Replies to This Discussion

Permalink Reply by acidrock23 on July 18, 2012 at 3:19am

230---> 190 would suggest to me that, if you didn't correct it, your basal is a little high, since it went down at night? I don't eat when my BG is 190, hardly ever. I will bolus and wait. It can be nerve wracking, at family gatherings and stuff like that. I also have a dog, and I'll walk her after I correct, we have a nice variety of loops (1/4 mile around the block, mile loop, 3.5 mile loop, etc...).

The only way to know how much 1U will bring you down is to take 1U and see what it will bring "U" down? If you are at 230, it may take a bit more but you can try out a unit and see what happens, be careful, maybe test in an hour to see if it's starting to work and then in 2 hours to see where you're at when it's peaking. I agree that you should try it w/o any carbs. Then you'll have that data in your "arsenal" and can move on to the next "target"? Good luck!!

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Permalink Reply by Parrformance on July 18, 2012 at 4:01am

Gary Scheiner's book "Think Like a Pancreas" would be a big help for this situation.

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Permalink Reply by Brian (bsc) on July 18, 2012 at 4:31am

I found "Using Insulin" by Walsh to also be very helpful. You will develop a "protocol" for this stuff, it will become second nature. When I wake high (or am high before a meal), I take a combined injection which corrects for my high blood sugar and covers the carbs in my meal. A reasonably safe starting Insulin Sensitivity Factor (ISF) is about 1:50, so 1 unit of insulin drops you about 50 mg/dl. Some people are more insulin sensitive (like children) and drop much further. Until you better understand these things, you should be conservative with corrections (i.e. never correct before bed). But you really should get the books and learn how to properly test and establish all of your factors.

And as AcidRock suggests, when you are really high, all those carefully measured factors don't work so well (you often become insulin resistant) and it is safer to get your blood sugar back to normal first before eating.

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Permalink Reply by denise102206 on July 18, 2012 at 5:59am

Thanks. This morning when my bs was 190 at 5m I went back to bed got up at 7am and it was 177. So I ate eggs and black coffee no carbs and took 1u of insulin. Now i'm just testing to see how much it drops me. So far by the 1 hour mark I had went from 177 to 161 and now at the 2 hour mark i've gone to 156. So far 1u of insulin has dropped me 21 points in 2 hours. Doesn't seem like much.

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Permalink Reply by Super_sally on July 18, 2012 at 6:56am

Hi,

You are still taking your basal? Don't not take it, even if you don't eat or don't eat any carbs.

Did you take any bolus for the eggs? You may find that you still need to take something to cover eggs. I personally find that I need 1 unit of bolus to cover my 2 eggs and coffee.

See where you are at 3 and then 4 hours. then you'll know how much the 1 unit dropped you this time. Probably you'll be something like a 30 point drop by the end of that time. So that will be your starting point for the next time to try this. Kind of reassuring, right. If 1 unit drops you 30 points then you are unlikely to go low from just 1 unit of adjustment.

The 30 points (or whatever you end up with) will be your starting point for your next trial at doing an adjustment when you are high. Say next time you are 170 then assuming 2 units drop you by 60 points, you would expect to be 110 3 - 4 hours after correction.

We are all different on how much 1 unit drops us. At the moment 1 unit will drop me approximately 40 points. When I was pregnant, 1 unit dropped me only 5 points. If I am high (close to 200) 1 unit will lower me less than if I am say 140.

You are doing great! This is all part of the learning experience.

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Permalink Reply by denise102206 on July 18, 2012 at 7:06am

Well in the morning I seem to be really insulin resistant so wouldn't my correction be different for like lunch and dinner? Because I really think 1 unit of insulin would drop me a lot more if it was a different time of day. So far at 3 hours I haven't dropped anymore then the 21 points :/. Yes I'm still taking my basal hopefully it will help it come down some before lunch so I can eat.SO is the test not accurate since I took 1 unit of insulin and ate eggs..? should I have ate nothing to see more accuracy?

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Permalink Reply by still_young_at_heart on July 18, 2012 at 7:53am

Hi,
It would have been ideal not to have eaten the eggs but I don't think the difference would be material.

A unit correction might drop you more later in the day when you are more insulin sensitive. With a 1:6 ratio, a 21 point drop in 3 hours isn't that unreasonable. I find that eating 1 gm of carb raises my blood sugar about 5 points and I think that is fairly common. A one unit correction covering 6 carbs would take care of about a 30 point rise which isn't that far off, especially taking into account a bit of rise for the eggs.

Maurie

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Permalink Reply by denise102206 on July 18, 2012 at 8:01am

Well I haven't figured out my ratio for breakfast yet though 1:6 still causes me to go high like 170's I was planning on lowering my carbs but today has thrown me off.

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Permalink Reply by still_young_at_heart on July 18, 2012 at 8:50am

Well if a unit of insulin only covers 4-5 carbs in the morning then 21 points would be dead on....

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Permalink Reply by Jonah on July 18, 2012 at 7:59am

Seems very reasonable to me; at 2 hours I expect the insulin to be about halfway done, and an insulin sensitivitiy of 42 is pretty normal for an adult.

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Permalink Reply by denise102206 on July 18, 2012 at 8:03am

well it's been 4 hours and hasn't dropped at all... it's actually a little higher... went up 5 pts. :(

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Permalink Reply by Zoe on July 18, 2012 at 10:15am

Denise, you can't do an accurate test of how far one unit of insulin drops you when you've just eaten. Even though you ate a no-carb breakfast, the food is still a factor.

You are right, though, that you might have different ISF for morning or later in the day. Mine is 1:42 in the morning and 1:62 at night.

How are your basal changes coming? Your original basal doses sounded very low to me, so don't be surprised if you still have to increase it a bit. You're doing great but I agree with the others that you should keep reading and re-reading the book (I forget which one you got). Look in the index for whatever issue you're puzzled by such as ISF and then see if you can match up what it says to what you're experiencing. It will help to build your confidence!

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