Total daily doses for T1s LADAs and 3cs?

[Amity Island]

We have a well known saying on the forum that ‘you need what you need’ when it comes to insulin doses, but a question from a new member made me begin to wonder what different levels of insulin doses we had among members of the forum with T1, LADA and Type 3c. (as T2s are more likely to be affected by insulin resistance).

Often starting ‘total daily doses’ for the newly diagnosed seem to be estimated based on units/kg with taller and heavier people generally needing more insulin. But I know slight T1s on high doses and

There’s no right or wrong dose - only what you need (neither high doses nor low doses are better or worse). And my expectation is that different people will have quite different needs because of differences in metabolism and sensitivity - plus general dietary intake, of course!

But just out of interest I wondered what the average TDD might be for various folks here. All of your basal doses and all meal doses.

Pumps often provide 7, 14, and 30 day averages, but MDIers will just have to make an estimate.

19u basal each day, bolus 8u am, 12u lunch, 10u tea. TDD = 49u. note. I do like carbs.

 

[Ian T]

My ratio is 1.5 units Novorapid per 10g of carbs so 20-40 units per day depending on diet plus 27 units Levemir for basal. I'm 6ft 3 and 14.5 stone so BMI 25.2

 

[Lucy Honeychurch]

25.9U basal on my normal profile, 23.5U on my work profile. Average TDD 35.

 

[Lanny]

Gosh! Sorry for intruding on this thread, a type 2 on insulin, but, it shocks me to see how MUCH less, type 1’s use or, is that how much MORE insulin T2’s need to use!

I’m 155cm, currently 84 kilos due to a combination of lockdown & fighting off the CV virus & on 148 TDD: 24 & 40 units basal Levemir midnight & midday; 32, 28 & 24 units bolus Novorapid! My usual weight is 78/79 kilos so, these last few months have put on about 5 kilos!

 

[m1dnc]

My current 30-day average: 46. And I'm 6'2'' and 14st 10lb.

 

[trophywench]

Yes Lanny - and when T2s are still producing insulin T2s very very often have to overwork their pancreases producing shedloads more insulin all the while than a non-diabetic ever does. That's what T2 does to the body and why it's so dangerous if left undetected and therefore untreated, for too long. Other than the fact that we all have trouble with dealing with carbohydrates, it is nothing like T1 or 3 whatsoever.

 

[leonS]

Wisdom of the ancients says that TDD should be about 0.5 to 0.7 times your body weight in kilograms. And about half of this should be base insulin. I take 28 units base and about the same quick acting with a weight of 80 kg.

Having lost 5 - 10 kg over the past few months (depends on how many months I go back) I did indeed need to reduce the dose.

The need for insulin tends to increase with time after diagnosis.

 

[Robin]

Wisdom of the ancients says that TDD should be about 0.5 to 0.7 times your body weight in kilograms. And about half of this should be base insulin. I take 28 units base and about the same quick acting with a weight of 80 kg.

Having lost 5 - 10 kg over the past few months (depends on how many months I go back) I did indeed need to reduce the dose.

The need for insulin tends to increase with time after diagnosis.

If that held true, I’d be taking 15 units of basal instead of 8.5. Like all 'averages‘ there’s as many above as below! I suspect it depends a lot on whether people are still producing any endogenous insulin. There was a study (details of which escape me now), which found that a lot of Type 1s were still producing a bit of their own insulin.

 

[Freddie1966]

I’d be taking around 30 units based on that .. I only take about 10 ! I would be permanently hypo

 

[trophywench]

Wisdom of the ancients wanted my hourly rate on a sliding scale overnight and during an operation to be 3 units ph - when my TDD basal is approx. 11u. In other words - my mileage definitely varies - exactly the same as 100% of other people's diabetes does!

 

[rebrascora]

I am currently back up to 24 units of basal and normally average about 8 units of QA so 32 units total but just recently things are a bit chaotic and needing quite a lot of corrections. Not sure what is going on.
My BMI is 24 and I'm 5ft 5

 

[brisr949]

On diagnosis i was 6 units of nova per meal with 18 levimir at night.

Now im 12 -15 nova and 40 levi still once at night.
Mine might be a bit higher as im still kind of eating what i want, within reason.

 

[atoll]

T1 juvenile onset,56yrs,86kg,5'10'',54u absalglar morning, 8+8u novorapid meals,8u absalglar evening,regular exercise hba1c 47,metformin sr500mg TDD=76-78u

 

[everydayupsanddowns]

Gosh! Sorry for intruding on this thread, a type 2 on insulin, but, it shocks me to see how MUCH less, type 1’s use or, is that how much MORE insulin T2’s need to use!

I’m 155cm, currently 84 kilos due to a combination of lockdown & fighting off the CV virus & on 148 TDD: 24 & 40 units basal Levemir midnight & midday; 32, 28 & 24 units bolus Novorapid! My usual weight is 78/79 kilos so, these last few months have put on about 5 kilos!

No worries at all @Lanny - T2s generally need lots more insulin, just because of the nature of their condition, but ‘you need what you need’ still holds true.

and I know several T1s (including some who have been members of the forum) who have needed similar or greater doses to yours.

Everyone is very different!

 

[Kerry Williams]

Type 1 on pump. 5'2" and 52kg. Carbs 80-100 per day. TDD average 19 units, basal 5. The carbs don't include the hypo treatments. I would go hypo every day at about 5-6PM, despite keeping the basal at 0.02 per hour, or completely switched off, through the afternoon. Track BG with the Libre so I can eat something before it drops into the hypo range. That's on a typical day, not a very active one.

 

[MrDaibetes]

Total daily dose (per day) 53 units according to my reports. I am type 1 on a 670g pump ^^.

 

[leonS]

I did NOT claim that the wisdom was correct, I only report it. As with most things diabetical it is at best only half true.

I give these examples:
Type 1 diabetics make no insulin.
No one over the age of 20 (sometimes 30) gets type 1.
The onset of type 1 is very rapid.
Complications can be avoided by careful control of BG.
A morning high BG is often caused by a night time hypo.

None of these statements is 100% true, most are false.

 

[trophywench]

Here's another - T2s never have Ketones/Non diabetics don't have them either.

 

[DaveB]

Gosh! Sorry for intruding on this thread, a type 2 on insulin, but, it shocks me to see how MUCH less, type 1’s use or, is that how much MORE insulin T2’s need to use!

I’m 155cm, currently 84 kilos due to a combination of lockdown & fighting off the CV virus & on 148 TDD: 24 & 40 units basal Levemir midnight & midday; 32, 28 & 24 units bolus Novorapid! My usual weight is 78/79 kilos so, these last few months have put on about 5 kilos!

It's so important if you are T2 and injecting lots of insulin to understand what your BMI is and taking stock of whether you may have insulin resistance due to excess weight. This can be a vicious circle. Whenever that is the case it's vital to ensure carb consumption is kept way down to reduce insulin resistance and in turn reduce the need for insulin.

 

[everydayupsanddowns]

Type 1 on pump. 5'2" and 52kg. Carbs 80-100 per day. TDD average 19 units, basal 5. The carbs don't include the hypo treatments. I would go hypo every day at about 5-6PM, despite keeping the basal at 0.02 per hour, or completely switched off, through the afternoon. Track BG with the Libre so I can eat something before it drops into the hypo range. That's on a typical day, not a very active one.

Interesting stats @Kerry Williams

It seems slightly unusual to have your basal and bolus insulins in such dramatically different proportions. John Walsh (Pumping Insulin) would suggest that for most people basal:bolus split would generally be between 40:60 and 60:40.

I may well be teaching you to suck eggs, but it makes me wonder when you last did a series of fasting basal checks in sections that cover the full 24 hours - to see eg what happens when you dont have breakfast insulin running over lunchtime (especially of your Duration of Insulin Action is on the longer end and nearer 6hrs than 5hrs)

I know that my team have often questioned my own balance between basal and bolus, and I‘ve experimented and ended up reverting to my general 60% bolus 40% basal from the 50:50 which was my team’s ‘preference‘ but it strikes me that your division gives you little room for manoeuvre.

What happens when you miss, delay or skip meals?