[stevessvt]

Hello, I have had diabetes for 15 or so years, the last 5 or so using a combo of Humalog and Lantus. Ill admit, I have not been a great diabetic, but have always taken my insulin when I should. A few months ago I had a scare with my eyes, which, in turn, opened my eyes. I went and checked my A1C, and was surprisingly decent (7.0).

Now I check my sugars often, and some foods are taking me by surprise. Namely rice and white bread.

My question is, if I underestimate my humalog amount, and end up going high when I check it 2 hours later, can I then take a booster humalog shot?
Earlier today I had 1/2 a sub (that I asked for on wheat, but got white), 2 hours later was 285, so I took 8 more units humalog to supplement the 12 I took at lunch.
Can I do this?
Thanks

 

[Shanny]

Welcome to our forum, Steve . . . good to meet you.

My experience with insulin is zip, but many others here have the answers for you.

Thank you for joining us! Come often and chat much.

 

[stevessvt]

Thank you! I'm trying to be a good diabetic, tough with no insurance. I'm going to pretty much try to cut out most white foods (white breads, rice, potatos) and see if I can do better.

 

[Shanny]

After being uninsured for the last twelve years, I have finally aged into Medicare and have had coverage for exactly eight days now! Holy cow - I dunno how I managed all those years without having some huge expensive emergency!

Your ideas for amending your diet are good too . . . seems like the fewer carbs you eat, the less insulin you would need, right? So the less money you spend?

 

[breezeonby]

Insulin

Hello, I have had diabetes for 15 or so years, the last 5 or so using a combo of Humalog and Lantus. Ill admit, I have not been a great diabetic, but have always taken my insulin when I should. A few months ago I had a scare with my eyes, which, in turn, opened my eyes. I went and checked my A1C, and was surprisingly decent (7.0).

Now I check my sugars often, and some foods are taking me by surprise. Namely rice and white bread.

My question is, if I underestimate my humalog amount, and end up going high when I check it 2 hours later, can I then take a booster humalog shot?
Earlier today I had 1/2 a sub (that I asked for on wheat, but got white), 2 hours later was 285, so I took 8 more units humalog to supplement the 12 I took at lunch.
Can I do this?
Thanks

Hi! From what my doctor has told me and from what I have read, you really should not stack your insulin doses. My doctor says to wait until your next meal and correct your high. There are a few different ways to do this and I will quote this from a book, when your blood glucose before a meal is 181-210 add 3 units of insulin and for every additional +30 add 1 unit. This info is from "Guide to Insulin" by American Diabetes Association. I will admit to taking some doses closer together than what the books and doctors will tell you, and the most than can happen is that you may experience a low. If you would have called your doctor he may have given you the go ahead on the extra insulin. You might also try and get out for a brisk walk if that is possible. Did the extra 8 units bring your blood sugar down?

 

[Richard157]

Here is one way to deal with this. Many diabetics try to be 140 or less when they test two hours after eating. If you are higher than 140 then you can take extra insulin at that time. How much you take depends on your insulin sensitivity factor (ISF). I know that 1 unit of fast acting insulin lowers my BS 12 points, so my ISF is 12. (It lowers it more than that during the night.) If I had 200 two hours after eating then that is 60 points too high, since I do not want to be above 140. So I want to compensate for the extra 60 points. I divide 60 by 12 and get 5. I need 5 extra units of insulin. If my ISF was 20 then I would divide 60 by 20 and take 3 extra units. This procedure works well for me.

 

[stevessvt]

Here is one way to deal with this. Many diabetics try to be 140 or less when they test two hours after eating. If you are higher than 140 then you can take extra insulin at that time. How much you take depends on your insulin sensitivity factor (ISF). I know that 1 unit of fast acting insulin lowers my BS 12 points, so my ISF is 12. (It lowers it more than that during the night.) If I had 200 two hours after eating then that is 60 points too high, since I do not want to be above 140. So I want to compensate for the extra 60 points. I divide 60 by 12 and get 5. I need 5 extra units of insulin. If my ISF was 20 then I would divide 60 by 20 and take 3 extra units. This procedure works well for me.

Thank you. My sugars at noon was 242. I took 4 units and at 3:30 I was 140. So I guess my ISF is 25. I imagine it also depends if you are still going up, or are staying even. I checked it 3 hours after breakfast. I have also been a bit sick lately, and that seems to be messing my sugars up too.

 

[Shanny]

Being sick definitely throws our sugars outta whack . . . sometimes rising BG is the first indication that something is going on.

 

[breezeonby]

ISF & Carb Ratio

Here is one way to deal with this. Many diabetics try to be 140 or less when they test two hours after eating. If you are higher than 140 then you can take extra insulin at that time. How much you take depends on your insulin sensitivity factor (ISF). I know that 1 unit of fast acting insulin lowers my BS 12 points, so my ISF is 12. (It lowers it more than that during the night.) If I had 200 two hours after eating then that is 60 points too high, since I do not want to be above 140. So I want to compensate for the extra 60 points. I divide 60 by 12 and get 5. I need 5 extra units of insulin. If my ISF was 20 then I would divide 60 by 20 and take 3 extra units. This procedure works well for me.

Richard: Is your ISF the same as your carb ratio? If not, what is the difference?

 

[Richard157]

A carb ratio is the number of carbs that 1 unit of insulin will cover. My carb ratio is 6 so I need one unit of insulin for every 6 carbs I eat. A carb ratio is used before eating something to determine the premeal or presnack dosage.

The insulin sensitivity factor (ISF) is the number of points that one unit of insulin will lower your blood sugar level. My ISF is 12 so 1 unit lowers my BG 12 points. The ISF is needed for corrections, when the blood sugar is higher than your target. My target is 90 so if I have a high of 150 and I want to reduce my blood sugar 60 points to reach my target, then I will need (60 divided by 12) or 5 units. If I have some insulin on board from a previous dosage then I would subtract that amount from that 5 units so my blood sugar will not drop too much.

 

[breezeonby]

Thanks for clarifying that. I do not usually have to worry about having a high. But in the past when I corrected a high, I needed 1 unit for every 10 points over 160. If I do run high I usually wait until my next meal to correct or for some reason my blood sugar usually comes down with my mealtime bolus if I wait the full 5 hours that Novolog is effective.

 

[stevessvt]

Man,.....I tried a Glucerna shake for the first time as a breakfast substitute. Had no idea what to take for insulin to counteract it. But,...it says it slowly motabalizes in your system. So I wake at 7am to a reading of 101. I drink the shake at 9 and take 3 units for it. At 9:30 Im feeling like Im going high and take a reading. 303. Damn. I take another 7 units. I took another reading at 11:40. 175. I think its still dropping. So I guess I know now that those things are pretty much a meal substitute, and need to take a normal meal amount of insulin. But why do they say it doesnt spike your sugars, when clearly it did?

 

[Shanny]

That Madison Avenue gang talks a good story, don't they? I've never tried any of the meal drinks, but here from the Glucerna website itself, is a list of the ingredients in a snack shake. The second and third ingredients are corn maltodextrin & fructose. How they can advertise that it won't elevate glucose is beyond MY comprehension!

WATER, CORN MALTODEXTRIN, FRUCTOSE, MILK PROTEIN CONCENTRATE, GLYCERINE, HIGH OLEIC SAFFLOWER OIL, COCOA POWDER (PROCESSED WITH ALKALI), LESS THAN 1% OF: SODIUM CASEINATE, CANOLA OIL, SOY PROTEIN ISOLATE, FRUCTOOLIGOSACCHARIDES, SOY FIBER, CELLULOSE GEL, NATURAL AND ARTIFICIAL FLAVORS, SODIUM CHLORIDE, MAGNESIUM PHOSPHATE, POTASSIUM CITRATE, CALCIUM PHOSPHATE, SOY LECITHIN, CELLULOSE GUM, CHOLINE CHLORIDE, ASCORBIC ACID, CARRAGEENAN, ACESULFAME POTASSIUM, POTASSIUM CHLORIDE, GELLAN GUM, SUCRALOSE, FERROUS SULFATE, dI-ALPHA-TOCOPHERYL ACETATE, ZINC SULFATE, NIACINAMIDE, CALCIUM PANTOTHENATE, CHROMIUM PICOLINATE, MANGANESE SULFATE, CUPRIC SULFATE, VITAMIN A PALMITATE, PYRIDOXINE HYDROCHLORIDE, THIAMINE CHLORIDE HYDROCHLORIDE, RIBOFLAVIN, FOLIC ACID, BIOTIN, SODIUM MOLYBDATE, POTASSIUM IODIDE, SODIUM SELENATE, PHYLLOQUINONE, CYANOCOBALAMIN3, AND VITAMIN D.

 

[breezeonby]

That Madison Avenue gang talks a good story, don't they? I've never tried any of the meal drinks, but here from the Glucerna website itself, is a list of the ingredients in a snack shake. The second and third ingredients are corn maltodextrin & fructose. How they can advertise that it won't elevate glucose is beyond MY comprehension!

I just checked my snack size Glucerna drink and it has 19 carbs so the meal size has to more than that. That maltodextrin will get you every time. I haven't drank any of the shakes yet but I would take enough insulin to cover the carbs.

 

[breezeonby]

Man,.....I tried a Glucerna shake for the first time as a breakfast substitute. Had no idea what to take for insulin to counteract it. But,...it says it slowly motabalizes in your system. So I wake at 7am to a reading of 101. I drink the shake at 9 and take 3 units for it. At 9:30 Im feeling like Im going high and take a reading. 303. Damn. I take another 7 units. I took another reading at 11:40. 175. I think its still dropping. So I guess I know now that those things are pretty much a meal substitute, and need to take a normal meal amount of insulin. But why do they say it doesnt spike your sugars, when clearly it did?

Wow, your blood sugar really spiked from the shake. Do you know what your IC ratio is? If you drank that shake at 9 and checked your bs at 9:30, sounds like your insulin didn't peak yet. I usually don't test for at least 2 hours after taking my insulin and I know that Novolog has a long tail.

 

[stevessvt]

Wow, your blood sugar really spiked from the shake. Do you know what your IC ratio is? If you drank that shake at 9 and checked your bs at 9:30, sounds like your insulin didn't peak yet. I usually don't test for at least 2 hours after taking my insulin and I know that Novolog has a long tail.

I use humalog, I think it peaks about 2 hours after. But I knew that even only a 1/2 hour, a spike that high clearly showed the 3 units I did take wasn't nearly enough. Ijust had lunch, and my sugars where 91, so I guessed pretty spot on for the booster shot.

 

[stevessvt]

As a plus, I just was accepted to Lilly Cares drug program. I will have a 4 month supply waiting for me at my doctors office on Monday! I'm already on the program for my Lantus. Makes not having insurance a little easier, and affording being diabetic a lot easier.

 

[Shanny]

That's good news. We have taken advantage of programs like this ourselves in years past. In fact, I think DH participated in Lilly Cares too. Now that we're both on Medicare, we still use a needs-based Missouri assistance program, so every little bit helps. One of the first things my pharmacist said to me when I was first diagnosed was "diabetes is one of the most expensive conditions to have". Dang!