BACKGROUND INSULIN

9 posts, 5 contributors

Search the DAFNE Online Forums

 
paulj DAFNE Graduate
Northumbria Healthcare Trust
36 posts

am i right in assuming that on average 1 unit of B/I should be relevant to 1 hour of the day.in other words you should be taking roughly 24 units of B/I PER DAY.i am on LEVIMIR at present and i take 9units for my daytime dose and 16 units at night. any thoughts or comments would be much appreciated
cheers
paulj Very Happy

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

There is some guidance on how to work that out somewhere but it basically depends on your mass, maybe someone of perfect proportion in terms of fat an muscle and general health would see the kind of basal need your describing.....

Someone else could shed some light likely....

JayBee DAFNE Graduate
James Paget University Hospitals NHS Foundation Trust
587 posts

Never thought of it like that... Currently take 25 BI Levemir total if wondering...

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

I used to be on 24 in the morning and 34 at night, now that I am pumping my total basal delivery is 26 units.....

So half pretty much, the same goes with the bolus doses.....

Injecting is only 50% effective.....shocking...Sad

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
423 posts

novorapidboi26 said:


Injecting is only 50% effective.....shocking...Sad



Perhaps the rotation of sites wasn't as good as it is now that you are using the pump? Using a pump helps to rotate the site more effectively. It is very easy to inject into the same places without really noticing, and that does lead to reduced insulin absorption. I do find myself injecting into the same convenient places, especially when I need to inject in public and want to keep it fairly private.

I listened to a pump specialist over the weekend, and he demonstrated how when the infusion set is changed, the new one should be placed close to the old one while the old one is in place so that you don't reattach to the same point, and then the old one can be removed. You would then work up the abdomen/back until you run out of abdomen/back to attach to, and then start again at the beginning. No doubt you have been told all of this before though :-)

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

I was always good at rotating sites when injecting, so my breakfast would be my right thigh, lunch my left, dinner my stomach, supper my bum....not always as strict as that I suppose.....

The science wasn't explained thoroughly but I understood it was down to the delivery, so instead of putting your dose straight in to one spot, the pump delivers it much slower, allowing for each unit to be absorbed before delivering the next one.....this is more so the case for the basal, as the total daily dose is split in to x amount of units an hour, which is then slit again by 6, so delivering a burst every 10 minutes......this kind of delivery can also be done with the bolus by using the dual and square wave functions.....but even when using a normal bolus, so all up front if you like it's still pumped in over 3-4 minutes.....

It's this delivery method which increases the efficiency from 50 odd percent to 90 odd....

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
423 posts

Cool. That is interesting to know. :-)

Plumcious
Sheffield Teaching Hospitals
11 posts

Hi

I've found that how much BI I'm on is affected by how fit I am - the fitter i am the less I need, although currently am on 9 units am and 9 pm and am not that fit.
Have you ever done the no carb day to check whether your BI dose is right?
You do your test on waking and if low treat as normal and don't have your breakfast insulin. If high correct as normal.
Then through the day you check your blood sugar as usual and don't eat any carbohydrate at all (unless dealing with a hypo). Obviously this means pretty much no fruit, no bread or biscuits, no cereal, no pasta etc (I know you know this, I'm just saying because I found it much harder to do that I'd imagined it would be)!
Then your tests show you whether your BI amount is holding your BG level or whether it's too high (which would be shown by hypos) or too low (you needing to correct).
I've never managed a whole day (I'm vegetarian and practically everything I eat seems to have carbs in) - I think when I do it again I'll make some carb free soup beforehand, and may buy sweeteners.

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
423 posts

Hi Plumcious (Great user name!)

I don't know that an entire carb-free day is actually necessary. A carb-free day for me would make a lot of what I do such as riding to work dangerous, so for me it wouldn't be helpful.

I definitely find that if I go for 3 or more days without exercising, that my BGLs will rise. I try and ensure that unless I am sick, that exercise happens every second day if not every day.

I think that determining the correct basal dose is reasonably easy to do by comparing the before bed BGL with the waking BGL. Testing during the day can be done as long as you start testing when the QA has been completely used - varies for each QA type, but for me on Humalog is about 3-4 hours. Most foods will also no longer be releasing glucose from that time, so you can begin fasting at that point, and then stop fasting when you have reached the end of the period that you are tying to test. So for example, if I wanted to check my afternoon levels, then I would still have breakfast about 7 am, then test at 11 am, and again at say 3 pm to see whether my BGs have risen or dropped or stayed the same over that period and work out whether I have my BI correct or whether it needs to be reduced or increased.

This gives a rough check of whether your BI is correct. There are plenty of other factors that could increase or decrease BGs though. Stress, sickness, menstruation, climate are just some of them.

Also, (I am vegetarian too), some foods are very slow-release and if I had had foods like beans, lentils chickpeas etc for breakfast in the above test, then I know that my BGs would keep on rising throughout the day, because these foods for me raise my BGs for 8-10 hours after consuming them.

Cheers,
WArwick.