Suggestion to Avoid Insulin Overdose

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Could you advise on how I calculate what dose to dial up for breakfast in advance tonight please. My ratios are 1u to 5g carbs and 1u drops 2 mmol.
 
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Lucyr said:
Could you advise on how I calculate what dose to dial up for breakfast
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Sigh. There is no need for any prediction but you're obviously incapable of grasping the simple concept. You seem determined to have an argument wherever possible. So to save wasting any more of your time, & more importantly mine & other members, I've added you to my ignore list. Bye.
 
RBZ5416 said:
Sigh. There is no need for any prediction but you're obviously incapable of grasping the simple concept. You seem determined to have an argument wherever possible. So to save wasting any more of your time, & more importantly mine & other members, I've added you to my ignore list. Bye.
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How do I dial up tomorrow mornings breakfast dose tonight if I can’t predict the dose? Would genuinely like someone to explain this to me as I haven’t got a clue how it could work.

My most common breakfasts are omelette, toast or porridge. I can’t tell until the morning whether I’ll be up in time for an omelette or whether I’d prefer toast though.
 
Lucyr said:
How do I dial up tomorrow mornings breakfast dose tonight if I can’t predict the dose?
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Depends how much your doses vary from day to day, I guess. Mine (for breakfast) are usually about the same. I don't think that's uncommon (I think people often eat pretty much the same breakfast, with occasional changes at weekends or on holiday).
 
Bruce Stephens said:
Depends how much your doses vary from day to day, I guess. Mine (for breakfast) are usually about the same. I don't think that's uncommon (I think people often eat pretty much the same breakfast, with occasional changes at weekends or on holiday).
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Doesn’t your bg change every morning? My carbs will be between 0 and 40 but that’s an 8u variation. Bg between about 5 and 9 is a 2u variation, so my breakfast dose is between 0-10u usually, it’s not a set dose.
 
The suggestion is not about setting the exact dose the night before but just a normal-ish amount and then adjusting it to what you actually need in the morning and as has been mentioned the air shot would mean you had to dial up the new dose anyway. If you look at the dose dialed up and go to adjust it to a much bigger dose for your basal, then I guess it would be a another prompt that you had the wrong pen, along with colour and perhaps feel since some of us tape or sticker one of our pens. For me I would just end up forgetting and dialing up another half a unit and doing a big air shot and wasting insulin, especially as I inject as soon as I wake up when brain isn't totally engaged. I also never look at the display because my eyesight isn't so good anymore and I am not gojng to start putting specs on to read it when I can just count clicks. I can't see it in the dark anyway. It might work for some people but it would just be confusing and wasteful for me.
 
I don't think oy would work for me either but others can decide if it works for them some May find helpful.

I've done this twice but on fairly small doses of livermer it was an easy fix.
 
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rebrascora said:
If you look at the dose dialed up and go to adjust it to a much bigger dose for your basal, then I guess it would be a another prompt that you had the wrong pen
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My bolus pen doesn’t go up to the dose I take for Lantus so I’d never ever mix the two pens up.
 
I split my basal into 2x whatever it is ie 2x 10, 11 or 12u) and put one dose into each buttock, so even with a smaller dose I can still get it doubly wrong, if I am not paying attention!
 
rayray119 said:
I've done this twice but on fairly small doses of livermer it was an easy fix.
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Altough in saying that the first time I did if I was is the middle of working out new carb. Ratios because they seemed to changing so I was oh great I know have no idea how much carbs I need to eat haha 🙂
 
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Another useful tip I had was to have two different coloured pens: one for basal which matched the colour of the cartridge, and another for my bolus. As I used half unit pens I was able to get children’s pens and even got stickers!!! (I still made the mistake of putting a basal cartridge in my bolus pen (better than the other way round!!! It took me a while to work out what I had done).
 
Another thought in predialling doses, I was also told to do a small air shot before dialling up my dose,. It is a while since I was on pens so not sure whether this is still recommended.
 
SB2015 said:
Another thought in predialling doses, I was also told to do a small air shot before dialling up my dose,. It is a while since I was on pens so not sure whether this is still recommended.
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That is still recommend due to the possibility of flauly needed etc which I have had before.
 
SB2015 said:
Another thought in predialling doses, I was also told to do a small air shot before dialling up my dose,. It is a while since I was on pens so not sure whether this is still recommended.
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Yes, the air-shot remains essential. Slightly perversely the more MDI time you get under your belt the easier it is to become complacent and not screw the needle on correctly thus get no insulin or just a portion. Then it freezes on you and because of that over-confidence you don't know how much of your dose arrived.
 
I'll make this my last post on this thread but will try just once more to explain the concept & the apparent misconception around pre-dialling.

The idea behind pre-dialling, as @rebrascora picked up on, is NOT that you're predicting your next dose. NOR is it preventing an air shot. It is simply a visual prompt when you pick up the pen, especially critical if you should accidentally pick up bolus instead of basal.

Illustration
Your typical basal is 20u & bolus is 5u. You pre-dial these values after each injection. Should you then pick up the bolus pen instead of the basal, you will see that it's set to 5u. This should act as a pretty big deterrent to then go ahead & administer 20u of bolus in error.

Now I accept that this isn't going to work if your pen can't go backwards, something that as I said I was unaware of. Not only do both of my pens go backwards but they also "unscrew" to set the dose. So even in the dark it should be pretty obvious whether the pen your holding has 5u or 20u dialled in. Again, other pens may vary.

Final point for those who missed the first word of the thread title, this is a SUGGESTION...
 
RBZ5416 said:
I'll make this my last post on this thread but will try just once more to explain the concept & the apparent misconception around pre-dialling.

The idea behind pre-dialling, as @rebrascora picked up on, is NOT that you're predicting your next dose. NOR is it preventing an air shot. It is simply a visual prompt when you pick up the pen, especially critical if you should accidentally pick up bolus instead of basal.

Illustration
Your typical basal is 20u & bolus is 5u. You pre-dial these values after each injection. Should you then pick up the bolus pen instead of the basal, you will see that it's set to 5u. This should act as a pretty big deterrent to then go ahead & administer 20u of bolus in error.

Now I accept that this isn't going to work if your pen can't go backwards, something that as I said I was unaware of. Not only do both of my pens go backwards but they also "unscrew" to set the dose. So even in the dark it should be pretty obvious whether the pen your holding has 5u or 20u dialled in. Again, other pens may vary.

Final point for those who missed the first word of the thread title, this is a SUGGESTION...
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I got it was only a suggestion it was nice of you to make a suggestion in case it could help others in the future
 
Bruce Stephens said:
On the outside they might be, but perhaps they changed something (and tested and got approval). I honestly don't know. It feels odd that anyone would think that disallowing reducing a dose would be a good idea, so I can only imagine there's some mechanical reason why that's easier to do. I'm glad at least some reusable pens no longer have that restriction.
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I feel it all comes down to copyrite from the different companies manufacturing these pens.
Lol, you hear stories about a certain phone company going “legal” due to another company adopting “rounded corners” in its design.
I’m lucky in one respect, I can’t fit my basal cartridge into my bolus pen & visa versa.

I would agree that mixing up the insulins is potentially a serious issue. I appreciate @RBZ5416 ’s kind thoughts on this topic.
 
RBZ5416 said:
So even in the dark it should be pretty obvious whether the pen your holding has 5u or 20u dialled in. Again, other pens may vary.
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I don't understand this bit so I am not sure my pens function the same. Do you mean the button comes out further the more you dial up? I had not ever noticed that even with my disposable pens, but then I was on small doses when I used disposables, but I don't think it is the case with the NovoPen Echo.
 
rebrascora said:
I don't understand this bit so I am not sure my pens function the same. Do you mean the button comes out further the more you dial up? I had not ever noticed that even with my disposable pens, but then I was on small doses when I used disposables, but I don't think it is the case with the NovoPen Echo.
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The more you dial the further the top spirals out. It has to get up to push down. 🙂
 
rebrascora said:
I don't understand this bit so I am not sure my pens function the same. Do you mean the button comes out further the more you dial up? I had not ever noticed that even with my disposable pens, but then I was on small doses when I used disposables, but I don't think it is the case with the NovoPen Echo.
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It is the case, (I just checked) but it doesn’t come out very much further for larger dial-ups, so I doubt I'd notice. What I would notice, though, is if I dialled back so I could do an air shot, I 'd notice how many clicks I’d dialled back. (or not, pre Novopen Echoes, I was capable of injecting, looking at the pen and wondering if I'd just injected or not).
 
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