# Insulin use



## spiritfree (May 20, 2013)

How much insulin do you use in your pump each day?                                        And what are your basals set at?                                                                         This really interests me a lot so please let me know yours.


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## Redkite (May 21, 2013)

You're going to get a wide range I think!

My son is pre adolescent so his insulin requirements are still relatively small.  His TDD averages 22U, of which 7.1U is basal.  His basal rates vary  - the lowest is currently 0.05U/H (late morning), and the highest is 0.475U/H from 3am-7am.


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## everydayupsanddowns (May 21, 2013)

14 day average suggests 33u TDD, with 11.6u of basal and roughly 180g of carbs a day.


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## bev (May 21, 2013)

Hi Spiritfree,

Up until 6 months or so ago Alex's TDD was 25 units.It has now risen to around 60! Thats teenagers for you! I am told that its still not a large amount compared to his peers as he seems to be insulin sensitive but that might change once he becomes a fully grown adult.

The split is 27% basal and 73% bolus.Bev


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## AJLang (May 21, 2013)

My TDD has gone down since going on my diet it's 21 basal and about 6 bolus i.e. TDD 27 before the pump my basal on it's own was 34


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## Dory (May 21, 2013)

TDD ranges from 35-65 depending on what I eat!  but normally around the 40-50 marker.  Basal rate accounts for 19u of that.


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## novorapidboi26 (May 21, 2013)

Yesterday was 64.700 units

That just over half what I was on when injecting......so still significantly more than your average bear....

My basal are:

00:00 - 05:00: 1.2u/h

5:00 - 10:00: 1.45u/h

10:00 - 17:00: 1.0u/h

17:00 - 00:00: 1.2u/h

I just recently increased my 05:00 - 10:00 rate from 1.4 to 1.45

In total the basal works out at 23.65units..


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## Redkite (May 21, 2013)

It's interesting seeing different people's basal/bolus split.  When my son started on his pump, the consultant (useless one at his old hospital) insisted on a 50:50 split, despite the fact that his Lantus was nowhere near 50% of his total.  We rapidly made changes to suit him, and he's now 30% basal, which his new (good!) consultant says is typical for children.  I'm interested to see it seems to suit some of the adults here too.


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## everydayupsanddowns (May 21, 2013)

John (Pumping Insulin) Walsh suggests that most people will be somewhere from 40:60 to 60:40 I think.

I was a bit surprised that mine was in the 30's % wise, but this *could* be partly just that it is a bit out at the moment. I seem to be correcting more than I should, which is probably related!


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## Northerner (May 21, 2013)

Hmmm...I don't use a pump. I suspect I'm in a minority of 1 here. My TDD is around 20 units, which is all novorapid/bolus. I was originally on 20 lantus (June 2008), but this came down to the point where it didn't seem worth it/necessary, and I haven't needed it since April 2012.


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## Redkite (May 21, 2013)

Northerner said:


> Hmmm...I don't use a pump. I suspect I'm in a minority of 1 here. My TDD is around 20 units, which is all novorapid/bolus. I was originally on 20 lantus (June 2008), but this came down to the point where it didn't seem worth it/necessary, and I haven't needed it since April 2012.


Wow so you're type 1 and don't need any basal insulin?  I'm guessing your pancreas is still making a trickle then?  Or do you get up for secret midnight feasts to top up your novo?


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## Northerner (May 21, 2013)

Redkite said:


> Wow so you're type 1 and don't need any basal insulin?  I'm guessing your pancreas is still making a trickle then?  Or do you get up for secret midnight feasts to top up your novo?



Nope! The reason I had to stop using the lantus was because I was waking in the low 4s on one unit - I stopped it altogether and still woke in the 4s and 5s! Sometimes I go through a period where I wake in the 6s and the odd 7, but usually that's because I went to bed at a very similar level, as my ailing pancreas keeps me rock-steady overnight. Best thing about it is not fearing night hypos


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## Dory (May 21, 2013)

Alan - you can go right off some people you know!!!


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## Northerner (May 21, 2013)

Dory said:


> Alan - you can go right off some people you know!!!



I am Diabetes Freak Man!


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## Hanmillmum (May 21, 2013)

My dd TDD is around 13 units ( give or take a unit depends on if she has been wanting snacks/eating more etc) with 4.5 units of basal.


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## Lauren (May 21, 2013)

Wow Alan, how are you on no basal insulin? Sorry if that's a rude question! Just really curious?


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## Northerner (May 21, 2013)

Lauren said:


> Wow Alan, how are you on no basal insulin? Sorry if that's a rude question! Just really curious?



I'm perfectly fine Lauren  Not a rude question at all. My consultant thinks I must be producing some of my own insulin which can cope with my basal needs, but I have to have some help when I eat, hence the novorapid


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## Lauren (May 21, 2013)

That's really great! Is there any hope for this happening in other type ones or are you just a one-off? lol


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## Northerner (May 21, 2013)

Lauren said:


> That's really great! Is there any hope for this happening in other type ones or are you just a one-off? lol



I think it's just one of those things. Basically, what appears to have happened to me is that I began to lose pancreatic function slowly over a couple of years, then I got a virus that shot my levels up so I ended up with DKA and got diagnosed. As I recovered over the next couple of years my lantus requirements began to reduce, presumably meaning that my pancreas was recovering to some extent. Eventually, nearly 4 years after diagnosis, I was able to stop the lantus, although I probably haven't recovered to the point I was at prior to diagnosis, so I need novorapid now and to be more careful about what I eat. Who knows what the future holds? 

I have heard of others who have had a similar experience i.e. Type 1.5, but not quite over the timescale that I have.


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## Lauren (May 21, 2013)

Well that's really good that your pancreas seems to have recovered a bit - maybe it will end up getting 100% better, that would be great! 

I'm going to wait for this artificial pancreas system to become more mainstream, you never know, maybe I'll end up with one


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## spiritfree (May 21, 2013)

Thanks everyone. Great replies.


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## JontyW (May 22, 2013)

Northerner said:


> I am Diabetes Freak Man!



So I'm another Diabetes Type 1 Freak Man! Some of you may remember that my biggest control problem was getting large and variable BG drops overnight (early morning hypos), and neither my consultant nor I could figure out the root cause.

However, after getting guidance from this web site on better understanding of how to check basal level, insulin-carb ratios and developing a complex spreadsheet for monitoring, *I think I now have the answer ..... I don't need any Lantus, just Humalog bolus.*

This is how it has changed ...

*Up to: Feb 2013:*
1. TDD of 65 with 12 Lantus (18%). *Overnight drop (ave) = 5, Max = 8 to 9 mmol/L!! This caused hypo on waking (<3) often 2/week.*

2. Basal fasting tests at various times of day always gave variable results .. just not consistent .. but 12 Lantus seemed 'reasonable'. Often got unexplained BG drop late afternoon.

3. Large overnight BG drop often associated with high bolus dose for evening meal (>22u). *So Humalog seems to carry on working well past the normal 4-5hrs in my body. So this provides enough background insulin*

4. Did trials with no evening meal/bolus .... NO real BG drop so confirmed likely cause due to too much insulin (in total) overnight.

5. Ave evening meal was 48 carbs

*March 2013:*
1. Gradually reduced Lantus to ZERO for a month .. now let's see what happens? Checked for Ketones .. all OK (I have never experienced any raised ketones in 43 yrs of Type 1.)

2. TDD of 65-ish with 0 Lantus (0%). *Overnight drop (ave) = 2 (so half what it was), Max = 3 to 4 mmol/L!! No hypo on waking (<3) apart from one high Humalog dose for evening meal.*

3. Reduced evening meal carbs from ave 48 to 38

*BUT ... End April 2013:*
1. Diagnosed with new autoimmune disease (No.5 for me!) - "Vasculitis (inflammation of the blood vessels)"  .... http://www.vasculitis.org.uk/about-vasculitis/what-is-vasculitis

2. Large steroid dose required, so had to restart Lantus to get enough background insulin to counteract the increased BG caused by steroid Prednisolone.

3. A few hypos on waking again, but starting to reduce steroid dose and Lantus level, so not yet sure about future dose.

I am convinced I now know the root causes of my large overnight BG drops. Having a detailed spreadsheet over the past 9 months has really made this analysis relatively easy.

Jonty


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## Northerner (May 22, 2013)

Fascinating Jonty!  It would seem that we are:





Which one are you?  We need another member!


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## JontyW (May 22, 2013)

Yeah .. I like your sense of humour!!

BTW: the Vasculitis that I have is affecting my lungs (asthma sufferer .. so breathlessness), and luckily NOT my heart and kidneys ....

That website I linked is very good at explaining all the varieties in some detail. Like all UK medical sites .... generally much better than their US cousins :-(


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## Northerner (May 22, 2013)

JontyW said:


> Yeah .. I like your sense of humour!!
> 
> BTW: the Vasculitis that I have is affecting my lungs (asthma sufferer .. so breathlessness), and luckily NOT my heart and kidneys ....
> 
> That website I linked is very good at explaining all the varieties in some detail. Like all UK medical sites .... generally much better than their US cousins :-(



I hope that the treatment goes well Jonty.


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## Adrienne (May 23, 2013)

My daughters TDD can be between 30 and 60 units, it all depends what she eats.  Her basal total is approx 16 units per day (can't be exact as she is at school with her pump), the rest is bolus.  She is around 30/70 with 30% being basal


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## seasiderdave (May 23, 2013)

According to Adam the pump my 14 day averages were:

TDD 27.65u broken down as 12.4u basal and 15.25u bolus for 266g of CHO.

Think I need to eat less


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## HOBIE (May 23, 2013)

40/50 units per day with approx 55% basal. Quite often miss lunch. Enjoy brecky & T


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## pgcity (May 23, 2013)

14 ish units basal and about 17 bolus for 140g of carbs


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## Phil65 (May 30, 2013)

I am very insulin resistant.....

basal 46 Units:

00.00 - 03.00 - 1u per hr
03.00 - 04.00 - 2u
04.00 - 08.00 - 3.5u
08.00 - 12.00 - 2u
12.00 - 16.00 - 1u
16.00 - 23.00 - 2u
23.00 - 00.00 - 1u

bolus on average about 80 units daily.

The addition of Metformin has not really reduced my insulin requirement


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