Huge bg drops

[corwin]

I'm confused again and can use some advice. I just started doing correction shots when I'm too high and I'm having a hard time figuring it out. Yesterday was a perfect example. I miscalculated a meal (high fat & carb content with only 5 units of novo), tested 2 hours later and I'm 245, waited another hour and I'm 280. Then I took 1u novo, trying to be carful, an hour later I'm 317. At this point I took 2 more units. 2 hours after that I'm 128, I figured it was a huge drop but not too bad. An hour later before the next meal I tested 91. Then I started eating and went badly hipo during the meal, took me a long time to recover probably becase I was eating slow acting carbs and high fat meal. Obviously I felt really bad untill I was stable again.

I'm trying to figure out what I did wrong. I probably should've noticed I'm going low too fast and corrected earlier with some juice. I'm also really surprised about the huge drop, it seems like 1u drops me over 100 point, could that be? It seems MUCH higher then I thought. What other things should I do and notice next time something like this happens?

Thanks in advance,

Corwin.

[sbuff28@charter]

You havto give the insulin time to work its magic. Usually it lasts over 5-6 hours so your definatly overlapping and compounding the insulin when you take multiple shots. This makes it a lot harder to do a mind calculation on what you need to eat.

It's kinda hard to understand exacly how much insulin and when and what you ate. did you bolus for the meal you went hypo in? how much?

You obviously underestimated the first meal...which is obvious. Then overcorrected, which is completly understandable since your new to this. This is how i would go about it next time you underestimate

1. wait 2 hours after meal, then if 300+ give yourself that extra 2-3 units of novo, that seemed to be perfect to bring you back to normal. Then test 2 hours later, eat like 10-20g carbs if neccisary 5+ hours later.
2. wait 2 hours after the meal, If 200-300 do take 1 unit of novo, test 2 hours later, then eat 10g carbs if neccicary.
3. wait 2 horus after a meal, If 100-200 do nothing! If still high (say 150+) before next meal take 1 unit extra. test 2 hours later.

If you do this and continue to run high day after day, then increase the correction by 1 unit at a time.

Try and figure out what your carb ratio is, It will help you judge your correction much better.


Only take one correction bolus inbetween meals and keep it at least 2-4 hours apart and give it time. Don't worry about going high, its a learning process and it wont be perfect to start off with. Also If eating your 2nd meal within 3 hours of a corection bolus i would subtract 1 unit from your meal time bolus to be safe.


1 unit drops me 100 points so thats normal!

[Erin]

It is really hard to do corrections without knowing your correction ratio. Did your doc give you one? Mine is 1 u : 40 mg/dl meaning, one unit drops my bg 40 points. You need one of those. then you can say, I want to be at 100, my bg now is 300, so i need to take x units of insulin. And like sbuff said, give the insulin time to do its work.

[Cinnabon]

It is really hard to do corrections without knowing your correction ratio. Did your doc give you one?

Your ratio is so important for corrections,this it will make a HUGE difference.

[vrocco1]

There are actually three ratios you need to know, and you will learn them over time. The first is; if I eat x carbs, how many units of insulin should I take? The next is; how much does one unit of insulin lower my BGL? The last ratio is; if I eat one gram of carbs, how much does it raise my BGL? The three ratios are related. If you find any two of them empirically, you can calculate the third. Check out insulin-pumpers.org for more info and calculators.

[Shotokan]

Another thing you will learn is the amount of time that insulin stays active in your system and the rate at which it gets "used up".

It varies slightly from person to person. For me, Novolog has very little effect after 4 hours. Therefore, my insulin duration is 4 hours. If I assume that insulin is "used" at a constant rate, then 25 % of the insulin is used up every hour. At two hours, I could assume that 50 % of the insulin is still active (yet to be used).

This remaining active insulin is sometimes called the amount of "Insulin on Board (IOB)". If you measure your BG at the two-hour mark, you can then estimate how much further your BG will drop over the next two hours because of your remaining IOB. If your IOB is not enough to drop your BG to your target, then you can inject just enough extra insulin to drop it to your target (when added to your IOB). But, of course, it will take another 4 hours to achieve your target BG (assuming you have a 4 hour duration).

In reality, insulin is not used exactly at a constant rate. However, the Cozmo insulin pump uses that approximation (other pumps use a slightly different formula).

Here is the website that another poster referred to that has all the details:
http://www.insulin-pumpers.org/howto.shtml

[corwin]

sbuff: Great plan, seems very logical, I'm going to follow it. I calculated my carb ratio to be 1:20 and was pretty happy with it, now it seems to go even higher, I think I'll guess 1:25 now and see how it works. Seems like my honeymoon is advancing.

Erin: No my doc didn't give me a correction ration, in fact he didn't even tell me to correct. However when I saw I'm over 300 I decided to do it myself. I let him know after I did and he seemed to agree it's at least 1u for 100 and I need more experience to figure it out.

Cinnabon, vrocc: I totally agree and I'm trying to figure out this ratio. The only one I thought I know was the insulin\carb which was 1:20 but now this seems to change as well.

Shotokan: Yet another thing for me to learn. I'll try to figure out the duration as well.

Thank you all so much for the great advice, the disease would've been so much harder to manage without this great forum.