hello! so I have been a diabetic 1 for only 6 months now and I am on a small dose of Lantus each morning.. I take only 11 units if Lantus in the morning and no other insulin with my meals. I find that after I eat a meal usually around 45 carbs or less that my sugar spikes to 200+ and stays there for At least 3 hours before it slowly makes it way back down to 150 ish... but at other times my Lantus does the job and my sugars stay down after I eat. is it what I am eating or does this just sometimes happen?
does anyone feel like I should be adding my mealtime insulin in so that my sugars do not sky rocket and stay that way for a long period? my Dr did OK me to start using if my sugars stayed this way but I'm just not sure I need it yet.
the one time i tried it before I ate my sugar was 145 and I had eaten a small sandwich with 1 unit Lantus and my sugar dropped rather low about 2 hours after. are u suppose to snack again an hour after your meal?
Thanks for taking the time to help so please help :-)
Laura Thanks! yes I am definitely in my honey moon phase still and its hard to keep at a good level. how do u administer half shots of novalog my settings are by one unit? I have an endo appointment next week so I will absolutely be talking with my doc more about this and what measures I can take to stay out of the 2s !!
Hi NoSugar.....- If there is a Wal-mart near you, they have syringes marked in 1/2 units. I use them b/c many times I take 1/2 units of insulin. You shouldn't take Lantus when you eat. It is a basal insulin, long-acting. You should take 1/2 unit of novalog when you check your BG 2 hours after eating. It is a bolus insulin, works right away to lower your BG from eating. If you find that your 2 hr. BG is high, then take the bolus dose when you eat and don't wait the 2 hours, but still check after 2 hours. b/c you are in your honeymoon phase, it is hard to judge how much insulin your pancreas is putting out. It takes a while to slow down on insulin production. Hope this info helps.
I have all insulin pens so I'm not sure I can get half doses out of it. I only take my long acting Lantus in the morning not with my meals because I know its log acting. I'm going to talk w my doctor next week I honestly do not even know what boluse means or what basile is because my Dr slacked on telling me like anything.... lol but I am going to ask lots of new questions next week! thanks!
Lantus is not meant to control your blood sugar after meals. It is meant to provide a small amount of background insulin 24 hours, and will affect fasting blood sugar, bedtime blood sugar and in between meal times.
If you are spiking to over 200 after your meals you need a bolus insulin (like novalog). It is not Lantus or Novalog. You need both because that is how you control your blood sugar. It's called MDI.
No you shouldn't have to snack an hour after a meal.When you say it became "rather low" what do you mean? What you have to do is figure out your Insulin:Carb ratio in order to know the right mealtime dose for you. You might need to drop down your basal a bit when you start bolus because right now your basal is being used to halp control your mealtime blood sugar as well (though obviously not doing it too well!).
If you are spiking to 200 and staying there for 3 hours, you do need bolus for your meals.
You can't administer 1/2 shots with pens. You need special syringes with 1/2 unit markings.
As for taking a bolus two hours after a meal if you are high, that is something different, that's called a "correction". Most people get started on an appropriate dose for bolus taken before meals first. Then later down the road they start learning to do corrections. Don't let your doctor talk you into a sliding scale or set dose for bolus; you need to learn to do an I:C ratio so you are bolusing for what you are actually eating. I recommend the book Using Insulin by John Walsh.
MDI (bolus and basal) is designed to imitate what is done by the body of a normal person without Diabetes. Their body puts out a small bit of insulin all day long to keep their blood sugar level. We use basal (or long acting) insulin in either one or two doses for that. Then a normal person's body puts out a surge of insulin when they eat. For that we use fast acting insulin for a "bolus". Do get Using Insulin, it will explain what few doctors bother with.
Just FYI, Zoe was incorrect in regards to pens. You CAN do 1/2units with pens, we do it daily with my daughter. You just have to have a pen that counts up by 1/2units. Ours is made by Lilly, but I know there are other companies too. Of course, there are syringes that do 1/2u as well and you can always go that route.
I stand corrected, Jen. I didn't know 1/2 unit pens existed! Which insulin is it and what's it called? I have a pump, but it's good info to have if someone else needs it!
My Dr gave me directions such as 1 unit novalog per 15-20 carbs I eat and if I am eating more to do the appropriate adjustments. is that what a sliding scale is or would that be considered the I:C way?
That is good to know I will have to look into that because as of now I just have the per one unit pens. we will see what my doctor says next week! thanks :-)
Good! That is "almost" an I:C ratio...lol. I:C ratios are an exact number, like 1:15. Then if you are eating 30 carbs you take 2 units. Many doctors tell patients 1:15, but that is just an average number to start on. When you use that, then you need to keep records and see how it works. If you are still high, then you would lower it to like 1:13 and try that. If you are low, you would raise it to 1:17, until you find the nmber that is right for you. We are all different and many of us have different ratios for different meals. For example mine are 1:5, 1:10 and 1:18 for the three meals. It's just trial and error to figure it out. And since you're insulin sensitive the 1/2 unit syringe would really help.
I do realize that the Lantus insulin is for background insulin throughout the day. I do spike over 200 after meals and it definitely stays there I usually eat breakfast and don't have to eat again until lunch or later...
when I used the novalog about an hour and a half my sugar was dropping into the 90`s from the 145 I started at before my meal. is that normal to do? I just get so nervous about getting lows that I am not at all looking forward to starting a fast acting insulin but I do have a feeling it is time
thank you for the explanation All the different terms used for insulin just confuses me! I think I will check out that book that you two mentioned, thanks!
90s are perfect numbers! But yes, going down 50 points would be too much if you hadn't been a bit high before your meal. You didn't say how many carbs that was, but you probably have a higher I:C ratio than what the doctor is suggesting. Like 1:20 or more.
Yes, I was a bit nervous when I started bolusing as well. Just make slow changes, start conservative with insulin and see how a certain ratio works for a couple days before making changes. Also keep glucose tablets to treat if you do in fact have a low.
We use humalog and humulin N, both in 1/2units. Our pens are not disposable tho, they hold the cartridges and we change them out monthly. We also give lantus by syringe, as those pens are disposable and only available in 1u increments. The 1/2u pens are usually marketed under a 'pediatric' pen.
Thanks, Jen; I had no idea that humalog came in 1/2 units. I've been on a pump since January 2011 and last week I ran out of sets and had to use shots for 2 days. I really hated how inexact the one unit doses were and with the syringe it was hard to even get that right!
I think that learning to accurately count carbs is hard, even if you have been doing it a while. I can look at a meal and I consider myself lucky to be able to estimate within 20% what the carbs are in the meal. And then when you factor in all the other variables, the time of day, whether I have just exercised. It is just not an exact science.
I've been using insulin for a year and a half. I still have stuff to learn, but I feel a lot more competent and confident about what I am doing. I can get my fasting numbers where I want and I can manage my after meal blood sugars really well. You've been given some key advice and the people here are really helpful. I'm sure you have wonderful success at this.
I was not aware of Humalog being available in a pediatric pen. Novolog is available in a pediatric version, it is called the Novopen Junior. The Novopen Junior allows dosing in 1/2 unit increments, although I do believe the minimum dose is 1 unit. NovoNordisk also has a new pediatric product called the NovoPen Echo, but I've not found it readily available in the US. The Echo also has half unit dosing and some other cool features.
I’m on Lantus also…if I dont take 8 units of Humalog after each meal my BG levels skyrocket to dangerous levels. If I do, my sugars stay normal. Not sure how much you would need to take for the amount of food you’re eating, but I’m pretty sure this is why your levels are so high…and talk to your Doc!
Eric
