[viranth]

Right before I go to bed I check my BS and make sure it's not under 7mmo/l (was told to eat if it was). But lets say it's 5-6 and I decide to eat, and I'm hungry so I eat a solid meal with bread. I would then take 8 IE of novorapid right before the meal.

Since I'm tired I would then go to bed after 30 minutes or so, should I then set the same dose as every night with Insulatard? I usually set 10 IE, but since I just set 8 IE of Novorapid, won't that lower my BS quite a bit?

Almost same question, but after I came home from the hospital, I notice I'm quite hungry (lost some weight the week in hospital). So I can eat at noon, then at 2pm I'm hungry again. Do I still take 8IE insulin at both meals? Seems to be working, but I'm just afraid of taking too much and getting very low BS?

Thank you =)

[ant hill]

Originally Posted by viranth

Right before I go to bed I check my BS and make sure it's not under 7mmo/l (was told to eat if it was). But lets say it's 5-6 and I decide to eat, and I'm hungry so I eat a solid meal with bread. I would then take 8 IE of novorapid right before the meal.

I would forget the bolus as the O/night basel will fix that.

Since I'm tired I would then go to bed after 30 minutes or so, should I then set the same dose as every night with Insulatard? I usually set 10 IE, but since I just set 8 IE of Novorapid, won't that lower my BS quite a bit?

Insulatard is a slower insulin than Novorapid and Novorapid has a fast onset and will be finnished buy 4 - 5 hours and Insulatard is a longer lasting insulin and a onset of 2 - 3 hours and finnished at 10 hours. These insulins are mainly for meals.

Almost same question, but after I came home from the hospital, I notice I'm quite hungry (lost some weight the week in hospital). So I can eat at noon, then at 2pm I'm hungry again. Do I still take 8IE insulin at both meals? Seems to be working, but I'm just afraid of taking too much and getting very low BS?

The idea is to test often!! and understand to bolus small for small meals and the like.

What type are you? and welcome to the forums.

[viranth]

I'm type 1.

Right now it's a lot to learn, especially with how I react to the food I normally would eat.

For example oat meal, I had a portion of that this morning, with rice milk. No sugar. And my blood sugar at lunch was 16.6 (mmo/l). And this morning it was 8.2, so oat meal definately gives me high blood sugar.

If I were to do some physical stuff (short walk etc) right after the breakfast, would the blood sugar still be as high?

[xMenace]

Viranth, the Novorapid covers your food and adjustments. The trick is to find how much you need to take for every gram of carbohydrate you eat. We usually describe this as units per carb. The funky part is that it can change at different parts of the day. WHat you did before bed was more-or-less correct.

The Insultard (aka NPH) covers what's called our basal secretions, that is sugars released from our body's reserves. This happens 27/7. The rate can be steady but it can also be very up and down. We all have our own pattern that is actually quite consistant.

Now your problems. Eating and taking insulin before going to bed is very risky, especially where you are new and have no idea what you are doing yet. You could have overdosed and had a nice hypo event. One thing you may find is that you naturally drop in the middle of the night which means you may need to take much less insulin for befpore bed meals. I'd have set an alarm 2 and 4 hours later to get up and test.

Yes you needed the Insultard very much. Never skip it. I also suggest you find a better insulin. That is a medium term insulin which many people have had problems managing. ASk your doctor about Lantus or Levemir.

Yes you need more Novorapid for that afternoon meal. There is a direct relationship between it and the carbs you ingest. Learn your I:C ratios. Test often, vary meal sizes, and keep good records. You should be able to find a ratio that keeps you in range for most foods. large, high fat, or high protein meals are always trouble.

[viranth]

How do you accuratly find out what your I:C is? By testing and more testing? Or are there some guidelines as to how much carbs for example one IE of Novorapid deals with?

I have lost some weight, especially when I was in the hospital. So now I eat at noon, then at 2pm I'm super hungry, and then again at 5pm (dinner) I'm super hungry and low blood sugar. (5.6 or so).

So right now, the two meals after noon is where I am the lowest, while the 8-9pm meal I have is when I go pretty high up. Then that's the last meal for the night, but I was just wondering if I decided to stay up later than lets say 10 or 11pm...

I did test something today though, I ate three slices of bread (low GI) set 6 IE (usually 8IE) and went for a 30-45 minute regular walk. At dinner check I had 5.6 BS, so that means I don't need to set as much (when eating what I did) and if I do some physical activity.

I've done tests at the hospital, at 2am and 4am. At 2am it was usually lower than at 4am, and then higher again at 7-8am.

The doctors at the hospital said that insulatard was fine for me, I asked them about the other types, and they said they could be used if I had problems keeping the blood sugar steady. But since it doesn't seem like I have any problems atm, I didn't need it right now. I'll ask them again when I get back on monday (home for the weekend).

Want to thank everyone for their help, every new advice and experience shared is something I appreciate.

[viranth]

A few new questions:

I read about this "Abbott navigator" glucose real-time measuring device, anyone use that?

If I go out to a resturant, you don't always get your food quickly. So if I set insulin when I get the main course, but then have to wait maybe 30 minutes or so for dessert, do I set another shot of insulin? Will the first shot cover it? or do you have to use the I:C ratio? And wouldn't it be risky to bolus, and then they came out later and said there were no desserts?

Thanks =)

[JJM335]

Originally Posted by viranth

The doctors at the hospital said that insulatard was fine for me, I asked them about the other types, and they said they could be used if I had problems keeping the blood sugar steady. But since it doesn't seem like I have any problems atm, I didn't need it right now. I'll ask them again when I get back on monday (home for the weekend).

.

Your doctors' statements makes me really suspicious - are they specialists in treating T1 diabetics? The standard joke was that NPH stood for Not Particularly Helpful.

Many of us used Insulatard for years but like xMenace says it is peaky and the modern alternatives (Lantus or Levemir) are much much better. I use Lantus, and I can go to bed with a BG of around 6, confident that if I test at 3 am it will be between 5 and 6 and if I test at 6 am it will still be between 5 and 6! With Insulatard I always had to have a bedtime snack - even then I would often go low or wake up high!

I think you will find life so much easier with a better long-acting insulin. Please talk to your doctors again
There are some other threads on the board discussing NPH, you might want to check them out.

Joel

[viranth]

JJM335:

Thanks for the info. If Insulatard is older than Lantus/levemir, then I will definately talk to my doctor about it.

I'm a bit nervous for going to bed if I get close to 7mmol, because it will drop a a whole lot of points and then go up some points around 4 am.

The doctors I talked to so far are not specialists, they give you the basics. But when I get to the clinic in 2-3 weeks, then I will talk to people with much more experience and possibly specialists.

BUT, I can always say I want it and they will probably give it to me.

[DanG]

Originally Posted by viranth

I'm a bit nervous for going to bed if I get close to 7mmol, because it will drop a a whole lot of points and then go up some points around 4 am.

I hated the night-time lows - that was when I took lantus at bed time.
I read here on df about split dose lantus where part of the lantus is taken at breakfast and part at bed time. I tried that and shortly after starting that experiment, I had a nasty night-time low - actually, very early morning low, paramedics came to visit.
So, now I take lantus at breakfast and do not have early-morning lows.
You might think of switching to lantus in the morning - if you are taking lantus.
Another suggestion, in all seriousness - the doctor that told me I had diabetes when I visited the emergency room 34 years ago, said I would know more about this diabetes (my diabetes) than anyone. I count that as sage advice and pass it on to you. Do not depend on someone who is earning a paycheck to provide information - it is their job, and sometimes they don't know and sometimes they just cannot care. Depend on them for some advice, but certainly very few paycheck earners know diabetes - your diabetes - like you do. Be careful, watch and consider all that is happening around you as you do the insulin game.

[lilituc]

Originally Posted by JJM335

Your doctors' statements makes me really suspicious - are they specialists in treating T1 diabetics? The standard joke was that NPH stood for Not Particularly Helpful.

I've heard that in Scandinavia, NPH is used differently. Not everyone is on a fixed dose twice a day, but instead adjust and use a form of MDI that can actually work. So maybe that's why they said that? I'd still go for the Lantus/Levemir myself, though.

[Eddy]

Originally Posted by viranth

If I go out to a resturant, you don't always get your food quickly. So if I set insulin when I get the main course, but then have to wait maybe 30 minutes or so for dessert, do I set another shot of insulin? Will the first shot cover it? or do you have to use the I:C ratio? And wouldn't it be risky to bolus, and then they came out later and said there were no desserts?

Ah, you're getting past the science and into the art.

Personally, I like to measure/estimate my food, then shoot. Humalog and Humulin-R start working quickly enough that I rarely need to shoot and wait... I agree with you that shooting ahead of time would be risky.

You'll use the I:C ratio no matter what. However, keep in mind that different C converts to glucose at different rates.

Examples I've found: whole-grain rice pasta, I bolus 1:1:3 Humalog:Humulin-R:Humulin-N. Wild rice, nearly straight Humulin-N. Plain raw pineapple, shoot Humalog, wait 20-30 minutes, then eat it slowly. Rice milk? I stopped. Mountain Dew? Forget it.

Meal size also can make a difference. I normally eat a 5U-7U meal. When being gluttonous (read: ~15U), I need to replace ~2U of Humulin-R with Humulin-N; digestion is slow enough that I need additional NPH to slow my insulin dose.

[novorapid]

i'm kind of new to this to but for your information the insulin unit per carb, that i go by is 1 insulin unit per 10 grams of carbs, now some people may be different. so an example of this would be at lunchtime a tuna sandwich 2 slices of white bread 37grams of carbs that would be 3.7 units of insulin so we say 4 units the tuna itself 0 carbs, let say we drink an orange juice with that 1 glass approx 35 grams carbs so we need 3.5 units of insulin. so at lunch our bolus(fast acting insulin) will be a total of 7.5 units lets say 8 to make it a round number. hope this helps you understand the insulin to carb ratio a little better but remember you have to adjust yourelf to find what is best for you. good luck.


novorapid (bolus) 3 times a day)48 units a day.
levemir (basal) 2 times a day) 56 units a day.