Again here ...

Greetings!: D at all times I pass here, I love coming to read and learn, I hope you remember the one that has been diabetic for 51 years.Then I tell you what I have happened.I need them to help me, the endocrine has changed the insulin for the Lantus and Apidra;He tells me that it is better than humulin and to see if in two months I became "bomber", the fact is that I started on Thursday in the morning , sent me 25 units of Lantus and per 10GRMS of Carbo 2 of Apidra.Tremendous lack of control, I kept my hem between 6.5 and the maximum 7 and I have always been delighted, now I have the sugar in the clouds, 350 when it comes to putting the first day the Lantus (yesterday) 358, I put 6 of Apidra and Apidra andHe lowered me at 2 hours to 254, at Hoas 12:00 for lunch a salad 0 carbo.1:30 p.m.202, 4:25 pm 145, 6:00 pm (152 before food) soup and salad and 4 of Apidra to see if it went down, 9:00 pm 260 3de Apidra, 11:00 183 (I didn't put myself more insulin. GoodIn order not to tire them, today I got up in 303 (5:00 am), I am horrified, I went up to 35 units today and 7 I put on Apidra (I just drink coffee with an almost no milk), at the time I check myselfAnd I have 313: Shock: And at 10:50 242 I have only eaten salad and raw vegetables yesterday and today a hard breakfast egg.Every time I can correct and get more apidra.

Kisses, nana the disappointed.:( answers please. Thank you !!!!!!!

Nana, if you manage to find the adequate dose of Lantus, the treatment is very comfortable because you will not have food schedules, you can even skip some food because the lantus controls the basal level.

What time do you get l antus?It is usually better to put it in the morning, to avoid night hypos.
How do you get up?The glycemia when awakening indicates the necessary dose of Lantus.Start there.Go up the lantus one in a unit until you wake up well.Leave 2 days for each change.
You have to go to bed around 140 and see the value when waking.

After controlled the Lantus, adjust the rapids, looking at post -complying blood glucose.

The adjustment can take you a few days, but it is worth it for the stability and freedom you will have later.: D

Hi Regina, in the post I had put it in the morning, I started on Thursday morning with 25 and yesterday the endo told me to go up to 35, a hard egg at lunch and now from Merianda 5 mushrooms andA small glass of tomato juice, I measured before and I have it in 183. My question: In the morning I put 7 of Apidra (I can already put more quantity? I can not control with Lantus only with the levels of glucose so high.8 hrs have passed that I put the quick.

Please keep giving me help, kiss ... and thanks.

<Blockquote Nana "" = "" Rel = ""

Kisses, nana the disappointed.:( answers please. Thank you !!!!!!!
I tell you my experience:

A few months ago I changed the treatment that I have had for 13 years (Insulatard NPH + Actrapid) for a treatment of these current called basal-bolus (or bolus-base) with the Lantus + Apidra insulins.
Although the previous treatment has also worked during all those years and I could continue to work for different reasons (among them it is that in the last era it was going on a bit of diabetes) my endrochrine proposed the change.

I had to get to the third month of the change in treatment to start seeing a continuity of good glycems: my first month was something similar to what you have told (an authentic roller coaster, giving three hundred, getting up with ketones ... etc)Second month, the thing was softened a little and it is from the third month when I can say that the basal-bolus (or bolus-base) works works, but we are going just as disappointed as you.
My last glycosylated hemoglobin with the insulating treatment NPH + Actrapid was 7.9 % (it is not a bad gydate but I was there PQ was mainly passing the subject) and my first glycosylated hemoglobin with the Lantus + Apidra treatment has been 6.9 % (I have to say that if I have managed to lower the glying, it is because I have been these months of the change above diabetes as I had not been on top since I debuted and came a bit uncontrolled), I think I still have some margin of improvement but notI am going to kill myself much more, with being there between 6.5 and 7 %, it is not enough for "profitable" (at least in my case) all the time you have to dedicate to diabetes to be below those values.
Maybe with a bomb is more "easy" to be in six low or high fifties, but it is not my case and I don't look for it (I spend a lot about the bombs, at least for the moment).

What I would tell you is that you have patience and that you weigh and control the carbohydrates that you eat and that you are quite strict with the schedules (try to maintain the greatest number of things constant).It costs after a lot of years of having diabetes to see that a change in treatment lacks you quite a long time (almost two months as my case has been, it may have influenced that it came from being a bit uncontrolled ...).

With the Lantus it is not only to find the appropriate dose, the time you put it is also very important, in my case the best schedule is at night (after having tried at noon) but each person is a world and there will be aWho also puts it at noon and there will be who goes well in the morning.

Lantus's movements are quite slow: make the movements of 2 in 2 units (perhaps to begin to notice a dose change, a day or day and a half to see it) and to assess if you have to change the dose change you should waitFour or five days to play again.
For Apidra's movements (or the ultra-appaire you use) you don't have to wait so much (theoretically if for two or three days you see that it is repeated that you leave high or low in that same meal the dose should be touched).

The Apidra (or the ultra-opted you use) usually lasts about 3 hours (maybe a little more, the higher the dose more should take into account its end) and usually has the maximum peak over 1.5-2 hoursof the puncture.

It seems to me to make calculations in plan: 2 U.I.of ultra-trap for every 10 g of HC is a bit excessive (easy to pass and have hypoglycemia).
But well ... Be careful with insulin ratiosBy HC PQ rations you can have three totally different ratios in the three typical meals (breakfast/food/dinner).

I will count my current situation (2500 calorie diet) only as an example, each one who makes their calculations with their data:

Breakfast: 5 rations of HC (50 g of HC) and 18 Apidra units --- & GT;I need 3.6 Apidra units for each HC ration.
Community: 10 rations of HC (100 g of HC) and 12 Apidra units --- & GT;NEED 1.2 APIDRA UNITS FOR EACH RATION OF HC.
Dinner: 10 rations of HC (100 g of HC) and 14 units of Apidra --- & GT;I need 1.4 Apidra uniades for each ration of HC.

Three distinus ratios in the three typical meals (breakfast/food/dinner).At breakfast I have to put much more "gasoline" than in the rest.

Changing the subject and returning to "correct" if you control out of the typical 6 or 7 (all pre-comidas, all post-comidas and one at dawn) and you see that you are very high you can put on a punctureExtra of Apidra (or the ultra-opide you use) with a small dose, the apidra lasts about 3 hours nothing more, will help you better reach the next meal.It is doing that or waiting for the next meal and putting extra doses in the puncture of that meal.

I just read your second post and it seems to me that jumping from 25 units to 35 units with the Lantus seems to me a very very big jump ...

Normally when a change in Insulatard NPH treatment is made to Lantus, the initial dose of Lantus is calculated as 80% of the daily dose of Insulatard NPH and from there it is moving from 2 in 2 (or at most 4 in 4), moving from 10 in 10 seems dangerous to me, a Lantus error is a mistake that lasts 24 hours (24 hours between the sword and the wall ...).

TNT, thanks for your answers, but I'm going to rely on the second.The new dosage of 25 to 35 is a very large jump, but the one who sent it to me was the endrocinologist, I the insulin he used was Humulin 70/30.

Do tell me what do you call between the sword and the wall?: Shock:

Can you or can you tell me how to change the Lantus schedules between one dosage overnight?

Kisses and quieros.

What I wanted to say is that if you wear a very high dose of Lantus you will be suffering the effects of that high dose for 24 hours, you could be a day at risk of hypoglycemia (unless you eat more than you needDuring all that day or you will lower the doses of Apidra at the meals of that day).

The schedule change of the Lantus can be done in several ways, if the schedule is changed forward (for example of noon at night) it would be necessaryDifference: one day with an intermediate schedule could be used (day 1 at 2:00 p.m., day 2 at 6:00 p.m.With several punctures of Apidra (the puncture of the food, and another or another every 3 hours until you reach the time of dinner where you already put the lantus at its new night schedule and Apidra's puncture for dinner).

Anyway, do not make many changes at once, I would tell you that you do not move the schedule of the Lantus yet, hold on with the schedule you now have and go by changing its dose, I already tell you that because of how I went to me you have tohave enough patience to see continuity in the results.

You have the body accustomed to another treatment with which you have been, the change costs, the body has to get used to the new treatment, there are also other things that you almost did before now they will not be necessary (eat mid -morning and eatin the middle of the afternoon) with the new treatment those intermediate foods are not necessary but if you want to do it, if you want to snack, you will need an extra prick of apidra.

Another thing that will surely see that it changes is the amount of carbohydrates that you have to take to trace a hypoglycemia, if the dose of basal insulin (in your case the lantus) is adjusted well need to drink/eat much less to go out to leaveof hypoglycemia.

In fine ... that you will see it, be patient.

Nana, be careful tonight, don't get too much, because, increasing 10 units, it's a lot.
The Lantus will have it tight when you wake up well (about 100).
The fast you always have to put it before each meal, according to the hydrates you eat.With Lantus you just can't eat hydrates, unless you need to overcome some hypo.
Look in my signature my daughter's treatm, to give you an idea, although everyone needs their dose.
There are seasons that you can vary a bit, above all, the dose of rapids.The Lantus almost never has to touch her.
Let's see if you manage to adjust soon: D

Thank you, they are loves, I will tell you how you are doing.I am: D with the help they give me.

Hi Nana!I think you have to get used to the new treatment, still I think you should not eat less hydrates than those that correspond to you, are sacred , only insulin is what you should vary, I do so be high or wetting I always take the same hydrates, if not, you can not control it.More or less it is what they have told you.Good luck, and to eat :))

Consu greetings, getting used to it is difficult, thanks for telling me about the hydrates, as I have high sugar, it makes me fear now, I will follow your advice.;)

Regina, your daughter in the rapids maintains more or less the same amount although the lunch and food vary a little?

TNT, you scare me with so many amounts of apride.: Shock:

Well, I think I'm more control now at 7:25 at night he gave me 91: I hope and don't give me a downturn at dawn, I got before eating 8 apride, at 4:00 I had198.

Tomorrow I follow the novel, forgive the schedule I put, I know that the one there is different but I do not want to get tangled with more numbers.: Mrgreen:

I repeat thanks for the valuable help they have given me.TNT forgot to tell you that I walk doubtful if I put the bomb or not.

Well, I think I am more control now at 7:25 at night he gave me 91 hopefully and I don't get downturn at dawn, I got before eating 8 apride, at 4:00 I had198.

At 10:00 pm 135 (I took three fingers of milk) and did not get more ape.
1:00 am I measured it and I had 224 (3 of apride): shock:

5:30 am, (212) :( lantus 35 and 5 of apride) I had coffee with a little girl)

I just measured it now 8:33 am 195. Three hours have passed since I click both and from 212 it only went down to 195. Something is, bad.I'm afraid to get more apidra.I'm going to sleep a little, I've spent the night in the sugar mediide and sleep overcome me.Yesterday I put the Lantus at 5:17 am and today 5:37 am does not matter that difference of minutes?

I am when I hang the saber and return to my insulin before, I am truly desperate and obsessed with the fingertips.:?

I read them later.

When passing to a basal-bolus (or bolus-base) treatment or if you are with insulin pump, carbohydrates have to be controlled much more than with other previous treatments (the HC had also to be controlled but not of aso rigid form).

Depending on the diet that prescribe you with the calories that are (something of the type: 1800, 2000, 2200, ...) a diet distribution can be reached by rations of carbohydrates in each of the meals of theday (something of the type: 4-6-6, 5-8-8, 5-10-10, ... or if something of type 5-6-3-4 or similar is going to snack).

Be the distribution that you are going to continue from the rations of carbohydrates in the different meals of the day that nº must be kept constant in each meal, it must be maintained fixed.

Example: If you have 5 rations of HC at breakfast you should always have breakfast that number of HC rations since the dose of ultra-opted insulin (in your case the Apidra) will be calculated for that number of rations of HC andIf several the number of HC rations the insulin that you would need would be different (the necessary dose could be calculated for another number of rations on the flight (once it will be time to do) but to avoid having to recalculate the doses, the number of portions must be maintainedof HC assigned in each constant meal).

If you follow this and you have a more or less stable diabetes your dose of ultra-opted insulin will also be constant or at least they will vary very little (sometimes you will arrive high at a meal and you will have to put some more dose to correct a little and that but that but that but that but that but thatIn general your doses will vary little).

Bringing a diet by rations has several advantages such as being able to vary the food that will be ingested in that meal maintaining the number of rations of that food.

Example: If you have 5 rations of HC at breakfast and those portions are distributed among lachers, flours and fruits at a given time if you feel like you could fill those 5 rations of HC only with fruits or only with flours (or if you arrivethe case only with cookies).

Another advantage although this is because of the type of basal-bolus treatment, it has already been commented on this thread, it is to be able to skip a meal (if you do not eat anything you do not put any ultra-opted insulin) it can occur if for example you areSick and do not at all in the body or on weekends you feel like sleeping and you don't want to have breakfast.

With respect to the amounts of Apidra that I use:
As a general comment, what I say is that those comments of "is a lot of insulin" or "is little insulin" or similar if they are not accompanied by something else, if they do not rely on anything else, they are empty comments since each one putsThe dose of insulin you need, if someone to eat needs 50 units of ultra-opted insulin and that figure is also the rest of the world should not say anything, it is what it needs.
And explaining my particular case a bit: I measure 180 centimeters and weight about 85 kilos, among the things that have to be taken into account for the amount of insulin that the most important is possibly the weight, equal to other things ifMore insulin is needed more.
What I can say is that the insulin injects is not so much: Lantus (32 units)+Apidra (18+12+14) = 76 units a day, I am below the insulin unit per kilogram and day (more specificallyI am injecting about 0.9 units per kilogram and day) is not so much but even if it was, if I need to silence everyone.
Regarding other things such as the distribution of the type of basal-bolus insulin is also not decompensated since it is more or less 42% basal insulin and 58% insulin for bowling and according to several authors basal insulin should be more or less 40% of the total (although there are also other authors who speak of a distribution 50% - 50%), whatever the castWe return to the same thing again, if everyone is going to shut up.

Yesterday I put the Lantus at 5:17 am and today 5:37 am does not matter that difference of minutes?

I do not believe that the lack of control of your glycemia is due to moving the lantus 20 minutes, possibly for what I have already commented in my first post of this same thread, for me the first month of the change of treatment was a madness similar to theWhat are you happening.

I am when I hang the saber and return to my insulin before, I am truly desperate and obsessed with the fingertips.:?

Be patient that in the end it is achieved, it cost me quite a lot to control my diabetes during the change in treatment (and that I have been on top of my diabetes as I had not been from my disease debut).

Nana, my daughter usually eats the same amounts of hydrates at each meal (although she eats different things), so the rapid does not vary almost.There are seasons in which it begins to rise after meals and then you have to increase the dose, (it usually coincides with times of more stress, exams .. or why yes).Lantus is put at 11 in the morning, get up early or not.So you don't have to get up the days that does not need it.

I believe that the Lantus dose already have it (you can approach with a unit up or down, but it is almost), very fast: D
The rapid ones go according to hydrates, but you can make equivalent menus, or repeat breakfast and meals the first days of adjustment.
You will see the freedom of food schedules, the decrease in hypoglycemia and the normality of life that this treatment gives.You can even eat a dessert with sugar from time to time, if you get two or three more units.
And as TNT says, the insulin doses are what each one needs, and are closely related to the weight of each person.
Keep this guideline, which you will see all the advantages soon.The bomb, of course it is the best possible treatment but, while you think about it, fight a bit with it.: D

At 10:00 pm 135 (I took three fingers of milk) and did not get more ape.
1:00 am I measured it and I had 224 (3 of apride): shock:

5:30 am, (212) :( lantus 35 and 5 of apride) I had coffee with a little girl)

I just measured it now 8:33 am 195. Three hours have passed since I click both and from 212 it only went down to 195. Something is, bad.I'm afraid to get more apidra.I'm going to sleep a little, I've spent the night in the sugar mediide and sleep overcome me.Yesterday I put the Lantus at 5:17 am and today 5:37 am does not matter that difference of minutes?

I am when I hang the saber and return to my insulin before, I am truly desperate and obsessed with the fingertips.:?

I read them later.

At least I slept 4 hours, I measured and had it at 64 (I took 3 orange juice) that was at 11:30 am
At 12:20 pm I had breakfast a 1 egg with spinach and mushrooms 4 Saltine cookies 3 ounces of tomato juice, I put on 1 of Apidra and now at 2:30 he had 156, although I like to keep it in 125 but hey but good... It is what you say the change is delayed and I am super impatient.Thank you for what they are helping me, I do not get tired of repeating them and I am already realizing what it is always worth eating the same amount of hydrates, what happened to me was that I jump my meals and I always walked with hypoglycemia, ofThere they wanted to make the change, truth that I have had the high sugar in these two days, but when I had it as today in 64 I did not feel it and before 80 I felt it low, that's why Regina makes me incapableThe dowers at night, because it does not feel.

TNT, forgive that it amaze me with the amount of the rap

All are very explicit to inform me and I so many years of diabetics and I am an ignorant with the new medications.

We continue to inform.

Hugs to everyone.

I believe, it is my opinion, that the most important thing, after having well adjusted the basal is to know the amount of carbohydrates that an insulin unit covers and thus be able to vary the amount of hydrates and make the diet more flexible.
I do not have a fixed diet and therefore varied the units of each bolus according to the amount of hydrates that I am going to eat and the glucose that I have at that time.The only thing I have fixed is the basal that I never move except if I am going to do sports for many hours like when I go to the mountain.
The good thing about this treatment, Lantus and Apidra, is precisely flexibility and I do not understand that of fixed diets both in calories and in many hydrates, unless you need to lose weight ..... at least I do not always feel like itEat the same, nor do I need the same amounts of hydrates every day ....: Mrgreen:

To learn to run first you have to learn to walk.

I believe, it is my opinion, that the most important thing, after having well adjusted the basal is to know the amount of carbohydrates that covers an insulin unit and thus powerVary the amount of hydrates and make the diet more flexible.
I do not have a fixed diet and therefore varied the units of each bolus according to the amount of hydrates that I am going to eat and the glucose that I have at that time.The only thing I have fixed is the basal that I never move except if I am going to do sports for many hours like when I go to the mountain.
The good thing about this treatment, Lantus and Apidra, is precisely flexibility and I do not understand that of fixed diets both in calories and in many hydrates, unless you need to lose weight ..... at least I do not always feel like itEat the same, nor do I need the same amounts of hydrates every day ....: Mrgreen:

Prado, the same thing happens to you and that is why I make the thing more difficult, I have to play with the apidra and I cannot put a fixed amount.

For those who are helping me.Yesterday I got the basal again from 35 to 38 and look at yesterday's values.

Today I put myself 38 with fear but well ... this was yesterday's measurement and corrections.

5:30 am, I woke up with 92 (I didn't have breakfast only coffee and milk)
10:30 am, 156 (it seems that the milk did not put the apidra uploaded me) at that time 6 of Apidra, breakfast and I left stores.
1:30 pm, 56 glucose (tremendous downturn) but I didn't alomorcé and at that time I ate 4 salt cookies and a little juice.
5:00 pm, 116
5:43 pm, (Apidra 5 food)
11:00 pm, 150 After a snack, they forgive I do not remember the Spanish translation now.(Something when bedtime)
I did not get up for fear of going down a lot.
2:30 am.204 (2 Apidra)

The endo seems that the lantus wanted to climb, since before yesterday I got up with 212, I remembered that you told me to leave me the same basal for a few days, I told it and told me to go up (it is more stubbornthat me): Mrgreen:

I told him to leave me a margin to raise it, now it was understanding the carbo and lacorrection.

Today my sheets were hit (I am always a clock at 5:00 am) I woke up at 7:00 with 128 and I put 38 of Lantus: Evil: And I had breakfast at 8:00 (without fancy) and put myself 6of Apidra.

I tell you that I feel much better and I do not have (except yesterday) the sugar descents that gave me and before I did not sleep well and now I do.

Then I told you why I got out of the sugar, in December last year I found cancer in the endometrium and had to do a total hystectomy in the month of March and after 4 months I started with the feet of Charcot (The bones of the foot fall) the doctors say that of 1,000 cases in diabetics about about 30 can happen to them due to the stress of the body and thank God they did not have to give me chemotherapy because it was on time, at least I ran with thatGood luck, but with my foot with a special boot and I have been with it for 4 months (I no longer do tai-chi and most of the time I was in bed at rest and luckily I have no injury or anything like that in the footAnd my hemo were always fantastic until they fell into the hospital and made chaos with my sugar.

Today my sheets were hit (I am always a clock at 5:00 am) I woke up at 7:00 with 128 and I set 38 of Lantus (...)

The food schedules with a basal-bolus treatment you can move or you can even skip some food, there you will have freedom of schedules (at meals) but with the basal insulin (lantus) there is no freedom of schedules, it has to be to beVery rigid, very punctual.

Center, if you have problems with the current schedule of the Lantus, ask to move that schedule to another time of the day where you have no problems to be able to meet it in a timely manner (if you have sleep problems, consider the move of the Lantus schedule at noon for example whereThere you will always be awake).

Until you meet this from the schedules of basal insulin, your diabetes control will not be good.

With respect to the meals you do ... with a basal-bolus treatment whenever something you eat, you have to inject ultra-trap insulin (in your case Apidra) however small.
The only exception to this is to have to eat something to get out of hypoglycemia, in that case you do not have to inject ultra-trap insulin.

I comment this because you have written it seems that you have breakfast twice (one at about 5:30 am and another at 10:30 am) and one of those twice (the one of 5:30 am) you eat or babiesSomething (coffee with milk or milk alone) and you don't get ultra-opted insulin (Apidra).
I do not understand because you have breakfast twice but if you do you should do it well, if the dose of basal insulin (lantus) you already have it more or less adjusted to your needs whenever you are going to eat or drink something you will need some apidra.
The lantus is only to cover the basal, it is only to cover the glucose that is releasing the liver throughout the day, the lantus will not cover the carbohydrates (however few) a glass of milk.

With a basal-bolus treatment if you are going to eat 6 times a day, those 6 times will need their corresponding 6 pricks of ultra-opted insulin (Apidra).
If this is very hard (every time you eat puncture and want to eat 6 times a day) ask for the insulin pump already.