Missed large insulin dose...

[Holyfire82]

Think I need just some reassurance more than anything haha!

I've been a diabetic 25 years in April and never missed an Insulin dose (I take one in the morning and 1 before evening meal...which is a lot larger than the first).

Last night after getting up and going to the toilet three times its dawned on me I've forgotten to take my insulin...by then it was 5am and seemingly too late to take it now. I've taken a larger shot this morning.

Have I done the right thing?

Worried that when getting my hab1c next month this will affect it as my blood sugar readings were so high this morning.

 

[Kaylz]

I'm not on a split basal but think it might have been better to keep your usual am dose and correct with rapid as required and resume normal service at pm xx

 

[Holyfire82]

I'm not on a split basal but think it might have been better to keep your usual am dose and correct with rapid as required and resume normal service at pm xx

I take humulin which is a.mix of fast and slow though.

 

[Robin]

I take humulin which is a.mix of fast and slow though.

Oh, in that case your options are rather limited, and you did what you could to bring your levels down. One spike over an average of three months for your HvA1c shouldn’t affect the result greatly, i wouldn’t have thought. I'm impressed you’ve never missed a dose in 25 years! I’ve missed several, and also had a few of those 'did I didn’t I' moments (before I got my Novopen Echo, which records the dose and time).

 

[Fagor]

I recently missed my evening Levemir - did wonder why BS going up all night. I took normal Levemir dose next am and just corrected with my QA (max correction 3 units) until it reduced - normal by evening, so it may take a while. Wouldn't think HBA1C would be affected if BS are normally Ok.
Main thing is "don't panic".

 

[DaveB]

BTW, are you aware that NICE recommends that new T1s are put on Basal/Bolus which gives better control and having the Bolus enables corrections to be made when needed. It's your choice between two shots per day of mixed or around five shots per day of Basal/Bolus; each has it's merits.

 

[Inka]

I take humulin which is a.mix of fast and slow though.

That’s fine if you’re happy with that. How much extra did you take? I know the advice is not to take a double dose to make up for a missed dose.

How high was your blood sugar this morning? I was on mixed insulin after diagnosis,but then swapped to the two different kinds that were in my mix but in separate vials so I could draw up the proportions of each that suited me. If you had that you could still stay on two injections but have more flexibility with meals and corrections.

 

[trophywench]

I can fully understand that being on 2 jabs a day would have been far easier for your parents when you were still at school - and of course if you've always had excellent control of your BG for 24hrs a day every day and still have - then that's still 100% OK.

But, I have to say I had lousy control on Humulin, and the most awful sudden hypos whilst driving home from work, wrecked 2 cars and surprised not to get a bill for replacing the crash barrier on the M42. I still thank my lucky stars that I never had a scratch and I didn't kill or maim anyone else nor their vehicles.

In 1994 when I changed to Humulin I and S it was the most modern insulin available in the UK, so most likely still was when you were first diagnosed - but by 2000-ish - when you'd have changed over from the paediatric diabetes clinic to the adult one - there were more modern ones still - Humalog was the first, then Lantus from the same maker, Lilly, swiftly followed by Novorapid then Levemir from Novo Nordisk.

It was just before the turn of the century when the NICE Adult T1 Guidelines were changed over to Basal/Bolus so all around that same time but as I say if you already had really good control on what you already used, and still consistently have, there would be no great effort to effect a change. No point changing it if it's still working well, is there?

What about other more modern things - eg have you been prescribed a Libre? - cos they've been in the News a fair bit in recent years and most of us find they help too alongside MDI and DAFNE etc. Do you know what I'm talking about in this last paragraph?

 

[Supratad]

Think I need just some reassurance more than anything haha!


Worried that when getting my hab1c next month this will affect it as my blood sugar readings were so high this morning.

Don't worry about that at all. You can't get it right all of the time but as other poster said, 25 years without ever missing a shot is very impressive.

 

[everydayupsanddowns]

Welcome to the forum @Holyfire82

Well yes, you’ve done very well to get to 25 years without making this mistake. Don’t beat yourself up - most of us have all been there. It’s very easily done, and you did well to recover the situation with the tools you had.

Has the experience made you tempted to try a more flexible basal:bolus system or are you happy with the results you are getting on your current system?

At the end of the day the only person‘s opinion who matters in deciding which insulin system you want to use is you. Drs and random strangers on the internet can have opinions and suggestions - but it’s you that has to make it work every day!

If you are generally happy as you are, I wonder if one slightly unusual option might be for you to have access to a rapid-acting pen for occasional corrections and/or snacks. So you can keep your system mostly as-is if it’s working well, but have a little extra flexibility when you need it?