Type 1, how much insulin do you inject per day?

Status
Not open for further replies.
C

Carlos

Well-Known Member
Relationship to Diabetes
Type 1
As title, I am curious about how much insulin Type 1s inject per day.

I inject Levemir morning and night, with doses varying between 6 and 10 units at each injection. These a long term variations, i.e., I may go for weeks with 8 morning and 8 evenings and then I need to reduce the evenings one to 6 to avoid overnight hypos. Then later on I may need to increase back up after a few weeks. I can usually link that to how much exercise I do.

Novorapid OTOH is fairly steady at 6-8-6 (breakfast, lunch and dinner) against 30-80-80 grams of carbs. I do correct down if I'll be exercising afterwards, and also to cover variations in carb intake.

That makes 12 to 20 units of Levemir and thereabouts of 20 units of Novorapid, plus/minus corrections, per day. How does it compare to others?
 
It doesn't matter how much or how little insulin people use, you need what you need 🙂
 
It can vary widely from person to person based on a huge variety of factors.

You might find this interesting from a conference I attended some years ago - some rules of thumb derived from clinical data, which can help specialist HCPs predict starting doses for T1s based largely on their weight, and using the 500 and 100 ‘rules’ (or 350 and 120) to estimate carb ratios and insulin sensitivity factors.

It’s not a bad guess for me using 350 / 120.

1677489310292.jpeg
 
As has been said, you need what you need and there is variability between people as well as how many carbs consumed, amount of exercise, etc. each day. So I wouldn’t stress about comparisons with others.

I have Levemir once per day, at night, and am currently on 28U and Novorapid for meals at a ratio of 1U to 8g carbs throughout the day. TDD is an average of around 53U.

My TIR (which I have set to be 4.5 to 8.9) for the last 90 days is 78% and Libre estimated HbA1c is 40 (I suspect blood test results will be a bit more than that figure).
 
I am definitely in the "it doesn't matter how much insulin others need" camp.
I find my needs vary greatly depending upon what I eat, how much exercise I do (or have done in the last couple of days), how stressful is the day, whether I am unwell, ...
My dose could be anything between 15 units and 35 units a day because I have very few "typical" days. I dislike habit and try to avoid it.
 
Hi all. Thank you for your replies. I understand that everyone is different and will have different needs and management strategies, so I guess what I was/am curious about is how that variety manifests itself in the numbers each of us push under our skin every day.
 
Carlos said:
I guess what I was/am curious about is how that variety manifests itself in the numbers each of us push under our skin every day.
Click to expand...
But why? Makes no difference to your doses or diabetes how much other people take, it’s too individual for comparison to be of any benefit
 
Robin said:
OK, it doesn’t make any difference, but I must confess to being curious as to where I fit in to the bigger Diabetes picture.
Click to expand...
Unless as well as insulin doses you also compare your weight, height, diet, insulin production, exercise, stress levels, other medications, and the other 40 ish factors that affect blood sugars and therefore insulin doses though, you won’t be able to interpret the results
 
Lucyr said:
Unless as well as insulin doses you also compare your weight, height, diet, insulin production, exercise, stress levels, other medications, and the other 40 ish factors that affect blood sugars and therefore insulin doses though, you won’t be able to interpret the results
Click to expand...
I’m not meaning to be at all scientific in this. It’s just that when my consultant says 'I suspect you’re still producing some endogenous insulin' and I look at where I sit in the range of basal amounts that people take, I can think, oh, I’m at the lowest end, I suspect he’s right. If he said that, and I could see I was taking a larger amount, comparatively, I might question why he was saying that.
(I know the definitive answer would be to ask for a c-peptide,but there aren’t any clinical grounds for me having one, so I wouldn’t ever ask because I don’t want to waste scarce resources).
 
I think it is a valid point that how much endogenous insulin production you have left will be a big factor in this. If you are relatively newly diagnosed, then you may well be in the honeymoon period and your body will be supplementing your insulin injections. I consider my insulin needs quite high now (currently 22 units of Levemir a day and my bolus needs can vary from under 10 to near 30u or maybe even a bit more on very rare occasions if I have a splurge, depending upon what I have eaten and including corrections)
I can be a bit resistant to increasing my basal doses particularly because I feel I already take quite a lot and this can make my diabetes frustrating, so it is important to just accept that you need however much you need and try not to compare with others as you can make it harder for yourself if you let it affect your decisions, as I sometimes do. I prefer to be using less insulin and I am happier when I am reducing my basal doses rather than increasing them. My general range of basal dose has been pretty steady for the last couple of years give or take a few units for being more or less active at any given time. I am currently carrying a bit more weight than I would like at about 70kg, so that basal calculation that Mike has posted above suggests that I am actually taking less than it calculates which would be 35u (0.5x70) and I am taking 22u..... which perhaps makes me feel a bit happier about it. I am not particularly interested in the carb ratios calculations because I follow a low carb way of eating most of the time but need to inject for protein as well as carbs so I don't see it as useful to compare bolus doses.
 
This will get the calculators going. 6' 2" and 98kg. 45u per day Actrapid and 40u per day Isophane. Total CHO per day 120 - 130 gm. So I am not that efficient in using insulin! :(
 
I have no pancreas. My average daily total is 30 units of which my basal is 9 units.

When I first met my current Endo he talked about a basal to bolus split of 50/50 and he encouraged me to try some different bolus ratios to move me towards that split. I tried and this didn't work; my current c. 1/3 to 2/3 split has been about that for 15 months. I read very recently that either Gary Scheiner or Stephen Ponder also use 50/50 as a starting guideline.

I can see that knowing something about a person's weight and bulid, etc is very relevant to this sort of crude data - but I confess that I am simply curious to know where my insulin needs sit in comparison to others. Thank you @Carlos for the question.
 
My basal is almost half what the weight calculation says it should be. I’m very sensitive to insulin. My basal is around 7 units (via pump). Recently my bolus needs have gone down - no idea why 🙄 But generally my bolus insulin varies between 10 and 15 or somewhere around there.
 
Proud to be erratic said:
When I first met my current Endo he talked about a basal to bolus split of 50/50 and he encouraged me to try some different bolus ratios to move me towards that split. I tried and this didn't work; my current c. 1/3 to 2/3 split has been about that for 15 months. I read very recently that either Gary Scheiner or Stephen Ponder also use 50/50 as a starting guideline.
Click to expand...

Yes I’m often confused by that. I can understand that it‘s vaguely helpful to have an idea of what is often found (John ‘Pumping Walsh’ also mentions 50:50, but suggests a likely range is somewhere 40:60 to 60:40)

I guess the thinking is that someone arrives at clinic who is struggling and their split is 5% basal and 95% bolus it might be helpful to try to adjust the split.

But it makes no sense to me to try to get someone towards 50:50 if they are doing OK. I mean… when I go into a shoe shop the assistant doesn’t say, “well sir, most men do take a 8.5 so you should probably buy that size...” :rofl:
 
Well I totally skew the 50/50 ratio. 40 units of basal a day but on a typical day no more than 7-10 units of bolus
 
I think the basal you use may skew the split, so the likes of Tresiba which you adjust to prevent night time hypos and give you a stable overnight readings may not provide enough basal cover during the day, so your bolus insulin will be taking up the slack, whereas with Levemir, it can be adjusted so that it is covering your actual basal needs more closely day and night, so your bolus insulin will be mostly just dealing with food and not need to be used so much for corrections or lower meal ratios to make up for any daytime shortfall in basal.
 
rebrascora said:
I think the basal you use may skew the split, so the likes of Tresiba which you adjust to prevent night time hypos and give you a stable overnight readings may not provide enough basal cover during the day, so your bolus insulin will be taking up the slack, whereas with Levemir, it can be adjusted so that it is covering your actual basal needs more closely day and night, so your bolus insulin will be mostly just dealing with food and not need to be used so much for corrections or lower meal ratios to make up for any daytime shortfall in basal.
Click to expand...
That sounds like my experience. I just couldn't get a stable pattern with Tresiba, whereas with Levemir everything just fell in place.

I didn't have any particular purpose in mind when I started the thread, I was just curious as to what the variations are.

Thanks everyone that have answered so far.
 
18/20u a day when I used Levemir, plus roughly 10 ish u Novorapid. Now 11 point something u basal and the same 10 ish u bolus, all Novorapid. So my TDD is about what my basal was, pre pump.
 
Status
Not open for further replies.
Back
Top