so I have an issue, this morning I tested myself prior to coffee, I was 7.7mmol two hours later I was 10.5 with two coffee’s in me, at 8:49am just before eating my breakfast it went up again to 12.4 now at 11:13 am had gone out to do some errands and now I am 13.2 just keeps going up. will not be eating till at least 1am today, had 13u of lantus this morning and 10u humalog to cover my bs and carbs, how would I bring down my sugars and when should I just allow my sugars to run high like this. I feel aweful when it is this high. my carb intake was 41 so was not high, everymorning I take a visalus health drink for breakfast, any help would be welcomed.
not sure if this helps but I am type 1 weigh 115-120 take Lantus 24 units evenning and 13u morning, as well as humalog to cover my meals. not on a pump yet.
The answer to your second question, "when should I just allow my sugars to run high like this" is pretty much never. The answer to the first question is more complex: You said you took 10 units to cover your carbs and blood sugar. Did you do that by using your ISF or just some kind of sliding scale? If the latter, then you need to figure out your ISF (insulin sensitivity factor) which is the amount one unit of insulin lowers your blood sugar. For example my ISF during the day is 1:35, so one unit of insulin lowers my blood sugar by 35 points. So if say I'm 180, and my goal is 110, I am 70 points high and will take two units. If I'm not down enough in 2 hours I'll correct again, but since you are on shots, you have to keep track of your IOB - insulin on board, so you don't stack your insulin.
If you don't already know your ISF, the best way to figure it out is trial and error, so when you are high start with a unit and see how much it lowers your blood sugar in 3 hours and keep records so you can refine the number as you go.
I'm guessing that you are not taking enough novolog for your breakfast carb needs. Personally I take 15 units of lantus at night, then I aim for 120g of carbs each meal.My insulin : cab ratio is 1 unit for every 20g of carbs so i
I usually give myself 6 units every meal. I'm no professional and I wouldn't advise anything too crazy for you to try without consulting with your GP.So really if I was you I'd increase my fast acting insulin before each meal by a unit a day until you find what works for you.
Thanks for the reply. All I know is 24u evening and 10u morning of lantus then for breakfast I am supposed to eat 60c - fiber divide by 5 to get how much humalog to take for the carbs at lunch same thing but 45 carbs and dinner 60 carbs divided by 10 then I have a scale so whatever my blood sugar is I look at the scale and add it to what ever I need to cover my food. If I have a snack anything over 15g of carb depending on the day I divide by 5 or 10. This is all they have taught me. The rest I’m learning from all of you and the Internet. Would be great to get rid of the highs I get.
Sometimes I think I am over. The diabetic center set me up this way and I use my fitness pal to figure out how many carbs. But for a while there I was getting lows after I ate at lunch or dinner would either go low or high. Can be very frustrating.
I test when I wake up, meal time and 2 h after I eat and at bed time. Always high in the morning, and usually at night. With or without snacks. Afternoons unless I have a low is good.
The best way to measure ISF (insulin sensitivity factor) and Carbohydrate Ratio are definitely not trial and error!
Try this calculator for Carbohydrate Ratio: http://www.managebgl.com/scenarios/calculating-carbohydrate-ratio.html
We'll be adding another for ISF shortly, just have to go and get my annual eye check done...
As for insulin on board (IOB) - you can easily track this with a system like ManageBGL.com, but naturally you need to enter your insulin into your phone to have this work for you.
In another thread we explained to you, dishers, that you are being given outdated methods to manage your D and recommended you read Using Insulin by John Walsh. A sliding scale is inaccurate at best. You need to figure out your I:C ratios to bolus for your food and your ISF to correct for highs.
You don't need to eat a certain number of carbs and 60 carbs is a lot for breakfast! You can eat any amount of carbs you want if you compute your I:C for say 1:12 rather than doing all that weird math!
I'm sorry, Simon, but many people on here with years of experience with Type 1 have found trial and error to be a much more accurate way to figure out ISF and I:C then any formula or software, because we are all different, and the only way to find what works for us is to try and see what happens, then tweak numbers. YMMV
On what basis do you say that trial and error is better than using a formula or software? ISF and I:C ARE formulas (or formulae), but a lot of people have trouble working with ratios, hence the worksheet I created. The ratio takes into account individual differences, that's why we use it, and that's why pumps use it too.
I guess that's why it's called a "calculator". Yes, ISF and I:C are formulas, but ones we create for ourselves, based on experience. No generic formula can take into account all the factors that makes one person have an I:C of 1:5 and another an I:C of 1:25. What you are saying doesn't even make sense, Simon. "'the ratio' takes into account individual differences, that's why we use it and that's why pumps use it too". Uh "the ratio" is what we each find for ourselves and then program into our pumps, they don't get in there by magic. All your calculator does is figures out that if you eat 30 carbs and take 2 units of insulin that means your I:C is 1:15??? I think anyone who has passed 5th grade math can figure that out for themselves. Why does the person take 2 units for 30 grams to begin with? Because, through trial and error they have found out their I:C ratio is 1:15. Not impressed.
I agree Zoe, have ordered the book just waiting for it to come in
I have been unable to see diabetes specialists for several years (priced out of the insurance market), so I am not up with current treatment plans, but I would be interested in knowing why your basal insulin is split so unevenly. I realize that some people have more fluctuation in basal needs according to time of day/night, but how did they determine that you needed almost twice as much at night? Also, are you taking your Lantus at exactly the same times each day, or do you just take it when you get up and before you go to bed? Is your exercise/activity level fairly consistent from day to day? I have come across an alarming lack of understanding of the differences between type 1 vs. type 2 diabetics among general medical professionals. The GP I have recently seen for insulin prescriptions is a recently diagnosed type 2 himself, and he tried to convince me that I could control my type 1 diabetes with Lantus alone. I think it is extremely important to get the basal right. Otherwise, there is no hope of making any sense of the effects of boluses and meals.
Thanks for the reply. The diabetic center gave me those numbers like that. I went on my own from reading and research tried the 500 rule. They decided to change that and told me to take 24 night 10 morning. They wanted me to take all of it at once told them that does not work for me so guess this is there. COmpromise. Not working either. I don’t see them for a month so goi g back to the rule if I understand it correctly and see if I can bring sugars down and level.
You might consider tracking down the books "Think Like a Pancreas" or "Using Insulin" which are both like owner's manuals for diabetes that will tell you how to figure out dosing for yourself, pretty much from scratch. It sounds like the center is sort of using trial and error but a month is a long time to try things. I usually do 3 days and, if it doesn't work, make further adjustments. But I am very consistent with what I eat, at least during the day most of the time. You can get the books on Amazon or, hopefully, at your local library. I like TLAP as the style is a bit more conversational but they are both excellent resources.
There has been a thread on here about the effects of coffee on diabetes, have a wee look. Not too sure what is in your visalus drink, could there be hidden sugars ? We are all individuals and it does take a lot of trial and error to figure ourselves out. Then when you think you've nailed it, it changes again. I take 1u of Novorapid for 10g carbs, but this can change at certain times of the day and month. If I had gone with the old advice my doctors gave me I would be on a massive dose of insulin and probably weigh 6000lbs. It's great that you are testing and you can see what exactly is going on. I just feel that it's a little bit muddled for you at the moment. I hope it settles down for you and you find what works for you. When I started from scratch I broke my day down into sections. Figured out how to get my morning and nightime blds into range, then when I had that done I worked on lunchtime and teatime. Good luck and keep us posted.
Yes I have the pancreas book and ordered the using insulin thks
Thanks the Visalus has 1g of sugar but then you add the milk of course goes up. Thanks for all the support I don’t feel alone anymore with this
Hi orbiter7, I am unsure why it is split so unevenly, but my best guess is that they want me to take it all at one time. I used to take 80u at night, then I lost a lot of weight, at this time I was stupid and had a fight with my endo, went off insulin, (he would not sign for me to get a pump). any hoot went back on the insulin, doc wanted me to take what I had been taking before, told him that I think it would kill me if I did that, he asked me what I was doing right now, told him I was taking 20u a day, he said well stick with that and increase it if you need to. started researching on the internet and found this forum where people were having issues with their lantus and were splitting it so I tried to take 10 at night and 10 day, seemed to of helped, then went to diabetic centre, they asked why am I taking it at night and why is it split, told them the reasons and they boosted my evening to 24 and kept my day at 10, it is now 25 night and 13 day and if I keep the carbs down seems to help, but going out of town to see someone else I am hoping, might be going to the brampton civic hospital where hopefully I can get some help. They don’t seem to concerned about my health here or how I feel about any of it. so still going to see them but tying to learn as much as I can since more and more issues are coming up because of my stupid stunt.
Hi Zoe. I am trying to take a person from a very basic understanding of their diabetes (where they are told to 'eat 3 exchanges for breakfast, take 4 units insulin' etc), to actually understanding the ratios behind it, leading to the knowledge and ability to adjust it.
People on pumps must understand ratios. There are plenty of people on pen insulin who are not familiar with ratios. Clearly you are well beyond this stage :-)
I am working on a system that advises the correct ratio, based on knowledge of the pre- and post-meal BGLs, and the carbs in the meal. This is 'progressive refinement' rather than 'trial and error', and I hope you will support this endeavor.