Your Insulin Regimen Will Include:
Dont Inject The Insulin Too Deep
Insulin is supposed to be injected into the fat layer under the skin using a short needle. This is referred to as a subcutaneous injection.
If you inject the insulin too deep and it enters your muscle, your body may absorb it too quickly. The insulin might not last very long and the injection could be very painful.
Advantages Of Intensive Insulin Regimens
- While intensive regimens require more calculation at each meal, they allow for more flexibility in timing and in the amount of carbohydrate content in meals and snacks.
- An accurate insulin dose will also result in better blood glucose control with fewer high and low blood sugars.
- Changes in activity and stress can be accommodated without sacrificing glucose control.
- Over time, high blood glucose correction can be separated from the food coverage. For example, if your blood sugar is very high , you can delay your meal and give yourself a correcting dose. Once your blood sugar falls below 200 mg/dl, you can inject your meal insulin and then eat.
- Learning these important skills will make managing your diabetes easier.
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Check 3 Am Blood Glucoses
It is important to make sure the basal insulin change is right for you. You will want to check your blood glucose at 3:00 a.m. for 2 to 3 days after you make a change to your Lantus®.
- If your blood glucose is below target range at 3:00 a.m., then decrease your basal dose.
- If your blood glucose is above target range at 3:00 a.m., then increase your basal dose.
How Are Insulin Doses Calculated
Insulin may not be given in a single dose. Doctors often calculate insulin doses according to:
- Basal glucose levels
A general calculation for a persons daily insulin requirement is as follows:
Total daily insulin requirement = weight in pounds ÷ 4
Alternatively, if you measure your body weight in kilograms:
Total daily insulin requirement = 0.55 × total weight in kilograms
Out of the total dose requirement, 30%-40% should be given as a long-acting or basal dose when you are fasting and between meals, and the remaining 60%-70% is for carbohydrate coverage and high blood sugar correction. This is called bolus insulin replacement.
Since there are different types of insulin and dosage varies according to blood sugar levels, it is important to consult your doctor regarding your insulin prescription and dosage.
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B: Increase Your Bolus Insulin Dose
You know to increase the bolus insulin dose if your blood glucose has been above target for 3 days in a row. Now you need to know when and how much to change it. Changing this dose is based on your Insulin to Carb Ratio.
- First, know your current Insulin to Carb Ratio. Your Insulin to Carb Ratio is _____.
- Next, use the chart below to know when to increase your bolus insulin dose.
|Results of Blood Glucose Test||Increase Insulin:|
|Abovebefore bedtime||At dinner|
- Last, use the scale below to DECREASE your Insulin to Carb Ratio by one levelfrom your current ratio. Decreasing your Insulin to Carb Ratio means you will be giving more insulin.
1:50 –> 1:45 –> 1:40 –> 1:35 –> 1:30 –> 1:25 –> 1:22 –> 1:20 –> 1:18 –> 1:15 –> 1:12 –> 1:10 –> 1:8 –> 1:7 –> 1:6 –> 1:5
What The Heck Is A Bolus
So you dont have an insulin pump, but I bet you have a smartphone.
What does that mean?
It means that you should meet mySugrs Insulin Calculator. Its a module integrated into the mySugr app that helps with your insulin doses . Btw. Insulin Calculators are also known as Bolus Calculators.
But 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, its your mealtime shot or a shot to fix a high blood sugar. mySugrs Insulin Calculator examines all of the messy numbers involved and then recommends a precise dose of insulin.
At mealtime, its super easy. Measure your blood sugar, tell mySugrs Insulin Calculator about your carbs, and well do the rest. Well even keep track of your active insulin . All you have to do is dial up the dose and take it.
Never heard of active insulin? Its a concept that helps reduce hypos caused by stacking insulin. Well explain it in more detail below.
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Not Drinking Enough Water
It’s not just what you eat, but also what you drink or don’t drink that can change the effectiveness of insulin. “Staying hydrated by drinking lots of water helps your kidneys flush out extra sugar floating around in your bloodstream,” Port explains. “It also helps medications like insulin work better, by helping to maintain good blood flow so the medicine can reach the tissues and cells where theyre needed most.” To remind yourself to drink water throughout the day, carry a refillable water bottle around with you. Use it a lot. And skip the sports and performance drinks, says Port, since they usually just give you more sugar.
If Youre Prescribed Bolus Insulin The Amount You Take Will Vary
If your doctor adds bolus insulin to your treatment plan, theyll prescribe a certain ratio of rapid-acting or regular-acting insulin to carbohydrates. This way your carb intake can be more flexible and youll adjust your mealtime insulin accordingly. Another option is to stick to a certain amount of carbs with each meal and take a fixed amount of insulin, though this approach offers less flexibility.
In other words, youll have to match the amount of bolus insulin that you take to the amount of carbohydrates that you eat. If you plan to eat a meal thats high in carbohydrates, youll need to take more bolus insulin beforehand. If you plan to eat a low-carb meal, youll take less bolus insulin beforehand.
You can also take bolus insulin to correct a high blood sugar. Your doctor will likely give you a correction factor to help you figure out how much insulin you need. This is also commonly known as a sliding scale.
Many factors affect the type and amount of basal or bolus insulin that you might need to take, including:
- how much insulin your body produces on its own
- how sensitive or resistant you are to insulin
- how many carbohydrates you eat
- how much exercise you get
- how much sleep you get
- how much you weigh
- alcohol intake
- other medications, such as steroids
Any other medications you take for type 2 diabetes can affect how your body responds to insulin therapy, too. Weight loss surgery can also affect your insulin needs.
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Letting Stress Get To You
Your mental health plays a big role in your blood sugar level. How? Emotional stress can cause swings in your blood sugar. This is in part because stress triggers the release of a hormone called cortisol, which can impair insulin sensitivity, according to a March 2017 article in the Annals of the New York Academy of Sciences. Port says this means the same dose of basal or bolus insulin can actually be less effective if youre stressed out.
Try to identify the stressors and sources of chronic anxiety in your life. Then look for a relaxation technique that works for you. Talk to your doctor for ideas. Get consistent sleep. Listen to music. Turn off all devices at night, Port recommends. If possible, make time each day to de-stress take a yoga class, do deep breathing exercises, set aside time to read a book or relax with friends, or establish a soothing bedtime routine to help you wind down.
Calibrating The Insulin To Carb Ratio
Before trying to fine tune the insulin to carb ratio used at any given meal, it is best to determine your basal insulin levels first. Any changes to the total amount of insulin you take in per day will mean you have to calculate your insulin to carbohydrate ratio all over again. This is done through basic trial and error. Make sure you take into account factors such as the time of day you are eating and your total body weight while deciding on the right insulin to carbohydrate ratio at any given meal.
It is important to keep a detailed record of your eating habits, the amount of carbohydrates you eat per day, the amount of insulin you are using, and the amount of exercise you do per day. Write down your blood sugar level prior to eating and then again at 3 to 4 hours after your meal. Dont eat anything else or exercise during this time and dont take extra insulin before measuring the second blood sugar level.
The best thing to do is to eliminate those readings you get that are impacted by other factors that affect insulin sensitivity, such as strenuous physical activity. You should also discount meals you eat at a restaurant as they are often very high in fat and you may not be able to determine how many carbohydrates are in the meal. This can throw off your insulin requirements and wont be helpful in determining your average insulin to carbohydrate level.
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Do I Need To Do The Math Every Time
Phew! Good to get those calculations out of the way!
But are they really out of the way if you need to inject insulin every day? Well, they can be out of the way with the help of Hedias insulin calculator.
Hedia takes the numbers for your insulin-to-carb ratio and your correction factor or uses the 500 rule and the 100/1800 rule and does the maths for you!
All you need to do is first tell Hedia your blood sugar level, which can be added wirelessly with certain blood glucose monitors. Then, add if youre having any carbs you can use Hedias food database to help.
Finally, tell Hedia if youre exercising and whether youve injected insulin recently.
Thats it! Hedia can now give you a personal recommendation for your insulin dosage. No formulas to fiddle with just a tap of a screen.
Have a go with Hedia at or the App Store!
Insulin Dosages On A Fixed Dose Therapy
If you are on a fixed dose insulin therapy , your doctor or diabetes health team will help you to pick the dose, or doses, which you need to take each day.
If your blood glucose levels are running either too high or too low, contact your health team who will be able to help you make any dosage adjustments as appropriate.
Check what the recommended sugar levels are, referred to as your target blood glucose levels
insulin duration chart
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Set Your Carb To Insulin Ratio
Maybe you think about your insulin and meals in a much bigger way. Like, thats a four unit sandwich, or, Id need at least ten units for that meal, for example. But we need to do the work from the opposite direction to uncover a piece of the equation.
If youre counting carbs by grams, we need to know how much work a single unit of insulin can do. In other words, how many carbs can you eat for one unit of insulin? If youre counting carbs by exchanges, well ask how many units of insulin you take for one exchange.
For example, if you count 15 grams of carbs as one exchange , and would also take one unit for that, then your carb to insulin ratio is 1. If you dont know your carbs to insulin ratio, start by talking with your doctor.
He or she can help find a good place to start, and you can do some testing to fine-tune the setting. You might have different ratios at different times of the day, which you can set here as needed.
Disposal Of Used Insulin Syringes
Used syringes, pen needles, cannulas and lancets must be disposed of in an Australian Standards-approved sharps container, which is puncture-proof and has a secure lid. These containers are usually yellow and are available through pharmacies, local municipal councils and state or territory diabetes organisations such as Diabetes Victoria.
Procedures to dispose of sharps containers vary from state to state.
For sharps disposal information and help, you can contact:
- state or territory diabetes organisations, such as Diabetes Victoria
- state Department of Health
Insulin needs to be stored correctly. This includes:
- Store unopened insulin on its side in a fridge.
- Keep the fridge temperature between 2 and 8 °C.
- Make sure that insulin does not freeze.
- Once opened, keep it at room temperature for not more than one month and then dispose of it safely.
- Avoid keeping insulin in direct sunlight.
Extreme temperatures can damage insulin so it doesn’t work properly. It must not be left where temperatures are over 30 °C. In summer your car can get this hot so don’t leave your insulin there.
There are various insulated insulin carry bags available for transporting insulin.
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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 diabetics 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 doesnt 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 , Humalog , and Apidra . 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.
Where Do I Inject The Insulin
Insulin is injected just under the skin. Your doctor or his or her office staff will show you how and where to give an insulin injection. The usual places to inject insulin are the upper arm, the front and side parts of the thighs, and the abdomen. Dont inject insulin closer than 2 inches from your belly button.
To keep your skin from thickening, try not to inject the insulin in the same place over and over. Instead, rotate injection places.
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What Is Different About Insulin Lispro
Insulin lispro is a new type of insulin. It starts working sooner than other insulin types. It also reaches peak activity faster and goes away sooner. Insulin lispro helps keep your blood sugar level from going too high after you eat. To keep your blood sugar level steady, your doctor will probably prescribe either a longer-acting insulin or another drug for you to take each day in addition to the insulin lispro.
If you need to mix insulin lispro with a longer-acting insulin, it’s best that you mix insulin lispro only with Humulin U or Humulin N, which are brand names for certain longer-acting insulins. Insulin lispro should always be drawn into the syringe first. This will keep the longer-acting insulin from getting into the insulin lispro bottle.
Types of insulin
Each type of insulin works at a different speed and lasts for a different length of time.
Quick-acting, such as insulin lispro , begins to work very quickly and lasts for 3 to 4 hours.
Short-acting, such as Regular insulin, starts working within 30 minutes and lasts about 5 to 8 hours.
Intermediate-acting, such as NPH or Lente insulin, starts working in 1 to 3 hours and lasts 16 to 24 hours.
Long-acting, such as Ultralente insulin, doesn’t start to work for 4 to 6 hours, but lasts 24 to 28 hours.
NPH and Regular insulin mixture, two types of insulin mixed together in 1 bottle, starts working in 30 minutes and lasts 16 to 24 hours.
Insulin Amounts Made Easy
Most people with diabetes will probably say that calculating your insulin is no walk in the park so much so that we have a blog post dedicated to 11 things that are as hard as calculating your insulin dosage.
With more people using insulin nowadays, its important to get help with calculating that important but tricky insulin dosage.
We hope that these formulas will have given you a general idea of how insulin is calculated, and help you in the process of determining your own dosage. We also hope that Hedia will turn the bore of those calculations into more free time for you!
Got a question about Hedia? Contact us at or with our phone number +45 7174 1663.
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