Okay guys need help with fast acting insulin

Okay My endo(due to my readings) has decided to keep me on NPH and now is starting my on Novolog. Along with Metformin dropped glipizide. Now I need your guys help. She said for meals dose 1:10 I know that means 1 unit of novolog per 10 grams of carbs. Then she put correction factor 1:35 above 100 as directed <------ this is what I don't understand help me out all, yet again!

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Permalink Reply by Kristin on March 4, 2011 at 12:10pm

The correction factor means that you take one unit for every 35 mg/dl that your blood sugar is over 100.

So if you are 135, you need to take one extra unit for correction. If you are 170, you need to take two extra units for correction.

Your endo should have explained this much more clearly. Is there a CDE (certified diabetes educator) who you can see in addition to your endo?

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Permalink Reply by Stardust31 on March 4, 2011 at 12:14pm

Ahh that helps. I do have 2 books Have to read on this subject! also I see that NPH and Novolog can be mixed. I also know that you have to put novolog in first then draw NPH..any thoughts?

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Permalink Reply by Kristin on March 4, 2011 at 12:15pm

I don't know about mixing insulins, but hopefully someone else will!

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Permalink Reply by MossDog on March 4, 2011 at 12:18pm

You are exactly right Stardust. You want to put the Novolog in the needle first. Otherwise there is not much more to worry about. When I was on NPH I found I would have to add a little air to the vial towards the end to make it easier to pull the insulin out as I did not inject air in since it was the second insulin you draw out (or you could inject air in as you go along)

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Permalink Reply by bsc on March 4, 2011 at 12:32pm

You can mix NPH and Novolog in the same injection, but it takes a number of properly ordered steps to make sure you don't cross contaiminate. You always do the R (clear) first. I like to remember that cloudy messes up clear, but clear won't change cloudy. Here is the steps that I use for a mixed injection (with NPH/R).

1. Inject air dose into R vial
2. Draw R dose into syringe
3. Draw NPH dose into syringe
4. Inject
5. Inject air dose into NPH

This ordering assures that there is no change of NPH messing up your R. A single spec of NPH could mess up the whole vial of R. You don't have to inject air until you see the end dimple, but I do it all the time to equalize the pressure.

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Permalink Reply by acidrock23 on March 4, 2011 at 2:51pm

I never liked mixing insulins. I used R/N but just did two shots. When I mixed them, it always seemed like the R would get "tired" faster?

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Permalink Reply by bsc on March 4, 2011 at 3:43pm

I can't really judge that. I don't really need much R at this point and only take it at dinner. I have heard that mixing can just end up smearing the responses. But of course, that is exactly the mixtard 70/30 type of response.

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Permalink Reply by Stardust31 on March 4, 2011 at 3:15pm

Not sure about the mixing have not done it yet. Now I have to ask. Do I take the rapid acting every time I eat? Also how long after I eat do you take it again? Last but not least, If you take your blood sugar after 2 hours and it is over and you have to take a correction dose do you take that dose right after you see that your BS is high at 2 hours?

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Permalink Reply by LiL MaMa on March 4, 2011 at 3:46pm

Yes, you take the rapid acting everytime you eat. You may take it right before you start but I personally try to wait 15-20 minutes for my insulin to kick in before digging in. Do not take another correction dose for 3.5 hours at LEAST especially in the beginning until you know your correction factor and learn how to estimate how much insulin you have left on board. You do not want to start overlapping your boluses which can lead to a severe hypo. It's best to figure out your correct insulin to carb ratio and not have highs rather than trying to correct them after. You may have an insulin to carb ratio of 10:1 or it may be 12:1 8:1 etc everyone is very different and even different insulin to carb ratios at different times of the day. For instance when your NPH is peaking you may need more carbs per unit of insulin to avoid a low. You should keep a food log writing down everything you ate, what your starting blood sugar was, how many carbs and units of insulin you took and what your 2 hour blood sugars were. Do you have the book "Using Insulin"? It is amazing at explaining all of these things, I still refer to it almost daily.

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Permalink Reply by Stardust31 on March 4, 2011 at 3:52pm

I have the book think like a pancreas and using insulin, still reading using insulin. I'm glad you referred that book to me. I just figured out you are supposed to do your correction dose with your carb coverage before the meal. Didn't know that.

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Permalink Reply by Emily on March 21, 2011 at 10:46am

It used to be that if you were "normal", you dosed about 15mins before the meal... 30 mins (or more) if you were using a correction factor. Play with the times because they are unique to your body... but those are good numbers to start with... oh, if you are below 80, wait to inject until after the meal...