Insulin needs changes

hades40's profile photo   10/31/2013 6:05 a.m.

Hello good, I am reading many issues here and I have more and more questions ... I was more or less controlled, I say more or less PQ did not go from 200, with the occasional very very severe hypo and on top of without detecting myInsulina Guideline Era from Lantus 16 - 0 - 8 and fast guidelines, apidra of about 12 UND to the day divided into meals, an average of 4 units for breakfast, lunch and dinner ...
For a month since I went to a new endocrine I have triedFast every 2 hours, an average of 46 und per day and even so I'm still between 220/270, it is a pass
Can several the need for insulin of the body? What can be happening?Not even the endocrine find the reason, it is incredible

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hades40
10/31/2013 6:05 a.m.
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I have no idea why that is happening to you, but surely you need more insulin.
Why do you put on the lantus departure?
How do you have the pres and pos values?I think that I have already asked you in another post
It seems that the Lent is disproportionate with the rapid ... 28 slow to 46 fast, let's say that the "normal" pattern is approximately 50%/50% (then varies depending on each one).
If you have little slow, this may be so quickly and for that same reason you do not get good figures.I would comment with the endo, to see if putting the insulin in a single dossis and increasing it you get better controls, than I think so.

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Velia
10/31/2013 6:27 a.m.

De los buenos tiempos, siempre quiero más...
Mamá de Ángela, ¡16 añitos, fiera!. Debut: octubre de 2003.
Bomba insulina Medtronic Paradigm Veo desde junio 2005
Última hemo 6.1

  

A month ago I had the guideline of Lantus departure, at 9 in the morning and at 9 at night, when I started with this endocrine tried to put on a single morning of 20 units and there began the chaos ...
Before starting with the endocrine, it had more or less acceptable values ​​in terms of highNotice symptom ... Seeing these hypos the new endocrine tried to provoke the Up to levels between 160 and 250 lowering the fast before meals and removing 6 undus of Lantus, in the end I leave it as follows:
Lantus 20-0-0
Fast: Up to 150 2 UND
Seeing the endocrine that shot at 400 and did not go down to the above 20-0-8 of Lantus and quickly because 1 more in each section
Look how I was yesterday that it was one of the lightest days:

Time ----- Glycemia ---------------------- HC
04:00 ------- 265 --------- 6 ----------------------------------
09:00 ------ 312 ---------- 8 ---------- 20 ----- 1- 1-
11:00 ------ 147 -------------------------------
15:00 ------- 205 --------- 5 ------------------ 1-
17:00 ------- 262 --------- 6 ------------------------------
19:00 ------ 315 ------------------------------------
21:00 ------ 225 ---------- 8 --------- 6 ------ 3- 3-
23:00 ------- 382 -------- 12 ---------------------------------
05:00 ------ 106 --------------------------------------

Know?I am that I can not, today I am going to unsubscribe from the gym because I cannot even exercise, I cannot concentrate to study the oppositions, the life is conditioning so much and they do not give me a solution that every day that spends the worse I see the subject,I am desperate, they tell me that they will enter me with emergency to see what happens and I am still waiting, they tell me about the bomb and stay there, but no solutions and here one having a bad time
On the other hand with what is happening, such a lack of control and how it is conditioning my life I am considering if I really have enough information to know certain basic things
As the lantus, the rapid, max or minimal insulin units that a person, hydrates etc etc
If I look like my diabetes, anything that eats (a piece of celery)My or that the endocrine does not explain them to me ...
I take what as detailed as a newspaper, and it only says that it makes no meaning but explanation or solution any
I hope I do not bother you that I tell you all this but I do not know who to let off steam that I can understand the situation

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hades40
10/31/2013 7:54 a.m.
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It is not surprising that you find yourself bad both physically and encouragement with those controls ... After seeing the list than yesterday's glycemia, I even reaffirm that you lack basal (I don't care as in a dose) ... Pre -of breakfast 312, pre of food 205, pre of dinner 225 and because you had made an intermediate correction ... come on, we must not have studied much to think that you are missing Lantus ... I would not miss aMinute more, you will see, having little basal with maintained hyperglycemia can produce a diabetic ketoacidosis, and you already know what that implies ... I if it were in your place I would not think it 2 times and planted me in the emergency room, which theendo.You tell him that you think you are missing Lantus, that you are getting very fast and blah blah blah.I don't want to be Mariangustias but I don't think you can stay for a long time with those figures ...
Did you mediate the ketone bodies?
Here we are to help as we can, so if it serves as relief, mission fulfilled !!!Come, don't leave it !!!

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Velia
10/31/2013 8:17 a.m.

De los buenos tiempos, siempre quiero más...
Mamá de Ángela, ¡16 añitos, fiera!. Debut: octubre de 2003.
Bomba insulina Medtronic Paradigm Veo desde junio 2005
Última hemo 6.1

  

Thanks Maja, I'm going to see what they tell me, I will tell you and how they don't give me a solution because I will start up the lantus, total, I lost the river

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hades40
10/31/2013 8:25 a.m.
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You tell us !!!;)

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Velia
10/31/2013 8:34 a.m.

De los buenos tiempos, siempre quiero más...
Mamá de Ángela, ¡16 añitos, fiera!. Debut: octubre de 2003.
Bomba insulina Medtronic Paradigm Veo desde junio 2005
Última hemo 6.1

  

Have I misunderstood your figures or really just take 5 rations of HC per day?1HC in the main food?What do you call 1HC?I say it in case the problem could come around.

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aaandres
10/31/2013 8:35 a.m.

Padre de Andrés, 17 años. Debut: septiembre de 2011.
Levemir (30ud. mañana y 24ud. noche) y Novorapid (en desayuno, comida, merienda y cena 40ud aprox - 24HC/día).
Medidor continuo DEXCOM G4 desde julio 2014
Hemo: 6.2 (Sept. 2013), 7.0 (Dic. 2013), 6.9 (Marzo 2014), 6,6 (Junio 2014), 6,7 (Sept. 2014), 7,0 (Dic. 2014), 7,7 (Mar 2015), 6,9 (Jul. 2015), 7,0 (Sept 2015), 7,4 (Dic 2015), 6,8 (Mar 2016), 6,6 (Julio 2016), 6,8 (Octubre2016)... 7,0 (Mar 2018)

  

I also see that you are missing Lantus.Surely if you climb the morning, you don't need more than a dose.I would try to put 25 in the morning .. and continue adjusting from there.
The value when you wake up is the best indicator of the basal, provided you use a single dose.

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Regina
10/31/2013 11:56 a.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

Now that you have fixed the table, I see that I understood well.
Or bad accounts of hydrates (which can help to understand what happens to you) or you are really taking very few and you have an added problem.
The recommendations are 4 to 5g per day per kilo of weight, which for a person of about 70kg would be 280gr to 350gr, that is, from 28 to 35 rations of HC.You just take 5!Where do you get the energy?

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aaandres
10/31/2013 1:46 p.m.

Padre de Andrés, 17 años. Debut: septiembre de 2011.
Levemir (30ud. mañana y 24ud. noche) y Novorapid (en desayuno, comida, merienda y cena 40ud aprox - 24HC/día).
Medidor continuo DEXCOM G4 desde julio 2014
Hemo: 6.2 (Sept. 2013), 7.0 (Dic. 2013), 6.9 (Marzo 2014), 6,6 (Junio 2014), 6,7 (Sept. 2014), 7,0 (Dic. 2014), 7,7 (Mar 2015), 6,9 (Jul. 2015), 7,0 (Sept 2015), 7,4 (Dic 2015), 6,8 (Mar 2016), 6,6 (Julio 2016), 6,8 (Octubre2016)... 7,0 (Mar 2018)

  

Hello again, I think the hydrates counting I do well, for example in the morning I take two biscues of whole wheat bread (10g each) with 25g of turkey in slices accompanied by 200ml of half -naming milk, in the middle of the morning depending on how to haveThe levels I take half apple, at noon a normal day is a salad of canons with half onion, a can of natural atun and a tablespoon of oil with 2 slices of biscot bread (another 20g of bread), in the afternoon aNavigated white yogurt and at night normally a salad or zucchini cream, grilled vegetableFrom the factory of Lantus or Apidra to be connected to a supplier directly hahaha

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hades40
10/31/2013 7:01 p.m.
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Put all the insulin you need to eat the diet that corresponds to you.

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Regina
10/31/2013 7:56 p.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

Go up the basal first, until you wake up with good values.Then adjust the r´pidas.You are getting quickly 7 times a day, you can't be like this.

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Regina
10/31/2013 7:59 p.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

A question that has just emerged, when they give us the diet for rations and such ... in the case of breakfast that puts 1 lacteos ration, 2 portions of hydrates and 1 fat ... the total ration of hydrate would be2 or 4?Is the dairy ration assumed equivalent to 1 of hydrates and fat to another?

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hades40
10/31/2013 8:01 p.m.
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Wow Hades, many spirits, insulin changes or units always give a little repair, but sometimes tests to improve are necessary.I spent several years without Lantus, just quickly, my endo did not want to get slow (go to know why) but I didn't finish finding the measures, so the first day the lantus put me terrified to see how I would react.It is also true that each body is different and in the end you will get to know you better than your endo.

Aaandres, I did not know the standard that of the HC, that has made me tell my weight and my HC and I am eating about 14 portions a day, according to your calculations, half of what I should for my weight.I am strange to imagine eating twice HC a day: o

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valky
10/31/2013 9:26 p.m.

DM1 Debut diciembre 2004.

  

Thanks Valky, there are things that doctors who have no explanation hahaha
It is assumed that the greater the amount of HC higher levels of sugar, right?
Am I telling the HC well?

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hades40
11/01/2013 3:03 a.m.
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@hades40 did you go through the emergency room/endo?What did they tell you?
@aaandres, is that formula also for adults?Because I think it is inversely proportional to weight, well this is an exaggeration, but what is true that the greater the less HC requirements you need.I do not know the rations that you must take, but it varies depending on age, sex, exercise, weight ... on the last visit to endo, he recommended my daughter to reduce rations because I had completed her growth phase, and logically its weight is greater than 3 years ago ... neither will a sedentary adult consume the same rations as an adult who performs an intense physical activity, has no more than looking at a cyclist for example, his diet is composed mainly of hydratesCarbon ... However, the specialist is the one who must also guide you about that.
@hades40, according to the data that you put from breakfast would be 3 portions of HC, S (milk and HC, s) more more than fats ... there are those who do not consider fats as a ration.

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Velia
11/01/2013 5:43 a.m.

De los buenos tiempos, siempre quiero más...
Mamá de Ángela, ¡16 añitos, fiera!. Debut: octubre de 2003.
Bomba insulina Medtronic Paradigm Veo desde junio 2005
Última hemo 6.1

  

Velia, is right, at breakfast are 3 of hydrates .. one of more meals TB is 3, yogurt is one and the bread two.I think you have to climb the Lantus, start with 2 units, but you will need more.Every time you get fast without eating, it is that the lantus is not doing if I work.

On the other hand, according to what Aaandres has put, I am taking less than half of the recommended hydrates, it seems to me that this formula is not correct.

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tica
11/01/2013 6:03 a.m.

Miembro del equipo de moderación del foro
DM1 desde 1988
Mamá de 2 niños y a la espera del tercero
Bomba + Dexcom

  

@Velia, I have found that formula in several Internet pages (almost all of them say the same) for all people in general.
More or less coincides with what my 13-year-old son takes and about 50kg of weight that takes 5-2-8-2-7hc (24 in total) according to endocrine indications (when he debuted two years ago, with about 40kg, he took4-2-6-2-5HC).Obviously, it is in growth phase but, from what I see, its dishes are rather scarce.A 5HC rice dish is really little rice, for example.I am sure that he would take double without problems.Or a dinner at the Hollywood or Vips, medium hamburger are already 5 long rations, without counting potatoes or dessert.
But as you say, it depends on each one and its activity.I think it is a fairly normal figure.

@hades40, you are not telling the rations of hydrates well:
- Breakfast: 20g of bread and 200ml milk: 2 rations
- mid -morning: half apple, depending on the size, 1 ration or more
- Food: you only take 1 bread.I don't know how you don't starve, heh, heh ..
- Snack: Navigated yogurt 1 ration if it is without sugar, 1.5 to 2 if it is sugary.
- Dinner: A slice of bread is half ration.With the zucchini cream you may reach 1 ration.

Total a day: 2-1-1-1 = 6 rations of HC

We have not been told that we have fats as a ration.Yes, we take them into account because they slow the absorption of hydrates.

The insulin guidelines of my son, right now, are 17+18 of slow insulin (tomorrow and night) and fast novorapid 8-0-9-3-11 in meals, in case it serves as a reference.Last hemo 6.2 (a champion!).

As you have told you, I think you have to get the slow.The fast is only to compensate for the intakes of hydrates, which in your case are rather few.You are compensating for the lack of slow to click many times fast.That is not normal.In addition, doing so prevents you from seeing how your body metabolizes hydrates and how many fast insulin units you need depending on the hydrates you eat.And you don't have to make such a strict diet if you don't want to.Hydrates you eat, fast insulin you wear.

When you are in more normal values, insulin needs will go down.I explain myself: to download a 200 to 120, it may need 3 rapid insulin units.But to download from 130 to 80, with a unit it is enough.
It is the analogy of "traffic jam": if there are many cars, it costs more circular.The same thing happens with insulin: if there is a lot of sugar, insulin costs it more circular and doing its function.

Much encouragement.I am your age and imagine what you are happening.

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aaandres
11/01/2013 6:32 a.m.

Padre de Andrés, 17 años. Debut: septiembre de 2011.
Levemir (30ud. mañana y 24ud. noche) y Novorapid (en desayuno, comida, merienda y cena 40ud aprox - 24HC/día).
Medidor continuo DEXCOM G4 desde julio 2014
Hemo: 6.2 (Sept. 2013), 7.0 (Dic. 2013), 6.9 (Marzo 2014), 6,6 (Junio 2014), 6,7 (Sept. 2014), 7,0 (Dic. 2014), 7,7 (Mar 2015), 6,9 (Jul. 2015), 7,0 (Sept 2015), 7,4 (Dic 2015), 6,8 (Mar 2016), 6,6 (Julio 2016), 6,8 (Octubre2016)... 7,0 (Mar 2018)

  

@tica: I attach any link, where it speaks of daily hydrates needs:
Link

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aaandres
11/01/2013 6:41 a.m.

Padre de Andrés, 17 años. Debut: septiembre de 2011.
Levemir (30ud. mañana y 24ud. noche) y Novorapid (en desayuno, comida, merienda y cena 40ud aprox - 24HC/día).
Medidor continuo DEXCOM G4 desde julio 2014
Hemo: 6.2 (Sept. 2013), 7.0 (Dic. 2013), 6.9 (Marzo 2014), 6,6 (Junio 2014), 6,7 (Sept. 2014), 7,0 (Dic. 2014), 7,7 (Mar 2015), 6,9 (Jul. 2015), 7,0 (Sept 2015), 7,4 (Dic 2015), 6,8 (Mar 2016), 6,6 (Julio 2016), 6,8 (Octubre2016)... 7,0 (Mar 2018)

  

Good morning guys to Andres, Tica, Velia, Valky ... Everyone in general hahaha ... first to thank you for all this we are commenting, every doubt that I take from my head, a new question that I ask myself or possibility that I did not contemplate,You are solving it with every thing you comment
I did not know to what extent my information was outdated total, in a few days I am learning a lot, trying to see when hydrate lowers an insulin unit, insulin resistance that I have at different times of the day etc ... A more information and ignoranceFrom some points, the greater the possibility of stabilizing the sugar than a priori is an odyssey ... I am going to be riddled with questions and that I give me solutions with data, that give me an intensive recycling course at all levels,The information is essential for me to be able to make my life in conditions or at least approach what I want ...
Regardless of everything that is happening to me, which I think has happened to many of us, what is most difficult for me to carry is the impotence that one has knowing that simply with putting on a bomb can half fix what happens and remain so calm(I mean doctors) ...
Yesterday I went to the endocrinology in my hospital asking about the famous call they had to do for admission ... they told me to wait (like this, without petroleum jelly) then comment on the lack of control that I had, carrying all the profiles ... answer: ifThey have told you that they will call you because they will already call you
Given this type of behavior one cannot do anything, and the worst thing is that the health of each depends on the criteria of people who are supposed to look at our well -being ...
It will seem a lie to you but since yesterday at noon, when I left the hospital without any solution, my levels seem to have reacted ... I do not know if it will be one not expected anything or because my head has stopped going around ...
117 Before the food with 4 UND of fast and 2 RAC of Hydrates (this time well counted hahaha)
152 at 2 hours, 83 before dinner with 3 und 3 of Lantus and 3 RAC of hydrates ... at 2 hours he went again at 390 and put 12 undees quickly ... This morning II have lifted with 95 I have put the 20 of Lantus plus 4 quickly and now I am with 81, I just had a coffee with milk hahaha
Let's see how the day goes, today promises
By the way, does anyone know how to try to pass a court for the 33% issue for oppositions?Yesterday at the Academy they told me that PQ did not try to pass the court and introduce myself to the part of disability ... it is possible that they give the percentage having such a lack of control, the retinopathy, the problems in the mouth (loss of dental pieces), that IThey are going to put the pump etc etc?

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hades40
11/01/2013 7:13 a.m.
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