So I am doing that, and staying in the range as best I can (with the occasional hypo)
But my question is, would the numbers possibly be more consistent if I reduced the basal and increased the bolus so that the TDD ratio of basal to bolus was closer to the 4/60 I have read about?
Opinions and advise welcome. Doctor has been helpful but basically said everyone is different and it takes trial and error to adjust for optimal numbers.
hello,
mixed insulin is a mixture of long and short acting insulin. You must eat on a fixed schedule and fixed amount of carbs, protein and fat, with mixed insulins. If you do not eat on time you will go low. Basically you have to eat to match the insulin.
A more modern approach is to take the short and long acting insulins separately. The long acting insulin is taken once or twice a day depending on the type of insulin.
My suggestion is to under-bolus rather than over bolus if you are uncertain when you are out, to prevent going low. I also often wait until the food comes so I can look at it rather than bolus 15 minutes I do at home (also because you never know with restaurant service when the food will actually arrive). I have some pages I copied out of a book that wouldn't be too hard to take with you and for you smart phone users you could look it up online (calorieking.com).
I am on the minimed pump with novolog and i tend to eat small meals throughout the day rather than large meals. This makes it difficult to gauge whether I bolused enough for my meals, since my insulin boluses overlap, so I can't follow the 140 after 2 hours ideal. Does anyone have any advice on how to estimate how much your bs will drop with however many units of active insulin remaining?
My son was diagnosed in December of 2013. He is now 13 years old. Type 1 is certainly a challenge for him and us. He likes Basketball and Baseball and now has an interest in Cross Country. I don't think we quite figured out the others sports before their seasons were up. He practices Monday, Tuesday, Thursday and Friday's with meets once a week. He decided a week and a half after Cross Country started to join. The coach said sure that's great. I think its great too.
Personally, I think it far more likely a medical problem such as a bolus/partial obstruction, than psychological, so I'd merely confirm with her that she knows it's something to avoid when readily avoidable, then book her in for a doctor consultation.
This was done early on (before the Pericardis was found)to check for blood flow/restrictions which was very slight. Are you suggesting that this is something we should test for again?
That is absolutely impossible to say, especially for someone on an internet website! All diabetics are different. I'm assuming she is Type 2 as that is the forum you are posting to? It would depend on her degree of insulin resistance, her weight and other factors. Is she newly diagnosed? Didn't her doctor give her a starting dose? Is she on a basal/bolus regimen or just on the basal (Lantus). You say she is having trouble adjusting doses. What was she on before and what were the results?
What would cause a mother's loss of blood pressure, and subsequent drop in the unborn baby's heart rate, immediately upon the injection of an epidural if no loading dose (i.e. bolus) was given?
The amount of drugs injected over, let's say, 10 minutes would be 10 times that given in the first minute. So why would blood pressure drop so drastically in the first minute but not over the next 10?
my co-worker gave me a new 10ml bottle of lidocaine, he uses it to give himself stitches. advice as to where to put the needle (i got from cvs insulin 31g-8mm),what to expect ie: will it burn- how long b4 its numb, and if i split the nail will it grow back? any advice will help..
For my boy, they would be pizza, pasta, ice cream, chocolate...If he has these, we do a dual bolus because I believe these foods take longer to metabolize or absorb, so if we do a NOMRAL bolus, he would go low and then we would treat the low with some carbs and then boom an hour or so later (when the pizza or ice cream fully kicked in) he is high!
As you know, this is an unpredictable disease.
As a rule of thumb, I want my son 100 or above whe going to bed.
I have been using the mini med pump for 4 years now and never had a single problem with the pump, now all the sudden anytime i try to bolus it says no delivery. Ive been though all the bogus trouble shooting steps, changed multiple sites, sets, reservoirs, sometimes switching sites 10 times a day to places I have never even used before just to see if it would work.... NOPE... NO DELIVERY. I was told it was the infusion site, it was my body mass (since i am a lean person, it was this it was that.
Secondly, what makes your husband believe he is not getting enough insulin during sleep hours? Symptoms? What are his bedtime and morning levels? Any recent change to his bolus [insulin dosage]? Is his bolus fast acting or basal rate [insulin pump, continuous supply]? Has he discussed his concerns with his doctor?
If you are only slightly low, say 70+ then I would just eat the meal as planned, only I may do my bolus just after I start eating instead of before, and the bolus may be slightly less than typical as part of what you eat will bring sugars up to normal.
If very low before a meal, then I would take glucose to correct the low. Note that 15 g of glucose may be too much. You need to work out how much 1 g of glucose will raise your sugars. If I was say 49....
My son has recently switched to Lantus and Novolog. I have a question regarding bolus insulin for snacks. How many carbs can he eat without having to bolus? He takes Lantus at bedtime, then Novolog for breakfast, lunch and dinner at a carb/ insulin ratio of 1:12. He goes to school all day, and sometimes gets hungry and I am wondering if it is necessary always for him to take insuling even for snacks?
Any ideas/input would be appreciated.
Re: Lidocaine Enemas. I am warning everyone to be careful. My brother just died 3/31/12 from a lidocaine enema. He was only 28. (Lidocaine Intoxication) Lidocaine in liquid form. I don't want anyone elses loved ones to die like this. I hope everyone will be careful when dealing w/lidocaine. it is a dangerous substance when not used properly.
The currently accepted treatment of choice is a basal (long-acting) insulin like Lantus once or twice a day and a bolus or rapid acting insulin before meals. A fixed dose of bolus like you describe is not as good as developing a carb ratio. You need to take the correct insulin dose each meal to cover what you eat (unless you want to eat the same thing every meal!).
There are no contraindications for using lidocaine for the purpose described. The only danger is that lidocaine completely anesthetizes tissue, which is why you can cut or suture an area treated by lidocaine. Thus it is possible to cause a tear or injury that would not be noticed until the lidocaine wore off. In the case of normal intercourse, this should not be a problem.
In a simple dental procedure, I had what I can only describe as a seizure after getting what was supposed to be lidocaine and epinephrine injection. The area never got numb, and the pain from the point of the needle each time they attempted to inject me was painful. I was taken to the ER and released after 8 hours with no explanation.
I read that lidocaine can cause a seizure. I have had injections many times with no problem. What could have gone wrong?
Are you on basal-bolus or mixed insulin. I hope you are on basal-bolus (if not, ask your dr), with both a short and long acting insulin dosed separately.
You need to do basal testing (you can google this) to determine what your correct dose of long acting insulin is to bring your fasting and back ground blood sugar close to normal (normal fasting blood sugar is 80 - 95 range).
Then you need to calculate your carb-insulin dose to get the correct dose of insulin to cover what you eat.
It probably isn't the lidocaine, it's the epinephrine that is in the lidocaine. You can ask your dentist to use an anesthetic without epinephrine, I have had tons of dental work and always ask for that. Dentist doesn't mind at all and I've never had any problems. It doesn't last as long but if you start to feel anything while they are working the dentist will just give you more. I have done fine with it.
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