Doubt with fast and intermediate insulin

Good day to all,

I tell you, in the morning my mother is injected with 20 intermediate insulin units and at night 10 units of it.He has a diet and eats his food at his hours, at night before dinner he sometimes has a 300 or 400 sugar level, in this case what should be done?

A doctor told us that when you have a high level of sugar, 10 fast insulin units will be injected but I am afraid that you go to sleep like this.We do not know whether to inject the rapid first and then the intermediate, etc.

Greetings and thank you very much.

Find this table:

150-200: 1 unit
200-250: 2 units
250-300: 3 units
300-350: 4 units
350-400: 5 units

What I understand is that for this case if before dinner has 400 inject 5 units of fast insulin, but for the whole night I must also apply the intermediate ????

The 10 units seem to me a barbarity, test first with 4 or 5 to see how the intermediate reacts and additionally.I understand that it is exclusively intermediate and the rapid only puts it on a timely manner.If those increases of 300/400 were often, instead of the rapmeals and see which gives high values, to increase the dose of that meal, but that should be done under the supervisor of the endocrine.

runing50 said:
The 10 units seem to me a barbarity, proves first with 4 or 5 to see how the intermediate reacts and additionally.I understand that it is exclusively intermediate and the rapid only puts it on a timely manner.If those increases of 300/400 were often, instead of the rapmeals and see which gives high values, to increase the dose of that meal, but that should be done under the supervisor of the endocrine.

That is to say that at night when I have it at 400 before dinner I can inject 4 or 5 units of rapid + the 10 intermediate for the whole night?

Are you taking an endocrine?

Surely need a slower insulin, there are 24 hours., And the rapid at each meal.

He looks like he doesn't use fast before meals.Do you put insulin before each meal depending on the amount of carbohydrates you are going to eat?
The table it has is correct but it is to correct the fast insulin dose before eating if it is above the target value.If it is at 160 and it would have to be below 140 before dinner or eat, according to the table you have to put 1 more unit of what you wear every day.
But because of their values ​​... I fear that it does not use fast or not in the right amount.

ruthbia said:
looks like it doesn't use fast before meals.Do you put insulin before each meal depending on the amount of carbohydrates you are going to eat?
The table it has is correct but it is to correct the fast insulin dose before eating if it is above the target value.If it is at 160 and it would have to be below 140 before dinner or eat, according to the table you have to put 1 more unit of what you wear every day.
But because of their values ​​... I fear that it does not use fast or not in the right amount.

In other words, apart from the intermediate insulin that we put in the morning and at night it is necessary to measure dinner for this case and if it has it high to put quick insulin apart from intermediate insulin to correct ???

Find this:

(Current glucose - Objective glucose) ÷ Correction factor = correction dose

For this example we will assume the following;
Current glucose is 220 mg/dl
Objective glucose or the desired level is 120 mg/dl
Correction factor is 50

Now we put these numbers inside the formula to calculate the correction dose.
(220 - 120) ÷ 50 = correction dose
100 ÷ 50 = correction dose
2 = correction dose

What I understand is that before dinner if my mother has 220 I apply 2 quick dose + your normal intermediate dose?

Thanks for the help!

Yes, but I would not have to need so many corrections if I had a good treatment.
When there are such high values, a slow basal insulin and a quick before each meal are usually guided.
A good treatment allows glycosilada less than 7.

Yes but
First you have to know your mother's sensitivity.That is not 50.
Second those 2 supposed units add to what I will eat.
Example:
- It has 220mg/dl before dinner.
- Your sensitivity (1 fast insulin you metabolizes 60-70mg/ dl)
- He wants to dine a salad, fish and a piece of fruit.That dinner is approx 30 g of HC or 3 rations of HC.

I could 3 units to burn dinner and 2 more correction for being at 220mg/dl.That is 5 units 20 min before dinner.

Your mother needs to get a novorapid or aspidra for each meal based on what she eats.Only with intermediate or basal cannot be on the thresholds.

Both the sensitivity factor and the rapid insulin ratio to calculate the bolus before meals is something individual for each person and varies according to the time of the day, so in this case it is not possible to apply closed tables that what they would do would beDo not work, probably your mother needs rapid insulin at meals, as you have told you in the rest of the comments, but to know what you have to wear, you have to adjust the parameters well and precisely (always under medical supervision, obviously).

For example: My sensitivity factor is 45 mg/dl in the morning and 55 the rest of the day and my rapid insulin ratios vary from 1 u.For 11 gr.in the morning up to 1 u.for 20 gr.At night at dinner, at which time I need very little fast insulin ...

By this I want to tell you that it is important to adjust your mother's treatment.Continuous glucose of 300-400 indicate that something fails and are harmful to the body, since they suppose very high peaks.I have many years, many years, that I do not see a 300 in my glucometers years ago ...

If it was good, which seems not the case, it could be perfectly only with intermediate insulin correcting with the fast I was like this, but it is currently a treatment that very few people use.
Until the endocrine sees your mother, that tantee putting the 4 units of rapid plus the intermediate when it is in the 400, to see how it reacts.You cannot change insulin until the endocrine decides.

I really appreciate your help.I will investigate more and everything I can read about this to know what to do and how to help.

A hug to all.