I:C

[Hadi90]

Hello.

I follow an insulin program, which may sound a little diffrent (reading all of the other questions).

I'm 18 years old, weighing around 191 and standing 5'11".

I take about 60 units of Lantus daily, using the pen, and that's about it.
I exercise a lot, swimming, so perhaps it is my high-insulin receptiveness that allows this amount of Lantus to cover ALL of my needs, I do take Actrapid (I hope you're familiar with it) when the glucose level gets high and I can use a little amount of it, but that is rare.

My glucose levels are usually normal, unless I eat too much sweets or so.

Now that you know what I do, I will present the problem.

I am going to add strength training (weight lifting) to my swimming, and as of now I am counting protine, carbs and fats in everything I eat and logging it.

By calculations, I am supposed to eat an enormous amount of food (most sources indicate about 3800 kcal), that means a lot of carbs, my Lantus won't be able to cover them.

So, I am going to lower the lantus, and I want to take Actrapid before major meals, but how much?, I know how much carbs and all, but how can I translate that to an amount of Actrapid?

I know all of you would recommend me seeing my doctor, but I'm stuck with one who is bad but the hospital gives me all my supplies for free (not even insurance), he actually prescribes insulin to me and makes a fuss when I change the dose, like it's an antibiotic or something, and he doesn't know a thing about sports.

So please help me with the best of your experience ^_^

[KevinHarney]

First of all your program do not sound all that off base from the norm.  But aside from that if it is working for you that is what is important not the plan itself.

Second, It is probably all of that swimming and exercise that allows you to get away with just using Lantus.  All of that exercise will burn a lot of carbs.

So adding strength training will probably use more carbs so lowering your dose of Lantus would be the correct thing to do.  But in this case you might want to try to use the Actrapid to lower your highs instead as you are currently doing.

You should be able to figure out what your carb/Actrapid ratio is pretty simply.  Take a reading and then take a specific amount of Actrapid and wait for it to have its full effect and then take another reading.  When you have that you will know the dosage for the carbs that you are adding and that should keep you close to normal.  You will also need to know your carb/blood sugar.  Ie If I eat 4 g of carbs my blood sugar goes up 20 points and I need 1 unit of Actrapid to lower it 20 points.  You can get your carb/blood sugar ratio by taking a fixed amount of carbs (easiest way is with glucose tablets) and testing before and after to see the rise.

Make absolutely sure that you are not adjusting the dosages of Lantus and Actrapid at the same time.  This is a recipe for disaster and make sure any changes that you make are slow.  Do not make huge adjustments or several adjustments at the same time.

[KevinHarney]

I am thinking perhaps that I am interpreting the times when a correction factor is used.  I think that I am not uderstanding under what circumstances to use that instead of the Carb Factor.  Can you clarify ....

[JDRF Volunteer RL]

Well, as with most things with diabetes, your milage may vary.  The calculations are pretty standard with many endos, but everyone's different.  That's the baseline calculation for corrections, but each type 1 must adjust the ratios to what they find works for them.

[KevinHarney]

Plugging in my own numbers the correction Factor seems way out of whack for me.  What could I be doing wrong ?!?!?!  Seems to be like 3 times my rate.  The Carb Factor seems to be more accurate in all cases to me....

[KevinHarney]

JDRF - those are great links!!!!  I have tried to explain this to so many people that it makes my head spin and now I have links to send !!!!  Thanks

[JDRF Volunteer RL]

Hi.  I’m not a medical professional, just the parent of a kid with diabetes.  It looks like you understand that Lantus isn’t designed to cover all carbs, but to cover the glucose that your liver dumps out all day long, and that you need a faster acting insulin to cover the carbs you eat for meals.  You’re looking to figure out two ratios, the carb ratio and the correction factor.  One is for carbs you eat, the other is for how much to dose for highs.  

This is a description of a way to figure the carb ratio:

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

It uses the total daily dose to figure out how many grams one unit of insulin will cover.  Then you can use that to figure out what to dose for the carbs you eat at a meal.  

The correction factor is similar:

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

When you start changing these, you may want to test more often for a couple days, to verify that you’re not going too high or too low.  Also give it 2 or 3 days before you make a change, sometimes your body takes that long to adjust.  Good luck.

[Hadi90]

Your reply is just what I need, thank you.

I know that the goal is in normal range glucose levels, I said it's diffrent because I've never seen anyone else take a dose beyond 20 units, that's all.

And I will be taking it slowly of course.

Thank you very much!