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Re: [IP] non responding highs
You mean you take an additional bolus after only 1 hour from the last bolus?
It's not usually a good idea to bolus again so soon, because you'll have
overlapping, unused insulin.
I'm going by the Unused Insulin rule outlined in Pumping Insulin. Starting on
page 125 and the product specification for Humalog.
Say your high-blood-sugar ratio is 1:40. If you calculated that you need 4.5
units of insulin to lower yourself from 300 to 120, AND you absorbed 60-80% of
that 4.5 unit bolus in 1 hour, then after the hour you should be at about 144
(almost at 120). If so, that's really cool I wish I could drop/adjust that fast.
If you are not dropping that fast, then you are proving to yourself that you are
not absorbing that high percentage of insulin in the first hour. You shouldn't
need to bolus again after just one hour.
You know what I mean? You aren't giving the insulin long enough to work.
However, if you were absorbing at 30% per hour, the way Pumping Insulin
describes, and your ratio was 1:40, it would be more like this:
At glucose test time you're at 300, but you want to be at 120
You take 4.5 units (because 300-120=180 and 180/40=4.5 units)
One hour later you've used only 30% (1.35 units), which drops you 54 points, so
your glucose would be 246.
Two hours later your glucose would be 54 points lower or about 192.
Three hours later your glucose would be 54 points lower or 138
Four hours later you dont have 30% left, you have more like 10% left (.45 units
which would drop you 18 points (because your ratio is 1:40) So four hours later
you would be around 120.
This is all assuming you arent eating anything or blousing or exercising really
hard during this 4-hour span.
If you look at the spec for Humalog, there is a chart that the manufacture put
together that shows the absorption rate in laboratory experiments. The patient
is given a dose of insulin. You see the serum insulin level start to rise in
about 15 minutes. At 60 minutes is about when you see the highest concentration
of insulin in the blood (they say this is when the insulin works the hardest).
But you still have 4 more hours where the insulin is being absorbed. So 30% of
that initial dose gets to your blood in the first hour, then another 30% the
next hour and the next, until you have only 10% left, and then finally none
Also I agree with Barbara, we should be careful when throwing out numbers. My
ratio is 1:50., If I took 1:40, like you said, I'd be on the floor!
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