Lantus and Novolog Control question

I find that 30u of Lantus in the evening and 20 u in the morning with 4
injections of Humalog through out the day works for me. I count the
carbs/meal and figure 8 carbs/u of Humalog. The Lantus I was put on 50u/day
by an Endocrinologist but I did not get a steady BG levels. So, on my own,
I've experimented and came up with this protocol. I test my BG 4 - 6 times
per day. Good Luck, some others on this board will give you a more in-depth
analysis and suggestions.
"andy wall" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

I just switched from NPH and one shot a day--to Lantus in
the morning

only,

Quoted message said:

and Novolog up to 6 shots a day--and testing my blood at
least 10-12 times

a

Quoted message said:

day--I don't see how I can determine the amount of insulin
I need for each meal--counting carbs alone is not working--
any ideas are welcome--as my highs and lows and
inconsistency are driving me nuts---

"andy wall" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

I just switched from NPH and one shot a day--to Lantus in
the morning

only,

Quoted message said:

and Novolog up to 6 shots a day--and testing my blood at
least 10-12 times

a

Quoted message said:

day--I don't see how I can determine the amount of insulin
I need for each meal--counting carbs alone is not working--
any ideas are welcome--as my highs and lows and
inconsistency are driving me nuts---

Visit your endo. Whether this is a nurse or a doctor.

They will tell you where to start and give some directions
for adjusting. There is no simple math to find units of
insulin to cover carbo hydrates. This depends on your
weight, activity level, etc. (If I shall spend the
afternoon in the garden, I may have to reduce my dose
before dinner by 50
%.)YMMW

Measure your BG before and after your meals and bring these
figures on your next visit. My diabetic nurse is far more
capable of reading these figures than I am after 25 years.

--
Hava a nice day! Bjørn BL.

"andy wall" <[email hidden]> wrote in
:"]news:[email hidden]:

Quoted message said:

I just switched from NPH and one shot a day--to Lantus in
the morning only, and Novolog up to 6 shots a day--and
testing my blood at least 10-12 times a day--I don't see
how I can determine the amount of insulin I need for each
meal--counting carbs alone is not working--any ideas are
welcome--as my highs and lows and inconsistency are
driving me nuts---

When you come down with diabetes, you forever more have a
certain amount of hassle in your life. You have a fair
amount of choice on how you want that hassle to express
itself, but it will be there. In broad strokes, you can have
a simple insulin regimen that requires very little effort
(e.g. 1 shot NPH/day) but requires strict eating and
activity patterns matched to the infusion of insulin into
your system to maintain target blood glucose values. Or you
can have a fair degree of flexibility in your eating and
activity patterns balanced by a more complex insulin regimen
which requires significant knowledge and effort to manage.

In this latter case, it is knowledge that is the key. You
have to know how much insulin to inject when. This involves,
among other things: Accurate assessment of your basal (long
acting insulin) requirement. Accurate assessment of the
number of basal shots required/day. (note that until the
basal dosage is correct, nothing else will work well and
many require Lantus to be given in split doses) Knowledge of
insulin:carbohydrate ratio which may vary during the day.
Knowledge of insulin:bg reduction ratio which can be
affected by activity level Knowledge of activity effects on
bg level Knowledge of absorption characteristics in your
body of insulin types taken. Knowledge of glycemic index of
foods eaten, including mixed meals. Ability to accurately
estimate carbohydrate content of food. This often requires
weighing all food consumed and looking up the carbohydrate
content for a period of time to learn estimation techniques.

I've probably forgotten several things, but the point is
that there is a steep learning curve and it takes time and
practice to get the transition from a simple insulin regimen
to a basal/bolus regimen to work.

A good reference is _Pumping Insulin_ by John Walsh and
Ruth Roberts which is in its 3rd edition. It is the classic
in the field but there are now several other books with
similar names which cover the same ground. It is written
from the point of view of using an insulin pump, but the
basic techniques are the same for a basal/bolus injection
insulin regimen.

The transition you are making is not a simple matter of
switching insulin types, it is a complete redesign of your
management program in one jump. Many of us worked our way
through a number of intermediate regimen designs along the
way which allowed us to learn things a little more slowly,
but even in one jump it is likely worth the work. I say
likely because the first law of diabetes treatment is do
what works for you. The best controlled diabetic I have
ever met was on a 1 shot of NPH/day regimen. He ate, not
equivalent meals, but exactly the same meals every day at
exactly the same times. He exercised exactly the same
amount at exactly the same times every day, 7 days/week. It
worked for him, so for him that was the best way to control
his disease.

--
-------
Charly Coughran [email hidden]