Thursday, 25 June 2009

Why would that hold true, or does it?

>I am still titrating my Lantus / Humalog dosage. At present I am shooting 60 units of Lantus at bedtime. My Humalog formula is one unit for each three carbs at mealtime plus a correction factor of (Meter BG - 120) / 20. This is pretty close but not yet perfect. I am curious about other folks' formulas.<

My insulin to carb ratio is 1 to 2 (1 unit of Humalog for every 2 carbs). My correction factor is 4 units for every 10 (maybe it's 15, I forget, since I don't use this very often) points over 120 on the meter pre-meal.

>I read somewhere the fast acting total for the day will be right around the amount of the long acting shot. Why would that hold true, or does it?<

FWIW, I've never heard that. Really, I don't know why that'd be true, since the two insulins have very different absorption rates and roles in the management of diabetes. I take 110 (55+55) units of Lantus and somewhere between 120 and 150 of Humalog daily, but that dosage schedule has been arrived at after literally years of ups and downs and adjustments, and I consider it very individual and absolutely not applicable to anyone in the world but me.

>What about Lantus split into two shots 12 hours apart versus one shot every 24 hours?<

It's probably too early in the game for you to make that change, simply because you don't yet know for sure what your final dosage destination is. You're adjusting both Lantus and Humalog at the same time, which I think would be kind of confusing all by itself, and to suddenly throw in this change (splitting the Lantus dose) would leave you wondering what's what. You certainly could ask your doc about it, of course, and the decision would be up to the two of you. Lantus and Levemir are considered 24 hour basal insulins, but the truth is, they don't "last" 24 hours in everyone. I was dosing at bedtime and then ending up too high in the evenings, so we decided to try dividing the Lantus into two equal doses approximately 12 hours apart. So far, I consider this a win for me-- I feel much more "even" all during the day and night, and I know I'm in a lot better control during the evening hours. But it took quite a while, at least 2-3 months, for me to really feel sure that this 12 hour thing is something that's to my advantage. Often when insulin changes are made like this, it takes a while to see the final result. At least it does in me. I'm curious to see if it makes any diff in my next A1c (one could hope...)

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