Hi

Status
Not open for further replies.
Mom of Type 1 said:
Is there a formula to calculate how much insulin needed for the food that you are gonna eat ?
Click to expand...
There is. You just multiply (or divide) the carbs by some number. Unfortunately the number is different for everyone and commonly varies across the day.

A common starting ratio is 1 unit for 10g, but it really does vary a lot and your son will be advised how to do it (and may well be started on quite different numbers).
 
I now see that you are in Malaysia so probably don't need a vitamin D supplement like we do here in the UK because we just don't get enough daylight and sun. As regards any other supplements, he does not need them unless he is deficient in them. Do you get regular blood tests as a diabetic in Malaysia? Here in the UK when we are diagnosed as diabetic, we get at least annual checks and if something is showing as low like vitamin B12 or vitamin D or iron, we supplement it.
 
Bruce Stephens said:
There is. You just multiply (or divide) the carbs by some number. Unfortunately the number is different for everyone and commonly varies across the day.

A common starting ratio is 1 unit for 10g, but it really does vary a lot and your son will be advised how to do it (and may well be started on quite different numbers).
Click to expand...
If your son is on a mixed insulin then this suggestion of 1:10g carbs does not apply and could be dangerous.
 
rebrascora said:
I have just reread this thread, admittedly skim reading but what you say here confuses me.
Which insulin's ins your son using. Can you give us the actual name(s) of it (them)..... apologies if I have missed this in my skim reading....

It would be highly unlikely for a new and young Type 1 to be started on a mixed insulin. It is usually two separate insulins, a long acting slow release (basal) insulin which covers the glucose his liver releases day and night and a fast acting meal time (bolus) insulin that you inject usually before each meal.

Do you have 2 different insulins that you use like this. One that is injected once or perhaps twice a day and the other than you inject before each meal?
Click to expand...
No, he only got 1 injection 3 times per day. I believe the insulin is already a mix between basal and bolus. Does it goes like this ?
 
If he is injecting 3 times a day with each meal then it may be just a fast acting insulin. Mixed insulin is generally just injected twice a day. Once you can tell us the name of his insulin we can be more confident of giving you suitable advice.

You being in Malaysia could make a big difference because there will be different insulins and different guidelines for using it.
 
rebrascora said:
I now see that you are in Malaysia so probably don't need a vitamin D supplement like we do here in the UK because we just don't get enough daylight and sun. As regards any other supplements, he does not need them unless he is deficient in them. Do you get regular blood tests as a diabetic in Malaysia? Here in the UK when we are diagnosed as diabetic, we get at least annual checks and if something is showing as low like vitamin B12 or vitamin D or iron, we supplement it.
Click to expand...
Yes, we will have a doctor whom we go see regular and get checkups, etc
 
rebrascora said:
If he is injecting 3 times a day with each meal then it may be just a fast acting insulin. Mixed insulin is generally just injected twice a day. Once you can tell us the name of his insulin we can be more confident of giving you suitable advice.

You being in Malaysia could make a big difference because there will be different insulins and different guidelines for using it.
Click to expand...
Ok, will find out the insulin type
 
That will help us a lot to give you suitable advice. Insulin is a very powerful medication and even just a small change in advice can make a big and potentially dangerous difference, so knowing and understanding the details is all important.

Just to be clear and so that you have realistic expectations, Blood Glucose levels go up and down throughout the day and night, even for non diabetic people, in response to a lot of different things. Food and exercise and medication are the three main things which affect it but illness or injury can have a serious impact and stress and lack of sleep and ambient temperature.... which may be more consistent in Malaysia than here in the UK, so you may see less variation from that. Alcohol also impacts levels but perhaps you and your son don't drink for religious or cultural reasons. Anyway, what I am trying to say is that spikes in levels are normal depending upon how high they go. If they are going very high or going up but not coming down for many hours then there are certain strategies that you can try to reduce the spike or drop levels that go high and stay high but again it depends on which insulin he has as to whether those strategies would be safe or even possible.
There is lots and lots to learn about diabetes but mostly you do have plenty of time to slowly learn, so try not to panic. You and hopefully your son will gradually get much better at managing it. I am pretty sure we all used to get massive spikes at first but gradually we found ways to use the insulin we have and to a lesser extent the food we eat, to smooth things out a bit and nothing bad happened to us as a result of those spikes, but long term they can increase the risk of complications, but over a period of a few months from diagnosis you will gradually start to learn to reduce them. Diabetes is a marathon as we say and not a sprint. Nothing needs to change immediately or be perfect, just slowly make a change one change at a time and see what works for your son and what doesn't and gradually adopt the things that work.
 
Mom of Type 1 said:
Is there a formula to calculate how much insulin needed for the food that you are gonna eat ?
Click to expand...

Yes, kind of (meal ratios) but not with mixed insulin. With mixed insulin, the percentages of slow and fast/meal insulin are fixed so you can’t increase/decrease one without affecting the other.
 
rebrascora said:
That will help us a lot to give you suitable advice. Insulin is a very powerful medication and even just a small change in advice can make a big and potentially dangerous difference, so knowing and understanding the details is all important.

Just to be clear and so that you have realistic expectations, Blood Glucose levels go up and down throughout the day and night, even for non diabetic people, in response to a lot of different things. Food and exercise and medication are the three main things which affect it but illness or injury can have a serious impact and stress and lack of sleep and ambient temperature.... which may be more consistent in Malaysia than here in the UK, so you may see less variation from that. Alcohol also impacts levels but perhaps you and your son don't drink for religious or cultural reasons. Anyway, what I am trying to say is that spikes in levels are normal depending upon how high they go. If they are going very high or going up but not coming down for many hours then there are certain strategies that you can try to reduce the spike or drop levels that go high and stay high but again it depends on which insulin he has as to whether those strategies would be safe or even possible.
There is lots and lots to learn about diabetes but mostly you do have plenty of time to slowly learn, so try not to panic. You and hopefully your son will gradually get much better at managing it. I am pretty sure we all used to get massive spikes at first but gradually we found ways to use the insulin we have and to a lesser extent the food we eat, to smooth things out a bit and nothing bad happened to us as a result of those spikes, but long term they can increase the risk of complications, but over a period of a few months from diagnosis you will gradually start to learn to reduce them. Diabetes is a marathon as we say and not a sprint. Nothing needs to change immediately or be perfect, just slowly make a change one change at a time and see what works for your son and what doesn't and gradually adopt the things that work.
Click to expand...
He is using Novomix, 3 times a day. It is a 30% rapid + 70% intermediate.
 
That’s an unusual use of Novomix @Mom of Type 1 It’s usually used twice a day, morning and evening. This is because the intermediate part of the morning dose is supposed to cover lunch so another Novomix injection shouldn’t be needed at lunch. Think of it as a two part injection: the morning fast covers breakfast, the morning slow covers lunch, the evening fast covers the evening meal and the evening slow covers the night.

You can use Novomix for Type 1 - I used it at diagnosis but only for a couple of days and only twice a day. Why? Because the proportions of the mix didn’t work for me - and they don’t work for many Type 1s either.

He’d be better off on a basal/bolus regime, taking fast only before meals, and slow either once or twice a day. When was he diagnosed? Is he going to be moved to a more usual insulin regime soon?
 
He was diagnosed on Tuesday because he went into DKA. They had been using novorapid to bring down the glucose and yesterday, moved to Novomix, injection thru pen.
 
Using a mixed insulin requires your son to eat meals to match the timing of the injections. This is an unusual approach for a Type 1. This makes it very difficult to adapt to changes in life day to day.
Here we are usually put on two separate injections: a background /basal injection once or twice a day, which deals with the glucose our body produces to keep us ticking over., and a bolus/ quick acting insulin which deals with the glucose produced from the carbohydrates that are eaten. This (MDI) makes life much more flexible and enables us to eat when we want to. I think it would be worth your son asking to switch to to MDI. It may seem more complex at the start but will make it easier to adapt the separate doses to suit his needs.

In working out our insulin dose for any meal, we need to know the number of carbs that we are eating at any meal. This takes time initially but then this info for our most common meals is embedded in our heads, and that becomes a lot easier. You are then just sorting out the carbs for new things.
For our individual ratios these change with time, for me both within the year and as the years have gone on since my diagnosis.

I am glad that I had a few years on MDI before going on to using a pump. I need to know how to manage injections for the times when my pump fails (rare but it can happen and often at the most inconvenient moments) . A pump makes dosing for meals easier as it can be more fine tuned. These also enable us to fine tune our background insulin hour by hour. These take a lot of work initially, and not everyone wants to have a pump attached to themselves all the time.

It would be worth offering the books suggested to your son. : Think Like a Pancreas by Gary Sheiner and Type 1 in children adolescents and young adults by Ragnar Hanas (I was 53 at diagnosis but still found this very useful)

Let us know how he gets on.
 
Mom of Type 1 said:
He was diagnosed on Tuesday because he went into DKA. They had been using novorapid to bring down the glucose and yesterday, moved to Novomix, injection thru pen.
Click to expand...

Ok, so hopefully this is a temporary measure while they get him better and assess his insulin needs. That’s similar to what happened to me. I was on an insulin drip, then Novomix, then changed to two separate insulins (fast and slow).

Wishing him well. DKA is horrible. It will take him a little while to fully recover but now he’s having the insulin he needs, he should be feeling better soon.
 
His urine still has some ketone..most probably, it takes time for the body to know that he is no longer starving as he was in DKA 5 days ago. Normally, it takes how long to get the ketone out ?
 
I don’t remember for sure @Mom of Type 1 but I think my ketones were gone in a couple of days. It depends how ill he is. Is he eating ok? How is his blood sugar?
 
Inka said:
I don’t remember for sure @Mom of Type 1 but I think my ketones were gone in a couple of days. It depends how ill he is. Is he eating ok? How is his blood sugar?
Click to expand...
Blood sugar is still high...but sometimes go down below 5, then shoot up 17...hard to predict...coz doctor still adjusting his novomix
 
Status
Not open for further replies.
Back
Top