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tobs52 Newbie

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T

tobs52

New Member
Relationship to Diabetes
Type 1
Hi everyone I was diagnosed in 2000 and am geting to the point where I am getting quite
confused with a lot of things like 15 units for 10g carbohdrate does that mean 15 units of insulin for evry 10g of carbohdrate, for example if I have 20 Carbs for lunch should I be taking 30 units
of Insulin or should I devide the carbs by 15 and only inject 1.3 units of Insulin
Please Help
 
Hi tobs and welcome to the forum. 🙂 What ratios have you been using up to now? Are you sure it's not 1.5 units to 10g? This would mean 3 units for your 20g carbs. As a general rule of thumb for T1 a ratio of 1:10 is used. i.e. 1 unit of insulin to 10g carbs. This can be tweaked up or down. I would be very surprised if it was anything like 15u to 10g for T1 as that would mean you would be extremely insulin resistant. Can you contact your DSN at the clinic/surgery to confirm your ratios?
 
Hi Matt Cycle thanks for your reply, sorry its so late getting back to you,
I sent a photo2 of what I got from Dr McIntyre at my diabetic clinic about a year ago
so I would be glad if you tell me what you think. also I have made a LibreOffice.cal file
to help me work out what my correction dose and food dose should be, see Photo Insulin Dose, but before this gets to long can I ask you to confirm if my correction dose is worked
out correctly what I do is take my Current BG of say 12.2 and then take my target BG of
8 away from it and that gives me my correction factor of 4.2 I then divide that by 2 and that
gives me 2.1 Insulin correction dose, I next take my Carbohydrate intake for that meal of say 20 and multiply it by 1.5 and that = 30 units of insulin for food + 2 units Insulin correction dose giving me a total dose of Insulin = 32 units But I now read that I should divide the 20 Carbohydrate by 15 and that gives me 1.3 units of Insulin + 2 units Insulin correction dose giving me a total dose of Insulin 3 units, So what is right Thanks

Photo2.png
InsulinDose.png


Matt Cycle said:
Hi tobs and welcome to the forum. 🙂 What ratios have you been using up to now? Are you sure it's not 1.5 units to 10g? This would mean 3 units for your 20g carbs. As a general rule of thumb for T1 a ratio of 1:10 is used. i.e. 1 unit of insulin to 10g carbs. This can be tweaked up or down. I would be very surprised if it was anything like 15u to 10g for T1 as that would mean you would be extremely insulin resistant. Can you contact your DSN at the clinic/surgery to confirm your ratios?
Click to expand...
Matt Cycle said:
Hi tobs and welcome to the forum. 🙂 What ratios have you been using up to now? Are you sure it's not 1.5 units to 10g? This would mean 3 units for your 20g carbs. As a general rule of thumb for T1 a ratio of 1:10 is used. i.e. 1 unit of insulin to 10g carbs. This can be tweaked up or down. I would be very surprised if it was anything like 15u to 10g for T1 as that would mean you would be extremely insulin resistant. Can you contact your DSN at the clinic/surgery to confirm your ratios?
Click to expand...
 
Hi Tobs. Looking at that I'm guessing you're T2? It's just that your profile says T1. These are concentrated forms of insulin. I'd be dead using these sorts of amounts! Are you new to insulin? Looking at the doctors notes your breakfast is 15u to 10g carbs and the lunch and dinner 10u to 10g carbs. Corrections are 1u to 1g carbs. So essentially apart from breakfast you're on a 1:1 ratio. Your target bg level appears to be set at 8 mmol/l.

(I can't work out what the bottom line of the doctors note says - +???? 10 mmol).

I think you're over complicating things a bit. Going on your example above of a 12.2 mmol/l level and 20g carbs. It would be a correction factor of 4u and 30u for the carbs. Giving a total of 34u. Before anything I would ask you to speak to your doctor or nurse just to confirm these figures after all I'm just a random person on the internet.
 
Matt Cycle said:
Hi Tobs. Looking at that I'm guessing you're T2? It's just that your profile says T1. These are concentrated forms of insulin. I'd be dead using these sorts of amounts! Are you new to insulin? Looking at the doctors notes your breakfast is 15u to 10g carbs and the lunch and dinner 10u to 10g carbs. Corrections are 1u to 1g carbs. So essentially apart from breakfast you're on a 1:1 ratio. Your target bg level appears to be set at 8 mmol/l.

(I can't work out what the bottom line of the doctors note says - +???? 10 mmol).

I think you're over complicating things a bit. Going on your example above of a 12.2 mmol/l level and 20g carbs. It would be a correction factor of 4u and 30u for the carbs. Giving a total of 34u. Before anything I would ask you to speak to your doctor or nurse just to confirm these figures after all I'm just a random person on the internet.
Click to expand...
Hi Mat No I am definitely Type 1 and have been on Insulin since 2000 I kept having to up my dose in order to get near my target of 9 mmol and by the way the bottom line of the
doctors note says target 10 mmol but i reduced it to 8 mmol can you tell me if these were your figures i.e. 12.2 mmol/l 20g carbs and a target of 8 what insulin would you inject and don't be afraid I just want to know if my calculations are right or wrong, I had an appointment with my Diabetic Doctor on the 16 / 1 / 19 09:00 am and she was happy to leave
things as they were, It was a few days after this that I read on a Diabetic Site that I should be dividing instead of multiplying so it is for these reasons I want to know how
other Diabetics would work it out Thanks
 
Hi Tobs
I too am surprised at the amounts of insulin you are using. As for how I work out mine

I started with 1 unit of insulin for each 10g of carbohydrates throughout the day.
I unit for 10g, 2 units for 20g, ...
I regularly tweak my ratios now and use
- 1 unit for 9g carbs in the morning
- 1 unit for 12g carbs at lunch
- 1 unit for 13g carbs in the evening
Like Robin I would be dead if I used the amount of insulin your ratios show.

Out of interest is your ‘diabetic doctor’ a GP or is this a Diabetes Specialist at the hospital? If you are struggling with getting levels under control it would be worth getting an appointment with Diabetes consultant.

Another thought is whether you have changed your meds? If I use steroids I know that my insulin resistance is changed and I have to adjust my doses.
 
tobs52 said:
Hi Mat No I am definitely Type 1 and have been on Insulin since 2000 I kept having to up my dose in order to get near my target of 9 mmol and by the way the bottom line of the
doctors note says target 10 mmol but i reduced it to 8 mmol can you tell me if these were your figures i.e. 12.2 mmol/l 20g carbs and a target of 8 what insulin would you inject and don't be afraid I just want to know if my calculations are right or wrong, I had an appointment with my Diabetic Doctor on the 16 / 1 / 19 09:00 am and she was happy to leave
things as they were, It was a few days after this that I read on a Diabetic Site that I should be dividing instead of multiplying so it is for these reasons I want to know how
other Diabetics would work it out Thanks
Click to expand...

Hi Tobs. When on MDI I had a ratio of 1:10 (1:12 at lunch) and correction of 1u would lower my blood glucose by 3 mmol/l. I'm on the pump and my overall total daily dosage has reduced with the ratios measured in fractions of units. On MDI for a 12.2 mmol/l and 20g carbs aiming for 8 mmol/l I'd have 1u correction and 2u for the carbs. (In reality I'd be aiming for 5-6 mmol/l myself so would take a 2u correction).

The insulins you're on are in concentrated forms - Toujeo is 300u/ml and the Humalog is 200u/ml. So your 100u of Toujeo at 300u/ml is a massive dose. All my insulins are 100u/ml, my daily carbs are around 150-200g and my total daily dose (basal and bolus) is between 30-40u. Have you always been on large doses or is this a recent thing?

I really think you need to confirm the figures with your doctor or nurse to make sure it's correct and you're safe with it.
 
SB2015 said:
Hi Tobs
I too am surprised at the amounts of insulin you are using. As for how I work out mine

I started with 1 unit of insulin for each 10g of carbohydrates throughout the day.
I unit for 10g, 2 units for 20g, ...
I regularly tweak my ratios now and use
- 1 unit for 9g carbs in the morning
- 1 unit for 12g carbs at lunch
- 1 unit for 13g carbs in the evening
Like Robin I would be dead if I used the amount of insulin your ratios show.

Out of interest is your ‘diabetic doctor’ a GP or is this a Diabetes Specialist at the hospital? If you are struggling with getting levels under control it would be worth getting an appointment with Diabetes consultant.

Another thought is whether you have changed your meds? If I use steroids I know that my insulin resistance is changed and I have to adjust my doses.
Click to expand...
Hi Thanks for the reply Yes my Diabetic doctor is a Diabetes Specialist at the hospital, I have always had a high resistance to Insulin I remember years
ago when I was using lantus insulin when I was injecting 60u 3 times a day I spoke to my GP about the high amounts and was to keep pumping it in.
You see I had a heart attack in 1990 and then again in 1993 and had stents fitted and was put on a lot of medication I am now fitted with a
defibrillator so maybe all the medication I am on is what has made me highly resistant to Insulin I assume you say you would be dead because that
amount of insulin would send you into bad hypo but on the other hand if I used the low amounts you use I would be in hospital because of High
Blood Sugars.
 
tobs52 said:
Hi Thanks for the reply Yes my Diabetic doctor is a Diabetes Specialist at the hospital, I have always had a high resistance to Insulin I remember years
ago when I was using lantus insulin when I was injecting 60u 3 times a day I spoke to my GP about the high amounts and was to keep pumping it in.
You see I had a heart attack in 1990 and then again in 1993 and had stents fitted and was put on a lot of medication I am now fitted with a
defibrillator so maybe all the medication I am on is what has made me highly resistant to Insulin I assume you say you would be dead because that
amount of insulin would send you into bad hypo but on the other hand if I used the low amounts you use I would be in hospital because of High
Blood Sugars.
Click to expand...
That’s why it is so important that we all do what we need to do for our own diabetes. As you say for me those amounts would kill me, for you they are what you need.
How are those ratios working for you now?
 
tobs52 said:
my Diabetic doctor is a Diabetes Specialist at the hospital,
Click to expand...
tobs52 said:
I spoke to my GP about the high amounts and was to keep pumping it in.
Click to expand...
I think there's a good chance your GP wouldn't want to overrule the specialist at the hospital, as long as things seem ok and they haven't actually messed up. Do you have a specialist nurse you can contact? They might be able to help with insulin, & some can deal with medication (even prescribe).
Does your GP do a medication review thing, once a year with an appointment?
tobs52 said:
so maybe all the medication I am on is what has made me highly resistant to Insulin
Click to expand...
It might be worth getting an appointment with something to go over all your medications & such.
tobs52 said:
I am now fitted with a defibrillator
Click to expand...
I have one too. They're interesting devices.
 
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