Thanks for the info. I am just curious to how others treat their diabetes. I don't know anyone in my area who is Type1 so hearing others stories helps me to make sense of it all.
Some days are just harder to deal with than others. Again, Thanks.
I've been pumping since 2003. I have 3 basals rates (0.7 from midnight to 6 am, 0.5 from 6 am to 2 pm, and 0.6 from 2 pm to midnight). My total daily dosage ranges from 19 - 25 units (roughly) depending on what I'm eating. My insulin to carb ratio is 1:20 and one unit of insulin brings me down 72 points (4 mmol).
They just raised my basals? I wonder how long this will be going on, the docs adjusting my basals?
Basals are never perfect. I'm forever adjusting basals. I'm guessing you are on a 512, by your screen name, which means you've been pumping for awhile. You should be adjusting them on your own by now.
__________________
Type 1 diabetes- Paradigm 523 w/ Humalog and RT Sensor
Severe GERD and Gastroparesis- Prevacid, Domperidone, Zofran & Carafate as needed
I am a 73Kg, 50 year old reasonably active male and I have been a T1 for 29 years. My total daily insulin usage is aboyt 27 - 32 units, 12 of which is Lantus.
Mark
__________________
Type 1 since 1977. On Lantus, Novorapid and Actrapid.
These answers aren't useful without knowing how your WEIGHT compares with ours. Dosing is best compared using units per Kilo of body weight per day. And also, it might be better to compare with the other females instead of us BIG guys. (Yeah, even though none of the women *I* know will put their weight on a website, not even anonymously. )
Although I weigh almost exactly the same as Mark1e, 185 lbs, my dose has always been a lot higher: almost 30 Units of basal (including a BIG peak for dawn effect), and about 30 Units of bolus on a typical day. This has, however, been consistent for many, many years, and no one thinks that I've got an insulin resistance which could be treated by other meds. And my BMI is normal, I'm not a short fatty.
.... Dosing is best compared using units per Kilo of body weight per day. ...
The rule-of-thumb for non-insulin resistant pumpers is that .25 units of insulin is required per pound of body weight (Pumping Insulin - John Walsh, pg 86). So for someone weighing 120 lbs, the expected total daily dose would be 30 units. Of course things like age, activity level, diet etc cause a lot of variance around this. And people on MDI typically require a lot more insulin.
Mark
__________________
Type 1 since 1977. On Lantus, Novorapid and Actrapid.
The rule-of-thumb for non-insulin resistant pumpers is that .25 units of insulin is required per pound of body weight (Pumping Insulin - John Walsh, pg 86). So for someone weighing 120 lbs, the expected total daily dose would be 40 units. Of course things like age, activity level, diet etc cause a lot of variance around this. And people on MDI typically require a lot more insulin.
Mark
I use way less insulin that that. I use about 2/3rds what I would according to that 0.25 units/lb. I'm super active though.
__________________
Type 1 diabetes- Paradigm 523 w/ Humalog and RT Sensor
Severe GERD and Gastroparesis- Prevacid, Domperidone, Zofran & Carafate as needed
The rule-of-thumb for non-insulin resistant pumpers is that .25 units of insulin is required per pound of body weight (Pumping Insulin - John Walsh, pg 86). So for someone weighing 120 lbs, the expected total daily dose would be 40 units. Of course things like age, activity level, diet etc cause a lot of variance around this. And people on MDI typically require a lot more insulin.
Mark
Wow. That seems like a huge amount. I weigh 145 (I'm not active, but I'm trying to be) so I "should" require 36.5 units (your math would give a 120 pound person 30 units not 40) and yet my total basals are only 14. If I eat a lot of carbs during the day I can maybe get myself up to 25 units total.
... I "should" require 36.5 units (your math would give a 120 pound person 30 units not 40) and yet my total basals are only 14. ... I can maybe get myself up to 25 units total. ....
Cora,
Thanks for pointing out the mistake. I have corrected the post. And, yes, there is alot of variability in insulin requirements. According to the formula, my "expected" total daily dose is 40.4 units. My actual TDD is about 30 units. But then I eat hardly any carb. if I was eating 200 grams of carb a day, my TDD would be 50-60 units. It seems you and Blondy are a lot more sensitive to insulin than Rick and I are.
There are big differences in insulin sensitivity, even amongst non-diabetics. The "normal range" for the insulin level test is <30. But a healthy insulin sensitive teenager, for example, would typically have an insulin level of <10. The pancreas of someone with and insulin level of 30 produces 3 times as much insulin. Amazing.
I am very envious of your your insulin sensitivity. It makes controling blood glucose levels much easier. Even mild insulin resistance causes disruptive blood glucose volatility, as both Rick and I have discovered. The only way I have been able to deal with it is to eat low-carb. I wish I didn't have to.
Mark
__________________
Type 1 since 1977. On Lantus, Novorapid and Actrapid.
I am very envious of your your insulin sensitivity. It makes controling blood glucose levels much easier.
Not always. When I first started pumping I was extremely insulin sensitive. I was using 7 units of Lantus a day, and Novolog with a 1:60 ratio at meals, and a 1:150 ratio for corrections (or something crazy like that). It made it damn near impossibly for me to have any control. I needed to take the Novolog when I ate, otherwise I went high, but the smallest I could take on injections was a half unit at a time (and even that was hard to measure) so I would have to eat 30 grams of carbs just to bolus, and I had to eat carbs in 30 gram increments, because 45 grams meant I couldn't bolus enough without bolusing too much. I also couldn't bolus till my blood sugar was like 250, which sucked, cause I had to walk around high, or else I bolused and had to eat at the same time. It was ridiculous- I was sooooo relieved to start my pump. Those days are long gone though, and I now use 20.2 units of basal, and bolus in a 1:10-1:15 carb ratio and a 1:50-60 ISF, which is perfect as far as I'm concerned.
__________________
Type 1 diabetes- Paradigm 523 w/ Humalog and RT Sensor
Severe GERD and Gastroparesis- Prevacid, Domperidone, Zofran & Carafate as needed
Thanks for pointing out the mistake. I have corrected the post. And, yes, there is alot of variability in insulin requirements. According to the formula, my "expected" total daily dose is 40.4 units. My actual TDD is about 30 units. But then I eat hardly any carb. if I was eating 200 grams of carb a day, my TDD would be 50-60 units. It seems you and Blondy are a lot more sensitive to insulin than Rick and I are.
There are big differences in insulin sensitivity, even amongst non-diabetics. The "normal range" for the insulin level test is <30. But a healthy insulin sensitive teenager, for example, would typically have an insulin level of <10. The pancreas of someone with and insulin level of 30 produces 3 times as much insulin. Amazing.
I am very envious of your your insulin sensitivity. It makes controling blood glucose levels much easier. Even mild insulin resistance causes disruptive blood glucose volatility, as both Rick and I have discovered. The only way I have been able to deal with it is to eat low-carb. I wish I didn't have to.
Mark
The insulin sensitivity is only nice with a pump. When I was on mdi I had horrible control. I have a 1:20 insulin to carb ratio. So a slice of toast is 0.7 units for a bolus. On the plus side you don't have to deal with stupid medical staff who say things like "boy, you're taking a lot of insulin". What morons. As long as your sugars are good, it doesn't really matter what you take.
... a slice of toast is 0.7 units for a bolus. ...
It is interesting to hear about how it works at the other end of the insulin sensitivity scale. For one slice of toast for breakfast, I would need to bolus 4 units of Novarapid. That is an insulin:carb ratio of about 3.75. It is higher during the rest of they day at about 1:5. My daughter, who became T1 at age 17 two and a half years ago, also uses lots of insulin. She injects 15 units for a meal containing 50 grams of carbo. I wonder if there is a genetic link ...
Mark
__________________
Type 1 since 1977. On Lantus, Novorapid and Actrapid.
It is interesting to hear about how it works at the other end of the insulin sensitivity scale. For one slice of toast for breakfast, I would need to bolus 4 units of Novarapid. That is an insulin:carb ratio of about 3.75. It is higher during the rest of they day at about 1:5. My daughter, who became T1 at age 17 two and a half years ago, also uses lots of insulin. She injects 15 units for a meal containing 50 grams of carbo. I wonder if there is a genetic link ...
Mark
Seeing as type 2, which is all about insulin resistance, is largely genetic, I wouldn't be surprised at all if it were.
__________________
Type 1 diabetes- Paradigm 523 w/ Humalog and RT Sensor
Severe GERD and Gastroparesis- Prevacid, Domperidone, Zofran & Carafate as needed
I am using Humulin N & R ,mixing in a proportion.But I am always confused about"Proportion".I take 10 units of R and 18 of N before breakfast,then 10 units of R only before lunch and finally 10+16 before night meal.
My morning numbers are rarely 100 otherwise 120 to 140. I want to keep morning number below 100.
Experts or experienced comments r required.Will it not be wise to take R before night meal and then N at bed time?
Note it that I am T-2 since 12+ years.
Dosing is best compared using units per Kilo of body weight per day. And also, it might be better to compare with the other females instead of us BIG guys. (Yeah, even though none of the women *I* know will put their weight on a website, not even anonymously. 
) 
The only way I have been able to deal with it is to eat low-carb. I wish I didn't have to. 
