Steady bolus, change food intake

Does anyone else do this? I’m still happily on the insulin pens (novalog) and rather than eating whatever I want, I take enough insulin for about 60-75g of carbs, then just change the amount I eat to match my insulin intake. I’ve tracked every blood sugar I’ve taken (only been diagnosed for about 5 months now) and my total, 2-month, 1-month, and bi-weekly averages are all at 100, +/- 7. Granted, if I go out to eat I may have to adjust the amount I’m taking, but maintaining the same bolus dosage and varying the carb intake also forces me to eat healthier and not overendulge too much. Thoughts?

The fixed dose regime has been around a long, long time. It was historically used in an approach called insulin mix which premixed a long acting insulin and a fast acting insulin so that a regime of 2-3 daily injections would provide “total” coverage. The results were not generally good. As you note, you “must” eat to match you insulin. And even worse the fixed regime drove an approach where you need to “overinject” to tighten control and then the patient has to “snack” to avoid lows.

The fixed dosing is considered archaic and should be discouraged as an appropriate regime. In your case, you may well still be having an easy time with a honeymoon. But eventually, I would expect you to need to swtich to a basal/bolus with carb counting. In the meantime, if your blood sugar average is truly 100 mg/dl with a standard deviation less than 10, then you are doing great.

ps. And I do eat meals that are the “same.” Every morning, I have a cheese omelette. Same food, same bolus, but I still choose to select the amount of bolus.

I’m far, far from honeymoon phase at this point. From my latest c-pep lab, I’m making 0 natural insulin. I still carb count, its just a different way of doing it. like I said, I eat between 60-75g of carbs which allows me to take 2 units. I’m injecting the exact same amount every day, 16 basal in the AM and 2 bolus per meal. I think it also helps that I plan out all my week’s meals at once so I’m not trying to eat 85% of a TV dinner or crap food like that.

I’m sorry, you were diagnosed in November, most type 1s have a honeymoon phase so I assumed your success with an atypical insulin regime might reflect a honeymoon. A good source of information on intensive insulin regimes is “Using Insulin” by Walsh. I’m glad it is working for you, but most people find that it does not work, it leads to poor control and weight gain. Just my opinion.

2 units for 60-75 carbs!?

Yeah, for me this just doesn’t work. My level of hunger really varies depending on a myriad of factors (hormones, activity levels, weather, etc). And that would be a the reason that I’m going on the pump…

Not a problem. I appreciate all the history and info regardless. I"ll have to give that book a read.

I started at about 1:20 but kept getting lows, so I eventually pushed it all the way to where it is now. I have a really strange T1 to begin with so we were thinking MODY, but tests were inconclusive or negative for the 5 types they tested for. That’s probably for another forum though. For here, yep, I’m really freakin’ sensitive.

For the longest time I covered my entire day with one injection of 70/30. I liked this much better than MDI. If for some reason I had to go back to injections I would pick up this routine again.