A need advice

[portok]

Hy everyone.
I really need some help if you experienced the same thing.
First of all i`m on lantus and i use humalog to cover what i eat.
So until 2 weeks ago everything went great i had good control and good HbA1. When i had values of for exemple 200 i used to take 2 unit of humalog and after 2 hours my value was 120. In that moment i use to eat and do my usual dose of humalog.
But now something changed. My values are not very good because i had some digestion problems, which now are solved.
When I want to correct a value of 280 and i take 2 units of humalog, after 2 hours i have 200 which is normal. But the problem is that if i want to eat after that correction, and i eat the normal amount of carbs and make my usual dose of humalog in one hour my values are dropping rapidly going even to hypo. Even if i have already eaten.
I really don`t understand what is happening and i`m very scared.
I don`t know if i made myself clear i hope i did and that you can help me with some advice.

Thank a lot.

[JediSkipdogg]

THere are two factors to figure for how much insulin you need to take when giving a shot. You have the first one down and that is the correction factor. It appears you have a 1:40 correction factor in that 1 unit of insulin brings your BG down 40.

The other number is your insulin to carb ratio. You may have had that perfected in the past, but whatever digestion problems you had changed that. I have a insulin to carb ratio of 1:19, so 1 unit of insulin covers every 19 grams of carbs I eat. My guess is that your stomach/digestive system is now digesting carbs differently and has changed whatever ratio you had before. You need to figure this new ratio out by possibly trying to cut back maybe 10% of the humalog you take.

I hope this helps, ask if you don't understand something.

[portok]

Thank you very much for your response. I really didn`t thought of that, that my digestive problem could change my ratio.
I really hope that i can solve this problem soon because i`m very scared that i can go very low and even if i eat sugar it will continue to go low and......
I hope that i can put myself together and regain my confidence, because right know i`m very scared of what can happen.
Can you tell if this kind of changement in carb/insulin ratio can happen often because i see that you have more experience. I have diabetes for 2 years.

Thank you again very, very much for your response.

[JediSkipdogg]

If you are sick, forget about anything with control. Other than that, your carb/insulin ratio will change slowly over time. It won't make any drastic changes overnight unless something else in your body makes it change (usually being sick or medically ill in some way.)

I wonder how solved your digestive problems are. If they made a permanent change in your ratio or if it's only temporary until it all gets better. I really can't answer on that part.

[Erin]

If you eat 2 hours after a correction with a blood sugar of 200 do you correct again?

If you are taking a second correction bolus (for the high bg, not the food) the overlap from the previous correction could cause you to go low. (The first shot had not finished doing its work and then you take more). Humalog can take up to 5 hours to be completely out of your system.

If you're not double correcting then I think JediSkipdogg is right on all points.