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Is ONE Unit of INSULIN Equal?

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"Think Like a Pancreas" by Gary Scheiner

"The more you weigh and the more insulin you take, the less every unit will lower your blood sugars." Pg 128

 

Sensitivity to Insulin based on Daily Insulin Useage - How much 1 unit lowers Blood Sugar

 

To determine your sensitivity factor:

 

Figure your average total daily insulin

Divide it into both 1,500 and 1,800.

The result is an approximate range of how much one unit of insulin will lower your blood sugar.

 

Example: 1500 / 28 = 54

1800 / 28 = 64

This means that every unit of insulin should lower BS approximately 54 – 64. (To simplify round off to 60.)

 

Is this "formula" the same for all types of insulin? Whether you take only rapid? Whether you take in longer acting? Whether you use a 70/30 Mix? Is ONE Unit of INSULIN Equal? *regardless of which type of insulin?

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The 1500 rule applies to using fast acting insulin (Humalog, Novolog or Apidra) to do corrections. The 1800 rule applied to doing this with Regular. Basal insulin is not intended to bring blood sugar down and we need to use dosages that keep BG at a constant level. These rules also can't be applied to the use of mixed insulin because it contains both fast acting and basal.

 

I don't find the 1500 rule that useful. I find the amount of insulin required to correct a high depends a lot on the the level of the high, and a linear formula just doesn't work.

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I have the same experience as Blue Sky. It proportionally takes more insulin for me to lower a 300 to 100 than it does to lower a 150 to 100.

 

My correction factor is about 50 (changes during the day) so it takes one unit to go from 150 to 100. It would take me 3.75 units to go from 300 to 100 if all other things are the same.

 

Each person is different and my own experience is that the same person can be different under different circumstances such as illness, stress and other influences.

 

My experience with 70/30:

I found it easier taking extra injections and having better control of my basal and my bolus insulins. Even NPH (with no regular) with its 8 hour peak was a nightmare if I was sick and throwing up--trying to keep track of how much insulin I had to "feed" when I couldn't keep anything down. After switching, I did very well on Lantus and Humalog.

Just FYI.

 

Mich

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The time of day matters too. During early mornings I'm using about three times the correction dose I use in the afternoons or around midnight.

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"I have the same experience as Blue Sky. It proportionally takes more insulin for me to lower a 300 to 100 than it does to lower a 150 to 100.

 

My correction factor is about 50 (changes during the day) so it takes one unit to go from 150 to 100. It would take me 3.75 units to go from 300 to 100 if all other things are the same.

 

Each person is different and my own experience is that the same person can be different under different circumstances such as illness, stress and other influences."

 

That is true in my case for sure. Diabetes has more wild cards than a riverboat gambler. About the time I get everything leveled, for no reason I suddenly need to change my insulin rates. Then it starts all over again. It sure gets frustrating, doesn't it?

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yup, i gotta agree with everyone

 

if my bg is 9, then 1 unit of insulin will drop my bg too much, so i simply reduce my carb intake for that meal

 

if my bg is 15, then i need 15 units of insulin to 'bring it back into range'

 

go figure! i can't :)

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I'm a bit confused by this.

 

I take 10 of Lantus. How much wouls making that *11* change my bg?

 

Lantus is a basal insulin meant to cover your basic underlying glucose output of your liver. If you were taking exactly the right amount of Lantus, your BG would stay the same as that reached 4 to 5 hours after a meal; it wouldn't go up or down.

 

If you then increased the Lantus by 1 unit, then your BG would slowly drop over the course of the day; after 24 hours you BG would be down 20, 40 60 points depending on how sensitive you are to insulin.

 

In your case, I suspect that you are a Type 2 taking a small dose of Lantus to "help out" the other medications or treatment. That's because of 1) you are taking ONLY Lantus, and 2) you are taking such a small dose. The same general considerations apply in your situation, but it is differeent from what what I do and most people on the forum do, so exactly what happens is hard to tell.

 

If your blood glucose stays rather high, say above 130, then I'd just try increasing the dose and seeing what happened. You need to wait about 3 days before you can tell exactly how a change works. I and many other, started at 10 units and then worked our way up to what is really effective for good control. I, for example, take over 50 units of Lantus per day (plus short acting Humalog also).

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I'm a bit confused by this.

 

I take 10 of Lantus . How much wouls making that *11* change my bg?

The 1500 rule doesn't apply to Lantus, for the simple reason that you will probably eat several times while the daily Lantus dose is active. But you may see a gradual decline in the numbers over the 24 hours after injecting. Do 11 units of Lantus for a few days. And if blood glucose drops too much, just change back to the 10 unit dose. ;)

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I had no idea that 1 unt made such a potentially large difference. Seems like the delivery system (pen) would have more than that much error in it..

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I do not even attempt a unit, unless I am over 200 LOL....I know, I am very fond of .5, and .4, sometimes it lowers me too much....I hate extremely hate correcting....I thank God I have the pump....because I'd be dead on the floor from all the insulin sensitvity I have...

 

When active I can be 1:100 high fat, I am stubborn it can be 1 unit to 60.....if I am high, high, I have to be really carful...I thought it would be ok to correct a 300 with three units once NOPE....I have to use 2 units and suffer the massive drop, and try not to be paranoid of the outcome...

 

it's not as fun, or the greatest to be so sensitive sometimes...

 

Cheryl

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Will anyone enlighten me how much one unit of intravenous regular insulin lower blood sugar intraoperatively in a diabetic patient

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Will anyone enlighten me how much one unit of intravenous regular insulin lower blood sugar intraoperatively in a diabetic patient

 

Everyone has a different Insulin Sensitivity Factor - how much one unit will change your blood sugar. There is no one answer to this. 1 unit for me drops my sugar about 40 points. Others will have VASTLY different results.

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If Im under a BS of 200 (which is 95% of the time) 1u of Novalog lowers me about 40 points. However, at a 300bs, I need about 1.3u for the same drop of 40 points.

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If Im under a BS of 200 (which is 95% of the time) 1u of Novalog lowers me about 40 points. However, at a 300bs, I need about 1.3u for the same drop of 40 points.
I get about a 30 point drop for each unit of insulin midday to bedtime. I need 1.5 units for that same drop from wakeup 'til noon. I use the Lantus and Novalog pens -- how do you guys get these .4/.5 amounts? Are you using syringes and viles instead of pens?

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Just to reiterate the most important point

 

insulin activity is not "one size fits all"

 

If I need to lover my blood sugar from 180 mg/dl (10 mmol/dl) to 125 mg/dl (7mmol/dl) ... I would need to take 550 units of insulin.

 

that means that 10 units of insulin reduces my BG by 1 mg

Most diabetics with no insulin resistance will see a ratio of between 1unit = 15-18mg ...

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Just to reiterate the most important point

 

insulin activity is not "one size fits all"

 

If I need to lover my blood sugar from 180 mg/dl (10 mmol/dl) to 125 mg/dl (7mmol/dl) ... I would need to take 550 units of insulin.

 

that means that 10 units of insulin reduces my BG by 1 mg

WOW!! :eek: Now THAT'S what I call IR!!! That's unimaginable. And how does a Type 1.5 have that much IR anyway? I'm still pretty IR at 70lbs overweight -- but I still only need about 1 unit = 25-30point drop.

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Just to reiterate the most important point

 

insulin activity is not "one size fits all"

 

If I need to lover my blood sugar from 180 mg/dl (10 mmol/dl) to 125 mg/dl (7mmol/dl) ... I would need to take 550 units of insulin.

 

that means that 10 units of insulin reduces my BG by 1 mg

Most diabetics with no insulin resistance will see a ratio of between 1unit = 15-18mg ...

 

Good Lord thats crazy and its the first time Ive seen anything like this. Do they make a concentrated type of insulin and how often does this happen to you?:eek:

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I've found with me to do it this way I check bg,then I take 120 from that amount,and then I take 15 into that,and the multiply 7,because that is "MY RATIO",I have discovered.

So say if my bg is 180,minus 120= 70 ,divide by 15=4,then 4 times 7=28, so 28 units for me,brings it down to normal range,I can't say by what,because sometimes it's more efficient and some times it's not. Thats why you have to try and try again,until you reach your own "place". This is what has worked for me,for now.

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I've found with me to do it this way I check bg,then I take 120 from that amount,and then I take 15 into that,and the multiply 7,because that is "MY RATIO",I have discovered.

So say if my bg is 180,minus 120= 70 ,divide by 15=4,then 4 times 7=28, so 28 units for me,brings it down to normal range,I can't say by what,because sometimes it's more efficient and some times it's not. Thats why you have to try and try again,until you reach your own "place". This is what has worked for me,for now.

 

Great formula, how did you come up with it and how long would it normally take for you to come down and to what final bg level? This is something Im still having a hard time with and don't fully understand. Your input is greatly appreciated.

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Just to reiterate the most important point

 

insulin activity is not "one size fits all"

 

If I need to lover my blood sugar from 180 mg/dl (10 mmol/dl) to 125 mg/dl (7mmol/dl) ... I would need to take 550 units of insulin.

 

that means that 10 units of insulin reduces my BG by 1 mg

Most diabetics with no insulin resistance will see a ratio of between 1unit = 15-18mg ...

 

:eek: Did you typo?

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This worked for *me*

I am type 2. I'm talking about quick acting humlog pen

 

At first

1. I went to a diabetic dietician and she figured out my sensitivity and she gave me a book that is a life saver :The Calorie King Calorie Fat and Carborhydrate Counter. She entered my sensitivity level and carb:insulin ratio into this spreadsheet

http://www.integrateddiabetes.com/gary_s_dosage_calculation_form.xls

 

So I have my handy pocket book and my spreadsheet. I go to a restaurant, look up my meal in the book figure out the carbs then give myself the dose I need based on the spreadsheet.

 

Then I found a little blurb on a website on how to figure out how much insulin you need. Try as I might, I can not find that site, but I remember what I did.

 

I waited until my BG was outside of normal. At the top of the hour, I gave myself 10 units of fast acting. I tested my BG every 1/2 after that. I did this several evenings in a row. I was able to determine that My BG went down approx 43 points(4.3 reduces it by 1 point) in an hour. So when I test and I see that my BG is say 240 and I want to be at 120, I know to reduce it by 120 points. I'm going to need 30 units. 43x3=129. this has not failed me yet and I've been doing it this way for a year.

 

I have not yet figure in lantus or metformin which is why I don't reduce it too far. I don't want to bring it down to 90 only for lantus or metformin kicking in and laying me flat.

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that means that 10 units of insulin reduces my BG by 1 mg

Most diabetics with no insulin resistance will see a ratio of between 1unit = 15-18mg ...

 

I realize this is old, but it's flat out wrong. A diabetic with no insulin resistance could expect 1u to drop them about 50mg/dL. A very thin T1 (or children) could expect more of a drop.. excess weight contributes to varying degrees of IR in everyone, so obviously if you are heavier, your ISF will be lower. I've actually heard it said that anything LESS than the standard 1:50 ratio is a sign of IR... it makes sense to me. It's kind of like the standard 1u for 15g CHO.. it works for some, but not for all.

 

Anyways, my ISF decreases as my BG rises.. so the corrections that work when I'm under 200 don't work as I go above 200, and especially over 300. One of the great things about my Ping is that it's really easy to override the ISF on the pump. I always override mine if I am really high, and almost always give a shot of what it calculated instead of a bolus if I am over 300.

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This worked for *me*

I am type 2. I'm talking about quick acting humlog pen

 

At first

1. I went to a diabetic dietician and she figured out my sensitivity and she gave me a book that is a life saver :The Calorie King Calorie Fat and Carborhydrate Counter. She entered my sensitivity level and carb:insulin ratio into this spreadsheet

http://www.integrateddiabetes.com/gary_s_dosage_calculation_form.xls

 

So I have my handy pocket book and my spreadsheet. I go to a restaurant, look up my meal in the book figure out the carbs then give myself the dose I need based on the spreadsheet.

 

Then I found a little blurb on a website on how to figure out how much insulin you need. Try as I might, I can not find that site, but I remember what I did.

 

I waited until my BG was outside of normal. At the top of the hour, I gave myself 10 units of fast acting. I tested my BG every 1/2 after that. I did this several evenings in a row. I was able to determine that My BG went down approx 43 points(4.3 reduces it by 1 point) in an hour. So when I test and I see that my BG is say 240 and I want to be at 120, I know to reduce it by 120 points. I'm going to need 30 units. 43x3=129. this has not failed me yet and I've been doing it this way for a year.

 

I have not yet figure in lantus or metformin which is why I don't reduce it too far. I don't want to bring it down to 90 only for lantus or metformin kicking in and laying me flat.

Wow --- that spreadsheet is AMAZING!!! SO helpful. I know my I:C ratio -- but how do you calculate SENSITIVITY and EXERCISE FACTOR? And I wonder how the Lantus would factor into it. Well Lantus ONLY affects fasting numbers.... so it shouldn't be in the equation at all I think.. Anybody have any insight on that?

 

Thanks for the chart.. Looks like I can adapt it for myself and change the numbers..

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