Hey (:

[Robanny]

Hey everyone,
I wasn't sure where to post this, so I just posted it here. Please feel free to move it if it's in the wrong place, etc. I'm new here (as of tonight!).

I have a few questions about units of insulin.

I've only just started caring about my diabetes after 10 years. I'm 19 and have suffered from depression since the age of approx' 11/12 (Though am happy to say that I've turned over a new leaf and am finally coming out of it), so just blocked everything out and ignored all the information given to me, etc. I want to get my diabetes under control and have finally decided that coming to a forum with other diabetics can help me.

I decided to start by asking this:
I am on Novo Rapid fast-acting insulin and Lantus long-acting insulin.

I was wondering if anybody could give me advice on how many units of insulin I should be doing in relation to my blood glucose reading?

For example:
How many units of novo rapid should I do if my blood sugar is... 9.0, 10.0, 11.0... etc, all the way up to being in the 30s 40s (which happens a lot due to my lack of control).
Is there a formula I could work with?
Like X amount of insulin units for X amount of 1.0s (cant think of a better name..) you want to reduce your sugars by? (For example: 1 unit of insulin to reduce my blood sugar by 1.5... or so on).

Also:
Is there a set amount of insulin to take after meals?
For example: If I had a normal sized plate of chips and pizza for dinner (though I don't usually, I'm quite a healthy veggie teenager! Ha-ha!) then is there an amount of insulin I should be taking? Is there a dose of insulin that would cover me for all normal-sized meals? And would this just be halved/quatered in relation to snacks, etc? Or am I going to have to start counting fat and carbohydrates etc in order to calculate every insulin dose? (See? I really have no idea! :( )

I've been working with blind knowledge for so long, I have no idea how much insulin to do in relation to my readings. I've always just guessed, and it's never helped as I've NEVER had constant, normal readings - they're almost always high or low.

I'm trying to start taking care of myself, and feel like I need this information to get started.

Any help would be appreciated!

Thanks a lot everybody,
Robyn
x

[genie86333]

Hi, Robyn.

I'm not an insulin user so I can't be of much help except to say this is something you need to get with your doctor about - and if the doc won't help more than he/she has, find a new one.

The reason for this is that everyone is different and the amount of insulin they need varies...for instance 1 unit can lower blood sugar by less than 1/10 of a point for one person but lower it by a point or more for another person, so it would be dangerous for us to give advice on amounts to use.

However, you do need to start counting carbs & learn how to take other things (the effects of fat, etc) into account & (with your doctor's help) figure out how much insulin to take for specific amounts of carbs or to correct a high blood sugar.

[DanG]

I've been working with blind knowledge for so long, I have no idea how much insulin to do in relation to my readings. I've always just guessed, and it's never helped as I've NEVER had constant, normal readings - they're almost always high or low.

Blind knowledge? - sounds like all of us.
If you have as a goal, to get your blood sugar at a level that is good for life - I'd say you are not operating with blind knowledge. Just get in there and do the insulin to manage to that point. Eat less, do less insulin. Eat more, do more insulin - that is the calculator.

I began doing insulin 35 years ago when I was a bit older than you are now, and back then, it really was blind knowledge - blood sugar was measured as a function of the amount of sugar that spilled in your urine, and blood sugar spills in urine was a color test using a strip of testape litmus type paper. It really was a blind test, since measuring sugar spill in urine was not an exact function - a mere indicator.

Best for you is to understand that food raises blood sugar, insulin makes that blood sugar useful for life. Too much insulin can take care of life in the wrong way - I would bet you have experienced that also? - as in woozy or taken to the hospital with low blood sugar? Yeah - don't do too much insulin or you end up in not a good place.

Watch what you eat - everything you eat affects blood sugar - some things affect blood sugar faster and moreso than other foods. Your veggies do not raise blood sugar at all, for the most part. Add some dressing or sauce to those veggies, and you begin to add to the blood sugar level. Breads will raise blood sugar slowly as they digest. Sugars will raise blood sugars really quick.

If you really want to do this for yourself - do it. As the doc told me 35 years ago - you will know more about this than me (the doc), so I took him at his word and learned about this stuff for myself. I rarely see the doc - only for prescriptions.

Blood sugars in 10 to 20 range are not good, but if you can bring them down over a period of time - you are doing good. Try to stay under 10, and if possible, get in the range of 6-7 average each day. Learn about your abilities and your body as you eat and do insulin - you will do fine.

[lark 27]

I was diagnosed type 1 at age 15 (18 years ago) and at the time learned exchange systems, where I was supposed to follow a dietitians advice to eat a set number of servings of grain, veggies, fruits, dairy, protein for a meal or a snack. This served me OK for a while and then college came where I did not follow the set regimens (and a while after college as well). I honestly did the guesstimate based on the volume of food I was eating--not really paying attention to the type of food. That's dangerous because a lot of meat is not going to raise your blood sugar, but I might take too much insulin for it. Conversely, a carb rich meal might spike my blood sugar to 350 (roughly 20) and I would be surprised.

I would check my blood sugar occassionally but not enough. I kind of relied on having low blood sugars to identify where I was at. Eventually I had a wakeup call where I had a seizure in the middle of the night from a hypoglycemic reaction. You develop hypoglycemic unawareness from having lots of low blood sugar situations so I didn't wake up and go raid the fridge. Luckily I was OK, but that was the point at which I became much more dedicated to managing my diabetes. That's when I really started carb counting and bsing my insulin dose on a reasonable estimate of the carb conteant of food instead of the goldilocks approach (this plate of food is real big so I'll have a real big dose of insulin; this plate is medium so I"ll go with medium dose).

I can't tell you what a good dose for you is. Definitely work closely with your Dr. and share information with her/him to figure out proper dosing. I'm 225 lbs. (about 100 kg. I think that is), and my dr. started me at that point at 1 Unit : 15 G Carb, but that could be way off for you. Over the years I've tweaked it quite a bit. Here's a link to general examples of how to determine insulin usage: Calculating Insulin Dose : Type 1 Diabetes : UCSF Diabetes Education Online (http://ucsf.mightyminnow.com/type1/diabetes-treatment/medications-and-therapies/type-1-insulin-rx/calculating-insuliin-dose.html)

But again, definitely work with your Dr. I also encourage you to read as much as you can about diabetes, here at the forum, search the web, go to the library or a bookstore. Sometimes it seems really challenging to figure it all out and then just when you're having consistent success, a curveball will get thrown at you, but the exciting thing is that with hard work, you really can control those Blood glucose levels instead of them controlling you.

Good luck and have fun learning,
Erik

[xMenace]

Hey and welcome.

Is there a set amount of insulin to take after meals?

Yes: zero! Insulin should be taken before eating. It might be called rapid acting, but it's much slower than insulin in normal person. I try to inject 20-30 minutes before eating. Of course you need to follow through with your meal plan and be careful about what activities you partake in. Driving for example is a no-no.

[yannah]

I have used my mental health problems to my advantage.

I am obssessed and nuerotic with BS readings.
I get depressed when I am over 140.
my last AC was up a point to 5.9 this week and I was bummed out. put my carbs back under 50 a day. I was edging up.

I am not kidding you with this. beleive me, I am crazy.
and right now, it is working in my advantage.

its just bizzarre.

just an FYI for you.

and PM me anytime.

[Tattoo azz]

Hi Robyn, welcome to DF. Firstly you're not alone, we all know how hard it can be to get control. There's a book by Gary Scheiner called "Think like a pancreas" it's a pretty usefull guide to have, it's helped me alot and given me huge insight into where i'm going wrong. Look it up on Amazon.

Ok, it sounds like you need a base to start from. I was told by my consultant that most diabetics in UK are started on a 3units per every 10grms of carbs regime (this is just a starting point, i know many here aren't on this, but we have to start somewhere). John (XMenace) is right take your insulin BEFORE you eat and try and lower your carb intake per meal if you can. The rest is really just a matter of trial and error, i know that isn't helpfull but each person here will be on a regime different from many others, even if they are on the same medicines. I know you're up in Skye at the moment, but have you ever been asked to go on a DAFNE course? This would benefit you as it explains the ins and outs of adjusting your dose for every meal. Maybe going on a course when you start uni in Sept might be easier for you, i'm not sure how good the hospitals are on Skye. Anyway, i hope to see you around the forums. Take care.
Azz

[Robanny]

Thank you everybody for your advice and support!

But something two of you have said has confused me a lot. I was told (by doctors) when I went on Novorapid insulin (and when I looked it up) that it could be taken before meals OR after meals - and I've always done it after my meals.

Are you seriously not meant to take it after meals? If not, why the **** did the doctors tell me it was okay? Do they just have no clue what they're doing? Are they guessing? What?!

I've been told so many things by diabetes doctors/nurses that always turn out to be faulse or lies - and it's really tough on me because it makes it difficult to trust what they say when I do need help!

:(

And another thing, I was never once told during my whole 10 years of having diabetes that you have to count carbohydrates etc with diabetes type 1. It has literally NEVER come up. Why? If it's so vital why have I never heard about it? What the **** is going on with the diabetes doctors/nurses I see here in Scotland?

[Cluck]

Ok, it sounds like you need a base to start from. I was told by my consultant that most diabetics in UK are started on a 3units per every 10grms of carbs regime (this is just a starting point, i know many here aren't on this, but we have to start somewhere).

Robanny, all the best on this journey. There is alot of good advice here but honestly you should be discussing all this with your doctor or endo first. Do your own research and read, read, read.

In the end, my diabetes is my responsibility and I've found that none of my doctors/dieticians know as much about it as me :).

Diabetic care in the UK seems quite poor compared to the US/Canada so I'm not surprised that noone has educated you about carb/insulin ratios. I'm English (living in the US) and my Type II mother (in the UK) does not even have a meter to test her BG. I can't believe it.

Personally, I would not start with 3 units of Humalog per 10 grams of carbs. This would literally kill me. I need approximately 1 unit per 10g carbs. Carb/insulin ratios are totally individual and it is something that you must work out for yourself or with the help of your doctor (see lark's link).

[DanG]

I was told (by doctors) when I went on Novorapid insulin (and when I looked it up) that it could be taken before meals OR after meals - and I've always done it after my meals.

Your doc is practical, really. He is trying to keep you away from a low blood sugar event. If you eat slow metabolizing foods for the meal and get wrapped up in the meal and other activity, you could have enough insulin in you, but the food does not hit the insulin until later and you might end up quite low. That happens often, especially if your daily routine is mixed up by some other activity. Taking the Novorapid after your meal is fine - it is not bad advice. I would suggest that you keep up the same routine, as you are used to it and so is your system. A change to before meal Novorapid might shock your system in a way you don't want to experience.

As to doctors - I think everyone should read your distaste for their care and stop counseling that you go visit the doctor. You have been doing this on your own for years, I would suggest you keep up the same type of care on your own. Be careful as you make adjustments in insulin dosing, as it can put you low in amazing ways.

Take the good advice of Cluck:
"In the end, my diabetes is my responsibility and I've found that none of my doctors/dieticians know as much about it as me."

Tell us more, ask us more questions, tell us more about how dumb your experience with doctors is - I don't depend on a doctor much at all either.