- So I Haven't Started To Bolus Yet -

[Delphinus]

But I will be soon.

I am currently doing basal injections only using humulin N and humulin R.

Again, I could Google, or ask around, but being a member here I have learned loads more then I probably could anywhere else. I just haven't looked up much about how to bolus until now.

Now, as a rule, is this how I should do it.

Check my BG level before I eat my meal, and bolus according to the results? And what is the ratio?

Or do I bolus according to how much I think I am going to eat? Like how many carbs it will be, then I bolus the units for that. Kind of like prediction.

I actually used to do this with my daughter, she had a guide she followed, but she has been living away for several years and I have since been diagnosed and haven't started to bolus yet.

[Subby]

It's pretty important to get this stuff really clear in the first place. I'd hate to think of someone googling to find out how to bolus, or even just going off forum replies. Yes you could probably work an understanding out those ways (actually, don't use random pages as a guide to bolusing, whatever you do) I think it's the sound idea that it should be done face to face with a diabetes professional. Your doctor hasn't shown you? Any chance of seeing an endocrinologist or Diabetes Educator?

[Delphinus]

It's pretty important to get this stuff really clear in the first place. I'd hate to think of someone googling to find out how to bolus, or even just going off forum replies. Yes you could probably work an understanding out those ways (actually, don't use random pages as a guide to bolusing, whatever you do) I think it's the sound idea that it should be done face to face with a diabetes professional. Your doctor hasn't shown you? Any chance of seeing an endocrinologist or Diabetes Educator?

I will be taking diabetes education classes, a 12 hour course over a three day period.

I just wanted to get a general idea from the people here.

The reason.

I have noticed alot of people here mention they only use their docs or diabetic nurses to get scrips, etc, and don't trust them otherwise.

For example, my dietitian told me I am only allowed three eggs a week because of the cholesterol. However the egg thread on here seemed to be more educational then she has for me. She also never heard of alloxan, and looked at me like I had four heads when I mentioned it, and what it was. Said she was gonna research it herself.

This is partly why I want to gather as much "intel" as I can, and from as many different sources as I can.

I hate that attitude, that if you are not a health care professional yourself, you can't possibly know something more then those that are in the field, which is the general attitude I get when I go to my appointments.

They also say to only test twice a day. I don't follow that either.

I wasn't going to use the info here as gospel, I just wanted to see what actually does work for people, cross reference it with what I will be learning, and put all of that against what will or will not work for me.

That is being pro-active, right?

[Subby]

Before going off on such a rant, you might like to simple clarify your reasons for your post and request. The way it was phrased sounded to me as if you were looking to get some info from any dusty corner and get going. I apologise for reading it in such a way and suggesting caution but really - your reaction here is extreme and quite distasteful to me.

[Scratch]

Get yourself the book, Think Like a Pancreas, by Gary Scheiner. It may be more helpful to you than any 12 hour course, although it's still a good idea to attend that.

I used that book to convert myself over to basal and bolus. With it, you'll have a handy reference helping to explain and clarify what you want to achieve with basal insulins, how to handle the bolus insulin, how to begin working out your ratios and correction factors.

[Delphinus]

Before going off on such a rant, you might like to simple clarify your reasons for your post and request. The way it was phrased sounded to me as if you were looking to get some info from any dusty corner and get going. I apologise for reading it in such a way and suggesting caution but really - your reaction here is extreme and quite distasteful to me.


I don't understrand.

A dusty corner?

Whenever I think of anything I might need to know, this is the absolute first place I think of and come to. I find the members here to be an amazing resource, and more then that, great people in general, diabetes aside.

Distasteful how?

I have been nothing but a respecftul member since joining.

I'm lost.

[Delphinus]

On top of that, I recommend this forum to diabetics.

I am sorry if you read my message as anything but a request for more information.

Had I thought of DF as a "dusty corner" I wouldn't visit it ten times a day nor be an active member.

I apologize for anything you may have read into my request for information.

[Delphinus]

Get yourself the book, Think Like a Pancreas, by Gary Scheiner. It may be more helpful to you than any 12 hour course, although it's still a good idea to attend that.

I used that book to convert myself over to basal and bolus. With it, you'll have a handy reference helping to explain and clarify what you want to achieve with basal insulins, how to handle the bolus insulin, how to begin working out your ratios and correction factors.

Thank you.

I was actually reading some reviews about this.

I think I may.

All I did, was simply ask for information. I am lost as to what I did wrong.

I didn't post with any kind of atttitude, cept toward the "professionals" I see every few weeks or so, and wanted feedback from those in the know.

Being newly diagnosed I have questions. Isn't that the point of this forum?

I still don't see how I went off on a "rant". Far from. That is not my style at all.

Now I feel like **** for asking anything.

[Gordonm]

The bolus is really just used for the food intake you eat. Mainly the carbs you eat. You have to calculate the amount of carbs then bolus for it. everyones carb to insulin ratio is different so noone here can tell you how much insulin to bolus. It is done with the Drs or educators advice. By no means is this set in stone. To get the bolus ratio takes time and testing to get it right. Just when you think you have it it goes haywire. A lot of averages are in play here. I have been at theis for close to 35 years. I take care of my diabetes with advice from the Drs. They are a coach you are the player. Learn as much as you can and apply it daily. It is not a perfect science. Good luck and keep asking questions.

[Subby]

From answering with the responsible statement of seeing your doctor (yes they gets loads wrong but bolusing should be learned face to face) I got a whole lot of defensive gumf that I found quite distasteful: because I can bet you a million dollars I know some of these things much better than you, or have certainly lived them, in my life and in offering ideas and advice to other diabetics. To be even remotely accused of an attitude that doc knows best in every circumstance, is, well, very distasteful.

So be it.

I apologised for the fact I read you post as a request for some info to get going on bolusing.

Your cue: Be graceful and move on. I mean, I did take the time out of my day to answer yor request, even if I got the intent wrong, correct?

The dusty corner comment was reference to my original impression that you would go to google, or here, to get some info to start shooting up boluses. I already apologised for getting that wrong.

Your continued fuss here about the issue, is your choice. Just as you say "Now I feel like **** for asking anything" I could easily say "Now I feel like **** for trying to help someone".

Just cool it.

[Delphinus]

From answering with the responsible statement of seeing your doctor (yes they gets loads wrong but bolusing should be learned face to face) I got a whole lot of defensive gumf that I found quite distasteful: because I can bet you a million dollars I know some of these things much better than you, or have certainly lived them, in my life and in offering ideas and advice to other diabetics. To be even remotely accused of an attitude that doc knows best in every circumstance, is, well, very distasteful.

So be it.

I apologised for the fact I read you post as a request for some info to get going on bolusing.

Your cue: Be graceful and move on. I mean, I did take the time out of my day to answer yor request, even if I got the intent wrong, correct?

The dusty corner comment was reference to my original impression that you would go to google, or here, to get some info to start shooting up boluses. I already apologised for getting that wrong.

Your continued fuss here about the issue, is your choice. Just as you say "Now I feel like **** for asking anything" I could easily say "Now I feel like **** for trying to help someone".

Just cool it.

I was cool. Until you jumped on me for not praising you with light speed. I am just taking it in. And want to reply properly.

Nothing I said was directed at you. It was a general reply.

I was suggesting people in general don't go by whatever their docs say.

Are you always this defensive?

My fuss wasn't originaly "continued". Was I supposed to say nothing back?

Did I go about my way? How fast did you want me to reply? I was waiting for a few more.

Your snap at me was only nine minutes later.

I am appreciative of your time and information, and had you understood my post, you would have seen I was suggesting members here know more then myself(Duh. Diabetic rookie. Hello. Stupid questions alert.), and seem to know more then the docs themselves.

I am still not sure what you read that set you off.

Anyway, take care...

[Subby]

I'm also more than happy to apologise for seeing your second post as a "rant" as well. You see, either you are talking to me in it or not. If so, you appear to be lecturing me on why DF is good and why my suggestion of a doctor is tantamount to suggesting docs know all and is this "attitude you hate" so much: which, conincidentally, is one I hate too.

If you didn't mean those comments to be directed at me personally in a conversational sense, despite begining your post addressing me, then I understand it was not a "rant".

Do you understand the idea of carb counting and insulin to carb ratios?

[Subby]

Oh,

There's lots of BS about this being about me needing to be praised in that message.

You seem to be throwing away your status of "respectful".

Are you sure I am the only problem here?

And a bit of advice.

Posting like this is overly dramatic.

Are you interested in your question

or nuking it out with whatever tools are at hand

with someone willing to help you in your endeavours?

[Delphinus]

I'm also more than happy to apologise for seeing your second post as a "rant" as well. You see, either you are talking to me in it or not. If so, you appear to be lecturing me on why DF is good and why my suggestion of a doctor is tantamount to suggesting docs know all and is this "attitude you hate" so much: which, conincidentally, is one I hate too.

If you didn't mean those comments to be directed at me personally in a conversational sense, despite begining your post addressing me, then I understand it was not a "rant".

Do you understand the idea of carb counting and insulin to carb ratios?

Yes. I do.

But the thing is, I am only doing basal injections, which are the same both times regardless of what I eat.

Anwyay... I am afraid to be naive now and ask anything.

I am going to leave this alone, and yes, now I will be on my way.

Take care Subby...

[Delphinus]

Oh,

And a bit of advice.

Posting like this is overly dramatic.

Are you interested in your question

or nuking it out with whatever tools are at hand

with someone willing to help you in your endeavours?

PS - I wasn't being dramatic. I was responding accordingly to being jumped on first.

Anyway, I don't wish to drag this out, that is not how I am, and not even sure how this got this way.

I am sure you are a great person, and the kind of person I look up to, when needing advice.

I am just lost, and still a bit out of the loop. Denial maybe? I dunno.

[Subby]

As I've been trying to say, (well, I use lots of irony so sometimes it's virtually invisible), forget the temporary communication difficulties. That's all they are. If you need to give it a rest because I read your post wrong and we had a rather silly session, so be it. I'd find that regretful.

The reason I ask about carb counting, was to find out if it was what you were familiar with, wonder if your daughter used to use that method. She may have been on fixed dose or perhaps with sliding scale. I am just ascertaining what expectations you have.

Next question I would have, is with this course, do you know if they are going to teach carb counting? Have they mentioned exchanges or the like, or grams?

[Gordonm]

:boxing: :boxing: :boxing:

Put the gloves down and go back to the post. Decent question maybe just worded a little poorly. :D

Yes carb counting is definitly needed to be understood before anything else. Education is the key here.

[jenb]

Delphinius - I agree with Scratch. Get 'Think Like a Pancreas' - a great book. I still refer to it frequently more than a year post-diagnosis. Once you are able to work out your own carb and correction ratios you'll be off to the races!

Good luck

Jen

[Delphinus]

Subby,


My daughter is on a sliding scale.

But she has lived in Calgary since Oct 2005. So it's been several years since I have had the routine.

There is a course outline, but it's a bit much to type up, and I have three broken scanners. :p

There are sections tho, called, Meal Planning, "A Fat is a fat is a fat", Healthy Eating, and Blood Sugars.

So I would assume.

Also, one thing that confuses me.

People use numbers in the hundreds, etc. My meter readings go by mmol/L.

So I see numbers between say 10 and 20. Yes, they are high, and should be between 4 and 7, but docs want me to come down slowly. Believe it or not, if I get a reading of say 10.0 mmol/L I feel like most people would feel when having a hypo.

My numbers are slowly coming down tho.

[Delphinus]

Maybe it's a Canadian thing? That I don't use those kinds of numbers?

[Subby]

:boxing: :boxing: :boxing:

Put the gloves down and go back to the post. Decent question maybe just worded a little poorly. :D


I think it's sorted now, I almost feel disappointed coming out of my silly boxing state... ;)

[Subby]

Subby,


My daughter is on a sliding scale.

But she has lived in Calgary since Oct 2005. So it's been several years since I have had the routine.

There is a course outline, but it's a bit much to type up, and I have three broken scanners. :p

There are sections tho, called, Meal Planning, "A Fat is a fat is a fat", Healthy Eating, and Blood Sugars.


Yep, the best advice is not to think about the sliding scale, whether she is still on it or not... thats a separate, older system. Carb counting and using an I:C factor, is where it's at! I wonder if there is a good website for carb counting... that book Scratch mentioned would be excellent to get.

Whatever course you do do, or whatever doctor or professional you may see, try and insist on using carb counting, don't get waylaid onto set doses and sliding scales and the like. As you said, those in the medical profession, despite all claims, can have limited ideas and oodles of confidence to go with it. I'm sure there are still docs out there who think 2 injections a day are enough.


Also, one thing that confuses me.

People use numbers in the hundreds, etc. My meter readings go by mmol/L.

So I see numbers between say 10 and 20. Yes, they are high, and should be between 4 and 7, but docs want me to come down slowly. Believe it or not, if I get a reading of say 10.0 mmol/L I feel like most people would feel when having a hypo.

My numbers are slowly coming down tho.

We use mmol/l here too. The others can use the converter for once, I always have to ;)

I've had this effect on coming down after a period of being high, don't worry, it's quite normal. It's the body being adjusted to high numbers, "feeling" that something lower is a low. It will pass, probably in a week or two, but you need to keep those numbers in a better place for the body to get used to that. And you'll need to keep feeling that way, resist the urge to go higher to avoid the unpleasant sensations. I know how disturbing they can be. But they will pass, just keep testing to be sure of your BG level any time you feel panicy about feeling like that.

[Delphinus]

Yep, the best advice is not to think about the sliding scale, whether she is still on it or not... thats a separate, older system. Carb counting and using an I:C factor, is where it's at! I wonder if there is a good website for carb counting... that book Scratch mentioned would be excellent to get.



We use mmol/l here too. The others can use the converter for once, I always have to ;)

I've had this effect on coming down after a period of being high, don't worry, it's quite normal. It's the body being adjusted to high numbers, "feeling" that something lower is a low. It will pass, probably in a week or two, but you need to keep those numbers in a better place for the body to get used to that. And you'll need to keep feeling that way, resist the urge to go higher to avoid the unpleasant sensations. I know how disturbing they can be. But they will pass, just keep testing to be sure of your BG level any time you feel panicy about feeling like that.


Actually, I may have been wrong, she carb counts.

When you bolus, do you go by your meter reading, and bolus according to that tho?

I am going to grab that book to.

I really do appreciate all the info, even tho we did get off on the wrong finger. :p

[Gordonm]

The meter reading will actually be a correction factor but yes it is included in the bolus along with the carb intake. If ihave a reading of 125 my target is alway 100 I have a correction figure of 1 unit for a 50 point drop and then I eat 30g of carbs, I'm about 1 unit for 15 carbs I would have to take 2.5 units of insulin. 2 units for the carbs and .5 units for the correction. My pump calculates a lot of this but I had to set up the figures which took a lot of time and testing.

[Subby]

Ok, thats good if she carb counts. The best way to think about bolusing and using your BG is to think of there being two types of bolus: a carb Bolus, and a correction bolus. Ah, well either I explain it half arsed or I put in a bit of detail, so here we go:

The carb bolus is self explanatory: it's a bolus to cover the carbs you are about to eat, that's straightforward. It's calculated this way:

You have a figure called you Insulin to Carb factor. Commonly (not always around the traps) this is a number, which is the amount of carbs that one unit of insulin will "cover" to keep things even. This number varies from person to person. It needs to be worked out at the start, and may need to be adjusted later or from time to time. I, for example, have an I:C factor of 1:6, which means for every 1 unit I inject I cover 6 grams of carbs. So if I was to eat a banana that was 12g, I would take 2 units.

A correction bolus on the other hand, is a bolus designed to bring your BG back into range. It is based on an ICF or Insulin Correction Factor (or sensitivity factor: different names, same thing). This is the amount of BG movement, in your case, in mmols, that one unit of insulin will bring you BG down. Again, it's an individual number, based on basically guesses, usually from your doctor, and well likely to need to be tweaked with experience. In my case, I have a sensitivity of 1, meaning that for 1 unit of insulin, it will bring me down 1 mmol/l.

SO, if I tested and I was 10 mmol/l, but I wanted to be 6 mmol/l, I would take a correction dose to bring me down 4 mmol/l. (So, 4x1 = 4units)

You can of course take a carb bolus and a correction bolus at the same time.

That's the basic mechanics! Have fun thinking about it. There may be better ways to calculate these things in the head or on paper. My pump does the work for me...

[Delphinus]

Ok, thats good if she carb counts. The best way to think about bolusing and using your BG is to think of there being two types of bolus: a carb Bolus, and a correction bolus. Ah, well either I explain it half arsed or I put in a bit of detail, so here we go:

The carb bolus is self explanatory: it's a bolus to cover the carbs you are about to eat, that's straightforward. It's calculated this way:

You have a figure called you Insulin to Carb factor. Commonly (not always around the traps) this is a number, which is the amount of carbs that one unit of insulin will "cover" to keep things even. This number varies from person to person. It needs to be worked out at the start, and may need to be adjusted later or from time to time. I, for example, have an I:C factor of 1:6, which means for every 1 unit I inject I cover 6 grams of carbs. So if I was to eat a banana that was 12g, I would take 2 units.

A correction bolus on the other hand, is a bolus designed to bring your BG back into range. It is based on an ICF or Insulin Correction Factor (or sensitivity factor: different names, same thing). This is the amount of BG movement, in your case, in mmols, that one unit of insulin will bring you BG down. Again, it's an individual number, based on basically guesses, usually from your doctor, and well likely to need to be tweaked with experience. In my case, I have a sensitivity of 1, meaning that for 1 unit of insulin, it will bring me down 1 mmol/l.

SO, if I tested and I was 10 mmol/l, but I wanted to be 6 mmol/l, I would take a correction dose to bring me down 4 mmol/l. (So, 4x1 = 4units)

You can of course take a carb bolus and a correction bolus at the same time.

That's the basic mechanics! Have fun thinking about it. There may be better ways to calculate these things in the head or on paper. My pump does the work for me...

Thank you. That is pretty much the information I wanted/needed.

I am getting frustrated that I am not seeing the numbers I want. My averages are between 11 and as high as 33(my meter doesn't go higher then 33).

I am increasing my units to, and portioning, counting carbs.

I am trying, and nothing seems to be working.

I was told it's going to be a while... I guess I have to have patience and realize I can't come down too fast.

[Subby]

OK. This is an exceptionally bad situation, I'll point out why I think so.

You are a type 1.
Your typical numbers are 11 - 33 mmol (200 - 600) indicating extremely poor control.
You are taking basal and trying to influence your BGs other ways.
You are NOT bolusing.

There is no way on earth you are going to gain control without bolusing. Every hour, every day you go without bolusing, you're risking grave consequences for your body, including extreme DKA, it starts at 13 mmol/l up, and is a situation that can lead to terrible damage and consequences.

What I understand must have occurred here, is a lack of education from your doctor. Either it wasn't stated that bolusing is part of the picture from day one, or you didn't quite get it. You MUST bolus to gain control. I don't mean this in a nasty way. It's just something that obviously hasn't quite struck home!

Much as my initial post to this thread was based on an incorrect reading of your question, it remains the best information for you to take to heart here. You need to get onto this - NOW - with a doctor. Get to an endo - ASAP - and get going with bolusing. We cannot guide you with starting doses. To do so would be medically negligent in the extreme.

[Delphinus]

OK. This is an exceptionally bad situation, I'll point out why I think so.

You are a type 1.
Your typical numbers are 11 - 33 mmol (200 - 600) indicating extremely poor control.
You are taking basal and trying to influence your BGs other ways.
You are NOT bolusing.

There is no way on earth you are going to gain control without bolusing. Every hour, every day you go without bolusing, you're risking grave consequences for your body, including extreme DKA, it starts at 13 mmol/l up, and is a situation that can lead to terrible damage and consequences.

What I understand must have occurred here, is a lack of education from your doctor. Either it wasn't stated that bolusing is part of the picture from day one, or you didn't quite get it. You MUST bolus to gain control. I don't mean this in a nasty way. It's just something that obviously hasn't quite struck home!

Much as my initial post to this thread was based on an incorrect reading of your question, it remains the best information for you to take to heart here. You need to get onto this - NOW - with a doctor. Get to an endo - ASAP - and get going with bolusing. We cannot guide you with starting doses. To do so would be medically negligent in the extreme.

My understanding was, they don't want me to come down to very low numbers just yet. To bring me down gradually. (Humulin N and R)

It's funny... Just now. I felt off, a bit weird. So I tested, and it was 8.7!

That is my lowest since being diagnosed over 5 weeks ago.

I feel like I must be having a hypo, because my body is so used to highs.

This is good news, because of the fact I understood what I was going on, and I felt the change, and immediately tested. I listened to my body, and was correct.

This may seem trivial to some, but it's a big step for me.

I am going to be seeing an endo.

And as mentioned before, I believe I am getting bad advice from the doc, and the nurse, and my dietitian. The dietitian is old school and suggested I eat no more then 3 eggs a week. Right then, I decided to do my own research, and ask people here, because as mentioned, I believe the people here to be a better knowledge base.

Again, thank you, I will heed your advice for sure.

Wow, I still feel loopy, but I am excited as well, I listened to my body, and I was right. :D

[Subby]

My understanding was, they don't want me to come down to very low numbers just yet. To bring me down gradually. (Humulin N and R)


Well I think their approach to only use basal, given your numbers, is foolish and potentially dangerous. Carbs NEED to be bolused for. If you really didn't want to come down too fast, it would make much more sense to simply bolus a little less, not forego it completely. It's almost like they are treating you like a type 2 with insulin resistance to reign in, rather than a type 1 with possibly zero pancreatic contribution to work with. I'd dump these guys and find other medical support, quick smart.


It's funny... Just now. I felt off, a bit weird. So I tested, and it was 8.7!

That is my lowest since being diagnosed over 5 weeks ago.

I feel like I must be having a hypo, because my body is so used to highs.

This is good news, because of the fact I understood what I was going on, and I felt the change, and immediately tested. I listened to my body, and was correct.

This may seem trivial to some, but it's a big step for me.


What you say is probably alien gobbledygook as far as other people are concerned. I understand it perfectly, as would many type 1s. who ever had control issues. (That's a lot ;) ) Keep it up.

[Delphinus]

Well I think their approach to only use basal, given your numbers, is foolish and potentially dangerous. Carbs NEED to be bolused for. If you really didn't want to come down too fast, it would make much more sense to simply bolus a little less, not forego it completely. It's almost like they are treating you like a type 2 with insulin resistance to reign in, rather than a type 1 with possibly zero pancreatic contribution to work with. I'd dump these guys and find other medical support, quick smart.



What you say is probably alien gobbledygook as far as other people are concerned. I understand it perfectly, as would many type 1s. who ever had control issues. (That's a lot ;) ) Keep it up.

Everything is alien to me. :D

I am just a rookie in this mad diabetic world, but I am getting there. It's just so weird having to do the job of an organ in your body.

People without diabetes can just eat, and voila, their pancreas does it all. We have to be mathemeticians, and our own personal physicians. Every meal is a game, most times we win it, sometimes we do not.

[Gordonm]

Honestly Humulin N and R is stone age type of insulin. Those types of insulin and I was on them years ago are very hard to keep in control. The much more modern Lantus and equivilent and Humalog and Novolog are going to give much better results. I know this is getting ahead of yourself here but if you are bolusing with R it is going to take about 1 to 2 hours to really start working. Humulin N has a peak so it is useless as a basal. I did this for years under the care of an older endo so I know how it works. When I switched to more modern insulin,Lantus and Humalog my numbers came in much better and I had far less extreme high and lows. It is all confusing right now but keep working at it. It is a daily struggle and will continue to be. Your numbers should not be that high. I rarely see a 200 now.

[Delphinus]

Honestly Humulin N and R is stone age type of insulin. Those types of insulin and I was on them years ago are very hard to keep in control. The much more modern Lantus and equivilent and Humalog and Novolog are going to give much better results. I know this is getting ahead of yourself here but if you are bolusing with R it is going to take about 1 to 2 hours to really start working. Humulin N has a peak so it is useless as a basal. I did this for years under the care of an older endo so I know how it works. When I switched to more modern insulin,Lantus and Humalog my numbers came in much better and I had far less extreme high and lows. It is all confusing right now but keep working at it. It is a daily struggle and will continue to be. Your numbers should not be that high. I rarely see a 200 now.

Part of the problem to, is at the moment humulin N is the only insulin I can get for free, and which is covered by the clinic I go to. The R, I was lucky enough to have donated. :(

I have no medical plan at work, and even tho I am in Canada, where insulin was first synthesized, I don't have the money at the moment for any form of rapid insulin. (Just referring to the irony how everything else is freely available in Canada, cept the thing I need most)

I don't make enough where I work, and have up until this point, lived cheque to cheque.

I'll find a way tho. I always do.

[Gordonm]

OK I see your situation. It can be made to work better than what your numbers show. It takes time and testing. The N is strange because it does not start to work for a couple of hours and peaks at about 8 to 10 hours then slowly goes away. I was on 2 shots of N, one morning one evening to cover the whole day. Then I would bolus with the R. Iwould have to inject an hour before the meal or so because the R takes a little time to get working. Just takes planning.

[Delphinus]

OK I see your situation. It can be made to work better than what your numbers show. It takes time and testing. The N is strange because it does not start to work for a couple of hours and peaks at about 8 to 10 hours then slowly goes away. I was on 2 shots of N, one morning one evening to cover the whole day. Then I would bolus with the R. Iwould have to inject an hour before the meal or so because the R takes a little time to get working. Just takes planning.

Yea, I take two shots of N, once at the beginning of the day, and once near the end.

And I am doing the bolus using the R.

It will just take a bit to get used to, for now, to find my ranges.