Insulin shot timings

[wael]

Hey folks,

When do you guys normally take your insulin shots? I usually take 3-5 units of Novorapid before lunch (and occasionally dinner), and 10 units of Levemir before going to bed. Let me know your numbers...

[jenb]

You must really be honeymooning if you're able to limit your boluses to one meal a day and such a tiny amount of Levemir!

On normal days I inject about 2 units of Novolog 20 to 30 minutes prior to each meal depending on BG and what I'm eating, then a half unit or so 30 minutes after the start of the meal. For social events I start with 2 to 3 units, then do hourly boluses and BG tests as needed. As for Levemir, 10 u @ 10:15 p.m., 6 u @ 6:15 a.m. and 3 u @ 2:15 p.m.

Jen

[xMenace]

I bolus 20-30 minutes before I eat, and the quantity depends very much depends on what I'm eating. Typically it's 4u, 6u, and 10u for meals then whatever for snacks. I bolus from 20 to 40 units of Novarapid a day. I aim for the lower number. I also inject Novarapid as my basal insulin every 3 minutes. I inject 23.1 units per day. I vary my dosages by the hour, most hours. I change my rates 16 times a day. My highest rate is 1.85u per hour at 6am to cover my dawn phenomenon and my lowest rate is 0.40u per hour at 11am because I need very little in the afternoons.

[networkguy]

I typically bolus 10-20 minutes before eating, and the amount depends on what Im eating. 1u for every 5g of carbs. My basil total for the day is 35.20u.

[Bountyman]

I inject 27 units of Lantus around 7 o'clock at night, then retire to a little TV. There was some question about how long Lantus lasted as a basal insulin so I tried an experiment yesterday. Medicare only covers three tests a day and my PA-C would rather I test my FBG, then my after-breakfast BG and after-lunch BG, so I have no idea what my BG is until the next morning.

Last night before dinner at 6 o'clock, 23 hours after the night before's injection, I tested my BG. 74 mg/dL. I guess it does last 24 hours. That, or I'm growing back my beta cells.

I feel for those that have to do multiple injections and tests during the day. Somehow (knock on wood) I've dodged the horrors of this disease.

I had labs done on November the 4th. Everything was within specs except my Hdl Cholesterol L 33 [40-60] and my A:G Ratio L 1.09 [1.1-2.4]. I looked over the results looking for a C-Peptide test but it seems they didn't do a C-Peptide test. I was curious to see if the test showed any human insulin.

I guess if I stopped taking my basil insulin for few days it should show up on my BG tests?

[Subby]

Boutyman, as a type 1 if you don't take either basal or bolus you should typically have escalating BGs quickly and possibly need a hospital within a day. But as we've touched on before... you just don't seem to have this level of insulin dependency that usually underlines type 1 - it appears you still have a lot of internal insulin, so are either honeymooning or type 1.5, or a misdiagnosed type 2. I'm not pushing that, and in the end what state your pancreas is in, is somewhat secondary to if your treatment is working, if it is working well. But that's what would typically happen if a type 1 didn't take shots for carbs or missed basal shots. Bad things quite quickly. As this condition can be so individual, and as the most important thing is to stay safe and well, paying close attention to how your own body responds to insulin/lack of insulin is the best thing (and you seem to do that very well).

[Bountyman]

Never sick a day in my life, ever, until new-onset diabetes. From what I've read about diabetes, since being diagnosed, there were signs of this coming from the last 2 years. I just thought I was getting old and accepted it. I'll be 67 the day after Christmas.

For the last 5 years I've been very sedentary due to a motorcycle accident that broke my back. Not riding pulled the wind from beneath my wings. Sadly, it defined my lifestyle. I withdrew into the computer and formed forums that were motorcycle oriented and tried to help people keep their rides in good tune, shared stories and handed out a few words of wisdom.

I gained at least a pound and a half a month from eating whatever I wanted to eat, whenever I wanted to eat it, and I drank exactly 3 gallons of whiskey a month. That's 1½ lbs. X 60 months. At 6'1" I went from 180 lbs. in 2004, to 272 lbs. when they weighed me at the hospital. I was also diagnosed with hypertension and hyperlipidemia and prescribed Lipitor 20MG and Lisinopril 20MG.

Just before I went into the hospital I would get winded peeling an orange and couldn't stand any longer than 5 minutes without excruciating lower back pain...and couldn't walk any farther 50 yards.

5 months later and I've lost 26 pounds, I walk uphill to the mailbox 200 yards away and then back. I have no pain in my back anymore, I sleep through the night to where before I was getting up several times a night and napping in the daytime. I no longer need a nap.

Candidly speaking, getting diabetes has been the best thing to happen to me since my testosterone level dropped to zero and I stopped chasing women!

I'm not sure if Medicare would pay for a C-Peptide test, or if they care rather I'm a Type 1, Type 1.5, Type 2 or a typewriter. I can't remember any of the males in my family ever being sick. They all lived to be over a 100 years old. When my father was 98 I had to put him in an assisted living place. He finally withered down to where he was bedridden at 99. Towards the end there he thought I was his brother, kept calling me Frank every time I came to visit and kept asking me how old he was. My sisters and I had a little party for him at the home on his 100th birthday. A little cake (my sister fed to him) a couple balloons, small talk and then he went to sleep. He died in his sleep that night. That's how stubborn that sumbìtch was.

Dang! I ain't usually this chatty. Sorry.

Anyway, I think not taking my insulin and monitoring my BG every 2 hours would tell me rather I'm producing my own insulin, don't you think? If it starts to get out of hand, like going past 180, or so, I can always grab my pen and inject my Lantus.

Here's the numbers I recorded. I seem to have bounced back fairly fast, I think:

7/4 3:00pm BG 530 mg/dL - HbA1c 15.3 at the ER
7/9 discharged Type 1 ["your pancreas has stopped producing insulin"]

7/9 nightime lantus 15 units
7/10 5:20am 231
7/11 10:00am 223
7/12 10:00am 215
7/13 8:00am 239
7/15 9:30am 189
7/15 nightime lantus 20 units
7/16 7:30am 173
7/17 8:00am 157
7/18 11:30am 168
7/20 9:30am 188
7/21 8:00pm 167
7/22 12:30pm 157
7/23 1:00pm 134
7/25 12:00pm 145
7/26 11:00am 136
7/29 8:00pm lantus 22 units
8/1 8:00am 119
8/6 nightime lantus 25 units
8/7 8:45am 125
8/8 9:00am 110
8/9 9:00am 106
8/12 10:15am 104
8/15 10:00am 103

9/15 8:30am 103

10/15 8:00am 94

11/15 8:30am 90
11/16 nightime lantus 27 units

12/12 9:30am 77

After breakfast (2 hrs) numbers nowadays are below 100
After lunch (2 hrs) (eating at least 60 grams of carbohydrates) under 110)

[Subby]

Bountyman, you do seem to me to need the insulin (I'd guess what you take would floor a non diabetic, although I can't be sure) but this lack of needing the food bolus... well that insulin must be being provided by your body, else you would go high as a kite after the meal. So you seem in a halfway state with your internal insulin supply. I think this is a good thing. You've got more natural attributes to work with than a pancreatically barren T1 like me.

I guess you could run experiments on yourself without the insulin, to see if your control holds or how well it holds. Always gotta say be careful - but you obviously know that.

The benefit to you to just consider if maybe you are T2, and the only reason I bring it up (I don't think it's that important in other ways) is you just might be able to ditch the insulin at some stage if you are, if you want to. Or reduce it. Drugs, and/or diet and/or exercise might be able to sensitise your body to the remaining internal insulin you have.

[Subby]

To answer the OP I take bolus insulin whenever carbs pass my lips, or whenever my BG is out of range enough to justify a correction. I also use my pump to provide basal insulin throughout the 24 hours, with different basal rates set through the day for my unique basal profile. So I look at it simply as:

- Food bolus using the correct I:C - with food
- Corrections using ISF or CF (correction factor) - when needed
- Basal insulin provided by pump basal rates (or at other times, 3x injections of Levemir through the day) - continuous coverage

[Bountyman]

Thanks for the insight, Subby. I think I'll hold off on the self-testing until I've lost some more weight and feel my body has somewhat settled in. If my pancreas is in fact in some type of recovery stage that should show on my numbers and I would then dial back my Lantus usage accordingly.