Adjustment Rapid dose??

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Dragon queen

Dragon queen

Well-Known Member
Relationship to Diabetes
Type 2
Hi

Can anyone advise how I work out adjustment dose on Novo rapid. Blood sugars at 15 before meal which I usually take 4 units to a 40g carb meal. I’m on Lantus 30 units at bedtime. But last night over night bloods at 18 and woke at 14. Because had Eccles cakes late as insulin causing digestive problems the raisins usually works.
 
You need to know your correction factor - ie how many mmols one unit of insulin drops you @Dragon queen That amount will be different for each person. You could try a very moderate correction dose but you would need to be cautious. My correction factor is 1 unit drops me 4mmol during the day, but in the evening/night 1 unit will drop me 8+mmols. Your correction factor will be different, not only because you’re not me, but because I’m on a pump not injections and I’m Type 1.

There is a way to estimate your correction factor, but it would be best to speak to your nurse about it.
 
Your insulin shouldn’t usually be causing digestive problems, but occasionally people can’t tolerate certain types of insulin (I’m one of them). If you want a larger amount of carbs during the evening, you’ll have to inject for it.
 
If you mean that you are suffering from constipation there are other high fibre supplements which do not contain carbs or extremely few without all the sugars and starches in an Eccles cake. I use psyllium husk and chia seeds and they work great for me.

As regards adjustment, do you mean calculating a correction dose to bring your levels down into range when they are too high? If so, have you been given a correction factor? The correction factor that they started me on was to assume 1 unit of insulin dropped my levels by 3mmols. So if I was on 14mmols and I wanted to come down to 6mmols, 14-6 = 8.... so I want to drop my levels by 8mmols. If you divide 8 by 3 (1 unit drops me 3mmols) you get 2,6666. I have a half unit pen so I can inject 2.5 units which is close enough.
Correctio factors vary from person to person and if you are very insulin sensitive then you might find that 1 unit drops you 5 or even 6mmols so you might only need 1 or 1.5 correction units to bring your levels back into range. Also you will find that you are more sensitive to insulin at different times of the day and if your levels are particularly high you will usually be more insulin resistant.... so your correction factor can depend on how high your BG is. Gradually you just learn to know how many units you need to bring your levels down from a particular level and don't really calculate it..... but that is the basic process....
 
Inka said:
You need to know your correction factor - ie how many mmols one unit of insulin drops you @Dragon queen That amount will be different for each person. You could try a very moderate correction dose but you would need to be cautious. My correction factor is 1 unit drops me 4mmol during the day, but in the evening/night 1 unit will drop me 8+mmols. Your correction factor will be different, not only because you’re not me, but because I’m on a pump not injections and I’m Type 1.

There is a way to estimate your correction factor, but it would be best to speak to your nurse about it.
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Thank you for your reply. I’ve been trying to speak to my DSN for nearly a month but they only have answer machine and when they call back it’s just office staff. Book phone appointment for 10 days ahead but could be anytime if day last time waited all day and the minute I answer door she rings at 4.57 then sends text say rebook. Leaflet says it can cause weight gain yet when I asked on here was told no but I’ve gained nearly half a stone
 
rebrascora said:
If you mean that you are suffering from constipation there are other high fibre supplements which do not contain carbs or extremely few without all the sugars and starches in an Eccles cake. I use psyllium husk and chia seeds and they work great for me.

As regards adjustment, do you mean calculating a correction dose to bring your levels down into range when they are too high? If so, have you been given a correction factor? The correction factor that they started me on was to assume 1 unit of insulin dropped my levels by 3mmols. So if I was on 14mmols and I wanted to come down to 6mmols, 14-6 = 8.... so I want to drop my levels by 8mmols. If you divide 8 by 3 (1 unit drops me 3mmols) you get 2,6666. I have a half unit pen so I can inject 2.5 units which is close enough.
Correctio factors vary from person to person and if you are very insulin sensitive then you might find that 1 unit drops you 5 or even 6mmols so you might only need 1 or 1.5 correction units to bring your levels back into range. Also you will find that you are more sensitive to insulin at different times of the day and if your levels are particularly high you will usually be more insulin resistant.... so your correction factor can depend on how high your BG is. Gradually you just learn to know how many units you need to bring your levels down from a particular level and don't really calculate it..... but that is the basic process....
Click to expand...
Aww thank you that helps. I’m new to rapid 2 weeks now but been on Lantus 8 weeks. My figures are better I have been in single figures was in high teens even twenty’s. Getting hold of my nurse is difficult only ever answerphone and office staff call you back who can’t help. They are so so busy.
 
The important thing to remember if you do do a correction, is that NovoRapid works over a period of 5 hours, so don't be tempted to do another correction within that time frame.... or at least 4 hours.
 
Dragon queen said:
Thank you for your reply. I’ve been trying to speak to my DSN for nearly a month but they only have answer machine and when they call back it’s just office staff. Book phone appointment for 10 days ahead but could be anytime if day last time waited all day and the minute I answer door she rings at 4.57 then sends text say rebook. Leaflet says it can cause weight gain yet when I asked on here was told no but I’ve gained nearly half a stone
Click to expand...

Do you take 4 units of Novorapid before each meal @Dragon queen ? Then the 30 units of Lantus at night? That will give you your total daily dose of insulin. That’s what is used in the calculation of someone’s correction factor.
 
@Dragon queen I think I answered your weight gain question on a previous thread. Insulin doesn’t cause weight gain. Insulin resistance can do though.

What leaflet says about weight gain? The side effects of insulin are usually listed as hypoglycaemia and rare allergic reactions.
 
Trying to get hold of your nurses for suggestions and advice sounds very difficult @Dragon queen - fancy the phonecall coming at exactly the time you had to answer the door, and then them not calling back a bit later :(
 
I worked out my correction factor by taking 1 unit of insulin when my BG was around 10mmol/l and stable. I took 1 unit and tracked what happened over the next 4 hours. This was in the days before CGMs were common so I was finger pricking every 30 minutes.
The difference between my starting BG and what I was at after 4 hours I took to be approximately my correction factor. It is only an approximation because it can vary at different times of the day, at different starting BG, depends how much exercise I have done, and more.
 
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