I'm on a basal-bolus insulin regime. I knew that. This basically involves me taking two different types of insulin: a slow-acting (basal) insulin (Levemir in my case) and a rapid-acting (bolus) insulin (Novorapid). The whole point of this insulin regime is to try to mimic what my pancreas would do if it did it's job properly (you just can't find the cells these days!) I take my Levemir at 9.30pm every night, and lasts approximately 24 hours (so if I were to not eat anything or inject any rapid-acting insulin, my blood sugars should remain steady. Should being the key word here!) I then take my Novorapid with any food that contains carbohydrate that I eat (N.B. like the last time I mentioned this book, this is just a summary of what I've read, and please remember I am not a medical professional, full disclaimer here!)
What I didn't know:
- If your basal dose isn't right, none of your other doses will be either.
- There's a horribly complicated formula for calculating boluses: The bolus dose = (food dose + corrections dose - insulin on-board) x activity adjustment I can safely say I will never be using this to calculate my injections! Give me the insulin to carb ratio any day!
- Spacing meals and snacks at least a few hours apart is important so that the bolus insulin can return your blood sugar level back to normal before you eat and raise it again.
- The timing of a bolus injection is actually essential. For foods with a high glycemic index (GI), you need to bolus well before eating, with moderate GI foods, soon before eating and with low GI foods, after eating.
- Linking in with above, the pre-meal blood sugar reading is also important when deciding when to take the bolus injection.
There's a hell of a lot more to this that what I realised! But what gets to me more than anything is the fact that I'm reading this all for myself now, three years after my diagnosis. Where was this education when I was diagnosed? Or in the years after my diagnosis as I adapted to living with type one? Because, a lot of what I've read seems pretty essential to me! Ok, moan over!