humalog

[worthy]

I have been a diabetic type 1 since the age of 16 , I became diabetic following a car accident( seatbelt damaged pancreous )I started on beef and pork and suffered low BS constantly . I have been using Humulin R and just started using humulog in combination with this to try and put weight back on , lost about 25lbs . I seem to be having trouble with the humulog . I know our readings are different in canada , 5 to 7 is normal.I have had sugars as high as 32 and used 10 units of humalog , half an hour later I am 34 , I don't understand this ? What is the ratio of humalog to carbs ? I had the flu and I know it can really mess up your sugars , but this was a month ago .Also , I generally feel better when my sugars are around 13 , anything below that and I feel the efects of hyperglycemea , I know that does,t make sense , but it is how I feel. Help please

[JDRF-Team-LRS]

Hello Worthy,
You came to a good place to get some answers and I find a few questions embedded in your posting.  I'm not a physician, but I have had diabetes for ~35 years.

Often we diabetics will lose weight if our blood sugars are running consistently high.  The reason is that, since the sugar is "swimming" in our blood and not nourishing our other cells (muscles, skin, organs), we urinate out lots of calories taht we consume.  The tragic irony is that while we are pee'ing out perfectly good calories, our body is literally starving!  The muscles & skin & organ tissue is not getting any of the glucose they need (because we're not covering our foods with enough insulin, which allows the glucose to enter the starving cells).

So, if I remember the Canadian system right (I think it's the system we use for our a1c readings here, too), even 13 is quite a high level.  My control used to be at about that level, too, and I remember well feeling "hypo" when I'd fall below that.  But what I didn't know then and DO know now, is that our bodies simply adjusted to dealing with extremely high blood sugar, and so even something closer to normal felt "low."  It took courage to begin to lower my average numbers and to trust what the docs had all been telling me, ... that I would, in fact, adjust and that with lower numbers I would not be damaging my organs and tempting complications.  The complications of uncontrolled diabetes can be severe and quite devastating, so I'd like to encourage you to consider working with your endocrinologist and diabetes team to strive to lower your numbers (you *will* gain weight when you are no longer pee'ing out the nourishment you're eating).

I visited a Calgary health website and noticed that the A1c recommendations are similar to what we're taught in the US.  They recommend striving for an a1c less than 7.  I am certain that, currently, a blood sugar of 7 would feel "hypo" to you, and yet that's the direction of health for you.

On a related note, Humalog begins to work VERY rapidly and also leaves our system rather rapidly.  Depending on your food choices, Humalog may not be effective when the "meal carbohydrates" hit your bloodstream.  What long acting insulin are you taking?  or are you using a pump?

I hope that msg has been a little help for you and I also hope you'll feel comfy enough to post more questions and/or to respond to this answer.  I believe that others will post replies, too, since your msg touches on experiences that most Type 1s can (unfortunately) relate to.

[worthy]

I use humulin n as a long acting insulin , generally about 45 units a day , and humulog to keep my sugars down , lately I have been checking my sugars every half hour to try and get a grip on them , my pharmasist told me that humulog lasts up to 2 hours , I have checked my sugars after injecting it , and it generally takes 1/2 an hour to come down 6 points ( 13 to 7 )
but I have become very brittle , a bowl of porage , no milk , can send me up 6 points , should I be using my humulin R as well as N and humulog .
Do you know the formula for humulog ( units to carbs )

[JDRF Team SGG]

I am not a physician, but am a type 1 diabetic who uses Humalog. The formula is slightly different for each individual. And I have noticed that different doctors use slightly different formulas, but the net math is very close to the same in the different formulas I have learned about.

Here's the one that works for me: First, you find the base number of units it takes to perfectly cover 15 carbs for YOU. That becomes your base humalog dose. Then, you add 1 unit for each additional 15 carbs you eat at the meal. Also, if glucose is higher than 110 when you test your blood sugar, I am told to subtract the number 110 from the reading, divide this difference by 30 and add that number of units to the base dose for the mealtime humalog to bring the high reading down. Another formula I have heard subtracts 80 from the high glucose reading and then divides the number by 40. I find that the result of both of these formulas is the same within one unit. If in doubt, I use both formulas and take the higher dose of humalog just to keep the glucose levels low.

But again, I must state that every diabetic is different, and I would ask my doctor what formula he or she recommends, for I have only given you what personally works for me. Your doctor knows your requirements and may have a slightly different formula for you to use.

[worthy]

thank you