Start of insulin

iVillage Member
Registered: 06-25-2006
Start of insulin
9
Thu, 03-27-2008 - 3:10pm

Hi all - Man do I need a hug! Sigh. I have been on and off this board for awhile but I guess I always know where the support and knowledge are when I need it. I was started on Insulin yesterday (so that I can start TTC soon). I have been on oral meds for 4 years and have an average A1C of about 6.4.


My fasting numbers are usually OK it is mealtimes where I always have seemed to need the extra boos - so my endocrinologist has me started in Rapid Acting Humalog.


Last night I had 90g of carbs (normally I only have 60 but it was a special occassion and I had discussed with my doctor in advance) and was nervous starting out so I only took 1/2 the recommended dose of insulin and ended up at 44 at 45 minutes post meal. I corrected and all was fine within 2 hours.


I talked to my doctor today and she changed my ratio of carbs to insulin from 1:15 to 1:30 meaning that I take 1 unit of insulin for every 30 carbs that I eat (she told me to try a few scenarios when I was home this weekend and had food around). Well I did this  at lunch today . I had 60 grams of carbs and took 2 units of insulin (the 1:30 ratio) and two hours post meal my blood sugar was at 194 – too high.


So tonight I will try a little more insulin, maybe a 1:20 ratio and see how that goes. Like she said it will take some time to get right so I am trying not to get frustrated (it is only the first day) but I am feeling like I want to cry and already feeling like I am never going to get this right and I will only ever be able to eat things with labels on it.


I am sorry I am whining I know - but I just feel - well overwhelmed. Thanks for listening...... 

Photo Sharing and Video Hosting at Photobucket
Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Thu, 03-27-2008 - 3:45pm

Hang in there Michelle!


iVillage Member
Registered: 05-17-2001
Thu, 03-27-2008 - 4:02pm

It's quite a challenge, I know.

~Misty~


 


iVillage Member
Registered: 04-03-2003
Thu, 03-27-2008 - 4:44pm

Wouldn't "times 5 then divide by 10" be the same as just dividing by 2. As in your example:

45 x 5 = 225
225/10 = 22.5

45/2 = 22.5

same thing, one less step and way easier than multiplying random larger numbers by 5, for instance if you have 23 grams of carbs you just divide by 2 and get 11.5 rather than doing 23x5=115 then dividing by 10 to get 11.5. For that matter, if you're just dividing by 2 you can easily take an odd number, such as 63, take half of the number one lower (which would be the next lowest even number, in this case 62), divide that by 2 (which would be 31) and add .5 to get 31.5 which is the same as 63/2 or (63x5)/10 (it's an even longer a process but most folks are usually pretty readily able to divide even numbers in half)

--Deb

Avatar for cl_maryfrances40
iVillage Member
Registered: 03-25-2003
Thu, 03-27-2008 - 10:10pm

Hi Michelle,


I am only on long acting insulin but I am pretty sensitive to it. Normally type2's need about 40 units of long acting insulin but I am back down to 22 once per day. The idea of using 1 unit per a certainly number of carbs allows you to eat pretty normally. Shortly you will be able to quickly figure out how many carbs are in what you want to eat. Of course eating out, you won't be as accurate as when you can weight and measure, but you will manage it. I suspect that you are probably going to settle out at 1:17 or 1:18. At least at the classes that I take they say this is the most common dosage. I will be interested to see how much you ultimately need.


I had a terrible time starting on insulin because of all the lows. Eventually I asked for a return visit to the dietitian and that helped me immensely. So keep this in mind if you have trouble with too many lows.


follow me

iVillage Member
Registered: 06-25-2006
Thu, 03-27-2008 - 10:28pm

Thanks for your reply MaryFrances -


Dinner tonight went much better. It is going to take me a bit to get it right I just have to remember to give myself some time - I am not so patient with myself sometimes.


Tonight I was much better. I dosed my insulin right and at 1 hour post meal I was 67 so a little low but rather than rush to correct it I waited and did not feel off at all and at 2 hours post meal I was at 98. So OK.


Apparently the rapid acting stuff really hits its peak at 1 hour - not the 2 everyone told me - so it seems like the span is 2 hours but the peak is 1 hour. Somehow now I have to just manage to figure out how to go low enough at 1 hour to be where I should be at 2 hours without going too low at the 1 hour mark.


My brain is so exhaused from all of the constant calculations and worry about when/if I will start feeling "off".


Thanks again for the support.

Photo Sharing and Video Hosting at Photobucket
iVillage Member
Registered: 05-17-2001
Sat, 03-29-2008 - 4:07pm

Deb, you're right!

~Misty~


 


iVillage Member
Registered: 06-25-2006
Sat, 03-29-2008 - 6:16pm

Hi all - Thank you so much for the encouragement and support.


Right now - 4 days on insulin I am leveling out pretty much where I should be at a 1:15 ratio. For those of you on long acting insulin (basal) as well, what my endo told me is that my metformin is acting as my long acting medicine right now. She has suggested with my OB that I stay on that until I become pregnant and then switch to long lastin insulin with the theory being that metformin has been shown to help with fertility

Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Sat, 03-29-2008 - 7:10pm
Glad to hear you are starting to get it leveled out!

iVillage Member
Registered: 05-17-2001
Sun, 03-30-2008 - 3:38pm

I am more than overflowing with pregnancy hormones right now, so I'm sending a ton your way!!

~Misty~