Question answers from yesterday
Common ways of increasing Basal insulin and correcting the fasting glucose include.
#1 adjusting the basal rate on a persons insulin pump yes
#2 adjusting the dose of Lantus insulin yes
#3 adjusting the dose of bedtime NPH insulin yes
#4 adjusting the dose of oral diabetes medication yes
#5 adding a medication to more effectively control
glucagon levels yes
#6 checking a 3 am glucose no
# 7 not eating a bedtime snack no
We have spent a lot of time discussing the importance of checking the fasting blood glucose and looking for patterns.
Review and suggestions
Persistent elevation of the fasting blood glucose suggest that you are not producing or taking enough insulin to maintain normal glucose and fat metabolism and it is time to talk to your health care provider about medication adjustments.
Occasional elevation is often unexplained but can be caused by an unrecognized low blood sugar at 2 to 3 am. It is time to start checking bedtime and 3 am glucose levels.
Occasional low fasting glucose can be a warning of a severe hypoglycemia in the future. It is definitely time to start checking bedtime and 3 am glucose levels and talk to your health care provider about medication adjustments.
Testing before meal and bedtime glucose levels
Starting the previous meal with a elevated glucose almost guarantees an elevated glucose before the next meal
Oral diabetes medications or injectables , such as Byetta or Victoza
(assuming you started the previous meal with with your glucose on target)
These test are useful for helping you determine if you are producing or taking enough insulin to allow you to use or store the glucose from the carbohydrate eaten with the previous meal.
a rapid acting insulin before each meal or snack have a little advantage. They have probable been trained to use *formulas that will allow them to take extra insulin to correct the elevated glucose and then also adjust the insulin dose to take enough insulin to efficiently use the glucose from meal.
* correction factors for Aperson
1 unit of insulin will reduce the glucose x amount
For example . Aperson has worked with their health care provider( usually a dietition / diabetes
educator) and determined that 1 unit of rapid acting insulin will lower an elevated
glucose level by 20 mg/d
glucose goal before lunch is 90 to 120 mg/dl
test result 160 mg/dl
Take 1 unit of insulin for each 20 mg /dl above goal = 2 units
#2Insulin / carbohydrate ratio
For example. Aperson has worked with their health care provider and determined that 1 unit of
rapid acting insulin will allow them to efficiently metabolize 30 grams of carbohydrate.
Carbohydrates eaten 90 gms
90 divided by 30 = 3 units of insulin
Aperson's total insulin dose 5 units
Track 3 is a good iphone app to help with these calculation
Have Fun , Be Smart and check your blood glucose levels wisely