Insulin dosage for type 2 diabetes

Sammy7
By Sammy7 Latest Reply 2015-04-25 09:02:52 -0500
Started 2009-03-01 12:03:49 -0600

My doctor has prescribed 60 units of insulin a day. I have type 2 diabetes and just recently have started using insulin to reduce the number of pills I take. I take a fasting blood test in the morning. I inject the insulin at 10:30 in the evening. My wife insists I take a blood test before injecting my insulin and VARY the amount of insulin based on this blood test. I feel that I should maintain a constant dosage until I have my doctor's recommendation to vary the insulin dosage.

Who wins the discussion, me or my wife?


34 replies

lanykins
lanykins 2015-04-25 09:02:52 -0500 Report

You win. Go by what your doctor tells you. He can understand your blood sugar variations. Testing is also important for you and your doctor.

jtcobjr.
jtcobjr. 2009-03-14 21:02:22 -0500 Report

Maybe, you ca help me here. My wife, like you dn't take bgl reading either, I don't understand why.I've taken very good care of myself, and fo that reason, I no longer have tp take meds, or test myself. I like to test, because it's the way, I learned how to care about me. I test three times a day

Bob in Stephens City
Bob in Stephens City 2009-03-11 19:59:31 -0500 Report

I go by doctors orders. I take 54 units of insulin at bedtime without fail. I rarely have low readings in the morning luckily and I have light snack before my insulin and this works.

Edie
Edie 2009-03-09 21:13:17 -0500 Report

I ended up on Lantus after a Surgery and my Surgen didn't tell me I was going on Insulin. My family Dr. sent me to a Diabetic Dr. and they put me on 87U at Bedtime and told me to check my Blood Sugar level before my shots and then again in the AM as soon as I got up in the morning. Within 6 months I was also on Humalog and within a year My Lantus was dropped to 80u and that is where it has stayed the Humalog has been changed several times over the past 5 years now. Always follow your Drs. orders not changeing anything till you speak to them. If your Fasting is very low and so is your Bedtime one call the Dr. after 3 days and let them know my Dr. told me. Also if your BG is bounceing all around the place don't stop and try to figure out what is going on call the Dr. imediatlly. Last Summer my numbers were all over the board and bottomed out several days in a row. below 60 and twice I passed out that is when I called the Dr. They said I was close to being put into the Hosp. Nothing to play around with.
With that said I hope it helps both of you to see what can happen if you play with the doseages with out talking to Dr.

MzPeaches
MzPeaches 2009-03-08 19:33:26 -0500 Report

I am a type 2 diabetic and I always check my bg levels on a fasting morning sugar before lunch and before dinner. This way when you call your doctor he/she can adjust the insulin you are taking at meal time. Always make sure to check your sugar 2 hours after a meal if your sugar is at the range your doctor wants it. This way you will know if you need to take insulin after your meals. Write them down dont forget. Call your doctor right away if you are still confused on how to take your insulin correctly.
Good Luck

daniel velazco
daniel velazco 2009-03-08 21:16:51 -0500 Report

I have been on Humilin 70/30 and I always test before I take a shot. My Dr.
has me on 170 units Am 7 Pm on a sliding scale. With that type of dosage I have to test often.
Dan

Beany
Beany 2009-03-08 22:21:03 -0500 Report

Checking your BS is a nobrainer! Do what your doc said but also keep the record of your readings for a while and see how they run. I'm shocked your Doc. started you out at such a high dose. I take lantus, 50 units at night but it was increased in 5 units per visit every two weeks untill we got it where we thought was best for me. I started at 15. It is a long acting insulin but I did have two very low falls within 30 minutes of taking it after not eating enough to carry me through those peticular evenings so it is possible be careful.One time I had checked it and had a reading of 197 and within 20 minutes it had dropped to 37. It was very scary, thank God my husband was here to get what I needed to get through it. Again be careful doseing yourself.

lawrence
lawrence 2009-03-09 13:49:03 -0500 Report

I also have type 2 diabetes . I also take lantis , my dietian and doctor have me counting carbs . I dont check my blood sugar when I inject the lantus. they have me check it at bedtime if I'm below 120 I eat a snack if Im above 120 then I take 1 unit of novalog, everyone is different , I would stick with what your doctor and dietian recommends . when I was first diagnost my acl were at 14 I now have it at 5.7 . good luck and have a wonderful day

Splender
Splender 2009-03-08 15:24:30 -0500 Report

I've been on insulin for a long time and am a type 2 diabetic. As long as you don't become insulin resistant it will help you. That's what I found out was true for me. Yes I would wait until you go to the Doctor before adjusting it yourself. Your Doctor needs to keep close track on you right now. Until you get on the right amount stick with how you feel about it. I've been testing my sugars 4 times a day for years now including the morning fasting. This helps the Doctor see how your sugars are during the day and night.

jsd2005
jsd2005 2009-03-08 01:35:53 -0600 Report

Performing a fasting blood sugar is a good idea and really a must. This helps you and your Dr. know what's going on with your body as it relates to the diabetes.

I also recommend always testing your sugar before injecting insulin as you can't undo the injection after it is done. If your sugar is low, it will go even lower and possibly cause significant problems for you. It is much easier to treat a high sugar, once you know it's high, than to treat a low sugar.Especially, once you have insulin on board.

There are methods of varying you dosage of insulin based on your blood sugar reading. This is called a sliding scale insulin treatment method. However, in your case, I would speak with my Dr. first. Make sure you have a log of your sugars and a food log also. I would also recommend testing your sugar two hour after you eat to see just what the insulin is doing with regards to your blood sugar readings. This will also help your Dr. decide what to do.

Sliding scale usually requires more frequent monitoring of your blood sugar reading. So, it requires more testing.
Usually, a fasting, before each meal and at bedtime. I think this is appropriate. You might try testing at these times. It can be very diagnostic to do this.

Talk with your Dr. first.

Randy42
Randy42 2009-03-07 21:18:44 -0600 Report

I think you should do what the dosage the doctor has set for you. I'm a type 2 diabetic but I don't take insulin though. I do take the metfornin and jest take what my doctor has me set to take. Thats 3 pills a day. My dad took insulin and the doctor had him set to 80 ml. Thats all he would take unless the doctor tells him different. This is jest an opinion of mine.

John J 29
John J 29 2009-03-07 19:09:11 -0600 Report

If the insulin is the long lasting variety (Lantus e.g.), IT SHOULD BE TAKEN IN THE EVENING, never in the am. Your actual BS at that point is virtually meaningless. Docs who really know this business are more interesten in averages than highs or lows.

Monitoring in the am following the nightly dosage is where the data exists that the Docs are after.

Just like going for an AiC, always fasting !

You win the night time argument, but your wife is right about the number in the am to see how the insulin is working

Been there and did all of this pills etc. and sice last October 2008 have maintained an average of 126 fasting and have an A1C of 6.5! following the above described regimen! Good luck

kdroberts
kdroberts 2009-03-07 20:54:13 -0600 Report

Lantus can be taken in the AM, a lot of people take it then or split the dose into two, AM and PM. Just depends on your situation. Fasting tests are a small portion of data that you need. Post meal peaks are the most important in my opinion. Lantus is a basal insulin so is working in the background. It helps as a base but wont help really with food.

Sarguillo
Sarguillo 2009-03-09 18:21:38 -0500 Report

Per my Diabetic nurse, I take my long lasting insulin as a split now, used to be 38 units at night. It was split to 15 am and 15 pm with a pill added at 2 meals. Emailed her my numbers and she adjusted me to 10 units in the am and kept the 15 at night. Let the doc view the log as it gives them a good idea what needs to be done.

IRISH-Q.T.
IRISH-Q.T. 2009-03-07 17:58:02 -0600 Report

I would say you should contact your doctor. You don't want to be injecting insuline when it is not necessary. Not Good!

bill121352
bill121352 2009-03-07 17:25:39 -0600 Report

if your doctor prescribed 60 units thats what u take,period! if this is working your blood sugar levels at waking should be in the proper range! if this insulin is lantus, or anotherlonger acting type, it will regulate automaticly the amount you need ,but if you dont take the proper amount it may not be available in your system.Unless your wife is a doctor or edocrinologist disregard her instructions ,lovingly !

bill121352
bill121352 2009-03-07 17:25:39 -0600 Report

if your doctor prescribed 60 units thats what u take,period! if this is working your blood sugar levels at waking should be in the proper range! if this insulin is lantus, or anotherlonger acting type, it will regulate automaticly the amount you need ,but if you dont take the proper amount it may not be available in your system.Unless your wife is a doctor or edocrinologist disregard her instructions ,lovingly !

Naomi - 31902
Naomi - 31902 2009-03-07 15:14:10 -0600 Report

Follow your doctors orders. If you think your wife has a valid concern contact your doctor to ask the questions. She isn't a doctor. If you are on Lantus you don't have to be so concerned about highs and lows.

robert hibbard
robert hibbard 2009-03-07 14:36:12 -0600 Report

I think it is important to know the sensations associated with both high and low blood sugars.The meter readings are important for determining the right quantity of insulin to be taken. also there are both fast and slow acting insulin.The Dr will be able to advise you

mary cool
mary cool 2009-03-07 12:34:37 -0600 Report

Your wifws right. You most certainly should be checking your sugar levels before any injection takes plaace

wilfredo
wilfredo 2009-03-07 11:57:00 -0600 Report

sammy, first thing, what kind of insulin? lantus? as a type 2, i inject 40 units lantus @ bedtime every night. if you're using lantus, never change your dosage w/o checking with your doc first. remember, lantus will affect you for 24 hrs, so there might be other ways to lower high sugars at different times of the day. check with your doc.

Ginetteb
Ginetteb 2009-03-07 11:30:44 -0600 Report

Testing before taking your injection is a good idea. Changing the amount of insulin on your own (depending on the BS number) is a bad idea.

My opinion: Test before taking the insulin and keep a journal for your doctor to review. Also test 2 hours after the injection and enter the number in your journal.

Your doctor cannot assess whether or not the amount of units he prescribed is correct or bad unless you give him/her the results of the 60 units he prescribed.

Jubedo
Jubedo 2009-03-07 11:45:26 -0600 Report

As a long time type2, and having been on insulin off and on for the past many years, I suggest that you NEVER inject without first doing a BS reading. For varying reasons, you may not be aware if your sugars are too low, and taking 60 units could put you in a crisis. If there is any adjusting to be done, especially since you are new to this, I would suggest that you discuss it with your dr. first. They can put you on a 'sliding scale' of insulin if your sugars aren't consistant, and then you would adjust depending on your current BS reading. It's a LITTLE more complicated than a set amount, but it would be more taylored to your particular situation. No two diabetics are the same. You can also ask for more diabetic teaching, which would put you and your wife on the same page regarding your treatment. (almost all ins. co. will pay for the teaching, and also to see a dietician for your case.) Good luck, and know that you will get the hang of it, even if it does seem a bit overwhelming right now.

celtic lioness
celtic lioness 2009-03-07 11:08:36 -0600 Report

I would say in my opinion to very definately go with what your doctor says until he/she says otherwise.I do concur that doing a test before you take your insulin and keeping a record of these readings to show the doctor is also a good idea and perhaps also adding a test say 1-2 hours after injecting your insulin just to see what difference there might be between the two readings. This is only a suggestion as the final word in any changes has to be made between you and your doctor. I take once a day insulin (the long lasting 24 hour kind) and take it in the morning, fasting and them sometimes just for my benefit I take another reading within 1-2 hours afterwards,this of course being after I have eaten breakfast.My insulin dose is increased by 2mgs in my readings are above 110 for three days in a row. Hope this helps in some way.
Good luck.

EddieB
EddieB 2009-03-07 11:01:18 -0600 Report

I take a BSL prior to injecting my insulin and then again 10-15 minutes again after the injection. I follow up with a BSL reading first thing in the morning after fasting all night for a comparison in readings.

BOTTLELAC
BOTTLELAC 2009-03-07 10:55:25 -0600 Report

DEAR SIR:
YOU SHOULD ALWAYS TEST SUGAR BEFORE
TAKING A SHOT. I AM ALSO TYPE 2 DIABETE.
BECAUSE YOUR SUGAR MAY GO TO LOW BEFORE
YOU TAKE THE SHOT. YOUR WIFE GETS MY
VOTE. GOOD LUCK.

kdroberts
kdroberts 2009-03-02 20:18:34 -0600 Report

Kind of both right. I'm guessing you are taking lantus, in which case there is really no point in adjusting your dose based on a blood sugar reading because it's a slow, long lasting insulin. However, you need to take your blood sugars for a while so your doctor knows how well the dose is working or not working. What she is talking about is really for mealtime dosing with rapid acting insulin but you still need to get the baseline so you can work out the formula to know how to adjust.

lipsie
lipsie 2009-03-01 15:49:28 -0600 Report

I must agree with them, be safe and go with the doctor on this one. It's way too early to mess with it in my opinion anyhow. Good luck though.

rbergman
rbergman 2009-03-01 13:49:22 -0600 Report

In my opinion and please understand that is all it is, an opinion. Since you just started insulin therapy I would suggest keeping it at the dosage the doctor has ordered. If you start varying the dosage he/she will have no idea if the 60units is enough/too much.
With that being said, it would also not hurt to take your BGL before injection so that you yourself can see where it was prior to the shot and then compare it to the fasting after the shot the next morning. Obviously if it is too much insulin this will show with the fasting test the next morning, but without a reading prior to the injection you don't have a comparison level.
Again, these are just my opinions and suggestions.
I will not take sides on the argument for you lol, ultimately it is your decision as you are the one with diabetes.

Best of Luck,
~Robin

roger
roger 2009-03-01 14:49:00 -0600 Report

ditto this is the way i started out keept every bg in a book and on my meter and gave them to DR but if did not like what i saw i called DR office and gave over phone and she changed things right then She was a pumper and was the biggest help i ever got. now i am on the pump and love it wish i had gone on it sooner

BeckyJ
BeckyJ 2009-03-01 14:54:21 -0600 Report

I've had this same question. Doc and nurses have me adjust per their orders. I log my BG's and insulin levels and call to adjust levels. Recently that has meant calling twice a week to adjust but that isn't the norm. Until you know more about how your body reacts to insulin you need to let the experts do the adjustments. I tried adjusting them myself once and ended up in the hospital.

roger
roger 2009-03-01 15:07:36 -0600 Report

that is why calling the DR is best at first . when you are ready to do it on your own they will let you know