First timer with some stupid questions!

[michelby]

Hey everyone, so I'm still at home recovering from my stint in the hospital, so when I need insulin I just open the fridge, grab a syringe from the box and go at it. So, when I exit into the real world, I have some questions:

1. What do you guys put your needles, insulin bottles in so that you can carry it in your purse, pocket, etc?

2. Do you prefill your syringes? How do I keep them cold while I'm at work?

3. If I have a snack, do I need to take insulin? My doctor only informed me of taking humolog before meals, but is a snack a meal?

4. What happens if I eat a meal, and then like 30 mins or so later I'm hungry again...do I start the process over and take humolog, or is the previous insulin shot going to cover it?

Just so everyone knows, I'm taking humolog before meals and then 60 units of Lantus at bedtime.

Thanks!

[princesslinda]

Welcome Michelby! There are no stupid questions. Stupid is not asking any, trying to manage everything by yourself.

I'm T2, not on insulin, so I can't offer a lot of advice, just wanted to say "welcome aboard."

[yanki01]

it doesn't sound comforting what your saying. I would suggest asking asking your doctor some of these things. I'm taking the same meds and would suggest you getting the humalog insulin pen so you may carry with you other than a vial and syringe. It's alot easier and more convient for me (although I'll be on the pump starting Monday). The lantus you could still stick with the syringe since you take alot of units.

For snacks, it depends on what you eat or drink to know if you need insulin. Testing your sugars would tell you if you NEED a snack. I'd suggest you also get with a nutritionist about reading labels and get with someone to do carb counting. Just watch your carbs & sugars on what your eating and drinking.

Good Luck!

[cynthiazinn]

Hey there,
I am a type 1 and a nurse:) I have been on a pump for a while here, so I will try to get this right! When I was on MDI (multtple daily injections) I shot-up
4X a day. No more than 15 min. prior to each meal (not snack) and at bedtime. If you are on a sliding scale just follow that. If you are using an insulin carb ratio, you will need to know how much insulin you require per carb. Mine is 1:9. That is pretty typical. I only refrigerate my back-up insulin. My in-use vial stays in my bag which is kept at room temp. I use a skidaddle bag designed just for diabetics, it is great (and expensive) but has a pocket for everything. Though it is against protocol I have never had an issue keeping my insulin room temp. Just avoid extreme temps. and exposure to light. Hope this helps.
Cynthia

[genie86333]

Hi, Michelle!

I'm not on insulin, but know from reading here the answer to a few of your questions.

First, you don't need to keep the vial you're currently using in the refrigerator - just at (cool) room temp (in other words, if you live in a hot climate & don't have air conditioning, refrigerate, otherwise room temp is ok - and less painful to use!)

Next, don't prefill, at least not too far in advance. I remember reading here that insulin breaks down less in it's vials...that being said, however, years ago my mom's nurse prefilled a couple weeks (at least) worth of syringes at a time because my mom was blind & couldn't do it herself every day...so it's not impossible (or at least not with older types of insulin), but not advised.

Snacks *do* need boluses if they have a significant amount of carbs. For instance, if you eat a sugar(but not carb)-free cookie, or some ham & cheese, you'd probably be fine...but a larger more carb-filled snack might need a bolus. Did your doc work out an Insulin:Carb ratio for you or did he give you a set amount for a "meal?"

As for snacking, bolusing, then getting hungry again, that's more complex, so I'll let someone else w/more experience cover that.

[butterflykisses]

Hey everyone, so I'm still at home recovering from my stint in the hospital, so when I need insulin I just open the fridge, grab a syringe from the box and go at it. So, when I exit into the real world, I have some questions:

1. What do you guys put your needles, insulin bottles in so that you can carry it in your purse, pocket, etc? I use a pump now but used to keep them in a pencil bag. Cheap and worked fine.

2. Do you prefill your syringes? How do I keep them cold while I'm at work? Never prefilled. You don't need to refrigerate the bottle of insulin you're using, just protect from extreme temperatures. This information is enclosed inside the insulin box. Opened vials can be used up to 30 days and then should be thrown away.

3. If I have a snack, do I need to take insulin? My doctor only informed me of taking humolog before meals, but is a snack a meal?
This is something that you'll need to talk to your doctor about. If you're using a sliding scale, injecting depending on your glucose level, that could be a problem. If you're carb counting, taking insulin depending on what you're eating it's not as much of an issue...but it will depend on how much you're eating whether you need to or not.

4. What happens if I eat a meal, and then like 30 mins or so later I'm hungry again...do I start the process over and take humolog, or is the previous insulin shot going to cover it? Same as the snack.

[fairyblood]

For instance, if you eat a sugar(but not carb)-free cookie, or some ham & cheese, you'd probably be fine...but a larger more carb-filled snack might need a bolus.

Most of what Genie said is right however I beg to differ on the sugar free issue. All carbs need insulin. Unless you are in honeymoon and have other things going on.

However some of these question could be dangerous to answer without knowing more about you and what insulins you are using. For instance if you are using NPH you may need snacks without boluses (rapid acting insulin).

I am not sure how much sense I am going to make without some education. I would recommend seeing a good CDE (certified diabetes educator) and buying some good books to self-educate.

I would recommend Think Like a Pancreas by Gary Scheiner and Using Insulin by John Walsh.

Good luck and keep taking to us.

[Paul W]

Those are good questions. Don't worry about keeping the insulin cold. Just don't let it get hot. I've accidentally let mine get too warm and it didn't seem to affect it at all. 60 units of Lantus sounds like WAY too much. I take 5 units at night and another 3 when I wake up, but I found 10 units total of Lantus was too much. Please ask your doctor about that again. Don't prefill syringes. Keep your insulin and supplies in whatever you feel comfortable with. I use a small black pack which my co-workers refer to as my "purse", which I enjoy. I NEVER take insulin and then wait to eat with Novolog/Humilog because it starts working so fast, unless I'm real high and I'm waiting for my BS to come down. I mostly eat my entire meal first and then reflect on how many carbs I've injested, then take a shot. What if you get half way through a meal and then start feeling ill or something? Then you're stuck with all this insulin on board. Now you HAVE to eat. Anytime you eat anything that contains carbs, whether it's a full meal or a snack you need to take insulin, unless you are correcting for a low BS situation. If you recently took insulin and it was the right dosage for your meal and then 30 minutes later you're hungry again, you still need to take more insulin, but less than you normally would for that many carbs because you already have some insulin on board. In time you will get a feeling for it. After a while you won't need to think so much about counting carbs because you will develope an understanding of how many carbs are in something just by looking at the density and size of the portion. And occasionally, like me, you will be way off and have to either take more insulin or eat some sugar. Such is life. I hope that helped.

[Subby]

60 units of Lantus sounds like WAY too much. I take 5 units at night and another 3 when I wake up, but I found 10 units total of Lantus was too much.

I take 80 units levemir for basal. I know other T1s taking more. It can be weight related, but not necessarily, as in my case. Just happens that insulin use is highly variable between people. There was a fascinating couple of polls recently, showing just how much insulin use varies between people:

http://www.diabetesforums.com/forum/diabetes/43924-how-much-insulin-do.html
http://www.diabetesforums.com/forum/diabetes/43983-how-much-daily-insulin.html

These are anyone (T1, T2,T1.5,GD,..) and total insulin use, so are very broad. You can also see some more specific cases in the replies.

Rather than comparing to other people, the answer as to what is the right dose is... what is the right dose? IE, is it working well. Definitely do consider your basal dose and also get back to the doctor, if you are getting lows or highs that you cannot ascribe to a bolus.

[owlyn]

Hey everyone, so I'm still at home recovering from my stint in the hospital, so when I need insulin I just open the fridge, grab a syringe from the box and go at it. So, when I exit into the real world, I have some questions:

1. What do you guys put your needles, insulin bottles in so that you can carry it in your purse, pocket, etc?

2. Do you prefill your syringes? How do I keep them cold while I'm at work?

3. If I have a snack, do I need to take insulin? My doctor only informed me of taking humolog before meals, but is a snack a meal?

4. What happens if I eat a meal, and then like 30 mins or so later I'm hungry again...do I start the process over and take humolog, or is the previous insulin shot going to cover it?

Just so everyone knows, I'm taking humolog before meals and then 60 units of Lantus at bedtime.

Thanks!

I haven't used syringes since pens came out over 10 years ago. Pens are much more convenient. In any event, you do not need to, and sholuld not
refrigerate the current vial or pen. You just need to make sure it does not get above 86 degrees.

I have a special bag I keep everything in. Meter, strips, insulin pens, needle tips (though the bag is also designed to hold vials and syringes). Room for much more, yet it folds up to a very small size. It also comes with a freezer pak for the summer. It is all shown here : Diabetic Supply – Dia-Pak – Dia Pak Deluxe (http://www.medicool.com/diabetes/diabetes_travel_dipakdel.php)
but I believe it is also available at Walgreens.

[TommyC1]

3. If I have a snack, do I need to take insulin? My doctor only informed me of taking humolog before meals, but is a snack a meal?

4. What happens if I eat a meal, and then like 30 mins or so later I'm hungry again...do I start the process over and take humolog, or is the previous insulin shot going to cover it?

Just so everyone knows, I'm taking humolog before meals and then 60 units of Lantus at bedtime.

Thanks!

I'm on Novalog and Lantus. I use pens and keep my novalog in my manpurse with my meter. I don't refrigerate it but I don't allow it to freeze or get over 85 dgrees F.

In general any carbs you eat need to be covered by insulin. But the insulin you take stays in you for a little while so you have to be carefull not to get too much by "stacking" doses.

I recomend you get a hold of "Think Like a Pancreas" by Gary Schiener. That covers all of your questions in fairly easily understood language.
I got mine from Amazon.

[strack350]

I use pens personally, and just stick them in my pocket along with a pen needle. Never had any problems. haha when I was using syringes, and vials. I would prefill a syringe with whatever I was taking and keep it in a cigar case. Worked perfetly and was the same size as the pens I now use:D I'm sure your not supposed to prefill syringes, especially mixed insulins but I never had any problems doing it:confused:

[xMenace]

Take it slowly!

Insulin is a dangerous substance. Make sure you are comfortable with your insulin regimen. Please consult your doctor or your diabetes educator for help on specific dosing questions like this. But please keep asking questions!

Yes we all know what we are doing, for us, at least we think we do. It is very difficult to tell someone else what to do even if we know your full details, which we don't.

Use your meter and learn to use it better. Test, Don't Guess!

[Erin]

Welcome! I agree with others about asking your doctor questions about when / how much insulin to take. Without knowing more about what you're doing, it is not easy for us to give that advise. :)

As for how to carry insulin around, after 10 years or so of having diabetes I completely gave up on keeping the open vial of insulin that I was currently using in the fridge. (I keep any back up supplies there until I'm ready to use them) I used to keep a bottle of humalog / novolog and a few syringes in an eyeglass case. I threw it in my bag and was good to go.

Room temp is fine for insulin. If you're going to extreme hot / cold temps then you need to think about insulation. Now I'm on a pump, so the insulin temperature thing is kind of a non-issue.

[Sunshinehoney]

Hi can you tell me where I get a skidaddle bag? Also I could not understand what the ratios people were posting were. My 14 yr old is carb counting and her nos. aren't as good as they were on the sliding scale. How do you figure you ratio of carbs to insulin

[DanG]

First off - I work in Schaumburg, just fyi.

1. I carry a preloaded 0.3cc syringe loaded with humalog in my lunch bag.

2. Yes - I prefill my syringe of Humalog with my day's needs and carry it to work - I don't like broken insulin vials.

3. A daily routine of exercise (or lack of exercise), eating, insulin will make your life easier with insulin. Any emotional surprise or physical surprise may really throw your blood sugars and sugar needs into a tizzy.

4. The best way to not be hungry after you eat is to eat real foods. Learn how to read ingredient lists so that you can wean your tastes away from processed foods - then you will not be hungry after eating and this question becomes irrelevant.

35 years ago when I started using insulin, the doctor told me I would know more than him about my diabetes. You can't pay a doctor enough money to care about you and your health. Doctors are slaves to the dollar just like all of us.

[shiftzor]

3. If I have a snack, do I need to take insulin? My doctor only informed me of taking humolog before meals, but is a snack a meal?

4. What happens if I eat a meal, and then like 30 mins or so later I'm hungry again...do I start the process over and take humolog, or is the previous insulin shot going to cover it?


The answer to the third question is the same answer to the 4th question, Test your bg. If you test your bg (blood sugar level) before you eat a meal or snack and then 2 hours later you will learn what will effect your blood sugar level. Testing one hour after eating a snack/meal will show you if the food is spiking your bg.

You need to watch out for carbohydrates in food. However not all carbs are born equal for example fibre is a carb but does not effect your bg. Reading labels on packaging will help you identify how many carbs on the item and will help you dose appropriately using an I:C (Insulin to carb ratio).

It all sounds like hard work to start with, however its not really. You get use to it and once you have learnt the effects different foods have on your bg you will know what to avoid. Just remember your body is different from everyone else's so you will have to work out what works for you and what doesn't. Some people can eat bread other avoid it like the plague. Forming habits is the best way of not forgetting and remember testing your bg is the only way to find out what is really happening.

I forgot to mention logging, either write down all your bg results with food items (carbs as well) or download the results to your PC and watch for trends. This will allow you to tweak all your doses to reduces the highs and lows, you only have to spend 10-20mins a week working out what needs to change. I personally like to catch reoccurring patterns as quickly as possible (I have a busy life like most) such as always going low in the afternoon, so I look at my patterns regularly and adjust doses accordingly.

Info about I:C (Insulin to carb ratio) (http://www.diabetesnet.com/diabetes_control_tips/carb_factor.php)