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Pat91
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The rule of 500 is something I read were by you add all your units up for 24 hours then divide 500 by the total of your insulin, that then gives you roughly how much insulin per unit you need for every 10g of carbs. Think that is right anyway
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Pat91
Guest
Hi there yes I have a number i did ring them earlier in the week as i was having a hypo, they said just to log everything and call back sometime next week to see my readings.
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Pat91
Guest
Thank you, if I went to bed without a sandwich and my readings before bed were say in the 6s or 7s do you think my blood sugar would be low in morning with the Lantus 26 units.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I couldn’t say @Type1Pat but I would advise that you don’t go to bed below 8 as an absolute minimum at the moment.
Your Lantus dose might be adjusted, you might even be given a different basal insulin, but you should be wary of hypos particularly at night. When on injections, I had a bedtime snack routinely.
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Pat91
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Ok brilliant, thank you for your help will carry on as I am for now, just done my readings again before lunch and they are at 5.8 so that's not bad is it.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
5.8 is an excellent reading 🙂 In the early days, it’s better to bring your blood sugar down gradually and it’s better to avoid hypos. You and your team can refine things later as things settle. It’s often said that a Type 1 is a marathon not a sprint, and that’s very true.
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
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Yes, you are right, it absolutely would not work for me either Robin!
@Type1Pat
As regards how many meals and snacks a day, that again is an individual thing. I usually manage on just 2 meals a day and sometimes only 1 with perhaps a chunk of cheese or some nuts in between as a snack. Once you learn to carb count then that will allow you to eat whenever you want to and adjust your insulin dose to match the carbs you eat..... this is the benefit of the basal/bolus insulin regime.... it allows you so much more flexibility. I imagine at the moment, they have probably just told you to eat normally... whatever that is, so that they can figure out your ratios and adjust your doses and particularly get your basal dose correct as that is the key to managing diabetes well.
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Pat91
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Yes exactly that, just have to eat regularly as such and log everything readings and what not. I did tweak my insulin a bit as the nurse advised me to lower my daytime dose but I found my sugars creeping up so went back onto my original 10 units of Nova instead of 8.
Once you get used to carb counting and dosing your fast acting insulin according to how many grams of carbs you eat, you will be able to eat as often as you want. I am a grazer so eat snacks between most meals. Thankfully, I am also very active so don't have to worry about my weight.
But the diet advice for Type 1 is eat as often as you would without diabetes.
Your night time insulin is different. It lasts about 24 hours. The aim of it is to keep your blood sugar level when you do not eat. So, on the correct dose, if you went to bed at 6.9, you should wake around the same number. There are a few things that could affect that but I won't confuse you, now.
As for dry toast, it is how I always eat my toast and have done since I was a child. To me, there is nothing worse than toast that's gone soggy due to the butter melted on it. But then, I'm weird.
I say "nothing worse" then remembered Brussel sprouts. And swede. And ...
But the diet advice for Type 1 is eat as often as you would without diabetes.
Your night time insulin is different. It lasts about 24 hours. The aim of it is to keep your blood sugar level when you do not eat. So, on the correct dose, if you went to bed at 6.9, you should wake around the same number. There are a few things that could affect that but I won't confuse you, now.
As for dry toast, it is how I always eat my toast and have done since I was a child. To me, there is nothing worse than toast that's gone soggy due to the butter melted on it. But then, I'm weird.
I say "nothing worse" then remembered Brussel sprouts. And swede. And ...
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Pat91
Guest
Do you guys recommend carbs with every meal or is it ok too just have a salad and tuna for lunch, yes I must say I prefer dry toast with eggs but I'm afraid I do like butter with marmite on toast , I wasn't eating before bed in hospital tho and I was on more Lantus, could this be because I'm more active now, thank you .
Once you are counting carbs, you can have as many or few carbs as you want in a meal as you would calculate your insulin dose accordingly. So a tuna salad would be fine.
However, whilst you are on fixed insulin doses, I would be very wary of doing so as you could hypo.
If you give this as an example of a typical lunch next time you talk to the diabetes nurse, it may encourage her to allow you to carb count.
And thank you for making me feel less weird with my dry toast preference. Although I would still not add butter with Marmite.
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Pat91
Guest
Does blood sugar increase when we are sleeping or can it only decrease as long as we are not eating directly before bed.
Our livers drip glucose into our blood stream 24 hours a day. If we take no insulin, our blood sugars would rise overnight.
The slow acting insulin, Lantus, mops up this glucose and stops the rise.
If you have no insulin, there is no reason for blood sugars to fall.
As I mentioned previously, there are other things which could impact our blood sugars but this is what I was taught at first and it helped me understand. So I am trying to keep it simple.
Carbs in food plus glucose from our livers are the two main things which affect our blood sugars.
The slow acting insulin, Lantus, mops up this glucose and stops the rise.
If you have no insulin, there is no reason for blood sugars to fall.
As I mentioned previously, there are other things which could impact our blood sugars but this is what I was taught at first and it helped me understand. So I am trying to keep it simple.
Carbs in food plus glucose from our livers are the two main things which affect our blood sugars.
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Pat91
Guest
Oh I see ok that helps a lot thank you, going back on your previous comment you were right, because I had very little carbs but still had my 10 units of Nova, I had a hypo 1 HR 20 mins after lunch,no noticed the symptoms and treated quickly with 3 jelly babies and 2 digestives, scary how fast it happens tho.
D
Deleted member 25429
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I was diagnosed with type 1 18 months ago at the age of 53. I like you went into DKA it’s scary and overwhelming. At first I was worried about going low when I was asleep now that my insulin is fairly stable I can go to bed at 5 and not worry about hypos . My advice would be test test and test some more gives you more confidence . It shows you how you react to different foods . For example beef is difficult but I am fine with a slice of seeded bread . We are all different and need different amounts of insulin . Without this forum I would not have the control I have
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
Sure it's the beef and not what you eat with it? Beef is protein, Nil carbs. Roast spuds Boiled spuds Yorkshire Pud and the gravy all contain a decent amount of carbs, before you even start adding any accompanying veg.
- Relationship to Diabetes
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Welcome to the forum @Type1Pat
Wow! It sounds like you’ve done a tonne of learning already! That inquisitive spirit will serve you well in the weeks and months ahead, but as you’ve discovered sometimes the more you learn, the more you realise there is to find out!
Things will be different in the short term, while you are finding your feet. But I get the feeling that you are capable of switching to a more flexible self-initiated intensive insulin therapy fairly early as you are asking all the right questions, so do push your clinic for that and get them to hand over some of the responsibility.
To recap:
The 500 rule is a basic rule of thumb for establishing doses based on your Total Daily Dose, which is often recommended to split 50:50 between basal and bolus. But it’s more a guideline than a rule and needs to be adapted. Plus the fact that your TDD may not yet be right, and your basal:bolus split could be 60:40 40:60 or somewhere in between. See also the 350 rule or the 400 rule... which are the same thing but give different results!
There are also ‘rules’ for insulin sensitivity (100... 150...) but again these are only helpful as starting points for you to tweak/adjust.
Plus
You aren’t currently carb counting, so it’s all a bit academic! 🙂
Fixed doses
While you are on fixed doses, you need to keep eating fairly consistent amounts of carb for each meal to ‘balance’ the insulin. This might be slightly different at different times of day (you may need fewer carbs in the morning, and more later in the day to balance the same dose). If your BG is in range before eating and your insulin and carbs balance your BG should be back to where it started by 4-5 hours after you injected/ate.
Insulin acts for a loooooong time, and that’s one reason why some HCPs are nervy of people checking BG between meals... because the number might be high, but you might already have enough ‘insulin on board’ to bring it down by the next meal.
Basal insulin
Your basal (or background) insulin should *only* hold your BG steady when you are not eating and don’t have rapid insulin acting. In time you will discover how to check and adjust this on an ongoing basis (because your insulin needs will rise and fall through the year), but for now the simplest benchmark is overnight. Eat your evening meal around 6pm so that it is out of the way by bedtime. Then your waking level should be roughly the same as your bedtime level. And you should not need to snack to make that happen. If you are worried set an alarm for 2-3am and check again then. Your BG is likely to be lowest around this time.
Well done on a cracking start! And do consider getting that Ragnar Hanas book or Think Like a Pancreas’ by Gary Scheiner
Wow! It sounds like you’ve done a tonne of learning already! That inquisitive spirit will serve you well in the weeks and months ahead, but as you’ve discovered sometimes the more you learn, the more you realise there is to find out!
Things will be different in the short term, while you are finding your feet. But I get the feeling that you are capable of switching to a more flexible self-initiated intensive insulin therapy fairly early as you are asking all the right questions, so do push your clinic for that and get them to hand over some of the responsibility.
To recap:
The 500 rule is a basic rule of thumb for establishing doses based on your Total Daily Dose, which is often recommended to split 50:50 between basal and bolus. But it’s more a guideline than a rule and needs to be adapted. Plus the fact that your TDD may not yet be right, and your basal:bolus split could be 60:40 40:60 or somewhere in between. See also the 350 rule or the 400 rule... which are the same thing but give different results!
There are also ‘rules’ for insulin sensitivity (100... 150...) but again these are only helpful as starting points for you to tweak/adjust.
Plus
You aren’t currently carb counting, so it’s all a bit academic! 🙂
Fixed doses
While you are on fixed doses, you need to keep eating fairly consistent amounts of carb for each meal to ‘balance’ the insulin. This might be slightly different at different times of day (you may need fewer carbs in the morning, and more later in the day to balance the same dose). If your BG is in range before eating and your insulin and carbs balance your BG should be back to where it started by 4-5 hours after you injected/ate.
Insulin acts for a loooooong time, and that’s one reason why some HCPs are nervy of people checking BG between meals... because the number might be high, but you might already have enough ‘insulin on board’ to bring it down by the next meal.
Basal insulin
Your basal (or background) insulin should *only* hold your BG steady when you are not eating and don’t have rapid insulin acting. In time you will discover how to check and adjust this on an ongoing basis (because your insulin needs will rise and fall through the year), but for now the simplest benchmark is overnight. Eat your evening meal around 6pm so that it is out of the way by bedtime. Then your waking level should be roughly the same as your bedtime level. And you should not need to snack to make that happen. If you are worried set an alarm for 2-3am and check again then. Your BG is likely to be lowest around this time.
Well done on a cracking start! And do consider getting that Ragnar Hanas book or Think Like a Pancreas’ by Gary Scheiner
P
Pat91
Guest
Hi there and good morning everyone, thank you for the kind words and advice it is very much appreciated, I have been eating before bed normally a sandwich, last night I checked my BG at 9pm after having my dinner at 5pm. At 6.7 I just had 1 digestive instead of the sandwich and set my alarm for 1.15am my levels were 4.6 to my relief, so in theory could I repeat this every night a d be confident my readings will stay around the same at night as. When I woke this morning they were still 4.6. had my Weetabix and 10 units of Nova, checked at 10am , so 2hrs 30 mins after breakfast and my readings were 9.1, is this ok as long as my levels are back down by lunch ? Thank you.
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