Bolus calculations help needed (sensitivity to insulin) - a la Think like a pancreas

Type 1 and LADA
#1

I'm reading Scheiner's Think Like a Pancreas. According to Table 7-4 Sensitivity to insulin based on daily insulin usage, I would be somewhere below the chart (less than 5) and max about 7. My Lantus is presently 4 and seems to be working ok. Morning fastings ~ 90 - 100 for the past 4 days. My bolus (novolog) may be between 1 - 3 (usually) - unless I have to eat out (that's a whole different story). Total daily insulin dosage : 4 + units.

How would I correct if my BG were >140 but around 200? 1 unit of insulin would decrease my BG by too much. (maybe 1/4, or 18 unit may work) Thus, I've been thinking about a pump. I've considered diluting the bolus insulin too. I'm unsure that I would be comfortable doing this, just in case I get my basal mixed up with my bolus.

#2

I use very little insulin; at 19 years with Type 1, I use 20 units TDD in my pump (and I am not some skinny little thing). I really think that the pump is excellent for those of us who don't require much insulin--and you really don't use much!!! It's hard to tweak down if you can only go at half unit increments. Just my two cents.

#3

I have definitely been thinking about the various options: the tubeless pod, the ones that incorporate the Dexcom...etc The discussions on this site have been informative, especially about site rotation (which we're supposed to do with MDI). First, I would like to have the Dexcom. The one week trial was all too short :(.

#4

I am three years into this and i am very insulin sensitive. i exercise a couple of times a day-long dog walks, commuting by bike to work, and then the real exercise-running or kettle bell work outs or zumba.
it has (and is) very difficult to use such insulin sensitivity and keep bg stable. i now have a half unit pen which helps, but lots of times i just have to organize my food and exercise around each other because even half a unit is going to put me low if i eat and then cycle to work.
i only correct if im over 180 before bed, a little less if its during the day if i cant exercise.
i cant get a pump where i live, but if i could,i would seriously consider it. being able to tweak in smaller amounts would really help, ill bet!

#5

My TDD is low as well, currently about 11 units, with 4 units of basal.
I am a pumper but also pump U50 novolog. This lets me fine tune my dosing and allows corrections as needed.
NovoNordisk makes a dilluent for novolog. I get it through my Endo. Then it is a simple process to make the dilution.

I had started to use the reusable novopen Jr to get half unit dosing before I went to the pump. Lantus does not come in half unit pens but you can take the cartridge out of the disposable pen and place it in the novopen to get half units.

The other option is to use syringe and needle with quarter unit makings. You would just pull your dose from the pen and use the syringe to measure and deliver your dose.

#6

I have both an Animas pump and the Dexcom G4 (I really hope that the Animas Vibe, which has been available in Europe for some time and combines the Animas with the Dex (note to FDA, hurry up!), is available to the U.S. market soon). It probably is best to start with the Dex, then move on to getting the pump if you are able.

#7

I've seen syringes with half unit markings; not quarter unit markings. would the quarter unit markings be BD? Do you have a url link for it? I spoke to my Endo who is opposed to dilution. But then again, the doc also thought that I needed to get off insulin. The doctors all seem to prefer to put the patients on oral medications.

#8

You have LADA/Type 1 diabetes and the doctor thinks you need to get off insulin? That is both crazy and malpractice, IMO.

#9

She wanted to get me off insulin before I requested the test for the anti bodies. I hope that she realizes now that insulin is the best treatment option. Then again, she wrote a prescription without instructions and the pharmacy did not fill it because they did not know how many cartridges to dispense because of lack of instructions as to how many units of insulin per meal, and number of times per day. This is quite unbelievable, yet sadly true.

#10

Insulin helps the cells utilize glucose (sugar) for energy.
Diabetics either don't produce adequate insulin (Type 1) or don't respond to the insulin that they make (Type 2).
Diabetics need insulin to utilize glucose for energy otherwise they go into ketoacidosis where the body starts to break down muscle for energy.