I hope someone can help me to figure it out. I am completely lost.
33 female. Dx November 2012.
I was sent home with following dosages: 12 NHP at night, 8 + 8 + 8 units of Novorapid. I needed to adjust those myself, because we don’t eat that amount of carbs at home and I got very low glucose values all the time.
I am breastfeeding my baby - that's why I've got NPH I guess. My fasting sugars are good within my target. Sometimes if I sleep longer than I should it could be around 6,7 (121).
I've adjusted my doses to: 4 NPH at 10:30 pm, 4 NPH +2 units or 4 units depending on carbs of Novorapid at breakfast (usually at 8:30), 2 lunch and 4 dinner of Novorapid.
I’ve split NPH myself because i got spikes during the day. Especially between lunch and dinner. One week it worked very good, together with cutting carbs but recently I had to increase carbs from 30 a day, because I’ve developed horrible rash the same i had prior to dx (described as ketosis rash). So 30 carbs are not good for me. So now it’s more like 50-60 a day.
So the problem is that injecting Novorapid at those dosage before dinner gets me nowhere - I get low 2 hours after the meal and then it spikes more like 4 hours after. I guess this is all the protein and fat.
I read both Bernstein and Scheiner and one seems not to eat all that amount of protein :-) and uses Regular and another’s calculations are based on much more carbs. If I eat less protein I am constantly hungry and increasing fat to 80% didn't help, I felt noxious, so I went back to "normal" amount.
1) What should I do to address spikes 4 hours after food? I read TGA groups and they recommend splitting Novorapid into 2 dosages. One before dinner and one after. But how do I figure out how much? 2 and 2 units? Is Novorapid too fast for me?
2)How should I proceed in the evening?
I eat my dinner usually at 19:30. My basal injection is at 22:30. Last week I had good numbers before injecting basal, but this week when I added carbs back at 00:00 I am very high, like around 7 (126), than it goes down during the night.
3) what should I do if I get very hight at 3:am? Should it be corrected with Novorapid?
I am totally lost.
4) How do I calculate 1:C ratio if i need to consider fat and proteins? Is there any approaches that worked for you? 500 rule or weight rule doesn’t really work for me, I get very high numbers, like 1:22, and I don’t feel it is the case or at least I can not get it to verify because of protein and fat. How can I do that?
I know about 50% and 10% converting to glucose in 4 and 8 hours. But how do I do it in practice?
5) How do I calculate sensitivity factors? Based on average total I get 3,9 - 5,5 and it is not really a case.
I get it to 4,5 (81 mg/dl).
Does this need to be re-checked on an empty stomach?
I’ve had 6,6 (118) and after 15 min it went to 7,7 (138) I’ve panicked and took 2 units more, going down to 4,6 and eating. Now it's 6,1.
Please don’t send me to my diabetes team :) they were not much of a help
:( because I am honeymooning they said.And they are not much for lowcarbing. I got very bad response there.