I take 18 units of lantis each night. I take a small amount of humalog at each meal. 1 unit per 12grams of carbs - about 3-5 units. So generally no more that 14 or 15 units a day. So my first questions is? That is a pretty small amount compared to most isn’t it?
Next question…if due to a crazy schedule, I need to eat more than 3 times, is it ok to take a fourth shot? Or is it better not to?
Finally what is the basic medical thoughts regarding insulin…In theory…If I take the perfect amount of insulin each day to keep my blood sugar in the 100 range. Does that make me pretty safe from diabetic complications? Does the long term insulin use cause problems down the road? Or are we just screwed?
It’s the right amount of insulin for you, and that’s all that really matters. The right amount is the amount that keeps your bgl’s in range. I take anywhere from 18 to 35 units of insulin a day, depending on how active I am, what and how much I’m eating and other factors.
Yes it’s ok to take a fourth shot of rapid acting insulin if you are eating a fourth meal and need the insulin to keep your bgl’s in check.
Yes, good bgl control does reduce the probability and/or severity of diabetic complications. I’m not aware of long-term insulin use problems, but would be more concerned with the long term problems caused by poor bgl control.
When I was first diagnosed, I used about the same amounts of insulin and I am considered type 1.
I think that the main difference between type 1 and type 1.5 is the speed of onset of diabetes. But a lot of this is still unknown.
I was diagnosed during college and I did not eat on a normal schedule at ALL! Some days I think that I took 12-15 injections. The thing that you need to be careful about is “stacking insulin”. If you take more than one injection of fast acting insulin within 3-4 hours, then it is hard to know how much active insulin is inside of you. So if you ate 2 hours ago and 1 hour ago and you measure and you are 160, it could be that you might not need any insulin to bring you down because the “tail” end of your two injections will continue to bring you down. (Does that make sense? I realize I’m not being very clear!). But in general, don’t be afriad to inject for snacks or extra meals. Just be sensible about it and remember that more injections = more eating which can mean weight gain.
About your last question, there is a lot of evidence to show that better control of blood sugar leads to less complications. But of course, people with very good blood sugar control can still get complications. Just like people who don’t smoke can still get lung cancer. Sometimes health conditions don’t only show up in the “most likely” cases. But there is a lot of evidence to suggest that we should control our blood sugars as much as possible!!!
I can’t repeat loud enough. Call your doctor! Do not make any changes to your medication plan without his/her direction. I am not a doctor and I am sure that any real doctor would not advise someone else’s patient to make a change without input from their endo or primary.
I can’t tell you about complications and when they start for sure. I read in a recent study somebody referred me to that complications can start “hatching” even when the BGs aren’t extremely high. To put it in plain language, it can start pretty early but you can avoid the worst of it by keeping your numbers as close to normal as possible at all times. I know this sounds impossible, but trying our best is all we can do and then nature will take its course. Of course, not all diabetics develop complications … that would be stereotyping and nobody deserves to be shoved into a mold and pronounced a certain way.
If you take your body weight in lb and divide by 2.2 to get in Kg and multiply by 0.4 units of insulin per Kg. It will give you and idea of an average insulin consumption for a diabetic with little or no insulin production and little or no insulin resistance. You can check you own consumption a see if you are in the ball park. Much higher you may be insulin resistant somewhat and much lower and your pancreas may still be working. There is a zillion other factors that affect insulin consumption: diet, exercise, …
My Endo said taking insulin was like driving a car he cannot say precisely when to turn. Do whatever it takes to keep the BG in the normal range at all times as much as possible. If you overinsulinate by eating too many carbs you can get into a weight gain spiral whit increasing insulin, hunger and body weight. If you are controlling your weight than all is well.
You cannot do any better than 100. Dr. R. Bernstein says that this will keep complications away. I read a scientific paper years ago that said insulin was fine for the heart and circulatory system. So no I think you are going to be fine from the diabetes but watch out for being run over by a bus.
The only consistent thing about diabetes is that everyone is different & their insulin needs are different. Many factors at play including a person’s size, age, level of activity & other hormones. And, insulin needs change in each individual. If you’re got good numbers & control, that’s what counts. But to answer your question, your doses aren’t large & 1 unit for 12 carb grams is good.
One thing to consider discussing with your doctor is taking your Lantus in two doses. Doesn’t necessarily mean that your current dose is halved. Many people have better control taking basal insulin in two doses, one in the morning & one right before bed. Are your between meal numbers good?
Contrary to what the drug literature says, basal insulin doesn’t last 18-24 hours. It didn’t for me & doesn’t for a lot of people. For some reason (explained to me by my endo & I didn’t understand the biochemistry at work), basal is used up faster while we’re asleep & lasts about 8 hours. Of course, if your between meals readings are good, then you’re probably ok with one Lantus dose. Just something to keep in mind if you see your numbers creeping up.
As Kristin said, just be careful by not overlapping your insulin.
I was taking a 40 unit shot of Lantus at bedtime and found it lasted more than 24 hours. Which is very inconveniant since you nay overlap at night. I asked my Endo about this and he said some patients 18 hours some less and some more. As a former Chem Eng I could see a larger dose lasting longer than a smaller dose. I do no know why it would be used up faster a night.
Bedtime and morning shots may be a good idea to minimize the effect if your Lantus does not last exactly 24 hours. If you overlap in the day it is easier to cope with than when you are asleep.
I used to do 40 Lantus about every 30 hours to avoid overlap very stressful to do. Now I do 20 at bedtime and 20 morning. Much easier to do and seem to work well.
thats great congrats on your control! … i sometimes wonder about the 1.5 thing because 8 years of having “type 1” i have never went over 18 units of insulin a day, or an a1c of 5.8 … it makes me wonder how i can do so well on such little insulin
If you weight less than 50 Kg then 18 units per day is about 0.4 unit/ Kg-day which is about right if you have little insulin resistance. Or it could be that your pancreas is still working a bit ? Very good BG control.
Hi Terry…I am a snacker and dose whenever I am going to eat, I unit per 15 g’s. You might also dose more when eating things that take longer to peak your BS like pasta, high fat, and high protein. As Kristin says, you do have to be careful of stacking…my worst scary lows when newly diagnosed were caused by injecting more insulin when I was high post meals. I tend to do this only when I am home or know I’ll remember to check and eat something if I need to.
I am T 1.5 also, I assume…9 units of Lantus and try to eat low carb so keep my Humolog to between 5 and 10 units p/day, but as someone said, that is very, very individual and it might change for whatever reason.
We all strive to find a perfect amount of insulin to make our blood sugars stay in that perfect target range, but if you’re like most of us, your insulin needs are going to change throughout your life. It’s an imprecise science.
But I have never heard a theory that insulin use over time is bad for anyone. It’s poor blood sugar control causing damage to your organs over a lifetime that brings complications. While insulin can cause weight gain, there is no need to fear taking the amount your body requires.
Shouldn’t be a problem to take additional insulin according to your insulin-to-carb ratio and sliding scale if you want to add a snack.
My Endo said injection insulin is like driving a car you turn as much as you need to, not more and not less. It would be nice if insulin was required in a precise ratio to our food intake. But in some of us the pancreas still works somewhat, insulin resistance varies, exercise has an effect, emotions have a great effect on BG, coffee, … and the phase of the moon.
Insulin, carbs, hunger, more insulin, more hunger, … death spiral is something to keep in mind.
I was struggling several years ago after a very bad siege with some stomach issues. After I got that in control, my blood sugar needed some work. Working with my endo, he suggested that my total Lantus should be the amout of my total Humalog. After trying that, I am doing pretty well. A1C of 6.1.
I take 6 units of Lantus in the am, and 8 units before bedtime. I use Humalog to cover meals. Usually 1-2 units at breakfast, 5-6 at lunch, and 7-8 at dinner. Of course, all this is based on what I eat during the meals.
I am currently trying to lose 5 pounds, and am having a struggle keeping my blood sugar up. I have tried lowering my lunch and dinner Humalog, cutting out fats, and find I am having low sugars more often that require glucose tabs. I think I may try to adjust my Lantus.
I only take 1 unit of insulin for 10carbs, so really everyone is different my younger brother who is 22years old takes like 1 unit for 20carbs yeah thats how different everyone is.
Linda, I cut back on carbs a while back and started to lose weight even eating lots of cheese, meat, nuts…high fat. I absolutely needed less Lantus eating that way and as I lost lbs.
Sorry for responding so late, I missed your post. Yes I take novorapid something like humalog for meals and corrections.
It is not a bad idea to cut the lantus a bit if you are having lows at night or fasting BG too low and/or cut the humalog if the 2 to 4 hour after meals are too low. You need (much) less insulin if you are on a hypocaloric diet.
I get shocked hearing how small amounts of mealtime insulin ppl take… I need about 8 units per meal to feel satisfied, sometimes 10 or more if i have desert. But I only have 10 units of lantus every evening, maybe thats why? My last Hb1ac was 4,6… Do you guys get good bloodsugar levels after only having THAT little insulin? or am I just too extreme when it comes to my post meal levels? I could probably take less insulin per meal but then my bloodsugar levels would always be a little on the high side. Im dead scared of complications and strive to have as close to normal bloodsugar levels as possible…
The only thing that’s important is that your insulin doses cover your meals & if you’re getting good results. Doesn’t matter if it’s a lot or a little, but what your BG is after meals. With an A1c of 4.6 (how fantastic!), you must be doing something right:)
No, don’t take less insulin with meals! Everyone is different & you’ve hit on a formula for success. Kudos!
Sorry, don’t know what you mean by the 10 units of Lantus having an effect.
