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Expert Answers (1)
09/28/09
09:43 PM
Dear angietz,
Thank you for writing into dLife. The situation you described can be easily addressed by using specific types of insulin. What we do at my practice is to use a 24 hour insulin once a day and have the person inject a short or quick acting insulin when you eat. The long-acting insulin is about half of the person's insulin requirements. If you sleep in, you don't take the short/quick acting insulin until you are about to eat. It is usually best if you don't give yourself short/quick acting insulin closer than every 3-4 hours, so instance, don't give yourself a noon shot then an hour later give yourself another shot. That makes the dosing of the quick acting insulin unpredictable and could give you a low blood sugar. The 24 hour insulin can be given once a day at the same time per day. So, if you like to sleep in, have your once a day time be in the evening. Good luck with this regimen. I know you can make it work for you and give you more freedom.
For more information about sleep and diabetes, just click here.
Answered By:
Janice Fisher
Accreditations: RD, LD, PHD, CDE, BC-ADM
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Community Answers (1)
10/02/09
05:03 PM
No, you don't. If you aren't fully alert, metering and taking a combination of insulins this way can be dangerous. (And if you were fully alert,why would you go back to bed?)
A pump user will slow or suspend the insulin delivery if a meal or activity is delayed. Getting up late in the morning is delaying an activity. With MDI you can do the same thing.
When I was diagnosed, pumps hadn't been invented. My job had me traveling across time zones and working odd hours. It took me a few years, but I figured out that if I had my basal insulin calculated correctly, and my diet in control, I would consistently have a morning fasting level that was safe. As long as I didn't eat or take a bolus, I could sleep as late as I wanted.
After I switched to LAntus and Humalog, I evened out my basal delivery by splitting it in half, duplicating the schedule I originally had when I used NPH Humulin. Normally I take half when I wake and half at dinner. If I sleep late one day, I split the time difference for the evening dose. If I sleep late, my basal need is partially 'covered' by the second 12 hours' activity of the previous dose. The reduced level of this coverage prevents me from becoming hypoglycemic.
If I sleep really late, I don't try to replace breakfast; I skip right to my closest meal either my morning snack or lunch, and resume my bolus doses. If I get up early to travel out of town, I take my morning insulin doses then, moving my meal schedule forward.
The key to keeping your BG in control and achieving your management objectives is to think like a navigator. Learn to use very waking and bedtime test as a position update, use every meal bolus and bedtime bolus as a "course correction".
Answered By:
psdaengr
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*** All information contained on dLife.com is intended for informational and educational purposes only. Our Expert Q&A is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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