Types Of Insulin Doses
To answer the question how much insulin should I take?, you need to know why youre injecting insulin. Youll be injecting different amounts depending on whether its basal or bolus insulin.
What is basal and bolus? Well tell you. But first lets have a quick look at how insulin injections work.
Insulin injections are taken when your own body doesnt produce enough insulin. You need that insulin because insulin is a fundamental part of metabolism.
Insulin makes sure that the sugar in your bloodstream can enter the cells to be used as energy.
Without that insulin, the sugar stays in your blood, and your blood sugar levels could get too high. So, when you eat or drink carbs, those carbs become sugar in the blood.
Bolus insulin
So, carbs will raise blood sugar levels. If youre insulin-dependent, this means that you need to take insulin injections whenever you take carbs, to bring blood sugar levels down. This kind of insulin injection is called a bolus.
Rapid-acting insulinis most commonly used for the bolus meaning you should usually inject between 5 and 15 minutes before eating or drinking carbs. This insulin remains active for 2-4 hours.
Correction dose
A part of the bolus dose includes the correction dose. This is because at some point, you might get high blood glucose/blood sugar either before eating or several hours after eating.
To bring the blood sugar levels down, youll need to inject insulin. This injection is referred to as the correction dose.
Basal insulin
Is 6 Units Of Insulin A Lot
You may need it if long-acting insulin isnt enough. The right dose depends on your target blood sugar level, how many carbs youre eating, and how active you are. You might start with four to six units of insulin. Your dose may go up two to three units every 3 days until you reach your blood sugar target.
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Example #: Formulas Commonly Used To Create Insulin Dose Recommendations
This example illustrates a method for calculating of your background/basal and bolus doses and estimated daily insulin dose when you need full insulin replacement. Bear in mind, this may be too much insulin if you are newly diagnosed or still making a lot of insulin on your own. And it may be too little if you are very resistant to the action of insulin. Talk to your provider about the best insulin dose for you as this is a general formula and may not meet your individual needs.
The initial calculation of the basal/background and bolus doses requires estimating your total daily insulin dose:
Common Conditions Associated With Insulin Resistance
Type 2 Diabetes
Following pioneering work by Bornstein112 and the Nobel Prize-winning work of Yalow and Berson,113 the first insulin assays became widely available in the late 1960s 28 it was subsequently confirmed that diabetic patients with so-called or maturity onset or type 2 diabetes had normal or increased plasma insulin levels. Insulin resistance was reported to be a characteristic feature of T2DM in the early 1970s.3 A progressive inability of the cells to compensate for the prevailing insulin resistance by sufficient hyperinsulinaemia, heralds the clinical onset of this disorder.3 While twin studies and linkage analyses are consistent with a strong genetic component in the development of type 2 diabetes, several decades of research have failed to identify a predominant genetic abnormality in the majority of cases.26 The aetiology of T2DM is thought to be polygenic, with environmental factors being superimposed upon this basic predisposition.
Insulin resistance typically predates the development of diabetes and is commonly found in unaffected first-degree relatives.28 The morbidity of the disorder relates both to the severity of hyperglycaemia and the metabolic consequences of insulin resistance itself. The primary defects in insulin action appear to be in muscle cells and adipocytes, with impaired GLUT 4 translocation resulting in impaired insulin-mediated glucose transport.28
Metabolic Syndrome
- Abdominal obesity
Dyslipidaemia
Hypertension
PCOS
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The Discovery Of Insulin
In 1889 German scientists Minkowski and von Mering noted, from their experimental work with animals, that total pancreatectomy led to the development of severe diabetes.4 They hypothesised that a substance secreted by the pancreas was responsible for metabolic control. Others later refined this hypothesis, noting diabetes to be associated with destruction of the islets of Langerhans. While Minkowski, as well as Zuelzer in Germany and Scott in the USA attempted, with inconsistent results, to isolate and administer the missing pancreatic islet substance, Belgian investigator de Meyer in 1909 proposed the name insuline, as did British researcher Schaefer in 1916.
Structure And Chemical Properties Of Insulin
Insulin was found to be a polypeptide in 1928 with its amino acid sequence identified in 1952. It is in fact a dipeptide, containing A and B chains respectively, linked by disulphide bridges, and containing 51 amino acids, with a molecular weight of 5802. Its iso-electric point is pH 5.5.5 The A chain comprises 21 amino acids and the B chain 30 amino acids. The A chain has an N-terminal helix linked to an anti-parallel C-terminal helix the B chain has a central helical segment. The two chains are joined by 2 disulphide bonds, which join the N- and C-terminal helices of the A chain to the central helix of the B chain. In pro-insulin, a connecting peptide links the N-terminus of the A chain to the C-terminus of the B chain.6
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Tools To Help You Find And Remember Your Carb Ratios
Using carb ratios is pretty straight forward if you use an insulin pump to manage your diabetes. Most pumps have a build-in bolus calculator and your medical team should have set it up for you and trained you on how to use it. If thats the case, you just need to focus on whether your ratios are accurate.
If you manage your diabetes with manual injections, you need to look elsewhere for a carb calculator or memorize or write down your ratio. The benefit of a good calculator is that it can keep track of active insulin and can help keep track of your injections and ratio.
Mobile apps: There are no FDA approved standalone apps that are approved for dosing recommendations in the United States, but I have used RapidCalc and found it to be accurate and easy to use.
Outside of the United States, good options are the Hedia and MySugr apps.
Smart insulin pens: Companion Medicals InPen is a smartpen available in the US only. It has all the functionalities of a pump, except for actually pumping, so it automatically keeps track of active insulin and has a bolus calculator. It sends the data directly to your phone via Bluetooth.
Smart meters: Some blood glucose meters also have bolus calculator functionalities or have an app that links with the meter.
How Much Insulin Should I Take For Low Blood Sugar
Insulin will lower your blood sugar. If your blood sugar is already low, you shouldnt inject more insulin.
Signs that your blood sugar is too low include sweating, dizziness, blurred vision, and significant fatigue. If this happens, try to consume rapid-acting carbohydrates, like sugared sodas, fruit juice, or glucose tablets, to get your blood sugar levels back up quickly.
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What Is The Role Of Insulin In The Body
Insulin is a hormone secreted by the beta cells of the pancreas and helps regulate glucose in the bloodstream.
After eating a meal, carbohydrates break down into glucose, which acts as the primary source of energy for the body. Glucose enters the bloodstream and stimulates the pancreas to make insulin, which allows the glucose to enter the cells and be used for energy production. Excess glucose gets stored in the liver as glycogen.
When glucose levels decrease in between meals, the stored glycogen is released back into the bloodstream as glucose to maintain optimum glucose levels.
Insulin acts as a regulator and aids in maintaining glucose levels in the bloodstream by signaling excess glucose to be stored in the liver for future use or producing required glucose when levels drop.
Benefits Of Pump Therapy
Unlike insulin pens or injections, data can be uploaded from most insulin pumps via web-based software. The data relating to glucose concentrations and insulin delivery can be reviewed by the health professional in conjunction with the patient. The GP should instruct the patient to download PDFs of these reports and bring them to their appointment.
Meta-analyses and randomised controlled trials have reported improvements in glycaemic control using insulin pump therapy compared to multiple daily injections.1 These include reductions in blood glucose, reduced hypoglycaemia , lower glycated haemoglobin , lower insulin requirements, and improved quality of life. The greatest motivating factor for Australians with type 1 diabetes to use an insulin pump is to improve their diabetes control.2
There are numerous benefits in using insulin pump therapy rather than multiple daily injections. However, it is important to recognise that there may also be some disadvantages .
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What Is An Insulin
Your insulin-to-carb ratio indicates how many grams of carbs one unit of rapid-acting insulin covers to ensure that your blood sugars stay in your desired range.
Your carb ratio is often initially set by your doctor when you are diagnosed but should be updated regularly . A carb ratio of 1:10 means that that 1 unit of rapid-acting insulin will cover 10 grams of carbs. A higher ratio indicates that you need less insulin to cover your carbs.
Let me give you an example:
If my carb ratio is 1:10 and Im eating 30 grams of carbs, Ill need 3 units of rapid-acting insulin to cover the meal , however, if my carb ratio is 1:15 Ill only need 2 units of rapid-acting insulin
That a higher carb ratio means less insulin can take a little time to wrap your head around but its an important fact when you start adjusting your carb ratio.
If you time the peak of your insulin with your meal, an accurate carb count combined with an accurate carb ratio will mean that your blood sugar should stay within your desired range and below 180 mg/dl .
If the timing of your insulin for the meal is off, but your carb count and carb ratio is right, you might see your blood sugar go slightly out of range but it should be back in range within 90 minutes
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.
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Exercise & Physical Activity
Since Chauveu & Kaufmans remarkable observation in 1887 that When a horse chews on hay the concentration of glucose in the blood draining its masseter muscle substantially decreases74 a large body of evidence supports the role of exercise in improving insulin sensitivity and its beneficial outcomes in insulin resistant states. Epidemiological studies such as the US Physicians Health Study have reported substantial decreases in the relative risk of type 2 diabetes with lifelong regular physical activity.75 Large scale randomised controlled clinical trials such as the Diabetes Prevention Program76 and the Finnish Prevention Study77 demonstrate a 58% reduction in progression of impaired glucose tolerance to type 2 diabetes by intensive lifestyle modification which included a minimum of 2030 minutes of exercise per day. Acute exercise increases GLUT 4 translocation to sarcolemmal membrane, whereas chronic exercise training increases Glut 4 mRNA expression.78 In addition to this insulin-dependent mechanism, enhanced glucose uptake into exercising muscle occurs by multiple insulinin dependent mechanisms.79 Exercise training appears to enhance insulin sensitivity by increased post-receptor insulin signalling 80 increased insulin-mediated glucose transport appears to be related to enhanced signal transduction at the level of IRS proteins and PI 3-kinase.79
Sites Of Insulin Action And Manifestations Of Insulin Resistance
The effects of insulin, insulin deficiency and insulin resistance vary according to the physiological function of the tissues and organs concerned, and their dependence on insulin for metabolic processes. Those tissues defined as insulin dependent, based on intracellular glucose transport, are principally adipose tissue and muscle. However, insulins actions are pleotropic and widespread, as are the manifestations of insulin resistance and the associated compensatory hyperinsulinaemia.3
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Putting It All Together
Now that you know the how and why behind insulin dosing, lets consider how you may calculate your insulin needs.
Youll usually give yourself an insulin dose around your meals since thats when you take in carbohydrates. You also will typically check your blood sugar to see if youre meeting your premeal target dose.
To calculate your insulin needs:
You may find that if you generally eat about the same amount of carbohydrates each day, you may be able to consistently inject the same amounts of insulin outside of special occasions. It takes time to find out how your body best responds to insulin.
Type Of Meal: The Impact Of Protein & Fat
Carbs might be whats converted into glucose in the bloodstream the fastest, but its not the only macronutrient that can impact your blood sugar.
If you eat large amounts of protein, youll most likely need to inject insulin to not see an increase in your blood sugar.
If you add large amounts of fat to your meal, youll most likely see a delayed release of the glucose into your bloodstream, which for many people means that they need to take two insulin doses rather than just one .
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How Much Does Prednisone Raise Blood Sugar In Non Diabetic
known as blood sugar, is simply too high The excellent news is that you can take steps to delay or stop sort 2 diabetes, which is the commonest form of the disease to develop in older adults If you have already got diabetes, there are steps you can take to manage the situation and prevent diabetes related health issues Losing simply 5 to 10 of your complete weight can help you decrease your blood sugar, blood strain, and levels of cholesterol Losing weight and consuming healthier can even have Diabetes And Hyperglycemia a profound impact on your mood, energy, and sense of wellbeing People with diabetes have nearly double the chance of coronary heart disease and are at a larger danger of creating psychological well being issues such as melancholy.
To decrease your stress ranges, try activities like mindfulness Normal Blood Sugar Level workout routines, deep respiratory, meditation, and yoga Oatmeal and barley are especially good whole grain choices for most people with high blood sugar Blood sugar is our supply of energy, and we want it to perform correctly, however in some people, it may possibly attain extreme levels With high blood sugar, there might be excess glucose within the patient s saliva.
A tubeless When Is Your Blood Sugar Too High pump that works wirelessly can be now obtainable You program an insulin pump to dispense specific quantities of insulin It may be adjusted to deliver roughly insulin depending on meals, exercise degree and blood sugar degree.
Unit Of Insulin Decreases How Much Blood Sugar
If you notice Blood sugar 119 morning fatigue frequently occurring right after you eat, though especially a carb heavy meal it might have to do with rising blood sugar ranges People will say, I wish to nap after lunch, or I just cannot open my eyelids after dinner, often after consuming something like a lot of pasta or potatoes or sweets, Dr Hatipoglu says To be clear, there s nothing incorrect Blood Sugar Levels with consuming these meals You would possibly Blood sugar drops after eating carbs 1 Unit Of Insulin Decreases How Much Blood Sugar must verify your blood glucose before meals and What Is A Normal Blood Sugar Level get insulin coverage for meals.
A low blood sugar stage, additionally known as hypoglycaemia or a hypo , is where the extent of sugar in your blood drops too low Daniela Jakubowicz, MD, a professor within the diabetes unit at the E Wolfson Medical Center, Tel Aviv University and Tel Aviv Medical Center A diabetic coma happens when your sugar will get too excessive such as 600 mg dL or All symptoms of hypoglycemia but normal blood sugar extra It is widespread between How Do I Know If My Dog Has Diabetes elder folks, folks which are chronically ill, and disabled When the pancreas doesn t produce sufficient insulin or cells reject Type 1 Diabetes High Blood Sugar What To Do the insulin so the How to lower blood sugar level instantly glucose stays within the blood and causes a variety of complexities and points for diabetes patients.
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