Humalog dosing

Well its been a month since I was put on Humalog, and i’m still not sure about it.

I was told to take 6 units before each meal, yet I did as told and my levels did nothing if anything they’ve never come down … if I take it after a meal then yes I do notice it come down a small amount one or to points but nothing close to getting it into “normal” range.

I can not call my endro because i am not even in my home country at the moment, and the time differance well not t bad but bad enough that I’m still not fully use to (been in a new country and time zone for almost 2 weeks now, and still for 4 moths and 18 days to go before I get back home. am three hours behind my normal time.

My lantus is a simmilor deal, i take 10 units a night with my 1000mg of glumetza and in the moring will see my normal numbers yet since I got here my numbers have never been below mmol 10 (180) … I do not like running this high all the time, here and there I have no issue with, but 24/7 isn’t good.

Anyhow, what I am wondering do you think I should do a sliding scale for the Humalog as in if I eat 22 g of carbs end up taking like 11 units of Humalog? or hold it out longer and continue to live with the high BGs, I never was given a run down on this type of insulin. All info I have on it if via the parent site of the stuff which isn’t very helpful. My endro didn’t give me the ins and outs of insulin use beyound do x at number x and there you go.

I only brought enough Humalog with me for 4 months - at the moment I do not have the funds to buy more nor the ability to see a local doc to get script for some (my own scrips are useless here, I already checked and walgreens doesn’t recognize it nor does walmart). Though with luck by time Id need to get more, I’ll have the ability to do so.

I’ve asked my mom to call my endro for more info, but he’s only in the office twice a week, and spends the rest of the time in clinic (so getting hold of him can be fun at the best of times). Thus any info, comments insight would be appreachated.

I feel your pain. I went through the very same thing before I switched doctors. I felt like I was playing the game Whack a Mole…always beating down highs. Everyone is different and even you are different from day to day; so, you cannot expect to take the same amount of insulin before every meal and get proper BG control. Besides, unless you’re eating exactly the same number of carbs with every meal…this idea simply will not work.

Your doctor needs to discover your insulin to carb ratio and procede from there to establish your meal-time insulin at the very least. Do not continue to live with the highs…definitely not a good idea.

I know this, but I am stuck for the next 4 months and 16 odd days till I get back home … so I need to figure things out here before I do to much damage to my body, and I actually do eat almost the same day in and day out because I have a limited spectrum of foods that I can actually eat without reaction (got one to many food allergies or sensitivities).

I have one of two things for breakfast each morning Yogurt and Fruit or Glucerna Ceral with 4oz of 1% milk

Lunch tends to be two slices of whole wheat bread with a single slice of ham/turkey or chicken with a stick of marble cheese and either a tbsp of mustard or light kraft mayo or a salad made with ice burg lettice with what ever fresh veggies are in the fridge (carrots, bell petters, radishes, celary and for dressing I use the sprits or plain extra vergin olive oil and a dash of balsamic vingar.

Dinner is 3 oz of chicken/turkey or on really rare occasion 3oz of beef always served with carrots/broccoli/coliflower or cucumber might have another veggie, but those are the common staples and they are served with 1/2 cup of white rice/corn or small baked potato

snacks depending on the day might be a can of regular pop (cant have diet stuff cause I am allergic to artifical sweetners including splenda), a glucerna bar, and assorted veggies (regardless snacks never go more then 30g of carbs for the whole day normaly 15 and 15).

I average 1500 cals a day with 165 grams of carbs (each meal is no more then 45 grams of carbs with no more then 30 grams of carbs for snacks - yes i do go over on occasion, but not daily) 30 grams of fat and around 150 grams of protein (i try to keep my protein and carbs close as I can in balance).

I’m on an insulin pump which automatically supplies my basal insulin…that would be your Lantus. My PDM (controller) is programmed with an Insulin-to-carb ratio of 1:7…Correction Factor-- 1 unit of insulin decreases BG by 74mg/dL (12:00AM to 7:59AM) and from 8:00AM to 11:59PM 1 unit decreases BG by 37mb/dL. This is because I have a different basal rate for day vs. night. This is MY programming. Everyone is different.

That being established…I would keep a log of what I ate and the resulting BG values based upon carbs consumed. This will help your doctor/CDE later. In the mean while a “sliding scale”, as you call it, might be a good idea…sounds like you mean to adjust you meal-time insulin. The only sliding scale that I had involved correction of highs…not adjusting any meal-time insulin. This is why I switched doctors. The below sites might offer some help to you in the mean while…keeping in mind that it’s BEST to have doctor’s over-sight!!……

I take Novolog as a suppliment to Lantus, but my dr has me on a sliding scale with the Novolog. If my bg is different I use the Novolog accordingly. Like this:
<150 nothing
151-200 4 units
201-250 6 units
251-300 8 units
301-350 10 units
351-400 12 units
>400 Call Dr.

I was also told that if I know I’m going to consume a starchy meal to add a unit or two to make up for it in advance.
Works great for me!

Wow! I too am allergic to Splenda!

It was so bad that the doc wanted to drill a hole in my skull and take a brain sample to see what the problem was!


I usually take about 5 units with my Cheerio’s and banana in the mornings, plus a 2oz piece of greasy sausage. The fat slows down the spike.

My ratio is pretty much like this: 1 unit to every 20g of carbs.

If I would be exercising very soon after eating, I can cut that dose in 1/2 or even eliminate the dose.

Even following this method, many things can influence the dosage, like the temperature you are in. High & low temps can make blood sugars out of control.

My doc wanted me to take my dose like this (postprandial):

150-200: 1 unit
200-250: 2 units
and so on.

Now, I take my dose of 5 units before eating, as much as 1 hour before eating, but usually right before first bite.

Every once in a while, if I know I will be eating slow carbs like pasta, I will switch to regular humulin R because it lasts a little longer.

I typically only eat 1-2 meals a day. When I didn’t have insulin, I ate 3 times a day, exactly on time.
Lifestyle limitations now prevent me from doing that.

If you have a lot of abdominal fat, you might need a longer needle.

As long as you don’t have any low’s, you can play with the dosage a little.

If your fasting BS is too high, then increase the Lantus by 1 unit a night until you get the numbers where you want them. Then stop increasing the dosage.

THEN, after you do that, and postprandials are too high, take 1/2 the Humalog at first bite, and the other half 1 hour later.

If you still have problems, increase the Humalog by 1 unit per meal until you get the numbers you want. Then stop increasing the dosage.

As long as you stay within 70 to 110 fasting and under 140 postprandial, you should be in good control.

If you feel reluctant about adjusting the dosage, then adjust your diet by spreading the carbs over 5-6 small meals evenly spaced throughout the day.

You can also drink 2 quarts (2 liters) of water with your meal.
The water dilutes the carbs and you get slower absorption.

In 3 days (Wednesday), I will be going to Red Lobster for my 10th wedding anniversary.

I will be eating a dozen fried shrimp, a steak, baked potato, glass of red wine, and anything else I have room for.

Once or twice a year won’t hurt anybody.

So, I will take 5 units of Humulin R and 5 units of Humalog to cover that meal.

Maybe you should follow the Dr Bernstein diet?


Are you dosing at your 2 hour post?

If you already know ahead of time what a particular meal will spike you to, why not take your dose before you spike?
Or at least 1/2 your dose at mealtime.

I switched from your sliding scale to my DAFNE system. MUCH better control.
And if I need more at the 2 hour, I just follow the bolus I was given.
I am going to try dosing similarly to yours for my DAFNE system. Maybe I can get better results.

I use Humalog most of the time. No Lantus or pills of any kind.

Not to take away from this thread but I really do not have any input yet as I will just be starting humalog for the first time tomorrow.
I am only 100 lbs and my endo told me a similar I:C ratio as yours.
except 15gcarbs for every 1 unit if I’m under 150
then 2 units if I’m 150-199
3 units 200s
4 units 300s

What is the DAFNE system? Any other advice before I start tomorrow? I am going to be using the Humalog Kwikpen

It takes a long time (years, if ever) to get dosages worked out with humalog. After 9 years, I am still tweaking my sensitivity factor and carb ratios. It’s important to understand that everyone’s insulin needs are truly individual and as you go on you will find what works best for you. I would say that if your Dr recommended that you take 6 units before meals he wanted you to try and eat a consistent amount of carbs at every meal? In that case, you could have your mom ask him how many carbs you should eat with each meal and then try to make sure you are sticking to that. My first endo had me doing that in the beginning. It was very confusing for me and I was all over the place, just as you are. When you get back to the states, try and see a CDE (certified diabetes educator) and a nutritionist. I personally think these people are more valuable than even endos because they support you so much as you try and figure out how to manage your D.

Best of luck to you!

Lil MaMa,

I too was given some such nonsense about 1-2 units per such and such blood sugars.
It didn’t work from day 1.

All that goes out the window if you change one little thing with your diet and/or lifestyle.

For me, I shoot 10 units every morning unless I know I am going to do hard exercise or not eat protein with my meal.

You see, much depends on what you are eating and what activity you do afterward.

Let’s say you eat a bowl of cheerios and 2 oz of cooked sausage. Let’s say you spike to 200. Then you shoot your 2 units of insulin. Assume that you either are still high or hypo 1-2 hours later.

Let’s say you ate the same meal but without the sausage. You spike to 250. You take that dose and suddenly you go hypo in 30 min.

You see the direction this is going?

It’s a tough balancing act - types and quantities of food, versus insulin dosage and exercise.

I learned very early on when I was given insulin to take my dose before eating. This kept my PP levels nearly normal and my latest A1C last month at 5.1 .

FAT and protein slow carb absorption a lot. Pair your carbs with food. A ratio of 1g fat to 2g of carbs to 3g of protein would work well for a light diabetic.

Some follow this - 1g of carbs to 2g of fat to 3g of protein in a meal.

Oh, about my A1C - I managed that without eating a single veggie whatsoever!

DAFNE means Dose Ahead For Normal Eating.

This means dose BEFORE eating. If you already know what a certain amount of food does to your blood sugars, then take the dose before eating, not after eating. This controls blood sugars as they rise.

Dosing after eating just raises your A1C and shows that you are noncompliant.

If you are uncertain as to what to dose yourself at, a simple rule: small mistakes mean small fixes. Too little insulin and you get a little higher blood sugars. Too much can kill you.

I started at 5 units, then worked my way up to between 10 and 20 depending on the carbs I eat and the activity I plan on doing.

But usually 10 units without blinking. And I split that dose. I take 5 in one spot and immediately 5 in a different spot.

MUCH better results for me anyway.

If a single dose works at the 3 or 4 hour mark, but not much at the 2 hour mark, you might want to try the splitting.

Let’s say you needed 20 units at the 4 hour mark. So, I would suggest taking 5 units and 5 units before eating. You can always take the remaining dose if needed. But if you take too much you can never ‘go back’.

Oh, I never followed the nutritionist meal plan. 75g of carbs x 3 plus two 15g carb snacks was far too much food for me in the beginning.

Now, I can eat far more than that when I want to. Just have to watch the body weight. More food + more insulin = a much fatter body.

The heavier you are, the more insulin you need.
The more caffeine you drink the more insulin you need.
The less activity you do the more insulin you need.
The more aspirin you take (within reason) the LESS insulin you need.

You will NEVER get an exact amount of insulin needed number.

For females, monthly hormone fluctuations easily affect blood sugars and insulin requirements, even if you take birth control.

The best you can do is a close guess. And constant monitoring. If I had a ton of data on a person, I might even be able to come up with a dosage algorithm. But even then some of it would be a guess.

Did you know that many over the counter items affect blood sugars? Alleve can raise blood sugars 30% or more!

Aspirin can lower blood sugars 10%. Or more depending on the person.

Even a slight illness that you cannot detect will affect blood sugars.

A slight lack of sleep will raise blood sugars.

Eating a high fat meal like pepperoni pizza can raise blood sugars for DAYS!

Here’s every A1C I had since I was diagnosed:
5.3 then started insulin immediately after that A1C test due to high spikes from summertime heat

Not bad huh?

My next one will be MUCH higher due to lack of activity (weather contingent) and eating mass carbs due to boredom.

But I can still adjust everything if I desire.

About the only way to get consistent numbers and dosages is to live an exact lifestyle.
Prison would fit that situation very well. But who wants that?

Treating diabetes must be a balance between lifestyle demands and body demands.

Treat one without the other and you get problems.

If you lived exclusively for the diabetes, then you wouldn’t have a life at all.
If you ignored diabetes and focused only on lifestyle, you again wouldn’t have a life (you could die or have serious complications).

For me, I use insulin as a tool to maintain some semblance of my former lifestyle. I just don’t eat too much bad foods if I can help it.

Google Dr Bernstein. He has great advice.

Note: I haven’t seen a CDE. My doctor said I was a diabetic ‘guru’ because I have great control and know a lot about how to effectively treat my disease. I guess this is why they never asked me to see a CDE.

Ideally you want a flat line of blood sugars. This is not easily done either.

Best possible advice to give you:

Let your glucose meter be your ‘food boss’. meaning that if it indicates a high spike after eating something, then either eat less of that or none of that item. It took me months to figure out what did what to me. And even that changes daily.

Works very well too. Some people spike weirdly with foods. Potatoes for one might be a decent spike, but for another it might be sky high. Depends on the person.