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Normal dose of insulin for Type 1 diabetic?

Hello there,

Just wondering what a “normal” dose of short-acting insulin would be per carbohydrate serving (+-15g)? I am currently injecting about 3 units Novorapid / carb (along with 30 units Lantus long acting Insulin in the morning) but am really struggling to control my sugars. I am trying not to increase my dose too much but my sugars bounce up and down all day and I’m really tired and irritable lately and have gone from a comfy 52kgs to 56kg’s!!!!

How can I  adjust my dose without going too low / running high? Is there any merit in cutting out carbs completely for a while?

– Jenna Ferguson (Age: 25; Type 1 diabetic for 6 years)

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  1. cathy raats cathy raats

    Hi I take Lantus but only at night as a Long Acting and my Short Acting is Apidra which I take 3 times a day. Maybe adjust what you are taking and when.

  2. Michael Park Michael Park

    Hi there.

    Not quite the expert on the type I situation, but I think that one of the things that type I and type II have in common, is the fact that at one stage or another, we all are going to battle with unstable sugars. Speaking as a diabetic with a tendency towards very volatile blood sugars myself, may I suggest a few things that have worked for me.

    1. Keep calm. I know that this is easier said and done, and I am perhaps the last person to be offering this kind of advice, but when one is calm about things, one can think a lot clearer about the matter.

    2. Discuss your problem with a qualified diabetologist–not just any medical doctor. Diabetes is a specialist condition which requires specialist intervention which in my experience, lies beyond the skill and competence of the average general practitioner. If you are seeing a specialist diabetologist privately, contact will have to be on an ongoing basis so that changes can be made to your insulin and other necessary medical interventions can be made. If, however, you are on the government health system, your problem in dealing with the matter becomes slightly more tricky.

    3. Keep a thorough diabetic diary in which you record your readings and comments pertaining to each reading. I hate to sound the expert that I am most certainly not, but one of the things that diabetics are not told when they are counselled, is the importance of keeping a diary and the manner in which to keep a diary. I have learnt some very important lessons from personal experience and when I do counsel diabetics, I devote a lot of time to the actual keeping of a diary. It should be remembered that carbs and the food we eat, are not the only factors that impact on blood sugar. Immotional stress, underlying disease, infection, climate, are some of the factors that could impact on the stability of your blood sugars.

    In my family, there are two of us who are diabetic. When my mother died last year, it was interesting to observe the impact this had on our respective blood sugars. The other person experienced a whole spate of high blood sugars immediately after the event but then the sugars started settling down.

    In my case, on the other hand, I initially continued with the stable blood glucose levels that I maintained up to that time, but as I was the in the front line, dealing with all of the arrangements and finally winding up the estate, my sugars became more and more unstable, and no matter what I did, they did not want to settle down. I even got to a point of asking why I should even bother about looking after my sugar levels.

    It was only after I had been through the first anniversary of everything, that my sugars began to settle down, but I must admit that there were also other factors at play here, which helped pour oil on troubled waters.

    If you would be interested, we could perhaps get together on Skype on a periodic basis and we could sit down and talk about keeping the diary. Remember, there is no perfect method for keeping a diary and I am extremely blessed with a sister-in-law who is a trained nurse, and my diabetic nurse care-giver, to have been able to talk through things and to refine the way in which I keep my diary today. It works for me, but remember that something else might work for you.

    4. Any changes that the diabetologist may make to your medication regime in the main, there are also a number of changes that you might have to make and that you would be able to make. However, and in order to render life less complicated, I would make these changes on a peacemeal and experimental basis and with the help of the diary, try to assess the effect that each change may have on your sugar levels. If you make a lot of changes simultaneously, it would be more difficult to quantify the effect that an individual change may have on your sugar levels.

    One of the dietry changes I made in order to help stabilise my sugars, for instance, is that, barring holidays and special occasions, I cut potatoes out of my diet altogether and eat rice as my starch instead. I have found that while the dietition says that potatoes are OK and while the right quantities of potato do not push my sugars over the top, having rice as my starch, causes me to have more stable blood sugars.

    As an aside I want to say this: high or low sugars are not the important thing to pursue, but it is more important to pursue stable blood sugars. If your sugars are stable, there is a reasonable chance that they will also be in the right range.

    Another thing that you might consider, and this is certainly part of my regime, is to try, irrespective of what you have for snacks during the day, to also settle for a late night snack which is as low GI and low GL as possible. The most neutritious snack that I can think of that would fit this kind of description, is a tomato sandwitch.

    5. Never rule out exercise. Walking and swimming are good, but if you really want a fivestar job, I would recommend that you consult a biocheniticist to help you work out a scientific exercise program. Chances are that while we make a big thing of diabetes on this forum, that you may have other exercise issues which a qualified biocheniticist can help sort out.

    On visiting the web site of the CDE for the first time, I was really sceptical about the role that a biocheneticist can play in the life of a diabetic, till a friend who is a biocheneticist, actually began to help me in the teeth of my own volatile sugars. To say that I am impressed with the results stemming from the involvement of the biocheneticist, is a gross understatement. I feel all the better for it and it has also helped me in some of the emotional struggles that I have been through in the past months.

    My say is by no manner of means the last say that could be had on the subject, but judging by my current sugar averages and projecting into the future on the strength of a special spreadsheet program I created myself for the management of my sugars, I believe that I must be doing something right to have gotten to the level where I have got.

    Please let me know if you would like me to help you further in this matter.

    Hope I have been of assistance to you.

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