Hello @tedqucik & friends there!!!
As I am getting close to 2300 hours here so I may anticiate an early morning hours there!! (may be)!!
So, Good morning there!!!
Many thanks for your detailed & too much informative response please. Yes, I agreed that dose changes must be not too frequent, rather I was just making my way gradually towards some acceptable readings & succeeded to bring down the spikes of 300-350 to under 250, but sadly hit by that nasty SCALP infection which took away all the efforts from me inside couple of days. For example, towards yesterday late evening, I succeeded to get 101 mg/dl, offcourse feeling too much hungry for not being eating reasonable since morning, even after taking 3 x10 apidra, so, finally I consumed around 60 gram carb at dinner. Two hours later, (@11:30PM) I checked BG & got 344, too much shocked to see, as my entire day efforts has been wasted in a couple of hours run. Naturally, I went crazy & took 10units of Apidra once more, & didn’t take anything, not even 1g carb,checked at 3: 30 AM again & got 208, checked again at 8:30AM & got 191. Lantus (20 units) were taken around 11PM. I mean, I have been doing dose changes abruptly in state of too much frustration. But I respect your advice, not to do too frequent changes & I will try to follow from here onwards!!
Generally, I took apidra almost 15 minutes before meal. But during these stated episodes, specially when running high, I did try to get it before an hour too; but never went into HYPO zone, rather never been there since its start from couple of week back. Minimum, I got so far in 90’s.
From those crude & bad experimentation, I am wondering, How does Apidra works?. I mean, If it is “344” & 1 unit drops around 30 then 10 units should drop “300” leaving behind only “44”, which didn’t happen inside 4 hours, not even after 8 hours. But sometime, I had noticed that apidra may have a tendency to drop BG by 50/hour or even 60/hour
Further, It has been seen that apidra’s power starts wearing out after 4 hours, so @50/hr, it would be capable to dispose only “200 mg/dl”, means, if there will be “350” at the start then it may be ended up at “150” after 4 hours. Right? , If there is some correction then please let me teach please, as to learn more about fast insulin.
Secondly, how many units will be required to bring down BG by 50mg/dl in an hour?
From yesterday experiment, It appears that there was only around 35mg/dl drop per hour (140mg/dl drop in 4 hours) when apidra =10 units, which looks that 1 unit apidra drop = 14mg/dl, So, will I get “28mg/dl” drop in case apidra = 20 units?
I will appreciate your kind & valuable response please.
(Lahore 30C, 2320 Hours)
As regards SCALP infection, it is getting better & primary care doc told me that it would take 3-4 more days to get even better.
Hello @joe & all friends there!!!
I think, I was replying at the same time as you were replying too, after submitting I got your above reply. Thanks a lot for taking sometime for me despite you are so away from your home, Good luck to you for your ongoing project as well. The guidelines explained above are well understood & I will try to practice it & will share the results as well, but it will take some time as I have been going through the scalp infection due to which nothing is stabilized, but I am on it. Further, I have been switched to Apidra & Lantus, combo, therapy just a couple of week back, too little time? But in the meantime, I have couple of interim questions as to see off infection phase comfortably.
1 – How apidra works?
I mean, let’s say, if pre-meal BG is 200mg/dl, & decided to consume meal (let’s say around 40g carbs), which may raises BG by another 200, bringing total possible value around “400”, but before start eating, inject ” XX” units of apidra & wait for about an hour as to allow the pre-meal “200” BG value to come down a little bit as to avoid too high spike after 1 hour of eating. In that case, how can I calculate “XX” units of apidra? as to avoid to see some “300” or more after 1 hour of eating?
(Lahore 32C, 1252 Hours)
thanks I am fortunate, I fly back-and-forth so I am not away from home that much but I do spend a lot of time in airplanes.
Apidra starts in 15 minutes or so, and works for 4 hours or so with a peak at 1 hour or so. it is just like Humalog or Novolog.
If you inject into pure fat, or closet to muscle, these numbers can shift.
If you are active (anything that increases blood flow) Apidra can have 2x power
If you exercise, Apidra can have 4x power
All standards are at +2 hours after eating, the +1 hour is not informative and tells more about the way your body is absorbing sugar than how insulin is working. all references are to +2 hours after eating.
sorry about the mmol/l I didn’t realize you were using mg/dl
it is very important to watch that your do not go hypo and have sugar around in cease you get into trouble. do not try this unless you are comfortable.
test Correction factor
with no eating, and no exercise above “normal” you need to find out how much insulin you need to drop your blood sugar. when you get a 200 mg/dl, you inject a “guess” and measure blood sugar at +2 hours and +4 hours. my first guess was 32 mg/dl per unit, so for me, if I get a 200 and I want my blood suagr to be 100mg/dl, I inject ((200-100))/32 = 3 units. and then test at +2 and +4 hours. adjust your “correction factor” as necessary and try again. I was pretty close my corection factor ended up at 30 mg/dl per unit insulin.
don’t try any of this with an infection as infection, steroids, stress will change everything.
again – walking you get 2x power, running 4x-10x power. it is very important to keep notes on how active you are.
Hello @joe & all friend there!!!
Good day to all!!!
Thanks @joe for supporting me when I needed it most. Glad to know that you are back home too. You have explained all about Apidra is tremendous. It really helps me a lot through these days of passing through scalp infection. Basically, I was too afraid to inject more apidra in one go, but after your great response, I injected 15 units in one go, & then wait about an hour, so that pre-meal “211mg/dl” came down, then eat about 35-40 gram carb meal, & checked BG @2 hours & found “179”, checked @4 hours & found “132mg/dl”, means, it works & showed better control than before. In state of infection, I have more tendency to eat, that’s why I inject an extra shot of apidra & checked, found within range, if not, in two hours, but for sure in 3 hours. If I tried too hard to avoid eating then I feel too much weakness, unable to walk properly, drowsiness, dizziness, fatique. These symptoms disappears when I take reasonable meal (around 60 carb meal),but got high BG in next 2 hours, which didn’t stay there too much & comes back within 210-230 in 3rd hour. I discussed all these with primary care doc, who advised me to take proper meal, because, more energy is required to heal the wound/infection. So, let’s finish this phase then I will share more results too.
Hopefully I am expecting to see assistant of Endo,on 21st June as follow up visit.
Thanks a lot again for helping.
(Lahore 37C, 1220 Hours)
Good day there!!!
One more result need to share please.
Today,Checked BG = 125mg/dl at 8:30AM. Inject 15 units Apidra, took breaffast around 9AM & carb was around 65grams. In between office hours & outdoors didn’t find to check BG @2 hours.Checked BG@4 hours (1:00PM) & found “27”. SUrprised me????. Didn’t feel any sign of HYPO during all these 4 hours? , yes, not feeling well since morning, rather feeling very passive & unfocused, but I supposed that it might be due to infection.How do u see it?
(Lahore 37C, 1322 Hours)
hi @munirnara, this is the danger of medicine. I am very glad you didn’t end up unconscious with that low. A hypo can com with warnings, or sometimes they can sneak up on you.
I suppose my best guess depends on how active were you compared to normal? Also, if I do have a meal with over 30 grams carbs, I try to be very careful for the next 4 hours. Careful meaning testing more and if I have to, adding sugar (such as juice). Everybody is different, but I find that 30 grams carbs keeps my need for insulin lower and my blood sugars a bit more predictable. I “typical” shot for me is about 6-7 units of fast insulin.
the law of small numbers is just that: big numbers (large carbs and big insulin shot) can lead to big mistakes, small numbers can lead to small mistakes. I do a lot better limiting carbs at meal time to 15-35 grams. Hope you are feeling better today.
Hello @joe & all friends there!!!
Thanks for being so nice & supporting consistently. Yes, I was feeling better in next 30 minutes then after doing correction, & checked again after 2 hours & found “125mg/dl”. Today, I was even more careful. Morning level “125”, injected 15 units of apidra, wait about 30 minutes, BF at 9AM (reduced carb intake today, took around 40 grams).Checked at 11AM, “157”. So going well so far!!!. Your saying about small numbers have been verified in a way & found OK.
Your guess regarding activeness is OK, yesterday, I needed to go out for a couple of times as compare to today, which means more active on yesterday than today.
Many thanks for your consistent help in seeing off these terrible days of scalp infection!!!
(Lahore 30C, 1208 Hours)
hi @munirnara good I am glad you weren’t sick from that low. let us know how that endocrinologist visit goes. you are welcome we are here to help each other! best of luck!
Hello @joe & all friends there!!!
Thx a lot for your kind & consistent support as to go through the ongoing infection days comfortably, it is about to heal.Yes, visited to the Endo (assistant) yesterday. updated her all about the happenings taken place so far in last 3 week. She told me just relax & be patient & advised to do continue with Apidra /Lantus (combo) as these are far better than previous insulin (humulin30/70). Further, advised me to increase the doses from (10+10+10) to (15+15+15) & see the outcome & in case if there is any problem just try to reduce/increase few units as per the numbers seen, but make sure BG must remains within the target ranges. She went on to advise that no matter how much & how many times it requires to inject; but numbers must be in target range, otherwise it is of no use.She also validated that due to the ongoing infection, it has been difficult to figure out everything right now, so just follow the advice & prescription for the next couple of week of time; & come again; but do not play with Lantus as it has been going & doing well, just try it with Apidra as per the need. Lastly, advice me to stay or atleast try to stay with either the same or similar meal plan without changing it too often; till we get some stability in numbers, & also ongoing infection gets over & then we will move on.
So, I have been following all these & my numbers are getting better.
Thank you so much for helping me as I am feeling that some sort of unexplained
anxiety has been getting over too!!!
(Lahore 32C, 1520 Hours)
I had the honeymoon stage when I was diagnosed. People have probably already answered this better than I can but the way I understood it was this. In the honeymoon stage your body has not completely stopped producing insulin but it can no longer produce it at the rate your body needs. During this stage is where your doctor will try to figure out the best insulin/carb ratio for your insulin injections, they will probably change every month or two as your body produces less and less insulin. This lasted about a year for me.
I do not know why it’s called the honeymoon stage though. Maybe because you’re feeling much better after you start getting insulin or something
My doctor said I’m in the honeymoon phase. I was diagnosed T1 1 yr 3 months ago at the age of 51. I use a pump and a CGM. if I eat no/low carbs I’m fine but eating normal carb meals (bread, tortilla etc) and my numbers are all over the place. I work with a Diabetes Educator who helps me make adjustments to my pump but now after over a year of frustration, I’m resigned to eating a ketogenic diet. It’s just easier. I’m exhausted trying to make carbs work in my diet.