Help with Insulin adjustments - NovoRapid

[marshmallow]

Hi
I switched to insulin form pills 2 months ago.
then I quit smoing and am eating more so my origianlly good control is now too high. I need some help and i called my doctor who said I need to see a diabetes educator, who is not booking until October. In the emantime they let me talk to a nurse who ws lightly helpful but I still am not clear. I need help with carb counting....
If anyone could help me while I wait until October, here is my question:

I eat breakfast at 6:30 and take 10 units of NovoRapid. - breakfast is not an issue because I always have the same cereal at the same time.
By 10am I am starving and have a nutrabar or granola bar - no injection, right? I am usually in the 5-6 range at that time - 4 hours later.
By lunch I am 7-8, which is again fine
QUESTION: If I have a salad how much insulin doI take compared to if I have a hamburger and fries? Yesterday I had a hamburger and fries and 6 hours later at suppertime I was still 12.9! Way out of range of 4-7!!
So, there must be a way to determine how much rapid insulin to take based on how many carb you have at that meal


Any help?

Thank you !

[Ted11111]

Doses of NovoRapid will vary from person to person definitely. It depends how much you weigh, and whether your T1/T2. I'm a type one and 4 units of fast acting insulin wouldn't be enough to keep 60g of carbs at bay in my blood glucose. The best thing is to do trail and error for while, and eventually you'll be able to estimate precisely. The only way is to find out yourself. Every recommendation of doses from doctors i've had to adjust and find out what is best for myself. For instance if i have a chinese takeaway (sweet & sour chicken with egg fried rice) i'll take 18 units of NovoRapid along with my long-acting insulin already present in my system. That's for someone of my weight of 85kg. For someone lighter/heavier the dose will vary

[marshmallow]

So I can snack in between meals as long as it is on protein. Only protein or mostly protein with some carb? This is good to know. I was getting hungry with no food for 5-6 hours!
I have a theory, does this make senes?:
Do you know why, by 6pm my sugar is still in range but like last night when I ate at 8 pm because I was busy, my sugar had gotten high? I had not eaten anything to make it go high. When I tested at 6pm it was 6.9, but I did not eat a thing, kept going until 8 pm and by then it was 10.2. How?
Also this made me think....does this mean that the lantus which is the base insulin is not high enough - two reasons: because the meal insulin taken at 12 noon is gone by 8 pm obviously and my body is on the lantus only at that point.  Also because i wake up high in the mornings....

sorry to use you as my nurse, but you are bing so helpful and quite honestly if you're up to this, i really don't want to wait until october to figure these things out! I can't believe they advise tight control but then tell you to wait until october to see a nurse for eduction!

[CoWriter]

Canadian 4- 7 translates to a blood sugar of 72 to 126.

Yes, of course you can have a snack mid-morning.  But if you eat PROTEIN instead of the granola bar, it won't make your blood sugar be high by lunch time.  Also what you can do is add some PROTEIN to your breakfast so you won't be hungry so fast.  The cereal lasts only about 2 hours.

hanburger and fries will make your blood sugar go sky high and remain high for a long time.

[marshmallow]

Thank you so much CoWriter, this makes a bit more sense to me now. I just knew that taking the same number of units regardless of what I ate was not right.

Um...why does it matter that I ate a hamburger and fires? You both mentioned it in your replies..the doctor did not say to watch what I eat as far as fat, etc. I am not overweight....just curious.

I do have 2 more questions if you have the patience:
It sounds like you are in the U.S. so your examples of 150 and over are different because our measurement in Canada goes 4-7 for the target range. So I"m not sure how to tranlate that.

next question: If I have breakfast at 6:30, do my insulin, check it at 8:30 and I am between 4-7 where I should be......can I have a small snack at around 10am because I am soooo hungry and to stay from 6:30 to 12:00 with only 1 small bowl of cereal is killing me...but if I haver a snakc at 10 am with no insulin then when I test pre-lunch it will be high....so is this ok? The nurse said she could not advise me that I had to wait for the diabetes educator, but I"m sure diabetic don't go around starving waiting for the clock to say it's ok to eat????

[CoWriter]

(fast food places have a list of the items they sell and the nutrition info.  It will tell you amount of carbs )


You take 1 unit of the insulin for every 15 grams of carbs.  So to figure the amount of insulin.....

You total the grams of carbohydrate to be eaten and divide by 15 (15 grams of carbohydrate equals "one carb").

For example....if for your meal you're eating

Steak = No carbs so don't count.
1/2 cup Mashed Potatoes = 15 grams carbs
1/2 cup corn = 15 grams carbs
1 slice bread = 15 grams carbs
1 cup milk = 15 grams carbs

So your total would be 60 grams carbs.


Now you divide the 60 by 15.....which gives you FOUR carbs.  That means you'll need to take 4 units of insulin.



HOWEVER.....if your blood sugar is high before your meal you'll need to also cover that.

For example, let's say that your blood sugar level before lunch is 250 ....and your goal was to keep it between 80-150. You would take 2 units of insulin for every 100 points above the 150.

So your goal was 150.....and your blood sugar is 250....that's 100 points above your goal.  So that means you need to take 2 units of insulin to bring it down to the range you want.  


So the total amount of insulin you need is the 4 units to cover the food you'll be eating PLUS the 2 units to cover the high pre-meal blood sugar.   A total of 6 units.

But remember that everybody is different and not everybody reacts the same....so you will need to keep checking your blood sugar and see how you do.

How much insulin should you have if you're eating a salad?  It depends what the salad has and what kind of salad dressing you're using....and the serving sizes.  Can't really answer that.  You'll have to start reading labels to figure out the amount of carbs in what you're eating.    

BTW, the granola bar is loaded with sugar and the hamburger and fries are very high in fat.  Not the best choices for a diabetic.  

[WaveRider]

Can I be honest with you? I'm not familiar with nutrabar but if its anything like granola bars its loaded with sugar. Good stuff mixed with a lot of bad stuff.
If your range is 4-7 but at lunch its 7-8, its not fine. You're out of range.
Hamburger and fries? Lets see, hamburger buns usually contain around 4 grams of sugar. Every 7 grams equals one heaping Tablespoon of raw sugar. You do the math. What else you did you have with the burger and fries? Ketchup? Ketchup has lots of sugar too. Phony fast food fries contain sweeteners to "make them taste better."
Read the post by Javelin. He notated what foods he ate and what they did to his body. Then he eliminated the bads from his diet and is in better health today. You can't base your insulin amount based upon carbs alone. Everyone reacts different to foods so its important to track what you put into your body, how you feel afterwards and what your test measure.