It is now later !!
At 8.00 am , blood sugar is 14.8, you eat 45 grams of carbs. Your insulin/carb ratio is 1 unit /15 grams , insulin sensitivity factor is 3 , and the basal rate from 8. am to 11.00 am is 0.5 unit/hour
....3 hours of basal insulin is 0.5 x3 = 1.5 u
.....Food bolus is 45 grams divided by 15 = 3 u
.....Correction bolus is 15-6 divided by 3 = 3 u
This totals 4.5 ( 1.5+3+3) so the insulin dose at 8.00 am to 11.00 am is 4.5 u of rapid -acting insulin by pen or syringe. Another dose is needed in about 3 hours.
There are 2 options for being off the pump overnight :
1. If long acting insulin is not available , continue to take Rapid-acting insulin every 3 hours overnight , as in the previous " daytime " example.
2 . Take Lantus insulin once a day ( Levimir not av.in Canada , when this protocol was prepared and I understand that originally Lantus was to be one shot daily ??)
use Lantus only if you will be off the pump more than 24 hours . Calculate the total daily basal amount of insulin and take one dose of lantus at bed time or in the morning and then every 24 hours . During the day , take rapid-acting insulin before your meals to cover the carb and correction.
When you are ready to go back on the pump , you should not have your pump deliver basal insulin until 24 hours after the last Lantus dose. If you want to wear your pump earlier , use the pump for your food and correction boluses , but a temporary basal rate of 0.0 u/hour until 24 hours after the last dose of Lantus .
Take NPH insulin at bedtime .
Add up the basal amount of insulin during sleep and give 1.5 times this dose as NPH . During the day , follow the " daytime " example .
Example # 1 : hours of sleep are 10 pm - 6 am . Basal rate during this time 1.0 u/hr
1u/hr x 8 hours =8 u x 1.5 =12 u . The dose of NPH is 12 u at bedtime .
Example # 2 : Hours of sleep are 9 pm-7am .Basal rates during this time are : 0.6 u /hr from 9 pm to midnight , 0.5 u /hr from midnight to 3 am , and 0.7 u /hr from 3 am - 7 am .
Calculate : 0.6u/hr x 3 hours = 1.8 u
0.5 u/hr x 3 hours = 1.5 u
0.7 u /hr x 4 hours = 2.8 u
Total = 6.1 u x1.5 = 9.1 u . The dose is 9 u of NPH at bedtime .
That's it folks ...it reminds me travelling from West Coast Canada to the Netherlands , while on shots ...all the math my Doctor and I had to do ..and the time zones . Give me a pump and let's travel is my motto now .
MM will get me a replacement pump pretty quickly and there is a pumper buddy in town , who will loan his spare pump to people at our pumpers support group .