Quote:
Originally Posted by jimmys devoted  For instance, I usually use 17- 30 units TOTAL per day. If I eat a lot of carbs (say 350 in a day), I will usually only need maximum 30-32 units in a day. This includes my basal AND boluses. Needing a maxiumum f 30 units perday on a divided dose is nto normal in type 1 regulation.
What is your base dose. Algorythm meausrments are base don .02-.05 for obese pateints per Kg per days with a base. Your units are irratic. I think perhaps you are the one who is fooling yourself. I am on abase of 52 units Lantus basal with a MAssachusets insulins liding scale base of 6 units..
Abse unit is ALWASY a specific amount based on weight. units between 17 and 30 are too fluctuaing as a base rate. If you are using sliding scale you are not using a abse rate which means theer are free availabe insulin in your blood stream.
In contrast, a Type 2 has insulin resistance and is usually overweight/obese.
They will need INSANE amount of insulin, sometimes as much as 100-150 units a day. This excess insulin is part of what contributes to their increased risk of heart attack and vascular disease. It is much better to try and diet and exercise to lose weight for a Type 2 then wait until it gets so bad they must use insulin.
If a person were to take that much insulin you woudl go totally hypoglycemic. Its way to omuch even morbidly obese are based on low levels of insulin, So what algorthytm are you talking about. Perhaps you ought to seek out more information on begining basal levels.
I understand some people will eventually need insulin no matter what, but often it need not happen if people actually make the effort to lose the weight and correct what causes Type 2 diabetes in the first place, which is insulin resistance. In most (but not all) cases, this can be done simply by healthy eating and lots of exercise.
Insulin sensitivity is ANOTHER main difference between Type 1 and Type 2.
INsulin LEVELS in the BLOOD stream are the indications for which type. |
Yes, that is another indicator, but
not the ONLY one. C-peptide alone does not always indicate the type of diabetes. Having a low C-peptide due to autoimmune destruction of beta cells (Type 1) and loss of beta cell function to due long-term insulin resistance (Type 2) are completely different things. It would be medically incorrect to diagnose which type of diabetes based on only c-peptide.
There are MANY differences between Type 1 and Type 2, which is why the terms insulin dependent, juvenile, and adult-onset/non-insulin dependent are no longer used. I suggest you review your training and update it. Which clinic do you work for? Are they willing to pay for your training? You NEED to know these things.
I hope I was able to make this clearer for you, and I am willing to help you by answering any questions.
And no, my dear, my insulin doses are not "erratic"! I said I use 17-30 units
TOTAL daily !!!
That includes basal and meals! My base rate is 12 units daily! LOL! Every Type 1 will need to daily adjust their insulin based on how much they eat, how much they exercise, if they are sick, and if they are experiencing menstruation. Just like a healthy pancreas would! If you are not constantly adjusting your insulin, you are NOT controlling your blood glucose! A healthy pancreas does NOT release a set amount of insulin! Plus, there is evidence to suggest that some long-term Type 1's make some small residual insulin from time to time. See the Joslin 50 year medalist study for more info! I can give you more info if you like. That certain can explain lability in some Type 1's. I also have Celiac Disease, which causes issues with absoprtion, and will cause me to become extremely insulin sensitive if I accidently cosume gluten. I will be low all day.
The "sliding scale" method, as you pointed out, is no longer used, because it is very poor in controlling BG's.
I use .5 units per hour in my pump, and I bolus ("carb count") to match my insulin to what I eat. My carb ratio is 1 unit for 15 grams of carbs. My basal rate remains steady at .5 units per hour and doesn't change, unless I am sick, stressed, etc. I am sorry I confused you. You can clearly see that my insulin needs generally change by how much I eat, which is normal. Of course, Type 1 diabetes is very unstable by nature of having to be your own pancreas and adjust every minute of every day.
My corrrection factor (how much insulin I need to correct a high) is (usually) 1 unit will bring me down by 3.0 mmol/l (54 mg/dl). Sometimes, though, my insulin sensitivity increases for no apparent reason. Once,
1 unit dropped my BG from 19.0 mmol/l (342 mg/dl) to 2.7 (47 mg/dl).
P.S. Type 2's still have alpha cells intact unlike Type 1's AND insulin resistance, so it is very rare they will go low, even if they DO take too much insulin. Their body can still compensate for low blood sugar. This is why severe hypoglycemia is rare in Type 2's. You are obese and have MODY, so if you were to lose the weight, you
may end up needing a dosage similar to a Type 1. And yes, some Type 2's use 100 units a day.
Good luck!
I also want to point out that Type 1 diebetics are usually thin their whole lives (almost 100% always!) and Type 2's usually are overweight/obese (but NOT always!). This is because Type 1 is not a lifestyle related disease, whereas as Type 2 usually IS. Another difference. I am insulted you referred to "obese" when asking about my basal rates! I weigh 120 LBS and I am a size 7!!!!! Like I said before, not everyone is a fat Type 2! Thanks a lot! Type 1's are usually thin!!!
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