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How Much Insulin Should I Take

How Much Insulin Does It Take To Lower Blood Sugar?

How Much Insulin Does It Take To Lower Blood Sugar?

A patient with newly diagnosed diabetes has a hemoglobin (Hb) A1c of 12.2% and glucose 350 mg/dL, despite increasing insulin (glargine [Lantus]) to 25 units. What else can be done to lower blood sugar? Continue reading >>

Type 2 Diabetes And Insulin

Type 2 Diabetes And Insulin

Getting Started When most people find out they have Type 2 diabetes, they are first instructed to make changes in their diet and lifestyle. These changes, which are likely to include routine exercise, more nutritious food choices, and often a lower calorie intake, are crucial to managing diabetes and may successfully lower blood glucose levels to an acceptable level. If they do not, a drug such as glyburide, glipizide, or metformin is often prescribed. But lifestyle changes and oral drugs for Type 2 diabetes are unlikely to be permanent solutions. This is because over time, the pancreas tends to produce less and less insulin until eventually it cannot meet the body’s needs. Ultimately, insulin (injected or infused) is the most effective treatment for Type 2 diabetes. There are many barriers to starting insulin therapy: Often they are psychological; sometimes they are physical or financial. But if insulin is begun early enough and is used appropriately, people who use it have a marked decrease in complications related to diabetes such as retinopathy (a diabetic eye disease), nephropathy (diabetic kidney disease), and neuropathy (nerve damage). The need for insulin should not be viewed as a personal failure, but rather as a largely inevitable part of the treatment of Type 2 diabetes. This article offers some practical guidance on starting insulin for people with Type 2 diabetes. When to start insulin Insulin is usually started when oral medicines (usually no more than two) and lifestyle changes (which should be maintained for life even if oral pills or insulin are later prescribed) have failed to lower a person’s HbA1c level to less than 7%. (HbA1c stands for glycosylated hemoglobin and is a measure of blood glucose control.) However, a recent consensus statement from Continue reading >>

Type 2 Diabetes And Insulin

Type 2 Diabetes And Insulin

People with type 2 diabetes do not always have to take insulin right away; that is more common in people with type 1 diabetes. The longer someone has type 2 diabetes, the more likely they will require insulin. Just as in type 1 diabetes, insulin is a way to control your blood glucose level. With type 2 diabetes, though, dietary changes, increasing physical activity, and some oral medications are usually enough to bring your blood glucose to a normal level. To learn about how the hormone insulin works, we have an article that explains the role of insulin. There are several reasons people with type 2 diabetes may want to use insulin: It can quickly bring your blood glucose level down to a healthier range. If your blood glucose level is excessively high when you are diagnosed with type 2 diabetes, the doctor may have you use insulin to lower your blood glucose level—in a way that’s much faster than diet and exercise. Insulin will give your body a respite; it (and especially the beta cells that produce insulin) has been working overtime to try to bring down your blood glucose level. In this scenario, you’d also watch what you eat and exercise, but having your blood glucose under better control may make it easier to adjust to those lifestyle changes. It has fewer side effects than some of the medications: Insulin is a synthetic version of a hormone our bodies produce. Therefore, it interacts with your body in a more natural way than medications do, leading to fewer side effects. The one side effect is hypoglycemia. It can be cheaper. Diabetes medications can be expensive, although there is an array of options that try to cater to people of all economic levels. However, insulin is generally cheaper than medications (on a monthly basis), especially if the doctor wants yo Continue reading >>

The Bolus On Board (bob Or Unused Insulin)

The Bolus On Board (bob Or Unused Insulin)

Visit our BOB on a Pump page for more info about managing your BOB while on an insulin pump. A great advantage of frequent injections and insulin pumps is the convenience of giving additional insulin any time a need arises. A bolus can be given for dinner then again more for an unplanned dessert and more for the high blood sugar that follows. However, when boluses begin to overlap, a problem surfaces. How much insulin is still working from these recent injections or boluses? Humalog and Novolog continue to lower the blood sugar for four to five hours after they are given. Only by allowing for the long action time of rapid insulins can bolus stacking and hypoglycemia be avoided. Determining BOB is especially important at bedtime. When several doses of rapid insulin are given during the evening hours, the bedtime blood sugar has to be interpreted in light of how much insulin is still left to work. A normal blood sugar at bedtime may be dangerous if a large residual insulin dose has yet to work. Likewise, a high reading at bedtime may require no additional bolus if sufficient BOB remains to take care of it. Newer smart pumps have a Bolus On Board feature that can help solve this problem. Enter your blood sugar and the correction bolus you want to take. The pump will tell you how much unused or residual insulin you have left to act and will recommend an appropriate bolus that will not cause a low. What Is Bolus on Board? The Bolus on Board (also referred to as Insulin on Board or Active Insulin) tells how many units of rapid insulin are still working. This helps in deciding whether more insulin or more carbohydrate is needed. Never assume you need more insulin simply because your blood sugar is high at the moment. Always determine how much bolus is on board before taking mo Continue reading >>

Insulin To Carb Ratio

Insulin To Carb Ratio

For patients with type 1 diabetes or insulin-dependent type 2 diabetes who take rapid-acting insulin when eating, it is important to understand the insulin to carb ratio, which can be used in planning the diabetic’s meals. It is relatively easy to do without having to worry about using math to calculate this ratio. When using the insulin to carb ratio, it is assumed that the carbohydrates we take in are responsible for increasing the blood glucose levels. Carbohydrates include simple sugars, fiber, complex carbohydrates, and starch. Fiber is not usually counted as part of the insulin to carb ratio because it doesn’t break down well in the gastrointestinal tract and therefore does not increase the blood glucose levels as much as other types of carbohydrates. Fats and protein content are not counted in the insulin to carb ratio because they, too, do not increase the blood glucose level as much as carbohydrates. When diabetics eat a meal, they often use rapid-acting insulin, such as Novolog (aspart), Humalog (lispro), and Apidra (Glulisine). The diabetic may also use regular insulin, such as Humulin R and Novulin R, but these are slower in activity so they are less effective at decreasing the blood sugar accumulated during the meal. Regardless of the type of insulin used, the important thing to do is to match the dose of the insulin to the amount of carbohydrate taken in the meal. This is why the insulin to carb ratio is used. The insulin to carb ratio tells the diabetic patient how many grams of carbohydrates they can eat that will be covered by each unit of insulin. As an example, a 1 unit per 10 gram of carb ratio (1:10 ratio) means that it takes 1 unit of insulin to cover for eating 10 grams of carbohydrates. Similarly, a 1:20 ratio means that you can eat 20 grams Continue reading >>

Adjustable Dosing

Adjustable Dosing

Adjustable Dosing NovoLog® stays in step with your activities and mealtimes. Your health care provider will teach you how to adjust your NovoLog® dose to your eating, activity, and blood sugar levels. NovoLog® is designed to closely mimic your body's insulin patterns at mealtime. It is changed slightly so that it acts more quickly than regular human insulin. That is why it is called analog insulin. Keep in mind, you will need to eat a meal within 5 to 10 minutes after taking NovoLog®. For information on food labels and carb counting, click here. You and your diabetes care team will also have to see how your physical activity affects your insulin dosage and adjust it as needed. For example, when you are very physically active, you have to decide whether to eat more or take less insulin, since both physical activity and insulin decrease the amount of sugar in the blood. Checking your blood sugar often when you are physically active will help you figure out how each type of physical activity you do affects your blood sugar. NovoLog® Dosing Tool Your diabetes care team can help you learn how to fine-tune your NovoLog® doses throughout the day. While you are figuring out how to adjust your insulin dose, you will want to stay in close touch with your diabetes care team. If you are using NovoLog® FlexPen®, you can select doses from 1 to 60 units in 1-unit steps. NovoPen Echo® provides precise half-unit dosing from 0.5 units up to 30 units. It also records the insulin dose and time passed since the last injection. If you have type 2 diabetes, ask your diabetes care team if the NovoLog® Dosing Tool might be right for you. This tool was created to help with adding and adjusting your mealtime insulin dose. If you’ve been taking NovoLog® for a while and your A1C is not Continue reading >>

Insulin (medication)

Insulin (medication)

"Insulin therapy" redirects here. For the psychiatric treatment, see Insulin shock therapy. Insulin is used as a medication to treat high blood sugar.[3] This includes in diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states.[3] It is also used along with glucose to treat high blood potassium levels.[4] Typically it is given by injection under the skin, but some forms may also be used by injection into a vein or muscle.[3] The common side effect is low blood sugar.[3] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[3] Use during pregnancy is relatively safe for the baby.[3] Insulin can be made from the pancreas of pigs or cows.[5] Human versions can be made either by modifying pig versions or recombinant technology.[5] It comes in three main types short–acting (such as regular insulin), intermediate–acting (such as NPH insulin), and longer-acting (such as insulin glargine).[5] Insulin was first used as a medication in Canada by Charles Best and Frederick Banting in 1922.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale cost in the developing world is about US$2.39 to $10.61 per 1,000 iu of regular insulin and $2.23 to $10.35 per 1,000 iu of NPH insulin.[8][9] In the United Kingdom 1,000 iu of regular or NPH insulin costs the NHS 7.48 pounds, while this amount of insulin glargine costs 30.68 pounds.[5] Medical uses[edit] Giving insulin with an insulin pen. Insulin is used to treat a number of diseases including diabetes and its acute complications such as diabetic ketoacid Continue reading >>

Insulin-to-carb Ratios Made Easy

Insulin-to-carb Ratios Made Easy

For those who take rapid-acting insulin at mealtimes and want any degree of meal planning flexibility, it is necessary to apply something known as insulin-to-carb (I:C) ratios. Now, if the mere thought of having to do math at every meal sends shivers up your spine, don’t despair. This is something that even the “mathematically challenged” can master in no time. The Method Behind the Mathematics One of the basic assumptions we make in the use of I:C ratios is that dietary carbohydrates, which include sugars, starches and fiber, are responsible for raising blood sugar levels after meals. Fiber, however, is usually not counted since it does not break down completely and does not raise blood sugar levels. And fat and protein have minimal short-term effects, particularly when consumed as part of a carbohydrate-containing meal. The rapid-acting insulin that we give at mealtimes is designed to offset the blood sugar rise induced by the carbohydrates. In most cases, insulin analogs such as aspart (Novolog/Novorapid), lispro (Humalog) or glulisine (Apidra) are used at meals. However, Regular insulin (Humulin R, Novolin R) may be used, but it tends to be less effective because of its slower action. Whichever insulin is used, success comes from matching the dose to the amounts of carbohydrate eaten. This is where I:C ratios come in. The I:C ratio specifies how many grams of carbohydrate are “covered” by each unit of insulin. For example, a 1-unit-per-10-grams-of-carb (1:10) ratio means that one unit of insulin covers 10 grams of carbohydrate. A 1:20 ratio means that each unit covers 20 grams. Calculating a meal or snack dose becomes simple when you know your I:C ratio: Simply divide your carbs by your ratio. If each unit covers 10g and you have a modest 20g meal, you wil Continue reading >>

Calculating Insulin Dose

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio.The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 4-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high blood Continue reading >>

Diabetes: How To Use Insulin

Diabetes: How To Use Insulin

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website. What is insulin, and why do I need it? Insulin is a hormone that controls the level of blood sugar (also called glucose) in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems. All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. (The box below lists the different types of insulin.) The goal in treating diabetes is to keep the blood sugar level within a normal range. Do I need to monitor my blood sugar level? Yes. You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or the office staff can teach you how to use the monitor. You'll need to write down each measurement and show this record to your doctor, so your doctor can tell you how much insulin to take. How often will I need to take insulin? Your doctor will give you a schedule. Most people with diabetes need at least 2 insulin shots a day. Some people need 3 or 4 shots for good blood sugar control. When should I take insulin? If you take Regular insulin or a longer-acting insulin, you should generally take it 15 to 30 minutes before a meal. If you take insulin lispro (brand name: Humalog), which works very quickly, you should generally take it less than 15 minutes before you eat. What is different Continue reading >>

Mysugr Bolus Calculator – Get Help With Your Insulin Dose (currently Available In Eu)

Mysugr Bolus Calculator – Get Help With Your Insulin Dose (currently Available In Eu)

back to Overview It's time for lunch. Your blood sugar is 165 mg/dl (9.2 mmol/L). You have a big slice of pizza, a bag of chips, and a cold Diet Coke waiting for you. How much insulin do you take? I can think of a few ways this goes: There’s not much to think about. You always eat the same thing and always take the same amount of insulin. You define the phrase “creature of habit.” You hate thinking about all of this stuff, so you just guess. You love doing a bunch of math before every meal, so calculating your insulin dose is fun and easy. I can relate to the first two. There’s a lot of value in routine, and I’ve also done my share of guesstimating. That last one? Enjoying all of the diabetes math? I’m sorry. That’s just weird. (I’m teasing. Kind of…) But there’s another option, and it makes thinking about your insulin doses easier and more precise. I’m talking about a bolus calculator. If you wear an insulin pump, you’re probably already using one (they’re often built in). You’re welcome to stay and read, but there’s not much new information for you here. However, if you’re using injections (syringes or pens), like most people with diabetes, then stick around. This article should be helpful. So you don’t have (or want) an insulin pump, but I bet you have a smartphone. What does that mean? It means that you should meet mySugr’s Bolus Calculator. It’s a module integrated into the mySugr app that helps with your insulin doses (note: mySugr Bolus Calculator is currently approved for use in Europe). What the heck is a “bolus,” you ask? Great question. A bolus, in our case, is a single dose of insulin given all at once. In other words, it’s your mealtime shot or a shot to fix a high blood sugar. mySugr’s Bolus Calculator examines Continue reading >>

Dosing Insulin

Dosing Insulin

One of the things patients often fear about being diagnosed with diabetes is insulin injections. In most cases, if you have type 1 you will be taking insulin a number of times a day. And, most likely because you are new to diabetes, the decision about which insulin to take and how to take it will be made by your health care provider. But as you learn more about the disease and improve your self-management skills, you will be able to participate more fully in your care. If you have type 2 and are transitioning to insuli—or transitioning from taking one injection of basal insulin a day to a regimen that has you injecting insulin before each meal and a dose either at bed or in the morning—it can be anxiety provoking. It is a stark indication that your pancreas is no longer providing sufficient insulin. Whether you have type 1 or type 2, if you need to take multiple injections of insulin a day, understanding the different ways insulin is titrated can be empowering—and having a discussion with your health care provider about which way may suit your circumstances the best, can diminish apprehension and give you a measure of control. There are three basic regimens available for people who use a basal/bolus approach. Fixed Dose With this method, a set amount of insulin is given at each meal, and the amount per meal can be the same or different. For example, someone may take 6 units at breakfast, 4 at lunch and 8 at dinner, or 8 for all meals. The advantage of this method is primarily ease-of-use. The amount is the same regardless of your blood glucose readings or what you eat. The downside is its rigidity. If your blood sugar is very high before a meal, it is unlikely that the insulin given will be adequate to bring your glucose down to target levels after the meal. The s Continue reading >>

About Fast-acting Mealtime Insulin

About Fast-acting Mealtime Insulin

What is mealtime insulin? Mealtime insulins are fast-acting insulins that are taken immediately before or after meals. As you eat, your blood sugar naturally goes up, or “spikes.” Humalog® (a fast-acting insulin) works to manage those blood sugar spikes and may help keep your sugar levels in balance. Humalog should be taken within 15 minutes before eating or right after eating a meal. People who take Humalog will usually continue to take longer-acting insulin to help manage blood sugar levels at night and between meals. Taking mealtime insulin in addition to longer-acting insulin may help to control blood sugar levels throughout the day. Low blood sugar (hypoglycemia) is the most common side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test your blood sugar levels as your doctor instructs. Talk to your doctor about low blood sugar symptoms and treatment. The orange area shows how blood sugar levels typically rise after meals. The pattern of insulin action may vary in different individuals or within the same individual. Comparing types of insulin Take a look at our overview below to find out about the different types of insulin. You’ll notice that there are differences in when the types of insulin reach your bloodstream, when they “peak” in your body, and how long they can last (length of time the insulin keeps lowering your blood sugar). Fast-acting insulin (also called rapid-acting) is absorbed quickly and starts working in about 15 minutes to lower blood sugar after meals. Humalog fast-acting insulin should be taken 15 minutes before eating or right after eating a meal. Depending on the type of diabetes you have, you may need to take Humalog with a longer-acting insulin or oral anti-diabetes medication. Continue reading >>

Sliding Scale Insulin Therapy

Sliding Scale Insulin Therapy

Insulin is the foundation of treatment for many people with diabetes. If you’re a diabetic, your body either can’t produce enough insulin or can’t use insulin efficiently. People with type 1 diabetes, and some with type 2 diabetes, have to take several injections of insulin per day. The insulin keeps blood sugar in a normal range and prevents high blood sugar levels. This can help prevent complications. The amount of insulin you should take can be determined in several different ways: Fixed-Dose Insulin With this method, you take a certain set amount of insulin units at each meal. For example, you may take 6 units at breakfast and 8 at dinner. The numbers don’t change based on your blood sugar readings or the amount of food you eat. While this may be easier for people just starting insulin, it doesn’t account for pre-meal blood sugar levels. It also doesn’t factor in the varying amounts of carbohydrates in a given meal. Carbohydrate to Insulin Ratio In this method, you take a certain amount of insulin for a certain amount of carbohydrates. For example, if your breakfast carb to insulin ratio is 10:1 and you eat 30 grams of carbohydrates, you would take 3 units before breakfast to cover your meal. This method also includes a “correction factor” that accounts for your pre-meal blood sugar. For example, let’s say you want your blood sugar to be under 150 mg/dL before meals, but it’s at 170. If you’ve been told to take 1 unit of insulin for every 50 you’re over, you would take 1 additional unit of insulin before your meal. While this takes a lot of practice and knowledge, people who can manage this method can keep better control of their post-meal blood sugar levels. Sliding-Scale Insulin Therapy (SSI) In the sliding-scale method, the dose is based o Continue reading >>

How To Lower Your Blood Sugar When It's Really High

How To Lower Your Blood Sugar When It's Really High

​This article is written for type 2 diabetics who need help coming down from a very high blood sugar during a single, isolated high blood sugar event. If you want to try an stabilize your baseline, consider signing up for my Baseline Blood Sugar Challenge course. ​THIS ARTICLE IS NOT A SUBSTITUTE FOR REAL MEDICAL ADVICE. If you're a type 2 diabetic and your blood sugar is high right now (greater than 300mg/dL for at least 6 hours), the first thing you should do is call your doctor. So, if you haven't called anyone for help yet, please stop reading this article and call your doctor. If your doctor is able to help, then you need not read on. Also, if you are having symptoms of Diabetic Ketoacidosis, stop reading this article and go to the hospital immediately. Diabetic Ketoacidosis can kill you if left untreated. But. If you're in a situation where your blood sugar has been high for an extended period of time, you could perhaps consider taking the following steps to solve your blood sugar problem. Disclaimer: This is friendly, non-medical advice from a random diabetic person you don't even know, which is a very (very) poor substitute for real, actual medical advice. Use at your own risk. First, you should try and lower your blood sugar without injectable insulin by completing the following steps: 1. Check your blood sugar. Write down the time and your blood sugar level. 2. Drink water (this doesn't actually lower blood sugar, but it helps flush sugar and ketones from your body, if you have them). Continue drinking water, but please don't make yourself sick. 3. Move. As in, walk. Walk around the block or walk in place or haul your ass up and down the stairs for 30-60 minutes. Walking helps your cells become less insulin resistant, which is what you need right now. Do N Continue reading >>

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