[grace girl]

In a previous thread you guys have explained stacking to me, and it's just led me to more questions.
When I first went onto this MDI routine I was under the impression that it was very similar to the pump. But there are few aspects that no one (dr or DE) have explained to me.
So, I'm going to throw a few questions at you.

1. In theory, if, say two hours after dinner someone offers you dessert, can you take a shot of your fast acting for that? Will it over lap with what you took two hours previously at dinner? I am assuming that to do this you would only shoot to cover the carbs you were consuming...

2. My DE has asked me repeatly if I made corrections with insulin in between meals on days that I was high. I always tell her that I haven't been instructed as to how to do this. If your in between meals, how does this affect you when you shoot for the next meal?
Is this a regular practice with MDI?

There's still so much I don't know! I can't decide of this endo is just doling out info to me a little at a time, or if he just has no plans to at all!

[camjen1]

My doctor wants me at a certain number before meals and if I checked and was above this number I would have to add in my correction bolus with my meal bolus. Now if I did all this correctly and my boluses are accurate I should be in normal range 2 hours after my meal.

Do you have a correction factor yet? For instance, for every unit of insulin you take it reduces your levels by this much.

Taking a correction in between meals is not going to affect you at all unless of course your correction factor is wrong to where it either didn't lower your numbers enough or it lowered them too much.

[grace girl]

Originally Posted by camjen1

My doctor wants me at a certain number before meals and if I checked and was above this number I would have to add in my correction bolus with my meal bolus. Now if I did all this correctly and my boluses are accurate I should be in normal range 2 hours after my meal.

Do you have a correction factor yet? For instance, for every unit of insulin you take it reduces your levels by this much.

Taking a correction in between meals is not going to affect you at all unless of course your correction factor is wrong to where it either didn't lower your numbers enough or it lowered them too much.

Yes, I do have a correction factor, and I use it with every meal. But if I go high late in the evening she always asks me if I corrected for it....which I've never been instructed to do, so I'v wondered if it was just something I haven't been told about.

[Keezheekoni]

Originally Posted by grace girl

1. In theory, if, say two hours after dinner someone offers you dessert, can you take a shot of your fast acting for that? Will it over lap with what you took two hours previously at dinner? I am assuming that to do this you would only shoot to cover the carbs you were consuming...

You just described stacking. Yes it will overlap, but that's technically okay...especially for dessert.

Originally Posted by grace girl

2. My DE has asked me repeatly if I made corrections with insulin in between meals on days that I was high. I always tell her that I haven't been instructed as to how to do this. If your in between meals, how does this affect you when you shoot for the next meal?
Is this a regular practice with MDI?

Basically if you are over 150 mg/dL before a meal, then you use your correction factor to get you below 150 *plus* take your normal insulin:carb ratio. Example: My correction is 1:20, over 150 and I have a 1:5 carb ratio. If I'm at 195 (Heaven forbid!) before my next meal, and I'm going to eat a meal that has 50 carbs, it'll look like this:

Correction=3U to take me down: 195-(3x20)=135
Carb Count=50 so take: 10U to cover the meal
Total: I will take 53U just before that meal

Clear as mud?

Originally Posted by grace girl

There's still so much I don't know! I can't decide of this endo is just doling out info to me a little at a time, or if he just has no plans to at all!

I think part of what you are seeing is him not trying to scare you off and make you not do a thing for yourself. My dh's doctor just started him out on 500mg of metformin 3 times a day, even though his A1c is 11.5! He actually told him that it really was so that he wouldn't be scared away and not return for follow up appointments. My dh is one of those who won't go to the doctor even if his leg is broken! LOL

Rikki

[seacomp]

Originally Posted by Rikki

Correction=3U to take me down: 195-(3x20)=135
Carb Count=50 so take: 10U to cover the meal
Total: I will take 53U just before that meal

I'm a T2 on insulin using MDI and I both "stack" insulin shots if needed, and take non-meal corrections.
Rikki example is similar to what I would do, except that were I that high, I would take the correction separately. Then I'd wait at least an hour, test again, then eat (that, of course, when I'm in a situation to postpone the meal). That's to eliminate putting an estimate on top of an estimate, and because I find the insulin dosing to be linear only around the normal point That is, I require more insulin to drop a 100 points from 350 then from, say, 200.
(Rikki's quote has a typo I think, the tital insulin is 13u not 53u.)

[Keezheekoni]

Originally Posted by seacomp

(Rikki's quote has a typo I think, the tital insulin is 13u not 53u.)

Eeek! Yeah, I'm just trying to kill myself in that example!

Thanks, I'd fix it, but I can't edit it. Just my luck!
Rikki