. If your BGs drop your basal is too low for that time period. Some of your initial bolus was covering basal need. Additional bolus therefore has a built in basal compensation rate and dropped you. If BGs rise, your basal dose is too much for that time period. Your new bolus contains a negative basal adjustment, so adding more food and bolus amkes you rise. Counter-intuitive I know.

[kgm0612]

Welcome to the forum, Eric.
Keez & xMenace gave you good tips & advice so I don't feel a need to add to it.

Karen

[deco]

I used trial and error to get insulin to carb rate that seems to work for me. I started with 3 units per 1 carb and I have settled on 4:1. Recently my sugars were all over the place and I couldn't figure out why. I went to the Lantus site and discovered that the maximum time to use a bottle of lantus was 28 days from first injection of air into the bottle. No one told me this!. I take 20 Units at bedtime so a 3ml bottle lasts a long time. I started a new bottle and the problem went away. I've started marking the date of first use on the bottle now and I throw it away after 28 days. I only use 2/3 of the bottle before I have to throw it away. I hope this info helps others. By the way check out my article on Stress and diabetes at diabetes-lifetips.com. I'd appreciate comments.

[GrammaBear]

Being new to this forum I don't know if it is ok to mention a book about using insulin, but about a year ago I bought a book called "Think like a Pancreas" by Gary Scheiner. It has a really good explanation about how to figure your insulin to carb ratio. It is a trial and error process though, or at least it was for me. My average blood sugar used to be near 200 daily, and now it is about 118-125.

GrammaBear
Type 2