How much insulin do I need to have ???

[Oldandugly]

Hi all, please feel free to join in. I'm a type one & unfortunately I am just off my honeymoon period, it was a good run 13 months, sadly it's come to the end. I have had all the Teems meeting & the visit with the Diabetic nurse, & although I was their I skimmed the real deal to be honest, if you haven't guessed already I'm a man! So now I have to take an interest that's what I'm doing now. Carb counting does seem a bit boring, so at this point your all giving me my justified stick, I get it. So my stupid question is this, I have a Lebre 2 It's great I love it but here comes the stupid bit, It tells me what my BG levels are why is there no AVARAGE guide for how much insulin to inject, I get it, we all process insulin differently but seriously it's like a big bow on a boxed present with nothing inside.
So my carefree life has now sadly come to an end bugger, give me your experience & yes I deserve the abuse.

Tar

 

[mashedupmatt]

Hi @Oldandugly - no one is here to judge, but can you tell us what insulins you are on at the moment, and what you have been recommended dosage-wise by your healthcare team?

 

[Lucyr]

, It tells me what my BG levels are why is there no AVARAGE guide for how much insulin to inject

If it gave an average suggested dose, then for some people it would be much too high and kill them. For others it would be much too low and kill them or at least make them ill. So clearly a manufacturer can’t do that.

 

[Oldandugly]

Wow, thanks for the reply. I have Abasaglar & NovoRapid, my numbers today have gone mental I have been on two tabs of Metformin & joy of joys until today I was living the high life. My numbers earlier are 14mmols & I have just had 8?? of the NovoRapid, it's levelling out at 13 now.
Tar Alan

 

[dannybgoode]

*Very* loosely, the suggested starting point for bolus insulin (your Novorapid) to carbs ratio is 1:10. Eg 1 unit of insulin for every 10g of carbs in a meal.

As Lucy says though, this depends on an awful lot of factors and will even vary for the same person depending on a variety of things so it's very hard to give an average that will work for everyone.

It is a starting point though and if you find it doesn't bring your BG down enough then increase it a bit, if it brings it down too much, decrease it a bit. This is where something like the Libre is useful as you can see what your levels are doing easily.

It is worth discussing with your DSNs to see if they can give you some more tailored guidance here

 

[Oldandugly]

*Very* loosely, the suggested starting point for bolus insulin (your Novorapid) to carbs ratio is 1:10. Eg 1 unit of insulin for every 10g of carbs in a meal.

As Lucy says though, this depends on an awful lot of factors and will even vary for the same person depending on a variety of things so it's very hard to give an average that will work for everyone.

It is a starting point though and if you find it doesn't bring your BG down enough then increase it a bit, if it brings it down too much, decrease it a bit. This is where something like the Libre is useful as you can see what your levels are doing easily.

It is worth discussing with your DSNs to see if they can give you some more tailored guidance here

Hi mate thanks for the reply. He is the thing, what's the point of the numbers on the Libre if they don't reference anything. Ie; 12.8mmols is my reading now, what is this related to? is 12.8 other than telling me I'm outside the good range. Don't get me wrong it's good info/warning but is there no correlation on carb intake?

 

[Inka]

Hi mate thanks for the reply. He is the thing, what's the point of the numbers on the Libre if they don't reference anything. Ie; 12.8mmols is my reading now, what is this related to? is 12.8 other than telling me I'm outside the good range. Don't get me wrong it's good info/warning but is there no correlation on carb intake?

No, not really. The Libre just gives you information about your blood sugar. Sometimes you can use that information to make educated deductions about problems, but you can’t look at the Libre and apply some magical formula that will then tell you exactly what you need to do.

Have you been recommended the two Type 1 “bibles” yet? (Very helpful books)

 

[Inka]

If not, there are a couple of books often recommended for Type 1s on this forum:

Think Like a Pancreas’ by Gary Scheiner.

And Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas (ignore the title - great for adults too)

Think Like A Pancreas is American but I liked the chatty style and it contains some great information, as does the Ragnar Hanas book.

 

[Inka]

I see from your earlier posts that they were arranging a CT scan for you @Oldandugly Has that happened yet? You also mention a little uncertainty from the doctors about your diabetes type, and that they were trying to “wean you off” insulin and onto Metformin. Can you explain a little more about that and what’s happening?

 

[dannybgoode]

what's the point of the numbers on the Libre if they don't reference anything. Ie; 12.8mmols is my reading now, what is this related to? is 12.8 other than telling me I'm outside the good range. Don't get me wrong it's good info/warning but is there no correlation on carb intake?

So, two different things. The Libre, as @Inka has said, gives you your blood glucose reading. You need to know this to work out whether you're taking enough insulin to cover the carbs your body is trying to process and/or to make sure it's not going too low and that you're in danger of a hypo (when you're BG is under 4 and you need to treat that urgently by taking a nice chunk of fast acting glucose. Note if you haven't been told about hypos and how to treat them you MUST speak to your GP or diabetic nurse about them and read up on them immediately).

The carb counting/insulin calculations are a standard part of living with insulin controlled diabetes. It's how those of us, either type 1 or type 2 who use insulin to control our BG manage things day to day.

The Libre helps as it guides us as to whether we are dosing correctly and we can make adjustments so it levels to go too high or too low.

Take for example tonight. I had been for a run and the Libre showed me my levels were dropping like a stone afterwards. This is pretty standard but meant I decided to take my Novorapid after I started eating a (very naughty) pizza. I also took a little bit less as often after exercise I do need less.

However, I'm coming up to the 4 hours that Novorapid is active for and my Libre is showing that my BG is still really quite high - over 12 - so I've popped in a correction dose of 4.5 units to try and mop up the excess carbs.

If that proves too much then I'll see that on the Libre graph and will be able to have a little intake of glucose so I don't go hypo.

Unfortunately there is no short cuts or 'lazy' was of managing insulin controlled diabetes. You have to carb count and then use the data the Libre is giving you to give tune your doses and correct where necessary

 

[Sally71]

Unfortunately if you want to remain healthy with well managed diabetes then you need to put effort in. My mum only takes fixed doses of Novorapid; I think this also means that she eats a fairly bland diet and knows how much carbohydrate to eat to fit those doses. But she also doesn’t test very often, doesn’t want sensors, and seems to think it’s perfectly normal for blood sugars to be bouncing around all over the place, and says it’s impossible to control it perfectly therefore why bother trying. She’s also always getting told off by the doctor because her hba1c is always at least in the 70s; she says it’s always been like that and she’s happy, and at her ripe old age maybe it doesn’t matter so much. This however is completely the opposite of what my daughter has always been taught, and as she’s still young I’d like to think that she will always manage her diabetes better, which then minimises the risk of complications. Sensors are a useful guide as to whether you are doing things roughly right or not and can help you to decide whether you need to increase or decrease your doses a bit, but there’s no magic tool to just do it for you.

 

[CliffH]

Hi all, please feel free to join in. I'm a type one & unfortunately I am just off my honeymoon period, it was a good run 13 months, sadly it's come to the end. I have had all the Teems meeting & the visit with the Diabetic nurse, & although I was their I skimmed the real deal to be honest, if you haven't guessed already I'm a man! So now I have to take an interest that's what I'm doing now. Carb counting does seem a bit boring, so at this point your all giving me my justified stick, I get it. So my stupid question is this, I have a Lebre 2 It's great I love it but here comes the stupid bit, It tells me what my BG levels are why is there no AVARAGE guide for how much insulin to inject, I get it, we all process insulin differently but seriously it's like a big bow on a boxed present with nothing inside.
So my carefree life has now sadly come to an end bugger, give me your experience & yes I deserve the abuse.

Tar

It's tough for all of us when we realise that our lives have changed - probably fairly drastically and possibly for life. So, it's okay to feel cross or sad about it - and even to be in denial for a while. Ultimately, though, you'll need to decide (with the support of your clinicians (and possibly this forum)) how to balance living healthily with having sufficient enjoyment in your life - and to accept that diabetes will keep moving the goalposts 🙄 .

 

[helli]

It's tough for all of us when we realise that our lives have changed - probably fairly drastically and possibly for life.

I agree that the diagnosis was tough - quite a few sugary tears were shed in the weeks that followed and more than a few times, I forgot to take all my diabetes paraphernalia when I went out.
But there is no way that I would describe the changed to my life as "drastic". I think the word I would use is "subtle". I had to buy a handbag to carry all that guff around in. But, unless they are close to me, most people wouldn't spot the difference.
I appreciate it affects different people differently and having an engineering background has definitely helped. Reviewing graphs and calculating insulin doses would be mind blowing for someone with discalculia, for example.

But what has really kept the impact to a minimum are the words of my DSN when I first met her "diabetes should not stop you doing what you want." In over twenty years it has never stopped me from travel, exercise, food, drink, work, ... It has taken a bit more preparation but never stopped. I guess that is what I mean by "subtle" changes rather than "drastic".

I would go as far as to suggest describing it as "drastic changes" is unnecessarily scary (although I appreciate it was meant in a good way).