Diagnosed type 1 LADA in June 2015 at age 60! Getting it sussed…positive most of the time and using Dario app to sort out my medication…lantus and novorapid…am on MDI. My problem is that my health team disagrees on a lot of things and I get very contradictory advice. I am very confused. Researched and set my correction factor at 2 mmol/L. Specialist said all results great so leave everything as is. Then dietician and nurse met with me and said that correction was way too strong…should be 5 mol/L. I asked for explanation but still don’t get how 2 can be stronger than 5. If one unit of novorapid drops my glucose by 5 how is that weaker ratio than 2. If this makes no sense to you join the club! But think I am missing something logical? …help?
Although it doesn’t seem to make sense to suggest that correction factor (I call this Insulin Sensitivity Factor (ISF) is “stronger” when the factor is smaller it actually is. The ISF is the amount of blood sugar that you drop for a single unit of insulin. To calculate a correction dose you take the amount that you are high (say 5 mmol/L or 90 mg/dl) and you “divide” that number by your ISF. Thus a lower ISF results in a bigger correction. If you calculate your correction with an ISF of 2 then you will calculate your correction as 2.5 units. If you calculate with an ISF of 5 then you will calculate a correction of 1 unit. Using an ISF of 2 when your actual ISF is 5 will routinely result in too large a correction and potential hypos.
It’s the whole inverse relationship idea. Here’s the formula:
Insulin units = amount high / correction factor
Since you are dividing by the correction factor then insulin units varies inversely with the correction factor.
As the correction factor goes up, the number of insulin units goes down. Conversely, as the correction factor is reduced the number of insulin units goes up.
I am basically going to say exactly what the others have already said only from a very slightly different direction.
The medical community is scared to death of insulin. When they think of insulin they come up with nightmares where their patient is lying unconscious on the floor & dying from hypoglycemia from too much insulin By contrast I think most of us who have been dealing with T1 and insulin for a while tend to have a more equivocal “stuff happens” perspective. You try to avoid hypos and catch and stop them before they happen. If they happen you treat them. Life goes on.
Anyway … my point is that to your dietician, nurse, and doctor “stronger” means more insulin. “Weaker” (i.e. “better”) will match up with less insulin which to them means less risk of sudden death with no warning. A larger ISF (Insulin Sensitivity Factor) equates to using less insulin so it’s better (for them). A small ISF means more insulin, more risk of hypoglycemia so it is both “stronger” and “worser”. ![]()
Sometimes you just have to take your med team by the hand, make soothing noises & keep telling them, “It’s OK. It’s going to be OK” ![]()
Hahaha. Thanks. I relate to this. I will do my own thing because I am beginning to understand this condition and really do see insulin as my friend. I feel like a new person since I have been diagnosed and have my " friend" . Don’t want hypos but I am not scared of them. At the moment they are infrequent and mild…I test heaps and treat early. Thanks for your help
