Numbers Near 300 Most of the Time

Determining Total daily doses by weight doesn’t take into account many other perhaps even more significant factors such as resistance, insulin sensitivity, type, activity level, stress level and maybe most of all, diet.A person who eats 30 carbs is going to obviously need way less TDD than one who eats 200. Just out of curiosity I just looked in Using Insulin. For my current weight, and using the numbers between “sedentary” and “moderately active” it says my TDD should be between 37 and 45. I actually take around 22. Big difference. I think the best way to determine one’s TDD, I:C ratio, and basal dose is to see what works. To start low and then go up gradually until you hit the level that works well most of the time; doing basal testing first and then figuring I:C and correction factors.

Interesting as I have been using the formula 3.5 x no. of carbs - eg. 10 grams raises my blood sugar by 35 points, 15 grams raises my blood sugar by 52 points, 20 grams raises my blood sugar 70 points and 25 grams raises my blood sugar by 87.5 points. This is what I came up with according to the book “Using Insulin” when I did the calculations as instructed.

120 mg/dl as a target sounds so out of reach at this point. Anything under 150 sounds good to me considering where I’m coming from. I do believe I have high insulin insensitivity based on the fact that the “should be” is so out of whack with what “is”. 1U of Humalog “should” lower my blood sugar 30 points but that rarely if ever is what actually happens. I almost never eat more than about 22 grams of carbs at a meal which, based on 3.5 x # of carbs should raise me 77 points. If I am at 225mg/dl before the meal and add 77 that would bring me up to 302 mg/dl. If my target is 140 mg/dl 2 hours after the meal, I would need to come down 162 points. In order to do that, considering 1U should lower me 30 mg/dl, I would bolus 5.5U of Humalog (rounded to 6U) 20-25 minutes before eating. But 2 hours later, 9 times out of 10 I will still be over 200.

If I am figuring everything correctly, at this point the numbers just aren’t working for me. I will keep trying and tweaking and hope I will move into a more steady place.

Right back at ya. You take care too. At my next endo appointment I will ask about the possibility of switching to a different insulin. Hope it works for you.

Hugs right back to you. Thanks so much. I will watch out for the Dreamfields Pasta checking 4 or 5 hours next time I eat some.

Yes I have had the c-peptide which showed just about “0” insulin being produced by my pancreas. I stopped short of getting the antibodies test because it is so expensive and I have no insurance. Each of the 4 doctors I’ve seen agree that I need to be treated as a type1 so taking the antibodies test is not a priority since it would not change my course of treatment. I believe I am one of the unlucky ones with both insulin deficiency and insulin resistance.

Yes, it does sound clear that you are type 1. I’m glad you had some intelligent docs that could see past your age and give you your correct diagnosis!

I would definitely not exclude though looking at treating the insulin resistance as well as the insulin deficiency. It could be the reason why you are struggling so much. I know it’s easier said than done to lose weight at our age. I was a lucky Type 1 - I lost 40 pounds at diagnosis, now I just have to keep it off! But losing some weight could do wonders for the resistance and a Type 2 oral med could also help assist your body in utilizing the insulin better. I truly believe in the law of small numbers - the less insulin you need the easier it is to control blood sugars. You’re ahead of the game in cutting carbs, which should help with weight loss as well. Hang in there, bb, and yes, you do look much younger! All my life people thought I was 10-20 years younger than I was, then it finally caught up with me and now I look my age…unless the light is very dim and someone judges by my style and attitude instead of the lines and age spots…lol.

Dear BB



Read through all of the post and so sorry you are having such a hard time. you may have the worst of all worlds a completely dead pancreas even your glucogon system may not be working well so you will go low possibly dangerously so if it is truly not working. Also judging from your insulin to carb ratio your are insulin resistant.



You can ask the doc to consider adding metformin to the mix it helps with insulin resistance even if you are on external insulin. And it does even out the blood sugars. It was of no use to you initially because your pancreas is dead.



Also I would eat a very low carb diet until you get things under control. Meat, fish and veggies with little starch like broccoli, cauliflower, green beans, egg plant, peppers, salad,

I’m switching to Levemir, too Lynne. I just got my box of pens in the mail today. I have nearly a full pen left of Lantus, but I think I’ll just start on the Levemir tomorrow. I’m anxious to see how it helps. I wasn’t doing terrible on Lantus, but it seems every couple weeks I’d have to push my basal in one direction or another, and then usually push it back again after a few days. Let’s post what difference we see!

You definitely have some resistance there, which will come down once you get into a nice target range. Hang in there. Get the basals into range first. Then work on the boluses. You need a stable basal round the clock figure. You’ll figure it out by fasting and testing all hours, finding peaks of basal, and another day omitting a different meal and testing. Glad you said you’ll start soon.

Thanks for the clarification, Alan; that makes sense.

BB, even though I understand you are definitely struggling for stability don’t make it harder on yourself by assuming those formulas and numbers are something all the rest of us fit exactly. They are just parameters and we all vary very greatly from those points. There aren’t a lot of “should be’s” that are universal. Just keep working at it bit by bit until you find what works for YOU.The formulas are one of the only things about Using Insulin I did not find particularly useful.

Thanks again Zoe. What you said here makes so much sense and your words will stop me from continuing to be all hung up on the formulas.

I think that jan’s post may apply only to growing teens. I am an adult Type 1 and take about half of what she says her niece is taking. Sounds like you do have insulin resistance.

Lots of great advice from everyone.

I was diagnosed T2 at 53. Everywhere I turned, I got bad info, misinformation & flat out ignorant recommendations. Certainly helps to have a great endo, if you can find one, but most of us are our own teachers, doctors & science experiment.

I don’t fit the profile & ratios in Using Insulin. Hypothyroidism & thyroid supplements play havoc with textbook ratios. When my thyroid doses are increased, my insulin doses increase correspondingly.

I follow Dr. B’s recommendations & have for over 2.5 years. No deprivation at all. I only weigh 103 lbs & at 30-35 carbs daily, I should use quite small doses, but I don’t. Probably due to thyroid med, but I’ve never found an answer. I’m not insulin resistant because it takes small doses to lower highs, but I need a good bit to cover a small amount of carbs. It’s a paradox.

Lantus is quite difficult to dose because it peaks & it also doesn’t last 24 hours as claimed. Levemir is stable & level.

I didn’t know that about thyroid replacement increasing insulin needs. I have never noted that, although my thyroid dosage has been pretty stable since dx. Interesting.

You too, Lynne!

Yep, it’s even listed as a med that raises BG.

I always attributed my increase in dosage around that time to my honeymoon wearing off and the changes after having a baby (I was dx with hypo in the first post-partum months), Good to know, so that if my thyroid does changes I can know to look for my insulin needs to change as well.

TDD is very individual. Depends on too many factors to list here!

I weigh more than bbclarke, am in my late 50s and not terribly active. Have no c-peptide and my TDD is ranges from 31 to 39 u a day… on a pump though - so, about 5-10 u per day less then when I was on MDI (depending on what I eat). And I have an HBA1C in normal range (6.8).