Change of treatment and doubts.

Hello:

It is my first message.As I am in a hurry I expose my question and tomorrow I will make my presentation in the corresponding space.

I am 46 years old and about 20 diabetic with insulin.

The point is that I have changed outpatient and my current header doctor when I get analysis tells me that I don't control myself well.This man is interested in my diabetes much more than my previous doctors, it seems that I have been lucky.

The question is that we have gone from using insulatard to breakfast and dinner to send me from today Lantus, a dose at 11 p.m.And every 40 more, I put 1 novorapid unit.
The novorapid I have to put it just before eating.

And in a week he has summoned me to take the measurements and adjust.

The question on the one hand is if it is a usual treatment, because of the little I have read in the forum it seems that if.What I am not very clear is whether the novorapid thing is to put it before eating as it has told me or then.

Do the rise peaks after eating, get off with the novorapid that would put me before eating or would only affect the excess before eating producing another climb after eating?I don't know if I have explained well.

Thanks and greetings.Juan

Hello Juan

The novorapid takes about 15 minutes to take effect (more or less, it depends on the absorption of each one, on the injection zone ... whether it is cloudy or if it is winter :)) the latter is a joke)
By putting it just before eating you will match the elevation of blood glucose caused by food with the effect of insulin.

This at breakfast, for example, does not matter because few people are having breakfast (we always go with a hurry);However, in a long meal, for example, we can be 2 hours with food or dinner ... and of course there is a lot of difference.

Yes, it is a habitual treatment, even in type 2 patients ...

The picos of after eating (wipe at 2-3 hours after eating), in your case, I recommend that you go down with exercise ... It would be necessary to see if your pancreas still works and your insulin sensitivity ...If you correct the high post -compromised values ​​with insulin you run the risk of hypoglycemia ... This is something to consult with the doctor.

Do you only get a novorapid if you go from 160?

Greetings and welcome.

Hi Owash, thanks for answering so fast.

At the moment it seems that if, only if I spend 160. I imagine that it is afraid to exceed medication.In a week, or before if I believe it appropriate, I have to take all the measurements of before and after each meal and from there we will change and adjust.

Anyway, as I have been clicking for 20 years and I will also value it a little.

I have other doubts that I will put later, now I'm going to work.

Thanks and greetings.Juan

Hello, Juan.
A question: haven't you gone through the endocrine consultation?Do you only take the head doctor?
Well, I know, there are two questions, but I tell you because the doses of insulin, especially those quickly, depend not only on pre -food values, but also on what you are going to eat.It is not the same to drink grilled meat with salad as paella, and it also depends on the amounts, the exercise you do, etc.

I spend a very complete website for you to take a look at all these issues:

And, of course, ask everything you worry.

Health and Welcome.

Hi Alea:

I haven't been going to the endocrine for a long time.The truth is that the header who took me before (in another health center) because of what I see now I didn't care about me, so I have been a bit self -taught in terms of modifying the doses in relation to what I ate.Luckily it has not gone as bad as it could have gone.Anyway, doctors' concern for their patients is an issue that would give a lot to tell.

My new doctor, with whom I am delighted for now, has already told me that he wants that in addition to him he sees me the endocrine.

Before registering today in this forum I already had a week, which I discover it, taking a look, and I already saw the page that you have put me, a very small part.

There is one thing that interests me especially because it seemed to me that in this forum it was very important and it is what they call the count of hydrates by portions, I think it also comes out on the page that you tell me.It seems very important to modify yourself the dose according to what you will eat.

Do I study what comes out on that website or is there any better place to learn it?It may be better to open a new post on this topic.

Greetings.Juan

True, it is important to know how much insulin you need, both as a basal (which does not vary too much) as with the rapid, which does varies depending on hydrates and exercise.
That website is magnificent as consultation, although, the same as this forum, they do not replace the endocrine.It is good help and here are many who consulted it.
Anyway, raise all the doubts you have and we will try to guide you, auqnue your experience is not little.
Greetings

More doubts:

Last night I put 30 from Lantus and 2 of Novorapid, today I wake up with 168, so far, I get 1 of novorapid and breakfast a glass of milk and 4 maria cookies that I calculate that they are 30 HC, then I get out of walking 1/2 timeUntil the driving academy, I give the practical class and go home 1/2h, at 2 1/2 h of breakfast I measure me and I have 245, I expected to have about 160 or less

Did you have to have put myself 2 from Novorapid or can it be that as I do nerves driving in the practices for this I have uploaded more than normal, or the two things?

Let's see what you can tell me.

Greetings.Juan

Hello Juan:
They can be the two things as you say, this knows that it is rehearsal-error, it seems to me that an insulin unit for that breakfast and starting from 168 is little, I would have laid a novorapid, but it is not the same for everyone, soThat you have no choice but to try until you find the dose you need by ration.

Ok, thanks Prado, it's true is a matter of testing.

Greetings.

Hi Juan, Welcome !!! ...
First, congratulations on finding a doctor who "occupies" your diabetes, it seems that for now it is successful .... I suppose that when they refer you to the endocrine it will be the one who is in charge of your evolution ... but hey, the important thingis that they are already underway.
With respect to the guidelines that you have given you, as you have told you, you will have to "test" until you find the most tight ... Of course I am from the same opinion of Prado, it seems little 1 unit for 3 rations of HC,s that are the glass of milk and the 4 cookies ... and more with the fact that parties of a pregnant pre ... but it is true, the nerves, the tension, can also make some "ravages" in the glycemia, in addition to something that does not happen to everyone, but you also have to take into account, insulin resistance at breakfast (common to many diabetics, and that with injectable is hardly corregible).I explain, in many diabetics the amount of insulin to cover 1 ration of HC, s at breakfast is very different (normally superior), which would need to cover the same amount of HC, s at food or dinner ....
You are already telling us ...
Greetings.

Try to establish a continuous diet in HC every day (I breakfast 70, such as 110 and ceno 100 HC) in this way it is easier to adjust the dose, because one of the variables (HC intake) will have it controlled (something, becauseIt is not exact science).

Mark a starting pattern 3 5 4 IU of novorapid (ideal is to fix your doctor, endocrine or educator) and then see.If after breakfast the three -day average is high (greater than 180) and you get high to the food, you raise a dose at breakfast.

You can apply the same to the rest of the dose.Ideally, you adjust the doses of each meal separately.

If you see that raising the doses of the meals to control the postpandial peaks you arrive under the next meal, go down the lantus a bit.

You will see how this system controls in a few weeks.

Once you have the balanced doses, you will know how many you need per unit of HC.And then you can make lighter meals, in which you calculate what you have eaten and click on that.

Greetings.

Hi Nacho, thanks for responding and for your advice, it is useful to me.

I wanted to consult one thing:

Today at 3 hours I have measured myself and had 86, so I took 1 glass of milk alone and 4 maria cookies and when measuring for dinner I had 324, so much goes up for how little I have taken?

To dinner I get 7 of Novorapid, Ceno Berengenas Rebozadas, 2 small peaches and a bread portion (I do not think it will reach 15 gr of HC) with kick.I had calculated 4 IU to lower the sugar that had and 3 for dinner, but at 2 hours I measure and I have270, I don't know what I failed, maybe the eggplants being fried with eggs and flour rise much more theglycemia?Anyway I just put 3 IU of fast see what happens.To this we must add the 24 of Lantus at 11pm.

Will continue ...

A hug.Juan

Holassss
1 glass of milk (200 ml) and 4 cookies are 3 "theoretical" rations of HC ... what "should" upload about 150mg/dl of blood glucose ... always theoretically
150+86 add up 236 approx ....
It may be that milk, in your particular case, goes beyond those 50mg/dl theorists for each ration of hydrates.

If you measured you at 9 pm and had 323 maybe that the Lantus does not cover you 24 hours ... that is usually normal in almost everyone.

4 ultra -grade insulin units, theoretically they are equivalent to 200 mg/dl of blood glucose ... so for that part, theoretically did well to lower the 324.
15 gr of bread is a unit and a half of HC, the peaches will be another unit and average or 2 portions ... so you might lacked the eggplants that together with the flour could be another ration or ration and a half more ...

The theory is clear: 1 ration HC .... 50mg/dl .... 1 ultra -grape insulin unit
After each one we are a world and we have to adjust this theory to our reality.

Hi Owash, Ummm!Thanks, you explain very well.But reading you, a doubt arises ...

I am following the method of rations that puts on this page:

Link

According to which 15 gr of HC = 1 ration, is this how you tell you?

According to that page:

300 gr of milk = 1 ration, which is the amount I take
3 Maria cookies = 1 ration, therefore 4 cookies = 1, 33 rations

Total = 2.33 rations

The page also says: 30gr of white wheat bread (which I think is normal) = 1 ration, therefore 1 fast unit and you say that they are 15 gr of bread = 1.5 fast.

Something does not fit me then

For the rest that you explain to me I agree with you.

Is there any website, where this or any post of this forum is best explained?

Hey, you are serving me a lot of help.

Thank you.Juan

For us, at least what they told us, the ration of carbohydrates are not 15 grs, but 10. I know that there is another "version" of 15 grs, but my calculations are:
A glass of milk (200 cc) are 10 grs of carbohydrates, that is, a ration.The peach has a ration for every 100 grs, if I remember correctly, so 2 small peaches, as Owash tells you, are 2 and a half rations, more or less.
And eggplant flour is more difficult to calculate, but they are also hydrates.

Read the website that has happened to you, and little by little you will automate the theme of the portions.

Greetings

Hello Alea, thanks for the clarification, it is what I was assuming to me.

What web had Owash, I don't see it?

Thank you

The website that says is www.clinidiabet.com
But she has posted it, not me: D

Hi Owash

Well, that website is the one that says that a ration is 15 gr of HC, but to follow the link that I have put.

Anyway, what mess

Thank you

Sorry, that one already loses faculties.
It is true, I put the link.
The truth is that I had not noticed that I put the 15 grs there.We follow the pattern of 10 grs = 1 ration.

The Alzheimer attacks me: Oops:

Yes, I also learned at first that a ration was 10 grams and when I put on the bomb the endo told me that it had changed and was considered a ration 15 grams but I still consider that a ration is 10 grams although the truth is that now no longerI count rations, I do it by eye:-/ .... and the truth is that I am not going wrong at all, as well as I look at the glucose minimum 6 times a day because if I'm wrong I correct ....: Oops: .... in the end ... that I should not be a good example: oops: