Re: ???rapid and long lasting insulin---samqkitty----
Hi Twokatss,
They are used in combination. Your body needs insulin for metabolic functioning even if you don't eat. The long-acting insulin is used for this purpose.
The short-acting insulin is used to cover the carbs when you eat. You usually have to learn to count the carbs in your food, a task that sounds difficult but actually just has a bit of a learning curve. Then, you have an insulin to carb ratio. For example, my insulin to carb ratio is 1:10, so for every 10 grams of carbs I'll be eating, I need one unit of insulin. After a while of counting carbs, you end up memorizing the carb content of foods you eat regularly, such as whatever bread you normally use, or whatever fruits you like (one apple +15 g, one slice of the whole wheat bread I use is 15 g)...and you just add up the carbs for your meal, divide by your ratio, and that's how many units of rapid-acting to take.
For combination foods (like stews, salads, etc.), you'll get used to estimating after a while.
As for taking rapid before meals and no long-acting, I don't think that's possible, but I'm willing to bet that if you start taking rapid for your meals, you'll need a lot less of the levemir. I think part of the problem for you, twokatss, is that they've been trying to use the levemir to cover ALL your insulin needs, and that's just a lousy way to do it, IMHO.
Re: ???rapid and long lasting insulin---samqkitty----
Thanks Ruth: I am getting too many lows. 2.2 mmol, 3.1 mmol
I actually think I am getting way too much Levemir. After ending up in emerg , with a low that my gluclose tabs could not bring up...the Dr there told me not to take the Levemir for 2 nights. And then start again at a reduced rate. Not to my surprise, my morning highs have gone down considerably...from 11 mmol to 6.8-7.8 mmol...I am having good daytime results with my rapid also...sliding scale but usually 8-10-18...readings after are 6 mmol --8 mmol...
Levemir has been reduced from 55 units to 42 now to 25. All seems good---for now....
Re: ???rapid and long lasting insulin---samqkitty----
I guess the message here is...don't listen to that nurse! It turned out the doctor was right...you were getting rebound highs, and needed to reduce the levemir.
A sliding scale is also an okay way to manage your rapid insulin...not quite as precise as counting carbs, but way better than overdosing on levemir!
It sounds like things are finally under better control, and I'll bet that's a huge relief to you...so glad to hear it.
Ruth
P.S. If your numbers start going up too high on the greatly reduced dose of 25 units of levemir, you can add back gradually until you get good numbers again. Best way to do it is no more than 2 units at a time, and give it a few days before adding more. You may not need to do this, but just in case....!