Help me please

[lbencomo]

I was just started on insulin 3 days ago. The doctor had me take 5 units of novolog 3 times a day with 1 unit for every 50 points above 150, and then I take 15 units of Lantus at bedtime. For the past 3 days I have been checking my levels 6 to 7 times a day and they have been between 167 and 297 and I can't seem to get them below. What can I do without taking more insulin?

[Zoelula]

Yay! Good for you, spiritwolf! It's amazing how much good those lifestyle changes can do!

[spiritwolf31]

My blood sugar levels were high and no matter what I seemed to do from taking pills to insulin to both..i couldnt get them under 400. This spring I began walking a mile (sometimes more if my boys could go the distance) and found the numbers dropping. I went from 400+ to below 200. I use to think the comments about walking being best a load of bull hockey but I proved it to myself and have been walking since. Cutting out sugars and subsituting with artificial sweetners and watching food (especially those carbs) helps immensely as well.

My goal was to get away from all or most of my meds (especially the shots) and before finding out I was pregnant I dropped from 20 units regular insulin before meals, sliding scale regular insulin throughout the day, 50 units Novolin N, 500 mg metaformin 2 x daily, and glimepride to just sliding scale insulin and 500 mg of metaformin 2 x daily. Of course now I am just on insulin and having a difficult time as I am more resistant it seems. Changing my diet and walking made a world of difference.

[Super_sally888]

Hi,

Good advice from Zoelula and Caregiver.  

I am also learning at the moment how to adjust carbs and insulin.  My levels weren't so high as yours, but you can do it.

If you want an easy way to track carbs I can highly recommend the Food Tracker on this site.  You can enter in what you eat and the amounts and it will give you carbs per day and carbs per meal (also calories, fat and protein).  I am currently finding that I need to eat less than 30 g of carb for a meal in order to keep my blood sugars on target (less even at breakfast time).

It is a complete new way of thinking and eating.  You are eating based on carbs and what they do to your blood sugar, rather than calories.

Oh the other big thing is test, test, test particularly now at the beginning, so you can get to know how your body responds to various situtations and foods and also how fast your numbers drop.

And do send the private message to Zoe. The website details she give you are for a very supportive and informative bunch of people already dealing with diabetes.

Best wishes.

[Zoelula]

Good for you, Ibencomo, on getting your numbers down. If you send me a private message I'll give you the name of a website where you can learn about different diets people use and about how to compute an insulin:carb ratio so you can gear your novolog to what you are eating which will help you keep your post prandials in target range.

[lbencomo]

I am working with an endo they are the one that put me on this dosage. As of the 6th my endo bumped me up to  10 units of novolog 3 times a day with 2 unit for every 50 points above 150, and then I take 30 units of Lantus at bedtime. This still isn't working so I changed it myself today to 20 units of novolog 3 times a day, and 30 of Lantus at bedtime. With what my endo was doing my sugars stayed over 250, but with what I'm doing my sugars are between 120 and 160. I have been searching the internet to find out on a 1500 calorie diet how many grams of carbs, protein, and fat I should have a day. I am a 39 year old female and I'm over 200 lbs over weight so I need to get this under control.

[caregiver222]

You are on the money, Zoelula, as usual.

Especially in your comment about it taking a lot of knowledge and experience to self-adjust insulin doses.

And your suggestion for a basal/bolus regimen is also hitting the nail with the hammer.

Managing diabetes takes effort, and studying, and questioning. It isn't a matter of simply "getting a prescription".

[Zoelula]

Thanks caregiver, for reminding me to be really clear when I make comments about the regimen a doctor has prescribed. I personally have learned a lot more from the John Walsh book and from other websites with thousands of experienced diabetics than I ever learned from a doctor. My experience has been that PCPs are woefully uneducated about insulin use and I hate to see someone struggling with high blood sugars on an outdated regimen. However,
It also takes a lot of knowledge to self-adjust insulin doses and this only comes with time. So I strongly encourage the OP to meet with an endo and diabetic educator to get on a regimen of basal/bolus use that includes I:C ratios to better control their diabetes!
(Btw I am a "she" :) )
Zoe

[caregiver222]

I suggest you go back and talk to your physician.

Novolog, a short-acting onset insulin, is only prescribed under "tight" medical control. It is used for very positive control of blood glucose levels. You really have to know what you are doing with Novalog. If you have questions or difficulties you should go back to your provider.

Zoelula always gives excellent advice, and everything he stated is100 perent correct.

That being said, I am concerned about anyone administering Novolog who has a problem. Generally, when first prescribed the physicians do not want you to deviate from their protocol.

[Zoelula]

Your doctor has you on a very outdated method of determining bolus (meal) doses, called a sliding scale. The standard of care is called an Insulin to Carb Ratio, which has you count your carbs then take the amount of units needed for what you are actually going to eat. In addition, if your numbers are that high even between meals you may need more lantus. 15 units is quite low for a type 2. My suggestion would be to see an endocrinologist as PCPs know very little about diabetes and insulin usage. I also highly recommend the book Using Insulin by John Walsh. You will probably find that even if you see an endo, down the road you will continue managing your insulin on your own. If you want, send me a message and I'll give you two websites with lots of other diabetics you can learn from. There IS a lot to learn, so hang in there. But it will get better!