Why insulin works and sometimes not

Some diabetes info that may help some.

Most of us diabetics are having troubles to keep their readings steady.
I’m one also who has little hair on my head left because when those sudden surprises
happening, it causes me to pull my hair every time. From time to time there will be some advice that is supposed to keep me from that pulling result. Don’t know if I formulated this properly but it will have to do.

One thing they tell me is to avoid the habit of eating the meat first at your evening meal before eating anything else. Any meat eaten first will block the other foods from being dissolved until the meat is gone. Meat takes longer, resulting in sugars entering often too late causing lows right after eating your dinner. I had this happening several times, could not believe that I could be low right after having had my dinner.

Then there is this little schedule telling WHEN to inject your insulin.
Based on testing your sugars 45 minutes before eating.

Below 50 When you finish your meal.
50 to 70 at mealtime.
70 to 120 15 minutes before meal time.
120 to 180 30 minutes before meal.
Over 180 45 minutes before meal time.

(If your pre-meal blood glucose level is below 70 mg/dl, eat or drink something containing sugar
right away to prevent hypoglycemia.)

If you look at Bernstein’s advice you see that the more insulin you inject at one time at one site
the longer it will take to be effective. Also don’t mix insulins with Lantus insulin.
Go to different sites often if you can for better absorbtion…

Now, I would like to see your opiniion about this, if you please?

JB.

I’m sure you’re familiar with YMMV (your mileage may vary). Knowing how Diabetes affects each of us is individual and doesn’t always adhere to the rules. Like you at times I drop low as I’m eating because of where my bs is so I eat first the food that will bring my bs up fast.

I’m pretty new at this, and am intrigued by the advice re timing. What are others’ reactions? Is it good advice?

JB …for me as a pumper ,helpful to use " dual and square wave bolusses " for my meal deliveries ; in other words spread out over a chosen length of time. I am also on low dose of approx 20 u daily …Dr. Bernstein’s advise on " large" amount of insulin delivery in one spot makes good sense …I guess , one could split the dosage .
My pump warns me NOT to bolus, when I am 3.8 ( x 18 equals 69 ) , but treat low and monitor …sometimes I override , depending what type of carbs .
And on the side …you seem as bright as prior to your very recent BD …age does not seem to matter at all to you , ha, ha

The concept of the timing insulin is good, but I don’t agree 100% with the numbers he posted. In my opinion, that is some very aggressive dosing that could lead to lows. I would not dose insulin at mealtime if I was 50. I would eat or drink something fast acting uncovered first to bring it up a bit, and then dose for my meal. I also would not dose 15 minutes ahead of time if I was 70. But the old YMMV applies here.

Kestrel, these are guidelines and everyone will make adjustments to these like I do according to your needs.

JB.

kestrel , please read my response too …I do trust my pump’s message , because it is set for ME …up to 69 and bolus ???
…I at age 70 plus like to play it safe :slight_smile:

well, looks pretty good to me JB…

MDI now about 17 yrs since age 45, using Levmire an Novalog’

ever since learning about stuff like this ( and not from Endo’s either) thru Books and These sites

Been ave 6% A1c’s for yrs now…



I try to take my BG test and Bolus for what I’m going to eat 15 min ahead of time as a rule



But I found by testing earlier was more difficult… unless I suspected being high…



I just test 2,3 and 4 hrs after ( post) mealtimes…



If I test at 15 min B4 meals and get a Higher BG? Then I delay when I will eat accordingly to a Bg/timeframe like yours… and if it’s above 200? Then I will change what I am going to eat , down to very low carb stuff…



If I am Low? I will treat the low seperately as not to screw up my plans for what my Carbs vs Insulin bolus is supposed to be… ( Glucose tabs usually ) or some 10-15 carb Juice, it takes less time than solid foods for me…

If I am High? I also have a seperate Chart I made that requires me to have a Different SF factor for every 45 pts above 80 to correct for…

If I am at or above 175 at bedtime? I will take a CB for it and my Levimire, but also will set my alarm for 3 hrs later, wake up, roll over and test and be ready to take another Cb if necessary ( about 50% of the time for me) to have that nice 80-120 range in the AM…


Book> Think Like a Pancrease…has helped me alot …



But things are always changing and always open to new and improved methods…

Elves

Kestrel, timing is important and other variables like bs ranges all are important. Diabetes is an eternal education.