[stevenhorr]

Hi,

I am a 38 yr old type 1 diabetic, diagnosed 1.5 years ago. My insulin 'honeymoon' phase is clearly over. Just a year ago, 4 units of Novorapid was more than enough for breakfast. I'd need a snack within an hour or two, and would round up nicely. Now for some reason, I need 14-16 units of Novorapid for the same breakfast, but I still go way too high after about 2 hours (11-13ish), and then drop like a canon ball. I then seem to spend the rest of the morning fighting terrible lows. I take Levemir (the long acting stuff) twice a day, 16 at night and 13 in the morning. Does anyone have any suggestions for how I can correct this? It's making my life rather difficult as I work a pretty intense, busy job and can't be guzzling juice and day to try and stay afloat!

thanks,
Steve

 

[breezeonby]

Hi,

I am a 38 yr old type 1 diabetic, diagnosed 1.5 years ago. My insulin 'honeymoon' phase is clearly over. Just a year ago, 4 units of Novorapid was more than enough for breakfast. I'd need a snack within an hour or two, and would round up nicely. Now for some reason, I need 14-16 units of Novorapid for the same breakfast, but I still go way too high after about 2 hours (11-13ish), and then drop like a canon ball. I then seem to spend the rest of the morning fighting terrible lows. I take Levemir (the long acting stuff) twice a day, 16 at night and 13 in the morning. Does anyone have any suggestions for how I can correct this? It's making my life rather difficult as I work a pretty intense, busy job and can't be guzzling juice and day to try and stay afloat!

thanks,
Steve

Hi Steve and welcome! Wow, you are really having some difficult issues. My only suggestion would be to decrease your morning dose of Levemir and possibly increase your night time dose. Stick around and I am sure you'll get lots of other suggestions. We are glad to have you as a member.

 

[Jen]

Hi Steve. Let me recommend two books that will assist you in setting the appropriate Levemir dose and determining your insulin to carb ratio and correction factors: Think Like a Pancreas by Gary Scheiner and Using Insulin by John Walsh. They will take you step by step through methodical processes to set the best insulin doses for your own particular needs. While I've found that there is still a little guess work and that nothing beats your own experience, these books were invaluable to me. I still use them when something changes or I'm having difficulty.

Jen

 

[stevenhorr]

Thanks Jen.

You're the second person to have recommended "Using Insulin" to me today. Guess I better get a copy!

Steve

 

[Jen]

Yup. It and the Scheiner book are like the holy grails for insulin use. Once you've gone through the whole process and are really comfortable with your regimen, also try Walsh's "Pumping Insulin". Even though I'm on MDI, I was able to refine my daily program by thinking more like a pumper. Sort of a graduate course!

Good luck with this. It can be frustrating at first (or even later - I can attest), but once you get it down many other things will fall into place.

Jen

 

[Richard157]

Steve, you have been given good advice. The only thing I have to add is the possibility of bolusing awhile before the troublesome meals. Breakfast is the one that is most likely to give me highs one and two hours after eating. Unless I used to take my bolus 30 minutes before eating so the insulin would have a head start. That worked quite well. Now I have an insulin pump, so I can program variable basal rates to achieve the same effect. It would not be wise to take the insulin early if your BG at that time is already low. I did it only if my BG was 100 or greater at that time. I have read about many people who use this technique.

 

[stevenhorr]

Thanks Richard. That sounds reasonable! I think I'll try it tomorrow.

Cheers,
Steve

 

[onaughmae]

I absolutely LOVED Think like a Pancreas. One of the best books I have read. Well organized and easy to understand. The author has a great sense of humor which keeps the material interesting and not too clinical.

 

[stevenhorr]

Steve, you have been given good advice. The only thing I have to add is the possibility of bolusing awhile before the troublesome meals. Breakfast is the one that is most likely to give me highs one and two hours after eating. Unless I used to take my bolus 30 minutes before eating so the insulin would have a head start. That worked quite well.

I tried the technique today with good results. Thanks again.