Insulin Adjusting

[marshmallow]

I think I did it right this monrig!
6:30 I woke up 9.3
6:45 I had my cereal and 10 units rapid acting
9:00 4.9 -  1 nutra bar 22g carbs
11:30 5.8

Does this mean that if I had not eaten a snack at 9 am, those 10 units would have been too much because my sugar was already 4.9 and would have continued to drop?
I don't understand how this works, that I ate 22 g of carbs and without any insulin I am atrill nicely at 5.8 - I am guessing that this is the 6:45 am insulin still working???

[CoWriter]

Good job!

A blood sugar of 5.8 is the same as as 106 (okay, so I'm cheating.  I found a place that converts it to US numbers since that's what I'm familiar with).....

http://www.reducetriglycerides.com/reader_triglycerides_conversion.htm

If you had not had the nutrabar, it would have gone lower by lunch time but probably not much depending on what time you eat lunch.

So you can do one of two things....

1.  You can add some protein to your breakfast so it will last you longer and you won't be hungry so soon.....like maybe some peanut butter.....or an egg.

2.  Or you can change the snack at 11:30am to something healthier than the nutrabar.  Maybe a small apple and nuts(never eat the fruit by itself!)....or a cheese stick and some nuts.


Okay....next, let's work on lowering your fasting blood sugar.  A 9.3 is the same as a blood sugar of 168 in US measurement.  Way too high.

You can lower your fasting blood sugar by having a bedtime snack....half hour before you go to bed.....and it must contain PROTEIN.    Are you doing that?

[marshmallow]

Thanky ou, thank you , thank you!
I'm glad that for the past 3 days I have been in the range of 4-7.
The only thing is that the morning readings are always way too high, today 9.9, yesterday 11.5, the day before 9.3.
He told me to adjust my nighttime lantus by 1 more unit every night until I wake up with a 7 or lower.
I thik if I keep increasing my lantus to cover my mornings, then my breakfast insulin will have to be reudced because right now it is higher (10 units) so that it covers my meal and also to bring down the fact that I am higher to begin with. I though I'd wait for the nuyrse to tell me what to do on this one.

Generally, I am so pleased that in 3 days I've got it in range! Before I was always 9-10 all days long!

[CoWriter]

"I thik if I keep increasing my lantus to cover my mornings, then my breakfast insulin will have to be reudced because right now it is higher (10 units) so that it covers my meal and also to bring down the fact that I am higher to begin with. "

That's right!  You're a great student!

Okay....you can wait for the nurse....LOL  Let me just explain to you so when she tells you what to do it will sound familiar.

The reason you need to lower your fasting blood sugar is because by the time the blood sugar is high, the damage to different organs has already occurred.  So insulin should be PREVENTIVE.  Insulin is supposed to work so that your blood sugar is not high.

Now let me explain why your fasting blood sugar is high....

Whenever you eat....food turns into sugar.  No matter what it is.  Things like carbs turn into sugar quickly....other things like protein take longer but eventually, everything turns into sugar.  And some of that sugar, is saved in the liver.  And the liver gives it back to you when you need it.

So during the day, you eat your meals and snacks so you always have sugar in your blood....but at night, you go many hours without eating.  Let's say that you have your dinner at 6pm and breakfast the next day at 7am....that's 13 hours without eating.  And during that time, your blood sugar goes down.  And the liver notices it....and it gives you a bunch of the sugar it had saved for you.  That's why in the morning, your fasting is high.  Because the liver gave you sugar during the night.

So.....if the liver gave you sugar during the night because you didn't eat.....what do you do so that the liver won't give you any?

That's right....you eat!  It's as simple as that.  

So you need to have a bedtime snack half hour before you go to bed.  The snack MUST contain PROTEIN so it will last you all night long.  If you have only cereal, it will last you only a couple of hours.

Examples of what you can have for a bedtime snack:

Half peanut butter or meat sandwich
Some nuts
tuna and a few crackers
cheese and a few crackers

When you eat the snack, your fasting blood sugar will be lower than the 9 you've been having.  Once you lower it with the snack, then you can start adjusting the Lantus.

By the way, Lantus is increased by 2 units every 3 days until you get to the 4-7 range.

And yes, once your fasting blood sugar is normal, you won't need the 10 units with breakfast.  But remember that your goal is controlling your blood sugar, not staying on the 10 units because that's what's comfortable.  You need to try to get better control before your surgery.  People with high blood sugar have more complications from surgery.