I just started Humalog two days ago. When I follow the chart I was given by the doctor it does nothing to lower my blood sugar. Example: Last night i Had a Cheeseburger on rye bread and sweet potato fries. My sugar was 101 right before I ate. I took 8 units of Humalog and 2000mg Metformin ER. Two hours later my sugar was 255. It continued to rise till it reached 301. At that time i was due to take my 24 units of Lantus. An hour later it began to drop and I woke up with a reading of 96. Is this normal? Does my body have to reach a certain level of insulin for it to be quick release as they say. Any thoughts you have would really be appreciated.
Are you calculating your Humalog dose by counting carbs or are you using a sliding scale which bases your meal time dose solely on your pre-meal blood sugar? If you aren't carb counting you should ask your doctor to refer you to a CDE who can help you learn how to do it. Using a sliding scale makes it very difficult to maintain good control.
To answer your question - hitting 255 after two hours and continuing to rise until you reach 301 is not normal. If you didn't take any additional Humalog and still woke up at 96, you probably need to increase your Humalog with meals and reduce your Lantus.
It takes a while to learn how to use rapid insulin. Give yourself time to learn but don't let your medical team tell you that wild spikes are inevitable. They aren't.
Did you count your carbs correctly?
Rye bread bun 166 calories 31 carbs
Sweet potato fries 14 fries 140 calories 20 carbs
1 slice American cheese 45 calories 2 carbs
Ground Beef Patty 3 oz. 213 calories 0 carbs
TOTALS 564 calories 53 carbs
Anytime I eat this many calories and carbs I get high blood sugar even if I'm taking insulin. I am female and I try to keep my TOTAL DAILY carbs to 50-100 or under. For me, under 50 grams of carbs DAILY helps me keep my weight and sugars down.
Below is a link and some excerpts from the linked article that may be of help. Take care.
The daily carb intake for male diabetics recommended by the American Diabetes Association varies between 135 and 180 grams for your three basic meals along with up to 60 to 90 grams of extra carbohydrates at snack time. Your daily recommended carb intake could therefore vary between 135 grams a day if you don't snack up to 270 grams a day. Since these recommendations are quite broad, the American Diabetes Association suggests working with a diabetes educator or registered dietitian to get more specific advice adapted to your personal situation, lifestyle and health status.
Some studies done with male diabetics show that a low-carb diet could be a good alternative to keep blood-sugar levels within the recommended range. Keeping your daily carb intake to 20 grams a day helped significantly decrease the average blood-sugar levels and triglyceride levels within two weeks, according to a study published in 2005 in the "Annals of Internal Medicine." Another study comprising mainly diabetic males showed that a low-carb diet providing less than 20 grams a day allowed participants to improve their diabetes control and even helped many of them to discontinue their diabetes medications, as published in the December 2005 issue of "Nutrition & Metabolism."
Recording everything I ate in carb counts and how much insulin, as well as the time of day, helped me pinpoint what raised my levels and how much my insulin had to be adjusted to get better readings. Some people for some reason do not count their beverages and I was floored to find out about regular soft drinks.
Thank you so much. I was never told to count or limit my carbs by my care giver. I will from today on. I was impressed that you were able to calculate my carbs so fast. Is there a site or book that you use that might be helpful to me?
Your right, the chart he gave me is based on my pre meal blood sugars. I will make an appointment with the CDE as soon as they are able to see me.
Thank you for your time and advice.
I just type in the name of the food and the word carb or calorie in my internet search engine and VOILA the information is right there. So you can search info on any food online :) I also keep a food journal on an Excel spreadsheet that tracks my calories, carbs, fats, proteins and sodium. I also type in my insulin usage on the same spreadsheet with the time and amount I take it. It really helps me control my blood sugar.
I was having trouble affording my insulin this past year because I got laid off of my job. But I recently got approved for Medicaid so I have the insulin I need again FINALLY. My most recent A1c was high, but I plan to be at least a 6 on my next one.
Did you take your injection just prior to eating ?
You may want to wait 15-30 minutes, for the insulin to absorb and start to work. Eating a salad or lower carb items first will also help so that the insulin is there when the food is being digested and raising your BG. Consider learning about glycemic index/load that show the relative speed that foods will impact your BG.
Since your BG went to 250-300, then your food was working faster than your insulin. Good for you for doing the BG testing ! Timing is a big part of keeping BGs in the normal range. In the beginning it is good to test often as you learn how the patterns work for you.
Considering you are now taking basal (lantus) and bolus (Humalog), it may be time to do some accuracy tuning to your insulin doses.
You want to set your basal rates first. This is effectively done by taking your lantus and fasting and measuring blood sugars to see if goes up or down or stays nearly the same.
For example. Wake up and take blood sugar reading = 96 (this is fine). Skip breakfast and monitor blood sugars until lunch time. If blood sugars stays about +/- 10 from the 96 your basal rate is looking good. if your blood sugars drop too much, then you need to reduce the lantus. If they rise too much, you may need to increase.Do you take lantus 1/24 hours or 2/24 hours? Some find that dosing twice a day gives them better and more stable than 1/24. I take levermir, which is 2/24 dosing and suits me best as my day time insulin requirements are only about 1/3 of my night time insulin requirements.
Repeat some thing overnight.
Once basal is well set, then you can go about adjusting the carb:insulin ratio.
You can google this. Also the books "think like a pancreas" and "using insulin" will tell you what to do.
The so-called "sliding scale" is obsolete nonsense. Think about it. To take a set amount of insulin based on what your blood sugar was before eating is to assume that a salad will have the same effect as a chocolate cake. How absurd.
As others have said here, the only way to accurately match food and rapid acting insulin so that they balance each other is by counting carbs. Insulin lowers blood sugar. How can you know how much to lower it if you don't know how much it's going to rise????
your right...thank you
Sounds like you are being treated by a general practitioner. I firmly believe that anyone taking insulin should see an Endocrinologist. I was started on insulin by my GP and received even less instruction for dosing insulin that you have received.
A lot of people have found that their GP is just not up to date on how insulin is calculated so they use an out of date method.
I would say too many carbs to begin with. If I ate a meal like that, I’d be kicking myself in the rear for it for two days. The burger on a bun is bad enough. Skip the fries. You don’t need them. See a nutritionist to learn how to eat. It’s a bummer to have to give up a lot of foods you love, but after several years of consistently high blood sugar from eating the wrong kinds of foods you start to get sick and tired of feeling sick and tired. Now is an excellent time to rethink your eating habits. Best of luck with it.
With me on humalog sometimes it takes more insulin to lower my levels.you need bro contact you doctor and let them what is going on they may need to reajust your humalog.hang in there sometimes it take a little while to get it all worked.have a blessed day