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1 Unit Of Insulin Lowers Glucose By How Much Mmol/l

Structure And Chemical Properties Of Insulin

My Daily Blood Sugar & Insulin Levels Type 1 Diabetes Edition

Insulin was found to be a polypeptide in 1928 with its amino acid sequence identified in 1952. It is in fact a dipeptide, containing A and B chains respectively, linked by disulphide bridges, and containing 51 amino acids, with a molecular weight of 5802. Its iso-electric point is pH 5.5.5 The A chain comprises 21 amino acids and the B chain 30 amino acids. The A chain has an N-terminal helix linked to an anti-parallel C-terminal helix the B chain has a central helical segment. The two chains are joined by 2 disulphide bonds, which join the N- and C-terminal helices of the A chain to the central helix of the B chain. In pro-insulin, a connecting peptide links the N-terminus of the A chain to the C-terminus of the B chain.6

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Your Insulin Regimen Will Include:

  • A basal or background insulin dose
  • A bolus insulin dose to cover the sugar or carbohydrate in your foodThis will be presented as an insulin to carbohydrate ratio . The I:CHO tells you how many grams of carbohydrate can be covered by one unit of rapid acting insulin
  • A high blood sugar correction bolus insulin dose to bring your blood sugar back into the target range. This will be presented as a correction factor. This correction factor refers to how much your blood sugar will drop after 1 unit of insulin rapid acting insulin.
  • What Is Dka In Diabetes

    cells within the pancreas launch increasingly more insulin to try to maintain blood sugar levels regular Gradually, these cells fail to keep up with the body s want for insulin If you ve been identified with diabetes, it s necessary to follow your well being care professional s recommendations and take all medications as directed.

    If you have any suggestions or more questions, please be at liberty to share them with us When you discover signs, usually multiple at one time, it s suggested to see a physician right away The data on this web site shouldn t be used as an different to skilled medical 1 Unit Of Insulin Decreases How Much Blood Sugar care or advice Contact a health care Symptoms Of High Blood Sugar provider if you have questions about your health For most individuals, eighty to ninety nine milligrams of sugar per deciliter earlier than a meal and 80 to one hundred forty mg dl after a meal What Is The Normal Blood Sugar Level is How Bad Is Type 2 Diabetes normal The American Diabetes Does b12 raise blood sugar Association says that most nonpregnant adults with diabetes ought to have eighty to 130 mg dl earlier than a meal and fewer than Fasting blood sugar at 100 a hundred and eighty mg dl at 1 to 2 hours after starting the meal.

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    Youll Need To Calculate Some Of Your Insulin Doses

    Youll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight.

    Your provider will prescribe an insulin dose regimen for you however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars.

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    Example To Calculate Insulin Dosage Level:

    Use of a standardized protocol to decrease medication errors and ...

    A person weighs 65 kg, his height is 150m and his fasting blood glucose level is 50mmol/L. Calculate the total number of insulin units needed each day for that person.

    • Fasting Blood Glucose level = 50mmol/L

    Solution:

    Let us find out the diabetes mellitus type 2 level of a person from the given values. Substitute the values in the formula,

    Initial dose =

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    Types Of Insulin Doses

    To answer the question how much insulin should I take?, you need to know why youre injecting insulin. Youll be injecting different amounts depending on whether its basal or bolus insulin.

    What is basal and bolus? Well tell you. But first lets have a quick look at how insulin injections work.

    Insulin injections are taken when your own body doesnt produce enough insulin. You need that insulin because insulin is a fundamental part of metabolism.

    Insulin makes sure that the sugar in your bloodstream can enter the cells to be used as energy.

    Without that insulin, the sugar stays in your blood, and your blood sugar levels could get too high. So, when you eat or drink carbs, those carbs become sugar in the blood.

    Bolus insulin

    So, carbs will raise blood sugar levels. If youre insulin-dependent, this means that you need to take insulin injections whenever you take carbs, to bring blood sugar levels down. This kind of insulin injection is called a bolus.

    Rapid-acting insulinis most commonly used for the bolus meaning you should usually inject between 5 and 15 minutes before eating or drinking carbs. This insulin remains active for 2-4 hours.

    Correction dose

    A part of the bolus dose includes the correction dose. This is because at some point, you might get high blood glucose/blood sugar either before eating or several hours after eating.

    To bring the blood sugar levels down, youll need to inject insulin. This injection is referred to as the correction dose.

    Basal insulin

    Why Its Important To Keep A Daily Log

    This is one of the reasons its important to keep a daily log that details your blood sugar readings, insulin given, and carbs eaten at meals and snacks, as well as moods, illness, anxiety/stress etcall of which can play a very important role in blood sugar control.

    Apart from this, we dont have any data to work with and it will be difficult to tell if what you are currently doing is working. The best way to establish how well your I:C ratio is covering your meals is to use a time when your pre-meal blood glucose is in goal range.

    So lets say before breakfast, your blood sugar is 100 . Thats great! Now be very diligent about the number of carbs you eat, and follow your estimated or physician ordered I:C ratio .

    Check your blood sugar 2 hours after the first bite of that meal and that number should be very telling as to whether your ratio is on or off. If it is in goal range , your ratio is probably spot on if it is elevated , it may mean you need to lower the ratio whereas if you come near to bottoming out , chances are you are more sensitive to insulin and you may need to increase the ratio .

    You may also find over time that you respond differently at different meals and with different meal composition.

    When calculating insulin/ carb ratio, its always best to err on the side of caution, estimating lower rather than higher to avoid hypoglycemia.

    Feel free to leave your questions and comments below.

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    Using A Cf To Correct A 2 Hour Post Meal Blood Sugar

    Correcting for a high blood sugar 2 hours after eating is using your best estimate!

    Things to consider:

    • how your insulin works
    • the type of meal you ate – high fat carbohydrate meal vs. high fibre, low fat carbohydrate meal
        • is it the type of meal that makes your blood sugars higher than usual for a longer than usual time, or
        • is it the type of where your blood sugars return to normal within the 2 hours

    Remember how your insulin works insulin action or duration of effect.

    Rapid acting

    • starts: 10-15 minutes

    How Much Insulin Should I Take For Low Blood Sugar

    Blood Sugar Levels Chart | Includes fasting and after eating

    Insulin will lower your blood sugar. If your blood sugar is already low, you shouldnt inject more insulin.

    Signs that your blood sugar is too low include sweating, dizziness, blurred vision, and significant fatigue. If this happens, try to consume rapid-acting carbohydrates, like sugared sodas, fruit juice, or glucose tablets, to get your blood sugar levels back up quickly.

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    The General Principles Of Sliding Scale Therapy Are:

    • The amount of carbohydrate to be eaten at each meal is pre-set.
    • The basal insulin dose doesnt change. You take the same long-acting insulin dose no matter what the blood glucose level.
    • The bolus insulin is based on the blood sugar level before the meal or at bedtime
    • Pre-mixed insulin doses are based on the blood sugar level before the meal

    How Much Insulin To Take For Bodybuilding

    Injecting insulin is not a safe approach to weight training. However, some bodybuilders will inject it as a performance-enhancing drug. They believe injecting insulin will allow energy in the form of glucose to enter their cells so they can build more muscle.

    This practice is unsafe and can lead to severe and potentially life threatening hypoglycemia, according to 2019 research.

    You should not take insulin unless you have diabetes. If you do have diabetes, talk with your doctor about how your training regimen may affect your blood sugar levels.

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    Total Daily Insulin Requirement:

    = 500 ÷ TDI = 1unit insulin/ 12 g CHO

    This example above assumes that you have a constant response to insulin throughout the day. In reality, individual insulin sensitivity varies. Someone who is resistant in the morning, but sensitive at mid-day, will need to adjust the insulin-to-carbohydrate ratio at different meal times. In such a case, the background insulin dose would still be approximately 20 units however, the breakfast insulin-to-carbohydrate ratio might be breakfast 1:8 grams, lunch 1:15 grams and dinner 1:12 grams.

    The insulin to carbohydrate ratio may vary during the day.

    How Much Insulin Should I Take: Correction

    Contour Blood Glucose Test Strips

    If your blood sugar is too high during a period of fasting , you can calculate how much of the blood sugar needs to be lowered.

    To figure this out, youll need to know your correction factor, also known as the insulin sensitivity factor.

    The correction factor is the amount of blood sugar that will be lowered by 1 unit of rapid-acting insulin.

    This should also be figured out together with your healthcare team, using trial-and-error. Meanwhile, a helpful standard formula is the 100 rule or the 1800 rule.

    Blood sugar is measured in either mmol/L or mg/dL. The 100 rule is for people who use mmol/L, while the 1800 rule is for those who use mg/dL.

    These rules are formulas that involve dividing 100 or 1800 by your total daily dose. Thus: 100÷ total daily dose = the number of mmol/L of blood sugar dropped by 1 unit of rapid-acting insulin.

    Alternatively: 1800 ÷ total daily dose = the number of mg/dL of blood sugar dropped by 1 unit of rapid-acting insulin.

    Lets say again that your total daily dose is 50, giving you the following calculation: 100 ÷ 50 = 2. This means that 1 unit of insulin lowers 2 mmol/L of blood sugar.

    Alternatively, the example could be the following calculation: 1800 ÷ 50 = 36. Accordingly, 1 unit of insulin lowers 36 mg/dL of blood sugar.

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    You’ll Need To Calculate Some Of Your Insulin Doses

    You’ll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight.

    Your provider will prescribe an insulin dose regimen for you however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars.

    Common Conditions Associated With Insulin Resistance

    Type 2 Diabetes

    Following pioneering work by Bornstein112 and the Nobel Prize-winning work of Yalow and Berson,113 the first insulin assays became widely available in the late 1960s 28 it was subsequently confirmed that diabetic patients with so-called or maturity onset or type 2 diabetes had normal or increased plasma insulin levels. Insulin resistance was reported to be a characteristic feature of T2DM in the early 1970s.3 A progressive inability of the cells to compensate for the prevailing insulin resistance by sufficient hyperinsulinaemia, heralds the clinical onset of this disorder.3 While twin studies and linkage analyses are consistent with a strong genetic component in the development of type 2 diabetes, several decades of research have failed to identify a predominant genetic abnormality in the majority of cases.26 The aetiology of T2DM is thought to be polygenic, with environmental factors being superimposed upon this basic predisposition.

    Insulin resistance typically predates the development of diabetes and is commonly found in unaffected first-degree relatives.28 The morbidity of the disorder relates both to the severity of hyperglycaemia and the metabolic consequences of insulin resistance itself. The primary defects in insulin action appear to be in muscle cells and adipocytes, with impaired GLUT 4 translocation resulting in impaired insulin-mediated glucose transport.28

    Metabolic Syndrome

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    Exercise & Physical Activity

    Since Chauveu & Kaufmans remarkable observation in 1887 that When a horse chews on hay the concentration of glucose in the blood draining its masseter muscle substantially decreases74 a large body of evidence supports the role of exercise in improving insulin sensitivity and its beneficial outcomes in insulin resistant states. Epidemiological studies such as the US Physicians Health Study have reported substantial decreases in the relative risk of type 2 diabetes with lifelong regular physical activity.75 Large scale randomised controlled clinical trials such as the Diabetes Prevention Program76 and the Finnish Prevention Study77 demonstrate a 58% reduction in progression of impaired glucose tolerance to type 2 diabetes by intensive lifestyle modification which included a minimum of 2030 minutes of exercise per day. Acute exercise increases GLUT 4 translocation to sarcolemmal membrane, whereas chronic exercise training increases Glut 4 mRNA expression.78 In addition to this insulin-dependent mechanism, enhanced glucose uptake into exercising muscle occurs by multiple insulinin dependent mechanisms.79 Exercise training appears to enhance insulin sensitivity by increased post-receptor insulin signalling 80 increased insulin-mediated glucose transport appears to be related to enhanced signal transduction at the level of IRS proteins and PI 3-kinase.79

    Putting It All Together

    How to test your blood glucose (sugar) levels

    Now that you know the how and why behind insulin dosing, lets consider how you may calculate your insulin needs.

    Youll usually give yourself an insulin dose around your meals since thats when you take in carbohydrates. You also will typically check your blood sugar to see if youre meeting your premeal target dose.

    To calculate your insulin needs:

  • Check your blood sugar level before a meal.
  • If your blood sugar level is in your target range, you do not need to calculate for extra insulin.
  • If your blood sugar level is higher than your target range , calculate how much insulin youll need. You should talk with your doctor about this, but usually, 1 unit will bring your levels down by 50 points.
  • Calculate the number of carbohydrates youre about to eat. You can usually estimate these using carbohydrate counters.
  • For every 10 grams of carbohydrates, give yourself 1 unit of insulin. Ask your doctor if this number may be different for you.
  • Add the number of units needed to adjust for both your target range and meal.
  • Administer the total units of insulin.
  • You may find that if you generally eat about the same amount of carbohydrates each day, you may be able to consistently inject the same amounts of insulin outside of special occasions. It takes time to find out how your body best responds to insulin.

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    Calculating Insulin Dose In Type 1 Diabetes From Diabetes Education Online

    Your doctor will prescribe an insulin dosing regimen for you to get you started on your type 1 diabetes that will include the three components of intensive insulin therapy: Basal Insulin Dosage a once or twice daily dose of long acting insulin Bolus Dosage a short acting insulin dosage based on the amount of the carbohydrates in each meal . Bolus Correction Dose For A High Blood Sugar a correction factor dosage to bring your blood sugar level back to the target range when it gets too high . However, each of these three dosages can change over time or even throughout the day and you will learn how to adjust up or down each of these three components. Of course, your diabetes team should always be available by phone or internet to counsel you on an appropriate insulin dosage for any of the three components of intensive insulin therapy if youre unsure. What follows are the first three examples* from Calculating Insulin Dosage from Diabetes Education Online which will show you how you will do it: *Example #4, Formulas commonly used to create insulin dose recommendations is in the next post of my blog study notes . First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-6Continue reading > >

    Creating An Insulin Sensitivity Factor

    Note: TDD = Total Daily Dose of insulin

  • 100/TDD = ISF if using rapid insulin

  • 83/TDD= ISF is using regular/Toronto insulin

  • EXAMPLE ONE: Teddy, TDD 33, takes rapid insulin

    100/33= ISF of 3

    1 unit rapid insulin is expected to lower Teddys blood sugar by about 3 mmol/L.

  • EXAMPLE TWO: Bear, TDD 80, takes regular insulin

    83/80= ISF of 1

    1 unit of regular is expected to lower Bears sugar by 1 mmol/L. This is aggressive a safer start may be an ISF of 2.

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