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Adjust insulin

IMADIS's profile photo   10/25/2010 6:49 p.m.

Hello good:
Well, I put you in a situation to see if you can help me to adjust the insulin levels a little, because I carry a unfortunate that takes me crazy and I do not know if I take a lot of one and little of the other.

I get Apidra as ultra -granted and Lantus (24u) as basal at night.
I get up with 151 at 06:00, glass of milk with zero colacao, and without losing a minute to the middle sobao ... coffee with milk + 2 cookies until 10:00 that I give 242 = 14 API 6 rations, to2 hours 133, and 40 minutes later with hiccup symptoms, 67, where I have to eat a mogollón to recover.

Well, these symptoms have been repeating them last week.If I punish less units (10), at 2 hours the index is too high, and I have to click again to correct myself, if I punish more units before lunch, at 2 hours, the index is good, but I do not arriveto food without an important drop.So my body I think that fast insulin metabolizes until 3 hours, and no 2 as they told me in the talks.

There goes the practical case.What am I doing wrong and how to correct it?

Thank you!: D

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IMADIS
10/25/2010 6:49 p.m.
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How are you in the afternoon?Does the Lantus last 24 hours?If so, Lantus's dose is fine.If you do not cover you 24 hours, you can try it in the morning, raising the dose a little.
In the morning, you get high to breakfast, it is to avoid.It will come better for breakfast before leaving home, putting you less apidra ¿10?
and not make that double breakfast ...
Let's see like this :)

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Regina
10/25/2010 8:22 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

  

How are you in the afternoon?Does the Lantus last 24 hours?If so, Lantus's dose is fine.If you do not cover you 24 hours, you can try it in the morning, raising the dose a little.
In the morning, you get high to breakfast, it is to avoid.It will come better for breakfast before leaving home, putting you less apidra ¿10?
and not make that double breakfast ...
Let's see like this :)

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Regina
10/25/2010 8:23 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

  

Imadis I don't know if I understood well, when you get up and take the glass of milk, do not you already insulin?If so, I think that you should click on when you get up since you get up something high.
I also use Apidra and I last its effect for more than two hours, much more, so the postprandial always looked at it at 3 hours and not at 2 hours.

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DiabetesForo
10/26/2010 4:23 a.m.
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The truth is that I did not understand your pattern very good ... I have understood Lantus at night and 3 punctures of Apidra a day ???

Please, if you put the hours you eat, the hours you click on and the hours you have those glycemiah could do something ...

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pedro jiménez
10/26/2010 4:54 a.m.
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Hello imadis..If you get up at 6 with 151 you may miss some basal, I would try to increase 1 or 2 units the lantus to see what your figures are at that time ... Once the basal is fixed you will have to adjustThat breakfast/lunch guideline that or I have not understood or seems very rare .... As you say you may not need that coach, and when you go to breakfast you put the insulin corresponding to the coffee with milk with the 2 cookies ...Mint and the posts of both breakfast, food and dinner to see how much insulin you need for each ration you take ... but it seems to me that it is essential that you first adjust the basal insulin.
Greetings.

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Velia
10/26/2010 5:03 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

  

First of all, thank you all your answers, and last my delay in the answer, fortunately, for the moments we live, I am one of the few who have a lot of work, and I thank and not miss.
For Regina, the basal decided my endocrine to put it at night so that I did not get so high to breakfast, before it put it in the morning, it arrived very high, putting it at night, I arrive lower than breakfast.It will depend on how I have told H.C in insulin units at night.The breakfast before leaving home, I discard it, I get up very soon and I will not get up before, the glass of colacao milk, it is rather a tradition, such as dressing, because since I am little and went to school, I already did this, then, this is part of the rite, I also thought that as I have to drive to go to work, I can avoid a downturn.But chatting among you I have realized that a breakfast is left over, so I will take the colacao at home and coffee at work, and I will leave the cookies in case I have a downturn, so as not to get so high to the lunch of the 10.00am Pedro, and I will change the 2 María cookies at 12.00 since at 15.00, and if not as something before the food, it is proven that I do not arrive.
As soon as I do not click on breakfast, it is because then (at 10) a lunch a snack, 4r + 1 piece fruit = 6r = 12 Api (my calculations, twice the dietitian) if I puncture 10 or less, at 2 hours, the values ​​are above 200.
Anyway, all this is a roll, and there are times that I don't know where to catch it.My work is very dynamic/static.It is so, or I am in front of the monitor for hours, or I do not feel for hours, so, I know that this has to do, the times I move more, I am more willing to suffer a descent than when I am in front of the monitor,But I do not decide.
At 18.00 in the afternoon I am forced to eat a piece of fruit, and apart from that I feel great for the hunger I have, it helps me reach some good levels to dinner +/- 21:00.
Do you know the bad of all this, what sometimes collapses me?Ays that Inteliegente was my pancreas who calculated all this for me, and I dedicated myself to other more imorting coas.Now that my pancreas has stopped segregating insulin, I realize the great role I played, and I wonder how many, what would have happened inside me so that all this is happening ...
I weight the bread, I tell the H.C I try to follow my table since the dietitian calculated it excessively low.Well, a few days I have been great, and I am surprised how well I calculated it because you are sorrows of 100, say how today, and other days, eating the same, same heavy bread, same h.c, skewed meThe same and ... disaster!Sugar through the clouds 240 or more, correction, automatically afterwards, I atiborro de H.C and another climb, and with this roller coaster I can be all day.Obviously that day has won diabetes by win, my humor is not good and I confine myself in myself, just like when I have a descent, I do not want to know anything about anyone, nor that anyone discovers how fragile I am at that time.For me it is a vital rule, although the compis of the curro I have already notified where I have the Glugagon Kit, and that if they have to act, that they do not waste time wasting ...
In principle Pedro, API 3 times a day before meals, I have this template, which is not good, but it is the one that I have achieved best, if it were not for the hypos that hit me at 3 hours by thetomorrow.(+/- API 12-10-8) and if any post is still high, then I correct it, so it will no longer be 3 punctures.Lantus 24u at night.
I have stayed with Velia, I think the basal is low, I should not get so high at breakfast, I will try to increase 2u lantus (26u) to see if I get lower, I will start seeing how.

Well I wish you all sweet dreams, and betterday for tomorrow.That science does not sleep and continue to investigate how to make our lives easier.
Thank you

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IMADIS
10/26/2010 6:29 p.m.
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IMADIS, do not increase 2 at once, raise the lantus 1 unit and wait 3 days to see results.If you get to dinner, it is well regulated.
When you have uploads (that happens to everyone) runs, (a fast unit usually goes down 50 glucose units ..) Stay around 150.
In the hypos, do not go eating ..., with Lantus a hiccRussians
I think you just have breakfast.You'll see how hemo goes well (you have a lot of control), and then you calm down and everything is easier.:)

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Regina
10/26/2010 7:25 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

  

Imadis, you are not so different from the others, do not believe ... I get on the walls when my daughter has high figures, my humor changes, and that I do not have diabetes: mrgreen: ... my husbandThe same happens.The important thing in those cases is what you do, measure and correct to see how much you have to put on.
I would point out what Regina said about what 1 fast unit falls.In principle for Humalog and Novorapid (I suppose Apid will be the same), the following rule: 1800/Total number of units submissive is used, including the slower the further the rapid.
In your case, 1800/24+30 = 33 approximately ... if I'm not mistaken, for each insulin unit you should lower the blood glucose 33 ... So you will not pass in correction.(That is called sensitivity factor).
I still insist on adjusting basal, you already tell us how the change is doing.Wait as they tell you 2 or 3 days, because the changes take to be assimilated by the organism ... Then we will see the fast.
One thing that surprises me when reading your signature is that they have not done a second hemoglobin.How long do they review you?Here normal is every 3 months if you are well controlled and every 1 or 2 if we have are bad.

Greetings.

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Velia
10/27/2010 5:29 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

  

Ahhh, Tb.I read that you want to take the pass to the bomb .... it is the best you can do: d.

Velia's profile photo
Velia
10/27/2010 5:30 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

  

Well, today it has been a disaster.He took away the 2 cookies I took before lunch so as not to get so high, and the thing worked.
Before lunch (125), I puncture less than API (10), because I'm going well, the day starts well, at 2 hours as always 12h, I picho to see how I go, (89) Well, I take apair of cookies to try to upload something ... at half an hour, sweating and with tremors (49): Twisted: juice and 6 cookies.
At 15h, (well to eat), (104) Pasta 6r + 2R 8 API, at 6pm, Ays ... (55): Twisted:

I would like to have more controls with the endocrine, in fact when I was the first visit in May, I quote for 3 months, but then in the window, they told me that before November it could not be ... and that I am going todo?Next week I finally have the endo, and I hope with the results of the hemo.And also drop him from the pump, but I think I'm going to take a click.I have read that in the Valencian Community, they are a bit reluctant to give bombs, so although I have a lot of enthusiasm, I think I know what is going to happen, and of course I have not had a year, so, I will have to wait for my turn.

Anyway ... Tomorrow will be another day.

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IMADIS
10/27/2010 3:53 p.m.
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It has not been a disaster, do not be so negative, you have been somewhat low, but you have removed the hyper.If you have climbed 2 from Lantus, go up only 1.
Lower 1 or 2 units of fast, and snack something, if you can.
You're doing very well: D

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Regina
10/27/2010 5:23 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

  

Of course, do not adjust the insulin doses for single -day glycemia.Take at least the average of the measurements of the previous three days.

That is, if two hours after breakfast you have had 140, 160, 150, which is an average of 150. Okay, do not touch it.

If the basal for breakfast give an average of 70, those of the food of 65 and those of the dinner of 72, you have plenty of Lantus.

First adjust the lantus, and then the rapid for each meal.

All the best.

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Nacho_71
10/28/2010 3:19 a.m.
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The problem of all this is not to adjust, is that there is no where to catch it.Last week eating the same H.C, I punctured me before Almazo 12 of API and at 2 h.I had to correct me because I was above 300. This week however is being down, eating the same H.C I am taking units, today 8 to see how.
With what I mean with all this is that it is not a simple rule of three, today it may work, next week you will have to make new changes.The only rule of three that it seems that it works for me is when correcting me.
And it is not that it is negative, only that this is because this is a lottery and it is better that the day spends, since with 2 strong hypos in a day as I am not going to jump with joy.

I believe that the basal I have well tight, days because other days are a roller coaster.

Anyway, we will see the day how it goes.
Ciao!

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IMADIS
10/28/2010 5:40 a.m.
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It is true, you have to be very stable, or have a more or less the same activity so that things more or less block ... I have at home the 2 poles, my very predictable husband and my daughter, very changing and with whomI have to break my head with each change of activity .... If your work is changing, as you commented, or if you have stress, everything will influence your blood glucose, so they will do not only the rations of HC, s that you take, if not their glycemic index, the fats, the proteins that accompany them ... and for curling the curl, the injection place will also influence, I do not know, infinite things .... maybe until you find the appropriate pattern you should haveIn mind all these factors, even if you seem tired, point what you eat, exercise, what you can think of and see, maybe it is a pelmada, but in the long run it is sure that it is worth it.And of course, if the result is that you sometimes need more basal than others, it is clear that with Lantus it will be very difficult to adjust, for this the pump is the best option, there is no residual insulin since the way to supply it is isLittle by little, and you also have different patterns to program your basal as you need it.
Come, a lot of encouragement, you'll see how you will get it.

Velia's profile photo
Velia
10/28/2010 6:07 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

  

Well, I don't want to get tired with the same subject, it is seen that this is so and the sooner begins to accept that hypos or hyper are part of me, I will not overwhelm myself so much with the subject.Today was another day with hip at 12, nor by clicking less insulin units, eating the same as always, with the fruit piece ... at 12.30 dizziness, I take 2 cookies, within a few minutes dizziness and sweat,I looked at myself (53) on the way to the fridge of the curro to the juice, I had the impression that I was not going to arrive and at any time I was going to faint :( I have wanted to cry and shout what I do ??? WhatI have to do ??

Yes Velia, I am realizing that in this disease not only tell the H.c that you are going to eat, tell everything, the times I get up from the table, the trips that I hit, if I make an effort, the stress, discussions, II know ...

I have a lifetime to learn so one day I will get to know myself better and learn the pattern.

Anyway, thank you all for your help and comments.

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IMADIS
10/28/2010 5:47 p.m.
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The first months are always of continuous adjustments (the pancreas can still react).When he spends more time, although control never becomes perfect, there will be seasons of greater stability.
You will improve, and when you see the next hemoglobin you will become quieter.
Meanwhile, we all hope you will arrive better treatments.:)

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Regina
10/28/2010 6 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

  

is that 12 or 10 units of apidra seem many ... or I have not understood

let's see
You have breakfast a milk glass with colacao ... do not click Apidra

in mid-morning, coffee with milk+2 cookies ..... and you put 8-10 Apidra units

Adding the glass of milk+coffee with milk+2 cookies ... I do not get 5 rations of HC, that is, I still have 3 or 5 units of Apidra

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DiabetesForo
10/28/2010 6:11 p.m.
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Yes I also seemed 12 units.Many, but it is the amount that prick me last week, and yet at 2 hours I had values ​​of more than 300 and I had to correct myself.

I punctuate at lunchtime, which is when, before leaving home I take a glass of milk with zero colacao, and in the curro a coffee with saccharina.

From 12 that click me a week ago I have dropped to 8, and downturn.The H.C that I say are not of the cookies or the glass of milk, but of the 80gr (4R) + Piece Fruit (2R) snack (2R) the same every day, last week and this, and months ago.

It is clear that something fails, or nothing fails and this is simply so and it is a matter of patience and to take note.

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IMADIS
10/28/2010 6:33 p.m.
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In my short experience, watch the fruit.I explain myself: the type of climb that makes it depends on how mature it is.The green you eat the fruit, the better it will leave you.If it is very mature, the blood glucose rises quickly.

When I debuted I had a couple of scares with the hypos, and quickly changed the chip.I preferred to start being a little taller, and sure.And then go up the doses little by little.My we have been more or less 15 to the debut, 7.1 at three months, 6,1- 5.8- 6.1- 5.4 I have been improving control every time.

My technique:

a) Point absolutely everything that it comed (thus could review that it had failed)

b) Respect the diet to Rajatabla, if breakfast were 4 flours, 1 milk, 2 fruit and 1 proteins, it is still exactly the same today.

c) At first, respect meal schedules.

d) Daily exercise, same amount, same time.

The balance of glucose is very delicate, with many factors influencing it.So the more values ​​try to keep stable for yourself, the easier it will be to adjust the insulins.

And encouragement, at first everything scares, but you can.Within a few months your diabetes will not be more complicated than wearing glasses.

Greetings.

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Nacho_71
10/29/2010 3:52 a.m.
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