Had a meeting with my diabetic doctor yesterday where he mentioned correction dosage, he suggested 1.4 presume 1 unit novorapid to lower reading by 4, am I correct in thinking that say I take my novo at breakfast 6.30 then take a reading at 8.30 if I find my bloods are still high I inject extra then, would that not clash with the insulin I would be taking at dinnertime 12.00...? he probably explained it a bit more but by that time my head was spinning regarding numbers and times.....any advice appreciated.
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Correction Dosage
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Robin
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You wouldn’t normally do a correction dose after two hours. You’ve still got insulin on board from your mealtime injection, which should bring you down to a normal level after 4-5 hours, when it is all used up.
Correction doses are normally added to a mealtime dose just before you eat, if you find that your levels haven’t returned to normal after the last meal.
Finding that you are high two hours after a meal is normally dealt with by checking you'd got the carb count right for that meal, or if you are having a'spike' after two hours, but then return to normal, altering the timing of your mealtime bolus, perhaps bringing it forwards by five minutes, and then another five, until you’ve ironed out the spike.
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1u to lower 4mmol/L is one of the common starting points, but sensitivity to insulin can be very individual, so you may find that is too strong for you… or not strong enough!
As @Robin says, it’s important to recognise that at 2hrs you still have ‘insulin on board’, and as you suggest ‘stacking’ insulin on top of insulin can be a bit of a challenge.
Prebolusing (leaving a short time gap between the dose and starting to eat) can really help iron out high BGs at the 2hr mark.
I think DAFNE suggests waiting until the next regular meal and adding any correction dose at that point.
However I have found making corrections between meals to be a very helpful and powerful strategy. Sometimes meal doses just don’t work as expected for whatever reason - and I find getting a correction in early can help to smooth out the peaks and mean I’m more in-range at the next mealtime. Having a CGM (eg Libre or Dexcom) is very helpful in this respect, because you can check your guesswork as the doses begin to act.
If correcting between meals I find it’s safest to only correct with the aim of getting me back to 9 (which is where my BG was supposed to have levelled out), and I can hopefully leave the insulin on board to deal with the carbs still being digested and get me back to mid-range from there.
As @Robin says, it’s important to recognise that at 2hrs you still have ‘insulin on board’, and as you suggest ‘stacking’ insulin on top of insulin can be a bit of a challenge.
Prebolusing (leaving a short time gap between the dose and starting to eat) can really help iron out high BGs at the 2hr mark.
I think DAFNE suggests waiting until the next regular meal and adding any correction dose at that point.
However I have found making corrections between meals to be a very helpful and powerful strategy. Sometimes meal doses just don’t work as expected for whatever reason - and I find getting a correction in early can help to smooth out the peaks and mean I’m more in-range at the next mealtime. Having a CGM (eg Libre or Dexcom) is very helpful in this respect, because you can check your guesswork as the doses begin to act.
If correcting between meals I find it’s safest to only correct with the aim of getting me back to 9 (which is where my BG was supposed to have levelled out), and I can hopefully leave the insulin on board to deal with the carbs still being digested and get me back to mid-range from there.
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