Insulin Question

[Sherry123]

My husband's niece has been a diabetic since she was 11 years old. She has always had trouble controlling her diabetes. I am not sure of how much insulin she should be taking. It seems that she is always taking insulin. I know that stress does raise the sugar level, but what else can cause this. She does not like to eat the way she is suppose to eat. I am not sure if her doctor has told  her how to. We recently took legal guardianship and we are learning. Her mom just let her do whatever. She sees a Nurse Practioner for her diabetes. I am not sure about this. She sometimes will give insuil 12 times a day.  Is this normal?

[JDRF-VOL-RL]

Hello, Sherry.  I'm so glad that you are taking the opportunity to learn as much as you can about how to manage diabetes, that's not something that everyone in your position would do.  

The first step to learn more is to contact her nurse practioner to get hooked up with a dietician, and in particular one that specializes in diabetes.  It is important to understand nutrition and how it relates to controlling blood sugars.  One of the things to know is that you need fast acting insulin every time you eat, and if she's not on a pump she needs a long acting insulin as well.  You may also need an extra shot once in a while to correct for a high blood sugar score.  But 12 shots a day is too many.  6 is the most I've ever heard of, unless the child is sick and spilling ketones.  The reason is that the fast acting insulins take an hour to reach peak, and 3 to 4 hours to fully work.  She's likely taking not enough insulin for a meal, and is chasing high blood sugars later on, which is why she thinks she needs another shot.  If she's eating that often, I'd start getting her to change her meals so that she eats more proteins.  Proteins would her up more, so she wouldn't be as hungry later on, and she would be eating less, and because of the fewer carbs she'd be eating she wouldn't need as much insulin, either.  

There is a carb ratio that needs to be determined to figure the proper insulin dose as well.  It is the number of carbs that a unit of insulin can cover.  Here is a decent description:

http://www.diabetesnet.com/diabetes_control_tips/carb_factor.php

Different times of the day may require different insulin to carb ratios.  For example, in most people, their livers start excreting glucose in the early morning hours, it's part of a natural cycle to get the body to wake up.  You will need more insulin to cover that natural glucose in the mornings, and less in the afternoons when the body isn't adding that much to your system.  

The correction factor is a different one from the carb ratio.  It is how much one unit of insulin will bring down your blood sugar.  Here's a decent description:

http://www.diabetesnet.com/diabetes_control_tips/corr_factor.php

There's lots of really good places to go for more information.  Here's a few places to go for more info:

http://www.jdrf.org/index.cfm?page_id=103432

http://www.childrenwithdiabetes.com/index_cwd.htm   (this one has email groups and forums for parents of kids with diabetes, I prefer the email groups)

http://www.dlife.com/dLife/do/ShowContent/type1_information/

http://diabetesnet.com/

Good luck!

[pumpgirl]

No, 12 shots a day is not normal being 11 years old she should only be taking about 4-6. This could be a tough but good questin...has she tried the insulin pump?  For me this works wonders. You can still eat what and when you want(still being careful)without having to give a shot. You should check them out. It made my life easier. It might even make life at school easier...

[angela802]

i have  been   diabetic since i  was  about 24 most  of  the  time i have  noticed just  after  i  take  my  insulin there  seems   to  be  a  cloud  of  funk  that  follows  me  around am  a  verry  clean person i  was  just  wondering if  this  may be  due  to just the  insulin