How to really understand insulin

sarahtrust
sarahtrust Posts: 85 Member
edited January 2019 in Motivation and Support
30 years type 2 diabetes but I still do what medics tell me without really understanding and mastering insulin use.
First, how do medics calculate the basic insulin dose?? How do they know it is right?
Second, if I wake up with 8.0 BG so what do I take for rapid dose and what do I eat and allow for exercise?
Third, what is one unit of insulin equivalent to in grams of carbohydrate?

Replies

  • mph323
    mph323 Posts: 3,565 Member
    I think these are questions you should be asking your care provider. What you should do if you wake up with BG at 8.0 may be very different than what someone else should do in the same situation. Wanting to understand more about the meds you've been prescribed is a great idea, and it's best to get the information from the person who is prescribing it.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    edited January 2019
    The answer to these questions varies from person to person. This is not something that should be determined by a "medic," but by a physician (preferably an endocrinologist). Relying on first responders to help stabilize BG with insulin is a very poor approach and is entirely reactive rather than proactive.

    I'm not sure this belong in the 'debate' section, btw.

    ETA: I am going to add that a ketogenic diet is most helpful for managing BG. That is at least one thing that is consistent for all diabetics.
  • vetvicki
    vetvicki Posts: 62 Member
    As a vet, I can provide some basic information here regarding diabetic animals- the basic principles of insulin vs glucose are the same as in humans...
    The starting dose of insulin for dogs and cats is 0.5 units/kg (I don't know that starting dose for humans. There will be a well researched starting dose. )
    We then take blood periodically to check their daily glucose curve and the effect the insulin has on their blood glucose. If your glucose is dropping too low, you MAY need less insulin. If your glucose is staying too high, you MAY need more insulin. We then adjust the dose according to the blood results. Insulin requirements can change over time. It can particularly be affected by changes in weight.
    We can also do a blood test called Fructosamine which gives an indication as to how well controlled their diabetes has been over the previous 2 weeks.
    Urine tests show whether glucose is being excreted in the urine.
    I'm not aware of any correlation between units of insulin and carbohydrate grams, maybe that's a human thing.

    This is a very basic overview. I suggest doing some of your own reading or get some basic diabetes control information from your healthcare provider.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    vetvicki wrote: »
    As a vet, I can provide some basic information here regarding diabetic animals- the basic principles of insulin vs glucose are the same as in humans...
    The starting dose of insulin for dogs and cats is 0.5 units/kg (I don't know that starting dose for humans. There will be a well researched starting dose. )
    We then take blood periodically to check their daily glucose curve and the effect the insulin has on their blood glucose. If your glucose is dropping too low, you MAY need less insulin. If your glucose is staying too high, you MAY need more insulin. We then adjust the dose according to the blood results. Insulin requirements can change over time. It can particularly be affected by changes in weight.
    We can also do a blood test called Fructosamine which gives an indication as to how well controlled their diabetes has been over the previous 2 weeks.
    Urine tests show whether glucose is being excreted in the urine.
    I'm not aware of any correlation between units of insulin and carbohydrate grams, maybe that's a human thing.

    This is a very basic overview. I suggest doing some of your own reading or get some basic diabetes control information from your healthcare provider.

    What you are talking about is referred to as "basal" insulin. In humans, some take this as a long-acting insulin while others get small amounts of fast acting insulin all day through an insulin pump. The insulin for carbs is definitely a thing in humans, but I had a diabetic cat and can say that carbs definitely had an impact on his BG as well... he quickly went to a carnivore diet so I didn't have to worry about this. That diet was better for him overall anyway.

    Type 2's don't always even need a basal insulin, but I repeat my suggestion cutting carbs to reduce and prevent post-prandial BG spikes.
  • sarahtrust
    sarahtrust Posts: 85 Member
    midwesterner85 wrote: »
    The answer to these questions varies from person to person. This is not something that should be determined by a "medic," but by a physician (preferably an endocrinologist). Relying on first responders to help stabilize BG with insulin is a very poor approach and is entirely reactive rather than proactive.

    I'm not sure this belong in the 'debate' section, btw.

    ETA: I am going to add that a ketogenic diet is most helpful for managing BG. That is at least one thing that is consistent for all diabetics.

    I see endocrinologist twice a year, he prescribes my doses but these are not working for me, usually high at night will ask for an earlier appointment (due July)
    I can't stomach a diet of protein and fat but will look at this again currently Thanks for your commen
    t What section should this be in?
  • sarahtrust
    sarahtrust Posts: 85 Member
    kimny72 wrote: »
    OP, the problem with asking this kind of question online is you will get posters giving you what amounts to medical advice sounding like they know the facts, when in reality they are relaying their personal experience and opinion.

    At your next doctor visit, you should tell them you would like to understand more about insulin and let them either explain it to you or refer you to someone who can. I don't know where you are or what your insurance is like, but someone like a diabetes counselor or a Registered Dietitian who specializes in diabetes would be a great idea.

    It's awesome that you want to understand it better, best of luck!

    thank you!
  • sarahtrust
    sarahtrust Posts: 85 Member
    thank you
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    sarahtrust wrote: »
    midwesterner85 wrote: »
    The answer to these questions varies from person to person. This is not something that should be determined by a "medic," but by a physician (preferably an endocrinologist). Relying on first responders to help stabilize BG with insulin is a very poor approach and is entirely reactive rather than proactive.

    I'm not sure this belong in the 'debate' section, btw.

    ETA: I am going to add that a ketogenic diet is most helpful for managing BG. That is at least one thing that is consistent for all diabetics.

    I see endocrinologist twice a year, he prescribes my doses but these are not working for me, usually high at night will ask for an earlier appointment (due July)
    I can't stomach a diet of protein and fat but will look at this again currently Thanks for your commen
    t What section should this be in?

    Can you call your endocrinologist or send an email (or similar) to get an update sooner? I don't think this is something that can wait until July.

    The thread was moved to Motivation and Support, which fits just fine.
  • Fflpnari
    Fflpnari Posts: 975 Member
    Look to see if you can speak with a diabetic case manager, Registered Dietician, Usually they work with your Endo. Also see if your insurance covers diabetic nutrition classes. These members can work together to help you better than the internet can. DM very serious and needs appropriate attention.
  • sarahtrust
    sarahtrust Posts: 85 Member
    our endo eventually upped the insulin -and gave me two more pills- still not working eventually got appt with dietitian to see Thursday this week - I have reached insulin resistance

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