OK, now let us get started with intensive Insulin Therapy. Dr. R.S. Beaser give perfect directions how ti do it and how does it looks like.
At first, set insulin dosing plan.
Usually it is based on your previous dose of insulin. Looks like Dr. Beaser simple forgot, we just stared with insulin therapy, so there is no previous dose of insulin. It is first one. And right now first time ever diabetic and doctor creating first insulin dosing algorithm, how to do so? Let us start. Not so fast. Dr. Beaser need a little bit more pages to say about nothing. Of cause, it is easy to talk then create algorithm how to dose insulin. What I suspect, he never will get to this point in this book.
"Once you started with intensive program...." - sorry, we did not start yet. How I suppose to do so? I really lost in direction and guidance. Is there some of them?
OK, now we go back to our usual life style, and adjust insulin to this style:
add units if if sugar is higher then your goal (how many units to add to compensate every mg/dl of elevated sugar level)?
reduce units if sugar is lower then normal level (how many units each time, how to find it out?)
pay attention to your mal plan, add units if you eat more then you planned, reduce units if you do not have appetite;
pay attention to your daily activity. If you are going to dust today, reduce a few units of insulin. If you have very bore working meeting for a few hours at the end of day, add units of insulin. Sorry, all the time I have no one idea when I have to add units and when I have to reduce them. If I am going dusting then it is activity and it will reduce my level of sughar. But at the same time if I did reduce dose of insulin then where from energy will come to do dusting? I am already lost in all that adjustment.
If blood sugar reading is high then try to find out:
what did you eat wrong today?
did you skip your acytivities today?
was your level of sugar low a few hours ago and not it is high because of rebounding?
Are you sick? Do you have cold? Did you have problem with boss or any other stressful situation on work? With children? With someone else?
Was today rainy day? It is Winter storm? It is Sunny day today? If so then today probably you need one unit less of insulin because of it is sunny day, nut three units more because of it would be rainy day tomorrow.
If you took 5 ml log today (O My God! i never able to do so) then probably you need to take 4 units less in insulin dose, 5 units at one shot. WOW! As long as I do remember Dr. Banting injected 10 units of insulin in his arm to test how insulin injection work on people. He was not diabetic at all. The question is, would one units of insulin effect diabetic?
"You may wonder at this point, "How do I learn to consider all of these variables?" The answe is Practice!"
I do, I practice. To find out what is good for me and what is not I simple do eliminate all those variables, and pay attention only for two of them, my blood glucose meter readings, and the dose of insulin I have to inject.
So, because of I do have my practice since 2011, right now my dose is 300 units. This is base. There is only one type of insulin I take, long acting insulin Lantus Solo Star. This insulin does not have peak of action, does not need to be taken with food. Also it give its action all day long, so at any time when I need insulin is ready to be used. It is all the time in my system.
I can take insulin in three shots, 100 units each, but more often I take 4 shots, 80 units three times a day, and the rest, 67 units in the morning or in the eve. It is not 300 units in pen but 307. I do not spring insulin, just because of it is too expensive to waist it.
So, it is easy to see that it is better to pay attention to the time of injections then for the dose of it.
If with 300 units level of sugar still high, above 200 mg/dl at any time, in any reading, I will add some units, up to 100 if I need. I never injected more then 400 units. But I will if it will be necessary. If I do have insulin reaction, low blood sugar, I will take a few units of insulin, about 60 or 80 units, and take my meal if it is possible. If it is not, for instance I am not home, then I will take one protein bar, 20 g of protein, and it will keep me good for the next 4 - 5 hours. I will not drop my daily dose of insulin. No need in this.
If insulin reaction is too often, meaning that 300 units is too much for this time, I will start to drop daily dose, slow, very slow, no rash. Usually in Spring and Summer daily dose of insulin less then in Winter and Fall, especially in Fall. In rainy day sugar would be higher then in sunny days in Summer.
This is all my practice. Simple. Not too much math. But really good understanding of diabetes and how to live with it in best way as possible.
At first, set insulin dosing plan.
Usually it is based on your previous dose of insulin. Looks like Dr. Beaser simple forgot, we just stared with insulin therapy, so there is no previous dose of insulin. It is first one. And right now first time ever diabetic and doctor creating first insulin dosing algorithm, how to do so? Let us start. Not so fast. Dr. Beaser need a little bit more pages to say about nothing. Of cause, it is easy to talk then create algorithm how to dose insulin. What I suspect, he never will get to this point in this book.
"Once you started with intensive program...." - sorry, we did not start yet. How I suppose to do so? I really lost in direction and guidance. Is there some of them?
OK, now we go back to our usual life style, and adjust insulin to this style:
add units if if sugar is higher then your goal (how many units to add to compensate every mg/dl of elevated sugar level)?
reduce units if sugar is lower then normal level (how many units each time, how to find it out?)
pay attention to your mal plan, add units if you eat more then you planned, reduce units if you do not have appetite;
pay attention to your daily activity. If you are going to dust today, reduce a few units of insulin. If you have very bore working meeting for a few hours at the end of day, add units of insulin. Sorry, all the time I have no one idea when I have to add units and when I have to reduce them. If I am going dusting then it is activity and it will reduce my level of sughar. But at the same time if I did reduce dose of insulin then where from energy will come to do dusting? I am already lost in all that adjustment.
If blood sugar reading is high then try to find out:
what did you eat wrong today?
did you skip your acytivities today?
was your level of sugar low a few hours ago and not it is high because of rebounding?
Are you sick? Do you have cold? Did you have problem with boss or any other stressful situation on work? With children? With someone else?
Was today rainy day? It is Winter storm? It is Sunny day today? If so then today probably you need one unit less of insulin because of it is sunny day, nut three units more because of it would be rainy day tomorrow.
If you took 5 ml log today (O My God! i never able to do so) then probably you need to take 4 units less in insulin dose, 5 units at one shot. WOW! As long as I do remember Dr. Banting injected 10 units of insulin in his arm to test how insulin injection work on people. He was not diabetic at all. The question is, would one units of insulin effect diabetic?
"You may wonder at this point, "How do I learn to consider all of these variables?" The answe is Practice!"
I do, I practice. To find out what is good for me and what is not I simple do eliminate all those variables, and pay attention only for two of them, my blood glucose meter readings, and the dose of insulin I have to inject.
So, because of I do have my practice since 2011, right now my dose is 300 units. This is base. There is only one type of insulin I take, long acting insulin Lantus Solo Star. This insulin does not have peak of action, does not need to be taken with food. Also it give its action all day long, so at any time when I need insulin is ready to be used. It is all the time in my system.
I can take insulin in three shots, 100 units each, but more often I take 4 shots, 80 units three times a day, and the rest, 67 units in the morning or in the eve. It is not 300 units in pen but 307. I do not spring insulin, just because of it is too expensive to waist it.
So, it is easy to see that it is better to pay attention to the time of injections then for the dose of it.
If with 300 units level of sugar still high, above 200 mg/dl at any time, in any reading, I will add some units, up to 100 if I need. I never injected more then 400 units. But I will if it will be necessary. If I do have insulin reaction, low blood sugar, I will take a few units of insulin, about 60 or 80 units, and take my meal if it is possible. If it is not, for instance I am not home, then I will take one protein bar, 20 g of protein, and it will keep me good for the next 4 - 5 hours. I will not drop my daily dose of insulin. No need in this.
If insulin reaction is too often, meaning that 300 units is too much for this time, I will start to drop daily dose, slow, very slow, no rash. Usually in Spring and Summer daily dose of insulin less then in Winter and Fall, especially in Fall. In rainy day sugar would be higher then in sunny days in Summer.
This is all my practice. Simple. Not too much math. But really good understanding of diabetes and how to live with it in best way as possible.
via Ravenvoron
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