when to eat?

[tkidwell1]

Hi everyone,

Very new to this so please bare with me. If I have high BS and it's my "scheduled" time to eat, do I take my insulin (5 novolog before meals) and wait for it tome down? If I eat won't it keep rising?:confused:

[Jan B]

It would be better if you could wait until your bg isn't high, but sometimes you have to do what you have to do! Can you leave the carbs out if you must eat now?

Oh . . . are you not carb counting?

Do you take 5 units no matter what you eat?

Ideally, you would correct the high & wait until your bg is about normal, then take the amount of insulin you need to match your food.

[tkidwell1]

yes, that's not a problem, I can't seem to get my numbers right! Only been at this for two weeks from hospital and I eat very little carbs but numbers are high all day and wake up with lows at 2 am every night! 24 levimire before bed and 5 novolog before meals, just don't know what I am doing wrong! SOOOOO frustrated and scared! went to hospital with 750 but seems as if I am always hovering around 200

[owlyn]

Why aren't you carb counting?

[tkidwell1]

I just learned carb counting from reading here, was told by Endo to take these amounts and didn't realize I could do this until reading here. Is it 1 unit for every 10-15g of carbs? I was afraid to start adjusting until I saw him again (next week).

[tkidwell1]

also, should I start correcting if over 140 after 2 hours? I was not told this either but read about it here. How much do I add to correct and do I do it after 2 hours if over 140?

[Jan B]

Everyone is different . . . test often -- even 10x a day if you can! I was started at 1 unit for 15 carbs, and a correction of 1 unit to lower 50 points. I'm still close to that. I hate to tell you what to do, but no matter what you do, test often!!

[Jan B]

also, should I start correcting if over 140 after 2 hours? I was not told this either but read about it here. How much do I add to correct and do I do it after 2 hours if over 140?

The fast acting insulins are supposed to last 4 hours, so correcting after 2 hours might not be right for you. Personally, I think my Humalog lasts about 3 hours tops.

I hate to tell you what to do since you don't know your correction factor! Or carb ratio! It will be nice when you get back to the doctor. Or could you call him/her and ask about the ratios?

[tkidwell1]

THANK YOU! I test it seems like 50 times a day! my fingers think so anyway!

[TenderVittleS]

Personally, I wouldn't correct at 140. At that reading, even 1 unit will bring me down too low. I just leave it there and feel fine.

[KCP]

Also if yopur experiencing hypo's over night, your basal may be off a little...
Keep going, you'll get the hang of it! :)

[LancetChick]

Levemir is generally not a once-a-day insulin, although there are those who do take it once a day on the theory that "bigger dose means longer lasting". If you haven't yet, you might try splitting your dose into two injections a day. Levemir does have a peak, so if you're taking a single dose of it in the evening, night time is when that peak will hit, and that may be why you're experiencing lows then, and highs later in the day when it runs out. Splitting the dose will mellow out the peaks and provide continuous coverage.

When to eat after a correction bolus depends on your digestion. My digestion is fabulous, so I take the correction bolus with the meal bolus, and my blood sugar doesn't go any higher. It may take a little longer to come all the way down than if I had taken only the correction bolus and not eaten, but hey, when you're hungry, you're hungry, and when the insulin has run its course in 3-5 hours, you'll be back in range no matter where you started in the beginning (assuming that's how long your meal will take to digest and that you have dosed correctly). You just have to experiment on your own to see. I find that logging everything that affects my blood sugar helps me see much better how food and insulin interact. If, like many people, you find that your blood sugar spikes fairly sharply after a meal, adding the correction bolus with your meal bolus will probably make you spike even higher, so in that case it would be wise to wait, perhaps adding some of your meal bolus to your correction bolus so that your blood sugar will come down faster, and you'll have more insulin in your system when the glucose load of your meal hits hardest.

A good reference book that I still find useful is Using Insulin by John Walsh.

A

[DanG]

yes, that's not a problem, I can't seem to get my numbers right!

Don't forget the goal.
The goal is to live, i.e. stay alive.
Whatever you do - stay alive. Numbers come, numbers go.

Now, if I were you - I am not, I have been at this for 34 years since I was 22, but, I have learned that you are smarter than the doctor. In fact, that is what Dr. Livermore (I love that name for a diabetes doctor in the mid 1970's) told me and he is the one that took me in at the emergency room at something like 900 - he said I would know more about this diabetes than he would. Take that into consideration in what you do, how you read and apply things you see here. Don't do this like mathematics - it is not exact at all - ever!! This varies from day to day, it varies from meal to meal, it varies from person to person.

Listen to the professionals such as your endo, but do what you gotta do. Sure, insulin is powerful stuff, but it ain't as scary as you might think. Be at ease in what you do, and do a bit of down-home experimenting. Then, tell the endo - or don't tell the endo - Do what ya gotta do.

I wouldn't correct for 140. I would correct for 200. For me, at 200 I would do 2 units of humalog, or let it float down on its own, perhaps. I take a bit more lantus so that lantus has a bit of action. Plus, I do lantus in the morning to avoid the 2AM scary wake-up calls. No more scary wake-up calls for me since I switched to morning lantus. Others split - and when I experimented with that - the paramedics were here at 3AM. Nope, I don't do that either anymore.

Lantus/levemir may not last full 24 hours. So, if that is true, I don't have any basal in me from maybe 11PM thru 7AM - big deal, I'm asleep.

I don't test too much - like others are guiding you towards - I like my finger tips, and I want to live - remember, living is the objective. I don't worry about finding I am at 200 - a 200 now and again is not going to make me blind in the next 20 minutes, and when I see 200, I know what to do - don't eat, or take more insulin. I test at meals, since that is when I can do something about the test information, i.e. eat, and/or take more/less insulin. A test at mid morning or mid afternoon is useless information for my use. If I am going to be going low - I still have some sensory faculties that tell me I'm in trouble. If I am 200, I will know that later when I am going to eat and take a bit of humalog. That is my scheme of running life - living is the objective.

Don't be bound to useless information and non consequential objectives. I am saying what my objective is and what I do - others here are a bit more attentive to information gathering, etc - you make that decision. Don't be living life for the endo either - live life for you. You will get the hang of it - really. Even without DF.

[Subby]

Hi everyone,

Very new to this so please bare with me. If I have high BS and it's my "scheduled" time to eat, do I take my insulin (5 novolog before meals) and wait for it tome down? If I eat won't it keep rising?:confused:

Yes it probably will, but in a perfect world won't rise a lot. It's a good idea to wait for it to come down at least a little if you can but as Jan B said, if you gotta eat you gotta eat.

yes, that's not a problem, I can't seem to get my numbers right! Only been at this for two weeks from hospital and I eat very little carbs but numbers are high all day and wake up with lows at 2 am every night! 24 levimire before bed and 5 novolog before meals, just don't know what I am doing wrong! SOOOOO frustrated and scared! went to hospital with 750 but seems as if I am always hovering around 200

First, don't beat you up, it can be astoundingly tricky and people can struggle with control for years with all the best efforts and intentions. The "stop testing and chill out" attitude you'll get from a couple round here and probably from some medical teams - well you can join me (and many others) in respectfully telling them thanks but no thanks, I'll take all the BG information I can get, if it's all the same. It's important to realise that people's experience with diabetes and how "easy" it is to control is remarkably varied. If you feel that tests are informing you and giving you useable data, I think you have every right to test away.

And at your current state (2 weeks in) you need as much as you can get. So, all that said:- it's clear that further adjustments are needed before your control settles down to a less traumatic state. Your doctor should be taking a good hand in this. For a quick couple of ideas from me from what you say:

Lows in night but highs in day suggest you should move your Levemir dose to the morning, possibly resulting in better action during day and weaker action at night, which is what you want from the sounds of it. You might be able to up it to more effective levels then. Lots of thought and ways to do basal with injection: listen to the people around here for ideas that may work.

Highs all day suggest your boluses are not enough across the board. Carb counting and working on a sliding scale of an insulin to carb ratio will really help your mealtime results.

A little down the track, prebolusing (or postbolusing), longer or shorter needles, alternative injection sites, exercise and activity, are all examples of other practical issues you can address in turn, to improve the action of your insulin and minimise fluctuations.

I just learned carb counting from reading here, was told by Endo to take these amounts and didn't realize I could do this until reading here. Is it 1 unit for every 10-15g of carbs? I was afraid to start adjusting until I saw him again (next week).

I get the feeling that you could just adjust upwards with your current system, for a little improvement, and wait for the doctor to hopefully help and collaborate on the carb counting and working out your Insulin to Carb ratio. I know it's not going great right now but even so, taking on too much at once is a recipe for more problems.

You should get some help from a dietician to get started with carb counting and diet, hopefully your endo will set this up for you, if not, ask.

also, should I start correcting if over 140 after 2 hours? I was not told this either but read about it here. How much do I add to correct and do I do it after 2 hours if over 140?

As you are currently, my opinion is a good short term goal would be to try to keep yourself below about 170 or 190, don't keep aiming to get right back down (lower numbers are of course fine and desirable, but just don't stress trying to get right down for the moment). Just relax as long as you are reasonably consistent. Running a bit high for a few weeks isn't going to hurt too much: lots of fluctuation from over correcting etc will make things worse. Not to mention rebounds: you realise that a low may invoke a response from the body sending you high for hours afterwards? No: aim for slightly high stability, until you get more tools in place and a firmer grasp on things.

[tkidwell1]

WOW! Thank all of you so much, I am already feeling a bit more comfortable just getting and absorbing information! I have learned so much in just a few short weeks from this forum.

I am grateful for the replies and hopeful that I get at least closer to some normal numbers, i am not even sure if I know what normal feels like any more.

[jennyz]

yes, that's not a problem, I can't seem to get my numbers right! Only been at this for two weeks from hospital and I eat very little carbs but numbers are high all day and wake up with lows at 2 am every night! 24 levimire before bed and 5 novolog before meals, just don't know what I am doing wrong! SOOOOO frustrated and scared! went to hospital with 750 but seems as if I am always hovering around 200

Do you have a correction dosage? I calculate my insulin by the amount of carbs I'm eating, but if my BS is higher than 140, I take 1 extra unit for every 30 points it is higher.

140 to 170 1 unit
170 to 200 2 units
200 to 230 3 units

...and so on- could you ask your dr. about that?

[jennyz]

I just learned carb counting from reading here, was told by Endo to take these amounts and didn't realize I could do this until reading here. Is it 1 unit for every 10-15g of carbs? I was afraid to start adjusting until I saw him again (next week).

One serving of carbs is equal to about 15 grams, but I take 1 unit of humalog for every 8 grams of carbs. It's a bit different for everyone

[shiftzor]

You need to read using insulin by John Walsh, it explains all of this. Keep asking questions and I have included a few links for you:

I:C ratio (insulin to carbs) (http://www.diabetesnet.com/diabetes_food_diet/500rule.php)

1800 Rule and Correction Factor (http://www.diabetesnet.com/diabetes_control_tips/corr_factor.php)

Standard Deviation (http://www.diabetesmonitor.com/m57.htm)

HbA1c (http://medweb.bham.ac.uk/easdec/prevention/what_is_the_hba1c.htm)

Basal Stuff (http://www.diabetesnet.com/diabetes_control_tips/basal_bolus.php)

Carb Counting (http://www.diabetesnet.com/diabetes_food_diet/carb_counting.php)

[tkidwell1]

Thank you very much for the links, I found it to be extremely informative!

[HollyB]

Hi,

Keep in touch with your doc and make sure they know about your daytime highs and nighttime lows.

It's normal for your bg to come down gradually over a few weeks after dx; they have to be careful not to go overboard and send you into bad lows .

I'm assuming with your fixed doses your doc has you eating a fairly fixed amount of carbs. That way, he can tweak your doses with the amount of food held fairly stable. Your fast-acting and Levemir need to be adjusted bit by bit until you're mostly getting no nighttime lows and mostly getting good waking and premeal numbers. Then you or your doctor can do the math to figure out your insulin to carb ratio, and THEN you can start eating as much or as little as you want, and dosing accordingly. For example, say you eat two pieces of toast (30 carbs) for breakfast every morning, and 3 units is enough to give you a normal blood sugar 3-4 hours later. That means your breakfast insulin to carb ratio is 1 unit for 10 carbs. If the next day you want to eat 50 carbs, then you take 5 units.

But you're only two weeks in and your blood sugars are likely to be up and down for a while until things even out. Hopefully your medical team is helping you with this -- when my son was diagnosed we were in touch every day at first, fiddling with his doses until they were about right.