Another insulin (etc) query!

[Sarmar7]

Two weeks since I started on MDI. For the last 3 days Ive been taking Insultard 20 units at 10pm. Going to bed with BG at about 7-8. Wake up at about 6-7 (or sometimes higher) Have breakfast (2 slices of granary toast usually) and then 2 hours later testing and BG is around 11-12.

Could it be that Im taking too little/too much Insultard or could it be the NovoRapid? After this things settle down during the day, with usually levels below 6 pre-meals, and 8 2 hours post.

Need some advice from the experts!

[seacomp]

could it be the NovoRapid?
You don't say how many carbs in the toast and how much Novorapid you are taking, but the first guess would be that you aren't covering your breakfast.

[Sarmar7]

Sorry!! Im taking 5 units with about 45 grams of carbs. I think this should cover it. It seems to have done the last couple of weeks, and Im very boring at breakfast and eat the same everyday!!

[seacomp]

Sorry!! Im taking 5 units with about 45 grams of carbs. I think this should cover it. It seems to have done the last couple of weeks, and Im very boring at breakfast and eat the same everyday!!
That's a 1 to 9 ratio. What's your ratio at other meals? Some members have reported that they need a high ratio at breakfast.
If you have permission from your doctor to vary dosage, why don't you try uping it, just a little.

[Sarmar7]

1 to 12 at other meals. They have given me permission to vary so I will try it. I have found that Ive needed to up my lunch and evening doses too.

[rzrbks]

That's a 1 to 9 ratio. What's your ratio at other meals? Some members have reported that they need a high ratio at breakfast.
If you have permission from your doctor to vary dosage, why don't you try uping it, just a little.

I'm one of those,

Breakfast is 1:6 (if I have regular coffee)

all meals without regular coffee 1:15

[koblenz]

Have you tried skipping our breakfast meal, and testing throughout the morning?

If you skip breakfast, and you stay pretty stable, then it sounds like a morning bolus issue. If you go high without eating anything, then you may want to evaluate the Insultard dosage/timing/etc.

Just a thought.

[rea]

I would raise your fast acting insulin dosage a bit, or, try eating some protein with your breakfast.

[Sarmar7]

Ill try that on Saturday. Think I need my breakfast when Im working tomorrow!

It might also explain things with the ratio's too.

Ill be back for advice if thats OK!

[DeusXM]

Sounds to me like you're probably not getting enough bolus insulin to cover your breakfast and what is probably a case of dawn phenomenon.