Totally confused

mapoe4 · #1 08-02-2008, 10:55 AM

I have read many post about carbs, basal, bolus, and corrections. And I just don't get it. I know that John gets so many carbs and such an amount of insulin. (3 units of Lantus in am). The endo told me that he would eventually need Humalog if he goes over 200 after meals. But I don't understand the rest of it. Is there a site that will explain this to me? I can't go out and buy any books because right now I am financially unable to.

frizzyrazzy · #2 08-02-2008, 11:07 AM

Here's the very un medical version..
Your body needs insulin two ways:
First, it needs insulin to fuel the cells (basal)
Second it needs insulin to process the food. (bolus)

Right now, because your son is so newly dx his body is having no trouble producing insulin for food so that 's why you only are using basal insulin. Eventually the production of bolus insulin will stop as well and you'll have to add in humalog.

Your dr has him eating set numbers of carbs at each meal so that it's easier to watch what happens.

Typically, for a child who takes both basal and bolus insulin (unless they're pumping) they use a long acting insulin (like lantus) and a rapid acting insulin (like humalog or novolog). There are other insulins but those are the only ones I'll talk about.

You give the lantus just like you do now, and that takes care of normal background insulin. Then every time he eats you'll give a shot of humalog. What most kids have is what's called an Insulin to Carb ratio. How much insulin can they eat for how many carbs. For instance, Ian's typical one is 1:30. so if he eats 30g of carbs he gets 1u of insulin. If he eats 60g he gets 2units. And we do that in fractions. Then if his bg is high we also give correction doses based on insulin sensitivity factor - how much does 1 unit of insulin bring down his blood sugar. Ian's is 150 and his target bg is 120 so if his bg was 300 he'd get just over 1u of insulin to bring him back to target. And again, we can do that in fractions of units.

But that's the basics of what most people do for D care. Insulin to match food eaten. No set number of carbs at each meal. And shots every time they eat.

Karenwith4 · #3 08-02-2008, 11:08 AM

It will become clearer over time.
Does your endo have a lending library? Our public library has a good selection of diabetes management books so you might find some help there.
There are also a couple of books you can download online that might help.

Think like a pancreas

and the Pink Panther one which I can't seem to find a link for.

You can also start here at the CWD diabetes basics page which will walk you through a lot of these kinds of questions.

hth
Karen

StillMamamia · #4 08-02-2008, 11:11 AM

I think if you share with us how much insuling you're supposed to give for x amount of carbs, and your correction factors, then we could help you more. Also any specific terms you're not familiar with, just ask.

FYI:
Lantus = your basal (background) insulin, long-acting (except for pumps, where only fast-acting is used)
Humalog= your bolus insulin (for meals and corrections), fast-acting

A helpful link for how long/active insulin is, scroll down for table:

http://www.childrenwithdiabetes.com/d_0n_110.htm

Other useful links:

http://www.childrenwithdiabetes.com/d_0n_000.htm
http://www.diabetesnet.com

Also, if you look at the beginning of this forum, there are sticky thread on acronyms/abbreviations. If you want to take a look, they mention some of the terms used on board.

HTH

mapoe4 · #5 08-02-2008, 11:13 AM

TY that makes a little more sense to me.

frizzyrazzy · #6 08-02-2008, 11:15 AM

I think the confusion comes because he doesn't yet NEED short acting insulin so your dr hasn't given you that info. Don't stress about it yet.

mapoe4 · #7 08-02-2008, 11:16 AM

John only gets lantus right now. I suppose he is to get 45-60 carbs at meals and 15-30 for snacks this is what they told me at onset and haven't said anything different even when I asked them.

frizzyrazzy · #8 08-02-2008, 01:16 PM

Quote:

Originally Posted by mapoe4

John only gets lantus right now. I suppose he is to get 45-60 carbs at meals and 15-30 for snacks this is what they told me at onset and haven't said anything different even when I asked them.

and that sounds pretty normal. They're just trying to get a handle on when he's going to need the fast acting. And by having him eat roughly the same amounts day after day, then you're taking out a variable which might reflect more in his numbers and make it harder to determine when the proper time to start that short acting insulin is. If you're having trouble with those carb amounts, then I'd ask for changes to be made - if they're too much or two little, certainly express that.

in any case, I am getting the feeling that you think what your dr is doing is out of the norm and it's really not.

hawkeyegirl · #9 08-02-2008, 04:09 PM

Quote:

Originally Posted by mapoe4

I have read many post about carbs, basal, bolus, and corrections. And I just don't get it. I know that John gets so many carbs and such an amount of insulin. (3 units of Lantus in am). The endo told me that he would eventually need Humalog if he goes over 200 after meals. But I don't understand the rest of it. Is there a site that will explain this to me? I can't go out and buy any books because right now I am financially unable to.

Check your PMs.

momandwifeoftype1s · #10 08-02-2008, 06:49 PM

Don't worry, you'll have plenty of time to absorb everything. The Pink Panther book and your training from the hospital will help get you through to the next phase of care - post honeymoon. And just so you know, I still don't get a lot of the technical stuff, but Connor is doing great! You'll be fine!

Amy