I don’t know any of the terminology yet. I’m going slow, feel like I’ve got a blindfold on and I’m trying to feel my way through this. Got diagnosed a couple of weeks ago. Was at the grocery store shopping when my doctor called and said you need to go to the emergency room and be prepared to stay a couple of days. I was buying a chicken sandwich at the time, because I just didn’t feel well. I put it in my purse and took it with me to the ER. My blood sugar was over 700, a big surprise to me. I didn’t even know what it should be, nor have ever had to care. All of a sudden I’m on an insulin drip and I decide that I should eat something because it might be a while before I get up to the hospital room. I’m eating my chicken sandwich when the nurse comes in… now I realize that I was completely out of it… when the doctor called me at the local food coop, I was very ho hum about everything. A friend picked me up since I wasn’t supposed to drive and I was very chatty and completely relaxed. The next couple of days are a blur. I was prescribed 24 units of Lantus. Had serious lows in the hospital on that, and continued to have them over the fourth of July weekend which made contacting my doctor impossible. So… over the last couple of weeks have been titrated down by the diabetes clinic nurse to 5 units. She thinks I’m type one and am on my honeymoon. The lows continued to occur… mostly at night so I asked her if I should halve the dose and give am and pm. She said no. My doctor said no. So I went looking on the internet and found you and after reading the discussions for hours and hours I finally got some REAL information! Thank you for supporting me in taking my own action to medicate differently because the last few days, I’ve had NO dangerous lows. Taking two at night and I wake up in low 100’s and take three in am, ten hours later, and have not had a severe low during day either. A little high… in the 130’s before my next meal about five hours later. I haven’t gotten any courage up to take the humolog yet. So I need to know if I should up my morning Lantus or should I start taking a premeal shot of the humolog. They gave me the pens. And what should my blood sugars be at? And should I measure before eating and right away after eating? Thanks for being here everyone! Carolyne
Hello Carolyne!! I am SOO glad that you found us!!! And that splitting the Lantus is working for you!
Yes, you are likely in your honeymoon phase, which means that your body still produces insulin.
I aim to keep my blood sugar between 80-140. That does not mean that it is always there, but that’s the goal. I only get worked up about bring above 140 for a long time or numbers above 200. But we all have our own goals. So hopefully others will post as well.
I think that if the highest that you are seeing is 130, then it might be best to not take the Humalog. Taking it might cause lows. But you should find out if you are spiking after eating. I would try measuring 1 and 2 hours after eating.
Were you instructed about how many carbohydrates to eat? If you are spiking when eating, then you should either take a small amount of Humalog or reduce your carbohydrate consumption.
Welcome! There certainly is great info here & many experienced & kind people to help. Keep asking whatever you need to know.
You’ll hear this over & over–everyone is different with their unique biochemistry, so there is no one-size-fits-all treatment plan. It takes a lot of trial & error & tweaking to get doses right. When I was diagnosed, I’d cry out of frustration wanting answers & for someone to tell me what to do & how. I’d do anything if only I knew what to do.
Please check out Jenny’s blog & book http://www.bloodsugar101.com. It’s wonderful.
I changed my basal dose on my own also from things I learned here, too!
The best thing you can do is keep logs of your BG by testing frequently. This is only way to see patterns & the only good way to fine tune doses. There are several on-line formats, endos usually have forms, or you could make your own. You should try to keep meals as regular as possible & at least four hours apart so that one meal is digested before eating another. Not easy, but it helps. You should log your morning BG as soon as you wake up, your BG before meals, two hours after meals (food isn’t digested immediately, though sugary things have a quick effect) & right before bed. People also test before, during & after strenuous exercise. We also test, of course, if we feel high or low. With your numbers, you should note how many carbs were in the meals & what you ate. Foods will effect your differently. Humolog needs to be matched to carbs, so counting carbs is crucial to good BG control.
People have different target BG. Mine is 80-90 for morning fasting & between meals & 120 two hours after meals. Like Kristin said, that’s the goal (& hard to attain). If mine is above 120, I correct with an injection. Over 140 is when damage occurs.
You’ll learn your carb:insulin ratio, how many units to take to correct highs & how to raise lows. This is another area where everyone is different based on weight, level of activity & their particular insulin sensitivity or resistance. Just as an example, 1 unit of Apidra (another rapid acting like Humolog) will lower my BG 60 pts. If I’m low, 1 gram of sugar will raise my BG 10 pts.
Start tracking those numbers & let us know how you’re doing. If you start seeing BG creeping up, you’ll need to take Humolog. During the honeymoon phase, you’ll need small doses. I started out on 1/2 units. You don’t want lows, but taking insulin & having good control will preserve remaining beta cells. You don’t want high BG burning them out, or causing complications.
Kristin is right on her advice. I was told to try for 80-120 with 100 being main goal. My only extra advice is this, being new Dx’ed the low feeling (which feels so good LOL) my be a little out of whack because your BS has been high for a while. It took me sometime to feel low at below 70, this the low point you should watch for. Before I adjusted to a more normal(?) BS I felt low at anything below 100. I also think that 130 is a little high and you should try some humalog before eating, my starting point was 1 unit humalog to 15 gr. carbs. I was Dx’ed about 1 year ago. When 1st trying to control BS it was hell I won’t lie a lot of hard work. It will pay off on my meter it has averages mine are 7 days 108, 14 days 107 and 30 days 107. My last A1c was 6.8. I test about 5+ times a day. PS skittles are great for lows eat 5 check 15 min if still low 5 more, etc.
Almost forgot hopes this info my helps on terminology. Dx’ed=diagnosed, DKA=Diabetic ketoacidosis(reason for hospital?), MDI= multiple daily injections, basal= base insulin(Lantus slow, long), bolus= boost insulin(humalog quick, short), hypoglycemia= low BS, A1c=glycated hemoglobin
I would go for 110 mgdl as a target but as the others have said this depends on individual preferences too. For example I am aiming at 120 mgdl because I am very sensitive to bolus insulin.
You should always test your blood glucose before you apply insulin. In the early stages I would recommend to check two hours after the meal to see how high your blood glucose will get. This will show you if you need to apply a little time gap between injection and meal (maybe 5 to 10 min). This time gap will help the insulin to get active for the meal that you are about to eat. I doubt that you need this because you seem to be sensitive to insulin. If you like you can create an account on our free project Glucosurfer.org. There you can manage your diary and create a share for the members of the Tu community. This way we can follow your progress for a while and give you some feedback.
I am sadened to hear that your hospital treated you with lows after diagnosis. This makes me sad and angry because it is common knowledge that patients must be lowered VERY slowly. It is adisable to reach normal values after a week of treatment with insulin. The reason is that the liquid exchange between your eyes and your blood stream works very slow. If you lower the blood glucose very fast the concentration in the eyes will still be higher for a while. This difference in concentration will likely cause an increased liquid flow into your eyes. This transistion phase is known to be very dangerous for the eyes and therefore the difference in concentration should be moderate. Several diabetics have damaged or even lost their vision because their glucose levels have been lowered at a rate that was to rapid for their retina.
Hi Carolyne, glad you found the TuDiabetes site, there are knowledgeable people here to help you through the early times when you are being overwhelmed with info and trying to learn how your diabetes and your body interact with different foods and meds. I am a type 2 so my target numbers will likely be a bit different than yours I strive for 90 to 110 but have been in the last 3 months 80 to 127.
Test often and be well,
Hi Carolyn…sorry you have been dealt this adventure. It sounds as though you are well on you way to learning what you need to know. This is a great place for knowledge and support. As mentioned, Jenny’s book is great. I have also learned a lot from Think Like a Pancreas and Dr Bernstein. I was just thinking this AM that what seems to work for me best, at this point, is limiting my carbs and dosing my Humalog 20 minutes before I eat (when possible) for the carbs I do eat…both things I learned here. The lows will become less frequent at some point but always be prepared for them. Pick a favorite non-chocolate candy or glucose tablet and always have some with you. I use those caramels with the creamy middle…2 = 15 grams of carbs. Good luck and keep us posted.
welcome, this is the finest in patients sharing information… as far as the terminology goes, i see that some of the common ones have been defined here, but this is all stuff that we made up as we went along. do not feel bad that you don’t know and please ask questions… if you make up better terminology… let us know.
i shoot for a blood sugar of 100, but i am generally happy to see something below 160
I aim low, between 70-120, but sometimes this is very dangerous. I have a tendency to run high, but I also have a tendency to slip into comas. I get nervous if I dip below 60, and will treat it to bring it back up around 90.
It’s all dependent on you and your comfort zone.
If your doctors aren’t listening to you, you need to find a new one. Simple as that. I’ve been through many doctors because if they’re not hearing me, then I can’t help myself. If I’m noticing symptoms, then they need to help me figure out what’s causing them and how to treat them.
I found Apidra on this site, as well, and my doc wasn’t very helpful (even though I send him monthly letters with my symptoms and questions about new medications - just to keep him up to date). It’s like how I explained it to my fiance recently. I may be a patient to him, and he has many other patients to worry about- but, I only have ONE life, so my one life is the only one that I’m worried about.
generally my goal is 120 + or - 10 depending on the time of day. At night it is 120 + or - 20. this doesn’t always work, but it is a nice goal so far.
Here is something interesting that a friend of mine told me - she just got back from being checked up on at the Diabetic Research Institute in Florida (she had been one of the first islet cell recipients - going 20 months without insulin - she is now using an insulin pump since her body eventually rejected the cells). - she was told that maintaining extreme tight control such as in blood sugars does more harm than good! Now, she was talking in A1C levels - not BG levels - supposedly cellular damage does not begin until 8.0% and higher, and that in order to maintain hypo awareness one much not focus on such low numbers.
She was saying that when her A1C went below 6.3% that her ability for hypo awareness disappeared (she passed out a few times). Now, my BG’s tend to be between 80 - 150 - and my A1C is 5.7% last time - but so far I haven’t lost the ability of hypo awareness.
I’m going to have to do abit of research on this (unless someone else already has here) - and see what this is all about
Yeah, I can’t confirm or deny what you’ve found, but I was told by three different endos that an A1c of 7.0 % is the goal. If it’s a little below, that’s good, and a tiny bit above is okay. But, 7.0 % is generally the goal
The goal should be below 6.0% without severe hypos. The awareness for hypos does not depend on the A1c but on the stability you can achieve. If your mean value is around 110 mgdl and you have good control (little variation) then your sensitivity to values below 70 mgdl will be perfect. Most important is that you are not getting used to low values. This means that lows should be treated with quick carbohydrates like gluco tabs and lows in the sleeping phase should be prevented.
I dont know if this will help you but after reading the “Pumping Insulin” book I made my own log sheet. The one in the book is called a Smart Chart. You can record your blood sugar, insulin, carbs and notes. It is made for a person on a pump but I think even on injections you could modify it. If you would like a copy email me at firstname.lastname@example.org and I will forward a copy. Its done in excel so you might need that program. I looked all over the internet trying to find one that was already done but in the end had to make my own so I am more than happy to share if anyone wants a copy.
Hi Carolyne! Recently went on the pump and my goal is 70-120. Still adjusting and tweaking but am seeing more bgs in this range! I would be careful with the Humalog…try testing after eating for a couple days to see if you spike. As I said I am still adjusting after close to a month! Good luck and best of health to you!
wow…I wonder if it is because most people get really low HgA1c’s by dipping very low more frequently…I know I read that in a study out just a few years ago. Explained why my A1 is so crappy…for the most part my BGs are great…but, just a few crazy numbers (site problems, overtreat low, ok…ate too much!) it brings me up to a zone I don’t recognize as my blood sugars! I have often asked…how do people get blood sugars that low all the time? The reality is…it is not all the time…again, my big beef w/ poor level of technology for measuring blood sugar and inability to set treatment goals for “euglycemia”. I cannot buy that euglycemia is bad for diabetics or islets. Dipping below normal, likely is.
My goal is between 80-140 but specifically 110 is my magic number I prefer. That is my goal number set on my pump.
70-100 before meals, 120 two hours after.
Now ask me how many decades it took before achieving those goals. big grin But I do alright now. I remember when I’d treat a 90 with a huge ice cream sundae because it felt low - that’s because I was sitting at 300 most of the time! In time, you’ll grow comfortable in whatever normal range your docs have suggested for you. But give yourself an adjustment period. It takes time. Do your best, and take that insulin.
I agree with Mel 70-100 before meals and 120 2 hours after.
I have Type 1.5/Lada. I was dx’d in 2004. I was placed on oral medication. I wasn’t mis dx’d at all but my Endo and I decided to try the pills out. He told me the pills will only work for a certain amount of time but I would need insulin. In Jan 2008, I was placed on insulin. My pancreas is still working just not putting out enough insulin. I know everything looks weird and can be overwhelming but the storm will calm down. You have to get use to your body and it’s needs. We all have diabetes but require different treatment. TuD is a great community, plenty of resources here. You can do it. Try to stay positive. I promise it will get better.