Share your insulin dose strategies - Page 2

Go Back   The Diabetes Forum Support Community For Diabetics Online > Diabetes Forum Community > Diabetes

Diabetes This section of the forum can be used to discuss anything and everything to do with Diabetes. Please use this general Diabetes section for any comments or discussions that don't fit into the more specific forum categories below. Please also ensure that all posts and threads are on topic, about Diabetes.


Like Tree18Likes

Share your insulin dose strategies - Page 2


Closed Thread
 
Shared Thread Thread Tools
Old 07-23-2016, 20:17   #11
Senior Member
 
Join Date: May 2016
Location: Minneapolis, USA
Posts: 799

Member Type
Type LADA
Diagnosed in 2011

555 likes received
273 likes given
Default

Ok, I will join in as I am also new to insulin. I follow lowish carb - usually 90 grm cap, although Friday Night popcorn night is a bit higher. I have discovered that delaying eating 1/2 hour after taking bolus is more effective for me. I plan for roughly 25 carbs per meal.

basal = levemir
bolus = novolog 9-5-7 +3 snacks
Target: Before meals <130 After meals = <140

Basal 36u at 8:30 p.m. night before.

8am
- BG 119
- 9U bolus
- 16 carbs
Amazingly FBS was good today. Not where I want but better. My 12 grain bread or oat nut bread is 22-23 carbs so I'm looking a smaller loaf size. Currently, 14 carbs, but it's white bread - not very flavorful.

11:30 a.m.
- BG: 100
- Bolus: 6U
- Carbs: 25 grams
- BG Post: 138
Really, no science here. I eat roughly the same amount of carbs at lunch every day, but I was having leftover Chicken Tetrazini, so gave myself an extra unit.

3:00 p.m. (snack)
carbs: 17
Failed to bolus.

5:00 pm
BG: 154
Bolus: 9u
Carbs: 32
After Dinner: 197
I think this is Levemir issue. I added 2 additional units because of starting the meal with a higher BG. I don't think Levemir is working substantially at all by dinner.

8 p.m. Friday night popcorn
carbs: 16 grams
bolus: 7 units
Used additional units because of aftermeal number at dinner and assumption about Levemir. I usually only use 3.

8:30 p.m.
Levemir: 32u

11 pm. Bedtime
BG 149

Total Carbs for day: 106 gr.
Total insulin for day: 63u

It's pretty clear to me that since I dropped metformin that Levemir is not actually working by 2 or 3 p.m. So, I'm moving the Levemir from the current 8:30 to 4:30 (when I take my bolus for dinner). If that doesn't work, then I have to start thinking about taking additional Levemir in the a.m. I haven't figured out the ratio thing nor do a correction unless BG is 200+. Heck, I'm still trying to get my basal dose right. My bedtime numbers are 149+ since a few days after quitting metformin, and, I think, part of the reason why my FBG is so high. Ok, maybe not. I could just be grasping at straws.

Daytona likes this.
__________________
T2 since 2011; LADA 2016
A1C 7.9 5/1/16 <---before MDI
6.9 1/9/17
6.6 3/9/17 & 6/15/17
MDI - May 2016
LCHF started 6/22/17

Last edited by Bunjee; 07-23-2016 at 20:19.
Bunjee is offline  
Old 07-25-2016, 18:33   #12
Senior Member
 
Join Date: May 2016
Location: Minneapolis, USA
Posts: 799

Member Type
Type LADA
Diagnosed in 2011

555 likes received
273 likes given
Default

Here's another day. 105 gr. is actually the absolute minimum that my CDE wants, so I will use this as another example day for new endo. I am usually lower than this except once or twice a week. I think my switch to taking Levemir at 4:30 instead of 8:30 has been successful. If I had been bolusing correctly, I'd have reached my goals all day.

basal = levemir - 36u
bolus = novolog 9-5-8 +3 snacks <---regular plan
Target: Before meals <130 After meals = <140

Basal 36u at 4:30 p.m. night before.

8 am
- BG 123
- 9U bolus
- 38 carbs
- BG 178 post meal
2 Eggs (1 gr) Toast (14 gr), cherries (23 gr) <--I have 2 fruits daily


11:30 a.m.

- BG: 122
- Bolus: 7U
- Carbs: 32 grams
- BG Post: 146
BLT. Lots of bacon, tomato, very little miracle whip. Bread: 14 gr carb per slice. This was unplanned lunch. Had I known, I would have skipped toast in a.m. (need for pills).

3:00 p.m. (snack)
Skipped snack

4:30: Levemir 36u

5:00 pm
BG: 91
Bolus: 9u
Carbs: 18
After Dinner: 116
Chicken with veggies, 1/2 mashed potatoes (haven't had potatoes in 3 months).

9:00 pm (snack)
Bolus: 3u
Carbs: 24
large apple + peanut butter

11 pm. Bedtime
BG 140

Total Carbs for day: 108 gr
Total insulin for day: 64u

So, what were my mistakes today? I should have measured the cherries AND skipped the toast. Alternatively, increased my bolus. Had the same breakfast this morning with no toast and 9 cherries (19 gr) and post meal was 140.

Lunch - I didn't know about the sandwich, but obviously 2 additional units weren't quite enough but not terrible. I will do 3u extra in future when having sandwich.

Dinner - went well. No problem there.

Snack - it was the last of these largish apples. Should have used 4u instead of 3 for bolus. I would normally split this size apple with family member but they had gone to bed and I was hungry! Going to bed higher resulted in higher morning reading so snacks at night just don't help like they did when I was still taking metformin.

I have tried to figure out ratio, but it's sortof pointless until I get that morning blood sugar titrated right. Going up another 2 units tonight.

__________________
T2 since 2011; LADA 2016
A1C 7.9 5/1/16 <---before MDI
6.9 1/9/17
6.6 3/9/17 & 6/15/17
MDI - May 2016
LCHF started 6/22/17

Last edited by Bunjee; 07-25-2016 at 18:38.
Bunjee is offline  
Old 07-25-2016, 21:15   #13
Senior Member
 
Bounty's Avatar
 
Join Date: Feb 2015
Location: NorCal
Posts: 394

Member Type
Type 2
Diagnosed in 2009

586 likes received
35 likes given
Default

Quote:
Originally Posted by auntiekris View Post
...this medical stuff doesn't come easy to me but I'm curious about it all even if it doesn't apply to me - at the moment anyways.
Auntie Kris, Hi. I was looking at your diabetes information that you've provided - thank you for doing that - and noticed that your A1c a month ago was 11.5. Since we're talking about insulin here...I was wondering, how did you, or your doctor, come to your 8 unit decision...and has your doctor ever suggested that you titrate up to see if you could bring your A1c down?

auntiekris likes this.

Last edited by Bounty; 07-25-2016 at 21:20. Reason: edited for speling
Bounty is offline  
 
Old 07-25-2016, 22:20   #14
Senior Member
 
auntiekris's Avatar
 
Join Date: Jul 2014
Location: Sonoma, CA USA
Posts: 294

Member Type
Type 2
Diagnosed in 2013

680 likes received
1020 likes given
Default

Hi Bounty -

I didn't actually start insulin until about a week after that A1c test, so really it's only been about 2 1/2-3 weeks since I've been on insulin. I've started a thread here - http://www.diabetesforum.com/diabete...2-insulin.html and I'll update after my appointment.

And it just so happens I'm having a blood test tomorrow morning and then will meet with my doctor on Wednesday for the first time after being prescribed insulin.

She was afraid of lows so originally started me off at 2u but since I was in the 300's I upped it myself until I've found that 8u seems to keep me between the high 60's to low 100's for FBG.

Twice since starting insulin I've been over 140 and still bounce around quite a bit in the early morning and early evening so will be talking to her about that to see what can be done to even me out even more.

Thanks for your concern, it's very much appreciated. I'll keep you posted!

Bounty likes this.
__________________
Dx Dec. 2013
A1c 8.2 on 6/24/14
A1c 6.7 on 9/23/14
A1c 9.8 on 2/2/16
A1c 11.5 on 6/27/16
A1c 10.1 on 7/26/16

44 y.o.
2000 Metformin XR
8 units Lantus insulin (started 7/6/16)
auntiekris is offline  
Old 07-25-2016, 22:53   #15
Senior Member
 
Bounty's Avatar
 
Join Date: Feb 2015
Location: NorCal
Posts: 394

Member Type
Type 2
Diagnosed in 2009

586 likes received
35 likes given
Default

Good to know. Wasn't aware that you had just started your insulin regimen. You'll do fine...I'm sure.

I was on Lantus from 2009 until 2013, 25 units. We were discussing in another forum what would happen if Armageddon rolled around and we could no longer get insulin...how fast those who took insulin would go downhill and what could we do to compensate for that. I volunteered to be a guinea pig, quit my insulin and report daily what was happening and how I coped with it.

The first few days my FBG went up about 10 points. On the fourth day it returned to normal (for me, FBG 101 mg/dL). It never went any higher after that...in fact my one-hour and two-hour postprandials got better. After two months of this I also quit taking Lipitor and Lisinopril and baby aspirin. As of last month...I've been drug and insulin free for 3 years.

I talked to my doctor about it and he said that mine was a unique case. Either one of two things happened. Either I had Flatbush diabetes and my pancreas recovered on its own...or I had abused my pancreas to the point it just said, "okay, we give up...when you decide to stop feeding yourself like you're 12...give us a call!"

Honestly? I think the withdrawals from Krispy Kremes are worse than those with heroin.

auntiekris and Bunjee like this.
Bounty is offline  
Old 07-25-2016, 23:22   #16
Senior Member
 
auntiekris's Avatar
 
Join Date: Jul 2014
Location: Sonoma, CA USA
Posts: 294

Member Type
Type 2
Diagnosed in 2013

680 likes received
1020 likes given
Default

Quote:
Originally Posted by Bounty View Post
We were discussing in another forum what would happen if Armageddon rolled around and we could no longer get insulin...how fast those who took insulin would go downhill and what could we do to compensate for that.
Hahaha, I think about that ALL the time. Even if I could outrun the zombies* in an apocalypse, it wouldn't matter because the D. would get me.

*which I couldn't - a tennis teacher once told me I had the slowest feet he'd ever seen!

Quote:
Originally Posted by Bounty View Post
or I had abused my pancreas to the point it just said, "okay, we give up...when you decide to stop feeding yourself like you're 12...give us a call!"
Lol, this cracked me up. And still sadly this was my month of May before the last A1c test.

I'm glad you were able to get off of everything, that's amazing!

Bounty likes this.
__________________
Dx Dec. 2013
A1c 8.2 on 6/24/14
A1c 6.7 on 9/23/14
A1c 9.8 on 2/2/16
A1c 11.5 on 6/27/16
A1c 10.1 on 7/26/16

44 y.o.
2000 Metformin XR
8 units Lantus insulin (started 7/6/16)
auntiekris is offline  
Old 07-26-2016, 00:12   #17
Senior Member
 
Bounty's Avatar
 
Join Date: Feb 2015
Location: NorCal
Posts: 394

Member Type
Type 2
Diagnosed in 2009

586 likes received
35 likes given
Default

At first they gave me a script for a Lantus vile and syringes. At my next visit to my PA-C I told him this vile thing's a bit fumbly...got anything else? He wrote me a script for a Lantus Solostar pen...with the 5/16" pen needles. What a difference.

I read up on injections and to not inject in the same place too often. I didn't know how often "too often" was. Neither did anyone else I talked to. Finally found a doctor who suggested a safe amount of time to keep from getting subcutaneous scar tissue would be about a two week rotation.

So, I got out a permanent marker, made 14 spots on my abdomen, numbered those spots on a graphic I made...then put those numbers on my calendar. Spot number 1 on Monday, number 2 on Tuesday etc. until two weeks were up...then start all over again. 4 years, never a bruise, never any skin complications or scaring that would need higher doses of the insulin. Below is the chart I made up. Worked good for me.






Daytona, auntiekris and Bunjee like this.

Last edited by Bounty; 07-26-2016 at 00:16. Reason: edited for speling
Bounty is offline  
Old 07-26-2016, 00:36   #18
Senior Member
 
auntiekris's Avatar
 
Join Date: Jul 2014
Location: Sonoma, CA USA
Posts: 294

Member Type
Type 2
Diagnosed in 2013

680 likes received
1020 likes given
Default

I'm pretty good about switching sides, but I'll definitely look down and think hmmm, where exactly did I inject the day before? Thanks for the great tip!

__________________
Dx Dec. 2013
A1c 8.2 on 6/24/14
A1c 6.7 on 9/23/14
A1c 9.8 on 2/2/16
A1c 11.5 on 6/27/16
A1c 10.1 on 7/26/16

44 y.o.
2000 Metformin XR
8 units Lantus insulin (started 7/6/16)
auntiekris is offline  
Old 07-26-2016, 01:18   #19
Moderator
 
Daytona's Avatar
 
Join Date: Aug 2011
Location: Chicago, IL
Posts: 2,665

Member Type
Type 2
Diagnosed in 2010

3090 likes received
2882 likes given
Default

I inject my basal on the side of my butt, since it's much less sensitive there to a large dose and there's lot of places to keep poking without repeating. Then I save my fat tire and tummy for boluses, as they are easier to discretely reach.

auntiekris likes this.
__________________
Pumping insulin since 2017
Daytona is offline  
Old 07-26-2016, 01:23   #20
Moderator
 
Daytona's Avatar
 
Join Date: Aug 2011
Location: Chicago, IL
Posts: 2,665

Member Type
Type 2
Diagnosed in 2010

3090 likes received
2882 likes given
Default

@Bunjee Have you thought about splitting your levemir dose? It definitely does not last a full 24 hours, and I get much better coverage by splitting it up. I actually overlap them a bit for extra "oomf" in the morning but it's pretty common to do them 12 hours apart.

Also there's a new basal insulin, Tresiba, that looks really promising. It lasts real long, doesn't have a peak and you can take it anytime of the day (as long as it is > 8 hours after your last shot). In another forum, I've been following along as people (T1's and T2's) have tried it and lots are even coming off their insulin pumps because it works so well. If my new insurance covers it, I may ask for a sample to see if it works better for me.

__________________
Pumping insulin since 2017
Daytona is offline  
Closed Thread

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
increasing insulin dose pctm Diabetes Treatment 62 09-27-2015 16:25
Insulin dose sy_crawley Diabetes Medication and Supplies 3 07-06-2013 16:55
15 Natural Strategies to Overcome Stress and Anxiety kantim Diabetes Forum Lounge 0 05-17-2013 12:49
Basal Insulin Dose breezeonby Diabetes Treatment 5 05-29-2010 13:43

LEGAL NOTICE
By using this Website, you agree to abide by our Terms and Conditions (the "Terms"). This notice does not replace our Terms, which you must read in full as they contain important information. You must not post any defamatory, unlawful or undesirable content, or any content copied from a third party, on the Website. You must not copy material from the Website except in accordance with the Terms. This Website gives users an opportunity to share information only and is not intended to contain any advice which you should rely upon. It does not replace the need to take professional or other advice. We have no liability to you or any other person in respect of any content on this Website.


All times are GMT +1. The time now is 08:08.




Powered by vBulletin®
Copyright ©2000 - 2020, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.
User Alert System provided by Advanced User Tagging v3.1.0 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.