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Re: [IPk] MDI - varying short acting amounts?

Hi Helen

I, too, had this often (and have it with my pump, too, sometimes). What I 
have done in the past, if it's someone "non medical" is select an "average" 
I take (say from the last week or 7 days) and give them that figure. 
Because those people aren't going to be directing anything medical, it 
keeps them happy while satisfying legal requirements... I would sometimes 
add that the amounts varied depending on BG readings, and most people are 
OK with that.

With medical people, I also explain/ed that I used a sliding scale, and 
that I have a very erratic lifestyle, meaning some days I would eat X carbs 
and other days I would eat Y, and that dose was always adjusted according 
to that, and to exercise, BG reading, etc etc. This usually worked for me 
without getting too messy. If people REALLY wanted all the ins and outs, I 
provided them, and brooked no criticism, pointing out that although my BGs 
bounced a lot, other methods/regimens I'd tried gave far worse results 
(this is no longer the case, as I've finally gotten serious with my dm and 
am testing a lot, whereas previously I didn't really test at all).

These days I just say "I'm on a pump and I will set it as it needs to be... 
if my BGs do *this*, you need to do "this"..." etc. Occasionally I have 
needed my endocrinologist to tell medical staff that I do actually know 
what I'm talking about, but more often than not, I've found most staff 
accept that I know my body better than they ever will. A little confidence 
goes a very long way!

You're definitely not the only one who's had the horror-stricken look from 
people who really should know better. Don't let them wear you down.


At 06:41 PM 6/04/2003, you wrote:

>This is just something that I thought I'd ask about as there may be a bit of
>experience on here. I have been on MDI for many years now (can't remember how
>long, but 15 +). Whenever I have to have any hospital appt or
>tests/procedures or at my diabetes appt or even for travel/vehicle insurance
>purposes, they always ask me about levels of insulin I am currently taking,
>how often I inject, etc. I always start by telling them the amount of
>glargine, currently 10 units, taken at night. Then I tell them about the
>short acting (Humalog now, as Novorapid wasn't working for me). Of course, I
>give myself an injection before every meal. But I also do lots of BG testing
>at various intervals throughout the day and test before every meal as well.
>So, the amount of insulin I give before a meal can vary, especially if the
>meal is not as high in carbs as say the same meal the day before, etc. Plus,
>if I have highs during the day, which often happens, then I give myself a
>shot to counteract that. My other illneses have a bearing on my control, too.
>The thing is, this is always met with astonishment and often horror!
>According to the norm, I should be taking x amount at bedtime then x, y and z
>during the day, no variations. But for me, life is just not like that!
>Sometimes I am not that hungry and want a smaller meal, other times maybe I
>feel like something more. My BG's may be low or high directly before a meal.
>I have always carb counted. It comes as second nature now.
>What I would like to know is, I've always been made to feel that it's only me
>who 'runs' my diabetes like this. It's unheard of! Does anyone else,
>pre-pump, use this method? I'm fed up of being put on the spot when asked
>about this and being made to feel I'm doing something wrong! Of course, the
>fact I have to do this to try and keep controlled should be another string in
>my bow for the argument for a pump, as surely this is how a pump is
>Thanks..feeling a bit of a freak!

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