Snap! The lancet pierced Nicole’s finger, one evening before dinner. Beep! The glucometer displayed a blood glucose level of 6.8mmol/L.
Too high. The aroma of lamb stew encouraged a quick calculation on Nicole’s part.
We know that 1 unit of humalog will lower her blood sugar 3 mmol/L. She needed to go from 6.8 mmol/L to 4.7mmol/L. That’s a 2.1mmol/L drop. 2.1 divided by 3 equals 0.7 units of insulin.
“Ahh!,” said Nicole with a sigh.
We’d run into problem a lot. We found we can only reliably measure humalog in 1/2 units. Trying to measure a 1/4 unit is not realistic.
Nicole had tried diluting the humalog per the instructions in Dr. Bernstein’s Diabetes Solution. Strangely, the insulin became totally inactive.
So we had resolved ourselves to rounding down to the nearest 1/2 unit of humalog. That may not sound like much of a sacrifice, but humalog is very potent. 1/4 unit is a fair loss.
So that meal, Nicole injected her 1/2 unit of humalog. Then she started to dose up 2.5 units of regular insulin to cover the meal.
“Hey,” I said, ” why don’t we just add an extra 1/2 unit of Regular?”
Regular insulin is about half the potency of humalog. So an extra 1/2 unit of regular would be the same as a 1/4 unit of humalog.
“It won’t absorb as fast as Humalog,” said Nicole. “But slow is better than nothing.”
Since that time, we’ve been using this method regularly. Anytime Nicole needs an extra 1/4 of insulin, we just add some regular to her postprandial dose.
She’s maintaining a HgbA1C of 5.2%, so I think it’s working . It probably helps a little that the correction is being injected from two different sites.
Of course, doing all these calculations, each time her blood sugar needed correcting, proved redundant and time-consuming. I’ve since come up with another solution for more quickly determining how much units she needs. I’ll share this in a future post.
–John C. A. Manley
P.S. When Nicole was using an insulin pump, of course, the manual claimed it could inject 1/10 a unit. Thanks to the scar tissue the pump produced, we were never even convinced it could inject a whole unit accurately, no less a tenth. For more on why we decided to dump the pump you can read: Ditching the Insulin Pump for Better Blood Sugar Management (Part 1)
P.P.S. If you’d like to learn from our experience attaining an HgbA1C below 5.4%, you can schedule a coaching call with me. I don’t give medical advice, but can help you understand how to apply what has worked for us in your efforts to improve your blood sugar management.