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Friday, 24 February 2017

Insulin dosuing according to the R.S. Beaser, MD. February 24, 2017

Joslin's Insulin Deskbook. Designating and Initiating Insulin Treatment Programs by R.S. Beaser, MD and the Staff of Joslin Diabetes Center. 2008.
Physiologic insulin replacement therapy. The book written by medical doctor, Joslin Diabetes Center staff. So, there is very reliable source of education I suppose, and what do I see in this education?
"These insulin doses are adjusted based on glucose level, food consumption, activity, etc. "
Great as I can say.  R.S. Beaser, MD even was not able to point out all the info we are, diabetics must put together to find out what dose of insulin inject into belly. There are all time a good deal spent on any Joslin's deskbooks and manuals how to do math in carb and calories counting, work out and calories burned, and show me, what dose of insulin I have to inject every time I take injection? Do I have to do all this math?
      Well, to be more clear just think about, would doctor every time count dose of medicine one Rx to patient? Not at all. It is easy for them, because of they have to Rx just one of a few different doses. Do doctors in hospital count every time what dose of insulin they inject? Not at all. They inject just the same dose for every one diabetic in coma or with high blood sugar, just dropping into vanes one drop after another, regardless of meal time, food, or etc. Do they count dose of insulin to inject for every diabetic according to the fat level or body shape? Not at all. So, really what R.S. Beaser, MD do talking about.
Rapid acting insulin
glucose range           pre-breakfast               pre-supper           bedtime
    0-50                               *                                  *                                   
    51-100                           12                                  7
   151-200                          14                                  8
  201-250                           16                                10
251-300                             17                                11
   301-400                          18                                12
   400>                               20                                 14
plus intermediate              36                                                      12.
well, do anyone see how easy and nice to follow this table?
The question #1:  how R.S. Beaser, MD. is going to drop blood sugar from 400> down to the 100?
The question #2: the table is for maintenance of blood sugar control? or it is the recommendations how to take blood sugar under control?
The question #3: The rise in blood sugar level going from normal level, 100 mg/dl with 12 + 7 units of insulin to 400 mg/dl  when dose of insulin is 20 + 14 in three folds. At the same time the dose of insulin is raised only 12 + 7=19 20 + 14 = 34 units. Less then twice.
      Well, I do understand, the full table is just absurd. Still, in this table must be some insulin added to cover carbs, and calories, and fat  and protein, and work out and so so so on. Is this really true that any one of us, diabetics type 2, can relay on this table?


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