Diabetes can own you. If you let it. It’s a disease that can dictate you life – for as long as you have it, or let it. A significiant chunk of our lives revolve around numbers, times, calculations, and food.
Figuring it all out can be overwhelming, and, if you don’t get it, the disease will grab and take you down.
The Insulin Regiment
Insulin is what the pancreas is supposed to produce, but in Type 1 diabetics, it doesn’t. In regular people, the pancreas will work to offset your internal system, the food you consume and any exercise you undertake. If a non-diabetic and diabetic eat the exact same thing (without taking insulin) and both checked their BS (blood sugar but sometimes bull s**t) numbers an hour after they ate, the diabetic’s number will be much much higher, regardless of the food consumed.
So – to fix that, a diabetic has to manually inject insulin. And of course, it can’t be easy. There is no magic pill with the “right” amount of insulin. There are many different insulin types to take, and, to make it even more complicated, how much insulin will depend on the person, their current blood sugar level, what time it is, what’s going on around them, and what they eat.
Sometimes, it just plain sucks. Sometimes, I just want to scream about it. Sometimes, I just want to ignore it. But most times, I try to smile, say it’s no big deal, and carry on with my life. I cannot let it get me.
Back to the facts. There are two rates of insulin in the regiment: basal and bolus.
Basal insulin regulates the glucose over a 24-hour span. It is the constant insulin released into our system to help overcome internal fluctuations. If set right, it is supposed to keep our blood sugar numbers within a good range, without varying more than 30 points up or down. Figuring out the basal rate is a bit tricky, but there are a few formulas to follow, for example, take your weight and multiply it by your height, divide by your dress size, and then add 3 if you’re a brunette, 2 if you’re a blond, and 1 if you’re a redhead. Ok, I’m just kidding, but it does factor in your weight. The rest of it really is a crap shoot, and again, unique to each diabetic. The doctors and specialists determine your starting basal rate and may vary it during the day to overcome times when your blood sugars spike or drop.
I currently have three basal rates: midnight to 6 am: 0.5 units/hour; 6am to noon: 0.55 units/hours; and noon to midnight: 0.40 units/hour.
Bolus insulin is the insulin we take when we eat something (read anything). It is an added boost that our system needs to cover the carbs we eat. If it is set right, there will not be a massive spike in our numbers. Different bolus rates can be created for each meal which take into account the lunar cycle, and the weather. Ok, I’m joking again, they only interplay with the basal rats and the time of day.
I currently have only one bolus rate, or Carb to Insulin ratio(C:I) of 12:1.
Sensitivity is the correction insulin I mentionned earlier. We each have our blood sugar target range, typically anywhere from 80 to 120. When we test our numbers, if the reading is above or below this range, the sensitivity factor comes into play to add or subtract insulin to bring you back into range.
My sensitivity is 50 – so for every 50 points that I am out of range, I need to take 1 unit of insulin.
Now for the test, I’ll make it easy for you: It is 6 pm. I am about to eat 84 grams of carbs and my blood sugar number is 200. How much insulin do I need to take?
If you guessed 9.0, you’d be right. That’s 84/12 = 7.0 for my bolus, and (200 – 100)/50 = 2.0 for my correction.
I can’t even begin to imagine what it is like for teenagers with Type 1. I am 34 years old and I often have trouble figuring it all out. Before each meal I read the food labels or consult my handy www.CalorieKing.com handbook to figure out the carbs. Luckily my pump does most of the calculating, but if you see me before a meal I’m usually trying to count aloud…
“So 6 fish sticks have 18 grams, I’m having 8, so 18 divided by 6 is 3 (is it, yeah, it is), 3 times 8 is 24, plus 41 plus 19… wait, 24 plus, how many, oh, right, 41, well, that’s 65, plus 19 is 84. Ok. 84 grams of carbs.”
That’s the real deal with diabetes, one sugar cube at a time.
