Corrective Doses of Insulin

Hi there
When I did my DAFNE course I was taught never to 'correct' by more than 3 units of insulin. I'm sure I've read recently that it is now acceptable to 'correct' by up to 4 units. Can anyone please confirm if this is right? I have just had a search through the online DAFNE Course Handbook but I can't seem to find anything that mentions specifically about this (although it might be me that's missing it ). If anyone could advise me I would be most grateful. Thanks in advance.
Jean

Hi Jean, I would correct to a maximum of 4 units, as if you BG is high (above 13) your insulin may not necessarily have the same reduction of BG as when in normal range. However I would advise you to monitor your BG closely while the higher corrective QA is in your system as to avoid any issues if your BG does come down quickly. Take care Deano

Please ignore that rule you have been told. It is contradictory to DAFNE rules and is best not exercised. I shall explain... with the assistance of the online DAFNE Course Handbook provided on this site.

As long as you know how much one unit takes your BG down by (the typical is 2-3 BG per unit but your personal needs may be different) then you should be concentrating more on how much you need to get yourself down to the BG you want to be. You will not need to take the same amount of correction every time because it more depends on the circumstances you're under each time - this is why DAFNE has the Step Wise Approach.

Also see the guidebook's Hyperglycaemia section if you're unsure still.

With nothing being stated about not being allowed to take above any amount - this should be enough indication to ignore the "units cap" rule. Quite frankly, I don't think it applies anywhere in the guidebook.

I understand it can be tempting to just stick to the same correction amount, but to restrict yourself can be a hindrance to your health - if you need 5 units for example and you only took 3, your BG pattern searching results will not show up correctly because you've not taken the insulin you needed under DAFNE rules. This can lead to you making mistakes with your insulin demand understanding and therefore taking longer to get to good control.

Hope this helps. Best wishes.

Thank you both for your replies - much appreciated.
Jean

If you look at the correction section within the hyperglycemia part of the handbook here it clearly states that if you are above 11, the recommended suggestion that 1 unit drops you by 2-3mmol may not apply.......

The 3 or 4 unit maximum that is floating about and also mentioned in the myths and misconceptions presentation is exactly that, a myth.......

When I previously discussed this on this forum it was suggested that this maximum was only applicable during the week of your DAFNE course and at any time when you are reviewing your doses from scratch, purely to be safe.......

If your confident in changing your doses and you know your bodies own responses you can take as much as is needed.......

I have investigated and found that if any reading is above 17, then 1 unit only drops me 1 mmol, so if I was at 20.5, I would take 15 units correction, and it works perfectly every time, so although each individual will most definitely be different, I believe this is the behavior of resistance to our corrections the higher our blood glucose reading are.......

JWo has explained this very well also, I am a walking talking example of these theoretical maximums being a load of nonsense.........

Thank you! Yes it was the myths and misconceptions thread where I had read about the 4 unit maximum correction.

I understand what you're all saying and I have re-read the sections of the handbook from the links you have provided.

Kind regards. Jean

also remember diabetes is not an exact science and trying to mimic the bodys production is difficult and a daily struggle but as you have found out there is plenty of help available. good luck