I was diagnosed April 8, so it has only been a month. My BG has gone from 450-500 to 100-110. I take 3 units of Humalog before meals and I started with Lantus at bedtime, (5 units) increasing 1 unit every 3 days until my BG was 70-150. I got there at 10 units. So, I guess I am in the "honeymoon" phase.
My only question- Can I safely up the Humalog to 6 units if I know I am having a high carb meal? My BG went to 100 points using 3 units for that meal (which I would like to repeat) I plan to ask my endo this, but he is not great at answering email.
BTW, I don't mind the insulin shots but I hate the BG testing.
Meal boluses need to be tailored to the carb and protein content of the specific meal. So your basic notion of using more insulin when you eat a meal containing more carbs is correct as far as it goes.
BUT.
To do it effectively (and safely!!), you need to be more precise than just doubling your usual dosage for something as vague and nonspecific as a "high carb" meal. You need to determine how much 1 unit of bolus insulin will lower your blood sugar, and how much 1 carb will raise it. Finally, you need to learn how to count carbs, i.e., to determine how much carbohydrate is present in a particular food, or meal. Then and only then, you'll have the data required for accurately matching insulin to food, which is the name of the game for keeping BG as close to normal as possible.
Learning to count carbs accurately takes time and practice, but there is help available. There are some good books available (one of the best is listed below), and there are mechanical aids as well -- "intelligent" scales that can weigh a food item and tell you how many carbs it contains. There are several on the market; the one used by me and several others here is the EatSmart. It's easy to find online.
Like anything else, counting and estimating carbs is a skill that improves quickly with practice. It may seem intimidating at first, but that will soon pass.
Here's the book I referred to. It's not the only one by any means, just one of the better ones.
Gary Scheiner, The Ultimate Guide To Accurate CARB Counting (Cambridge: Da Capo Press, 2006)
I agree with David. You would not want to randomly go from 3 units to 6 units. I'm also confused: You said your BG went to 100 points using 3 units for that meal. Assuming you mean two hours after the meal, that is a perfect number; why would you want to increase the insulin?
But yes, in general you need to learn to count carbs, then figure out your Insulin to Carb ratio for each meal. Some doctors start people at 1:15. But if you know the number of carbs you have been eating and have kept careful records of your results than you may have a more exact place to start. Let's give an example (which may not be your actual experience). If you took those 3 units for a meal with 30 carbs and you ended up nicely in target, then you might guess at 1:10 as a reasonable I:C. Keep trying that eating different size meals. If you are consistently high, go to 1:9; if you are consistently low go to 1:11. But don't make changes on one experience, look for a pattern, then stay with the change for a few days.
Learning to count carbs and Figuring your I:C ratios (you may have different ones for different times of day) may take some work but once you get it accurate it will allow you to eat vastly different meals and still bolus with confidence.
It looks like you're a type 2 diabetic. A 'honeymoon' period is typically referred to a type 1 diabetic who still has some islet-beta-alpha cell function and still producing some of their own insulin, which will eventually all burn itself out; varies in terms of how long that honeymoon period will last.
Did your endo put you on insulin to get your BG's down quickly and then you'll try an oral medication, diet/exercise, etc..? Also, you need to be counting carbs not just upping your insulin doses randomly. Most everything, other than protein/fats, have carbs. Do you have an opportunity to meet with a CDE (certified diabetes educator)?
Oh, I see, you mean a 100 point jump, not just a BG of 100. Yes, you still need to work on determining I:C ratio. Please as everyone is telling you, don't just randomly double your insulin dose! You have to go about it carefully and systematically. If you don't feel you can do this without help ask for referral to a CDE or dietician but make sure they are educated in I:C ratios and don't just suggest "set doses" or "sliding scales" which don't work well.
Yes, I am a type 2 diabetic. I have not met with a CDE but that sounds like a good idea. My endo thought I would be on insulin forever. I don't go back to him until November but I may make an earlier appt. mostly to have my A1C checked again.
That's an interesting view of T2 diabetes--being on insulin forever, straight from the time of diagnosis.
A GP can really check your A1c, but if you're newly diagnosed and on insulin, maybe you should go back before November. (Why so much time? 7 months is an awfully long time to not visit a new doctor.) And I second the idea of a CDE.
I agree that waiting until Nov. is too long and I will make an appt. sooner. I don't want to switch doctors, partly because I feel so much better, partly because he diagnosed a different problem when other doctors had missed it, and partly because he is conveniently located. Maybe he based it on my A1C which was 14.5.
I'm a T2 on insulin for 2 years. I did the oral meds for almost 20 years but if I could go back I would start it much sooner if not from the beginning, Not because I like shots or the infusion set that I use now but because insulin brings a level of accountability that is not necessary with the orals.
I agree with everyone else that if someone is doing Humalog for bolus then the amount needs to vary for the carbs in the meal. Learning carb counting is a must and establishing the correct ratio is also a must.
I also feel that more frequent trips to the doctor is necessary at least until the necessary skills are learned to safely dose insulin.
