and how long should I wait before I correct a high?
No you need to adjust your lantus dose so that you remain flat during the day.
You need to do the basal testing first - then work on the bolus testing.
A good Basal will keep your BG within 30 points of where you started at while you have no bolus or active food on board. For the basal testing it does not matter if your a bit high when you start as long as you are not too high, follow the procedure in TLAP. Once you get that worked out , then you can work on getting to a more normal fasted BG by using a correct dose of humalog to cover your food and make corrections if you get the carb count wrong.
It take doing this in steps, but you will get there.
Once this makes sense to you then come on back and ask all the new questions you will have. Some on is usually here to share their experience and help as best they can.This will depend on how long it takes for rapid to stop working for you. You will need to test this to see. If you check out DIA - duration of Insulin activity in TLAP it will show you how. Once you know how far a unit will drop you and how long it is active then you can start to see how long to wait before correcting.
you will still need all these numbers (basal dose, IC ratio, CF and DIA) and experience with MDI before you move to a pump
okay...thank you
I feel safer doing the injections cuz it's familiar ground. thanks again
If Lantus is dropping you, lower the Lantus. Don't back off the Humalog. Basal is just supposed to keep you level between meals & overnight. Despite what Lantus brochures say, Lantus doesn't last 24 hours & is best taken in two doses. I hated Lantus because it has peaks & valleys. Not stable. No matter how I changed timing & doses, I had afternoon lows. Levemir works far better for me & it doesn't sting. Lantus obviously does major marketing to be popular with doctors since it sucks.
Correct immediately, unless you have insulin on board from a previous injection. Usually rapid acting lasts 4-5 hours.
It was my understanding that Type 2 diabetics can get away with a low carb and/or ketogenic diet...But NOT Type 1 diabetics....Is that true?
T1s can do low carb as well, it means smaller bolus doses, so less risk of spikes/crashes. Would not reduce your basal needs as much as your bolus requirements.
When I was only on basal at my dx and before I was seen by endo, I could only do 10-15 gm carbs per meal with out spiking. Remember that low carb was the only treatment modality available for T1s before the availability of insulin.
Physical activity, building muscle and increasing cardio will increase insulin sensitivity and lead to lower basal requirements. It will also spill over into your bolus requirements as the more insulin sensitive you are the smaller he bolus dose Will be as well.
Ree,
Hope you’ll consider a recommendation of someone to guide you in taming BG & dosing insulin. Awful to live with anxiety & confusion. No need to go it alone. Endos don’t have the time & are woefully behind in current treatment. Franzi Spritzler is a wonderful, knowledgeable, caring Certified Diabetes Educator & Registered Dietitian www.lowcarbdietitian.com. I met Franzi here & she’s been video interviewed on Tu. She knows her stuff & her clients love her. Wish every diabetic had a Franzi to help them. You can consult with Franzi by phone, Skype & email.
Yes you do take less fast acting insulin. You can even not take meal insulin if the lantis is dropping your BG a lot a lot. I would back off the humalog and tell the doctor at your next appointment. You can work it the other way too. If lantis seems to let your BG go high you can increase your humalog doses. And this is really the best. We should always dose more or less depending on if BG is rising or falling.
Backing off the rapid is a temporary fix and it does not do anything to fix the real problem of too much lantus.
Need to do your basal testing first, then work on carb ratios and correction factors.
Ree, just wondering what your target BG is, for me when first dx'd it was 100, with under 70 considered a low.Initial recommendations where to correct when over 200.Have come a long way from that initial set up wit much improvement of A1C with minimal time under 70. You can do it too.
SO...last night I went to bed with a blood sugar of 269 and ate 1/2 a string cheese, which was four hours after I took my Humalog at dinner time (ate at 6 and went to bed at 10pm).....this morning 3am it was 178, at 6 am it was 163 and now at 7am it is 170....IS THIS what I am supposed to be doing as far as basals go? MY 1st concern now is how much Humalog to take for my meal now that I am under 200,... and the fact that 16.5-17 units of Lantus last night dropped me 100 points from 10pm to 6am.....Feedback please
My target is 150....I was thinking about taking 1 unit then eating 15 carbs to see how that does.....I may cut lantus back to 16 tonight
Okay...that makes sense to me
Since I am an hour late on eating breakfast already would it be a good time to do my basal testing now? Basal testing is 4 hours....right?
No one can tell you how much Humalog to take without knowing how many carbs you're eating & your ratio of carbs/insulin. (Know you don't have a ratio yet.) A sliding scale is shooting blind. Goal, of course, is having fasting under 100 & two hours after meals under 140.
Ideally, the correct basal dose will keep BG the same waking up as it was before bed. Enough basal will lower you eventually since it's slow acting, but it's better to correct with Humalog & arrive at a Lantus dose that keeps BG level without major drops.
Don't eat before bed with high BG.
Requirements for Basal Insulin Testing
1. No food being digested
a. You may not consume any calories for at least 4 hours leading up to the basal test.
b. The meal/snack preceding the basal test should be low in fat.
c. Do not consume any calories during the basal test, unless your blood glucose drops low.
d. You may have water, diet beverages and other non-caloric foods during the test.
e. No caffeinated beverages during the basal test.
2. No bolus insulin working during the basal test
a. Do not bolus for at least 4 hours preceding the basal test.
b. Bolus normally (do not extend the bolus) for the last meal/snack.
c. Do not bolus during the test, unless your blood glucose is above 250.
I usually run them for at least 8 hours, so a morning one would be fasting overnight, skip breakfast and have a very late lunch.
Then your checking your BG every hour over the test.
Okay great....thank you for that
pull out your copy of think like a pancreas and look at the section on basal testing, it has all the rules.
If you only have about 4-5 hours you could try a preliminary DIA and correction factor test. If you take 1 unit Humalog and then follow where you go for the next 4-5 hours you can see how long it will have any effect and how far it will bring you down.
Rules for that are also in Think like a pancreas.