Thank you for the excellent video! I have also been a T1D only on injections for over 45 years and have not had any diabetic complications so far. I have done it so long that I haven't needed to carb count as I can just look at the type of meal, the time of day and expected activity and I know about how much insulin to take. I also micro-dose as needed with the help of my Dexcom CGM, which can be as much as 3 to 6 times a day, which is very important for good control! My 90 day CGM data today shows a 102 mg/dl average glucose, 35 std dev, 5.7% GMI and 88% TIM, which is very typical, and my a1c's have always been between 5 and 6 for as long as I can remember. I might be able to get even better with a closed loop pump system but I am happy with my control without all the work required to use a pump. I use Tresiba basal insulin once in the morning that rarely I need to change unless I am sick and Lyumjev short acting, which is great as the duration matches the balanced meals I typically eat and for for corrections because it is fast acting. I do tend to eat healthy, eat smaller meals and snack in between and I eat dinner early around 5 PM so it doesn't cause problems after I go to bed. I drink alcohol moderately, maybe 1 drink a day, and never smoked. I maintain a healthy weight and stay active by working out 3 times a week for 2 hours split into cardio and weight training and usually do some light exercise on my off days like walks. Exercise also greatly helps to keep my diabetes in good control and healthy at age 63 (people say I look 40!). I provide this information because I think it has worked great for me without having to put in a ton a work in managing my diabetes and maybe it could help others.
I have watched many of your videos. I was DX T2 about two months ago, so I am just getting used to the diet/insulin process. I am good with math and have a medical background, so I can keep up with your points. I am also using a Dexcom D7. This video has given me a great deal to think about. I need to research the stats on my long-acting insulin because the half-life is greater than 24 hours. I am considering splitting up the dose into two separate sessions. The biggest hack you gave me that I love is using an insulin syringe to extract the last bit of "juice" out of the pen when it won't push out anymore. I am sure that is to be consistent and reliable when you are a pen, but if you can draw up the last 5 or 7 units in a traditional syringe, why waste it!
Great video, thank you! Wish I'd watched it a year ago when i was diagnosed. I do find that high protein meals, like omelettes, make me need far more insulin than I usually would, was quite shocked by how much. I also find that I'm far more insulin resistant when I'm tired, in addition to when stressed or ill. If i get a poor night's sleep then I'll often need up to 50% more insulin the next day. It's certainly a steep learning curve!
Thank you. Yes, so much can impact blood sugars including sleep and protein. Check out this video on what can impact blood sugars, I think you’ll find it interesting ua-cam.com/video/pLBqSRb1w_A/v-deo.html
Your videos have helped me get my type 2 diabetes under control. This video had some really good points. My treatment looks different as I take a rapid acting insulin before I eat three times a day. I follow numbers that my doctor's have given me. At bedtime I take one injection of long acting insulin at a prescribed number which is 55. I find that I start going up in blood sugar at about 7am. What and why is that? Thank you so much for your great information and help!
I’d say one of two things could be going on. Either your long-acting is too low and you’re slowly trending upward overnight. Or, you’re in range overnight and start to climb either early AM or when you get out of bed. This could either be Dawn phenomenon or “feet-on-the-floor”. Most of us see that morning rise. So, if it’s the long climb overnight your doctor might want to increase your long-acting. If it’s an early morning rise, you could ask your doctor if you should take a small dose of rapid-acting insulin when you wake up
Both Lantus and Levemir’s duration is 24 hours. But you might find that you metabolize it a little differently. I think that’s why many endocrinologists I’ve talked to recommend taking it both morning and evening
I would like for you to make a video on how to inject your self and the areas of the body to be injected. I’m new on using insulin I’m going to start in a couple of days . Thank you for your info
26 yrs living with t1d and never felt that pen injection correct for sure coz always my levels get hight so I quit using it and syringe got love that sting old baby
Informative video, thank you! Since you inject, how do YOU handle instances when the needle injects improperly - slips, and maybe injects less than set up to inject?
Great advice as usual. I've been micro dosing more over the past year or two. Currently on Novorapid (for meals, corrections and snacks) and Levemir twice daily. Insulin on board is very important, and I use the mylife app for calculating insulin on board and dosing. Maybe the Omni app is only available on iOS, or not in Australia? One thing I have added more recently to my dosing calculations is carbs on board if I want to snack between meals or to help calculate correction doses more accurately. This is more complicated and depends on the timing and types of meals previously eaten (slow, medium or fast absorbing), but it helps keep my blood sugars in range more often. I use a spreadsheet to do the calculations as I don't think there are any apps to do this. It's still a lot of trial and error though. As you mentioned, it's hard to stay in range all the time because of what life throws at us.
That’s awesome. I’m not as structured about “carbs on board” but I do include it in my mental calculations. But sounds like you’ve taken it to a whole other level 👏🏽
Again you have some great info. Just wondering if you have much drifting on your Carb Ratio or on your correction factor. I had stayed at 1 unit for 10 grams on Carb Ration for years and 1 unit for 25mg/dL then it seems like I had a major shift to 1 unit/5 grams and 1 unit for 12 mg/dL.
Yeah, mine does change as well. And pretty awesome that you’ve noticed it so that you can make the appropriate adjustments 👏🏽 For me, it seems linked to my activity level and overall lifestyle. When I’m less active or travel more it will change. Currently, my carb ratios are ~10 but my correction factor is much lower from around 10 PM through 4 AM than the rest of the day (and that’s relatively new)
I think it depends. With the super long-acting insulin (Tresiba/Toujeo) it doesn’t matter. For Lantus or Levemir I’d schedule it so it works best for your blood sugars. If you have an afternoon blood sugar peak it might be optimal to take your long-acting in the morning. A morning peak, maybe take it in the evening. I’ve experimented until I found the timing that works best for me but it’s also a great conversation to have with your doctor
Thanks great video ❤❤ so if you didnt inject enough for your meal or your correction you wait at least 2 hours for a correction dose do you use the pen app to figure the dose or by calculating thanks love the channel getting better an better🌸
Thank you for your videos. Type 1. Underweight, 5'7", 110 lb female. I take Tresiba, long acting. I'm low carbohydrate and no sugars. I still stay high all day around 155-180 ... after 11 units Tresiba and meals like an avocado, or broccoli soup, or almonds, or celery. I then crash all night long ... 50 - 55. I'm not doing the meal time injections because I'm low carb, on the Tresiba long acting, and crashing all night. Can anyone advise?
You’d have to discuss it with your doctor but I guess that you need less Tresiba and small doses of rapid-acting when you eat, even if you eat low-carb
Hello their, how many units of long acting Do you usually take morning and during evening time? Mine i take morning time only @8 AM 10 units of tresiba. Thank you
How much long acting we each need is highly individual, so comparing doses really makes sense. But, because you asked, usually around 20-21 units split into two doses
Ma'am, I'm Alice, I am having type 1 diabetes since the age of 6 . now I'm 13 and I'm taking 14 units of rapid acting insulin Apidra penfill, because my blood sugar is always high it always stays in 390 mg/dl.that's why I'm taking 14 units of Apidra, my lantus dosage is also 14. My doctor didn't tell me to have 14 units, but I'm taking 14 units apidra because my blood sugar is always high... please tell me how much units I should take Apidra and lantus... Please ma'am , your 1 reply is a lot for me🙏🏻
I can’t give you dosing guidance, only a medical professional is allowed to do that, but it sounds like you need your doses adjusted. Try asking your doctor for guidance or (if possible) ask for a referral to a diabetes educator. You might also find this article helpful diabetesstrong.com/insulin-to-carb-ratios/
My mom is 91 amd we just started long acting insulin which she never wanted to start but the meds weren’t controlling her blood sugars adequately ie rybelusus,metformin and prandin.she hates needles and is frail and is sensitive to psin.I found the thinnest shortest needles ie 4 mm w 32 gate and sge only wants shots in back upper arms..refuses all other areas… she feels psin all the time w each shot and grimaces and sometimes screams…her blood sugar is now great but any suggestions on reducing pain? I wipe aria w alcohol wipes, wait till it dries , go in quickly at 90 degrees after pinching area ( w or wo pinching sge feels pain)
I'm sorry, that sounds traumatic for both of you. Look into getting er an iPort (from Medtronic). You change the port every 3 days and inject insulin through it. So not needle piercing her skin on a daily basis, only a pinch every 3 days.
@@DiabetesStrong thank you but she would hate having this on her skin - she hates anything attached to her body...we only inject once per day ...so probably not a fit for her right now......
Thank you for the excellent video!
I have also been a T1D only on injections for over 45 years and have not had any diabetic complications so far. I have done it so long that I haven't needed to carb count as I can just look at the type of meal, the time of day and expected activity and I know about how much insulin to take. I also micro-dose as needed with the help of my Dexcom CGM, which can be as much as 3 to 6 times a day, which is very important for good control!
My 90 day CGM data today shows a 102 mg/dl average glucose, 35 std dev, 5.7% GMI and 88% TIM, which is very typical, and my a1c's have always been between 5 and 6 for as long as I can remember. I might be able to get even better with a closed loop pump system but I am happy with my control without all the work required to use a pump. I use Tresiba basal insulin once in the morning that rarely I need to change unless I am sick and Lyumjev short acting, which is great as the duration matches the balanced meals I typically eat and for for corrections because it is fast acting. I do tend to eat healthy, eat smaller meals and snack in between and I eat dinner early around 5 PM so it doesn't cause problems after I go to bed. I drink alcohol moderately, maybe 1 drink a day, and never smoked. I maintain a healthy weight and stay active by working out 3 times a week for 2 hours split into cardio and weight training and usually do some light exercise on my off days like walks. Exercise also greatly helps to keep my diabetes in good control and healthy at age 63 (people say I look 40!).
I provide this information because I think it has worked great for me without having to put in a ton a work in managing my diabetes and maybe it could help others.
Thank you for sharing
I have watched many of your videos. I was DX T2 about two months ago, so I am just getting used to the diet/insulin process. I am good with math and have a medical background, so I can keep up with your points. I am also using a Dexcom D7. This video has given me a great deal to think about. I need to research the stats on my long-acting insulin because the half-life is greater than 24 hours. I am considering splitting up the dose into two separate sessions. The biggest hack you gave me that I love is using an insulin syringe to extract the last bit of "juice" out of the pen when it won't push out anymore. I am sure that is to be consistent and reliable when you are a pen, but if you can draw up the last 5 or 7 units in a traditional syringe, why waste it!
So happy to hear that my videos are helpful. Thank you for watching and for sharing your experience
Great video, thank you! Wish I'd watched it a year ago when i was diagnosed.
I do find that high protein meals, like omelettes, make me need far more insulin than I usually would, was quite shocked by how much.
I also find that I'm far more insulin resistant when I'm tired, in addition to when stressed or ill. If i get a poor night's sleep then I'll often need up to 50% more insulin the next day.
It's certainly a steep learning curve!
Thank you. Yes, so much can impact blood sugars including sleep and protein. Check out this video on what can impact blood sugars, I think you’ll find it interesting ua-cam.com/video/pLBqSRb1w_A/v-deo.html
@@DiabetesStrong thank you I will 🙂
I will have to go back and study this more! It looks like it will be helpful Thank you
You gave me hope to achieve a good HbA1c with MDI. I'm newly diagnosed with T1D (three and a half months ago). Thank you so much.
Super happy to hear that. You can do it
Your videos have helped me get my type 2 diabetes under control. This video had some really good points. My treatment looks different as I take a rapid acting insulin before I eat three times a day. I follow numbers that my doctor's have given me. At bedtime I take one injection of long acting insulin at a prescribed number which is 55. I find that I start going up in blood sugar at about 7am. What and why is that? Thank you so much for your great information and help!
I’d say one of two things could be going on. Either your long-acting is too low and you’re slowly trending upward overnight. Or, you’re in range overnight and start to climb either early AM or when you get out of bed. This could either be Dawn phenomenon or “feet-on-the-floor”. Most of us see that morning rise.
So, if it’s the long climb overnight your doctor might want to increase your long-acting. If it’s an early morning rise, you could ask your doctor if you should take a small dose of rapid-acting insulin when you wake up
@@DiabetesStrong Ok, thank you. I will definitely be in touch with my doctor.
Solid video! Thank you for making it. 😃👍
Thanks
Great Information! Thank you.
I use Lantus as my long acting insulin, how many hours does Lantus lasts in my body? Please reply
Both Lantus and Levemir’s duration is 24 hours. But you might find that you metabolize it a little differently. I think that’s why many endocrinologists I’ve talked to recommend taking it both morning and evening
I would like for you to make a video on how to inject your self and the areas of the body to be injected. I’m new on using insulin I’m going to start in a couple of days . Thank you for your info
I think this is the video you’re looking for ua-cam.com/video/AIhcpWBP_cQ/v-deo.html
26 yrs living with t1d and never felt that pen injection correct for sure coz always my levels get hight so I quit using it and syringe got love that sting old baby
Informative video, thank you!
Since you inject, how do YOU handle instances when the needle injects improperly - slips, and maybe injects less than set up to inject?
This video is quite helpful 😊 as I do have problems with counting carbs and I'm a user of Levemir and humalog for my fast acting
Glad it was helpful
Great advice as usual. I've been micro dosing more over the past year or two. Currently on Novorapid (for meals, corrections and snacks) and Levemir twice daily. Insulin on board is very important, and I use the mylife app for calculating insulin on board and dosing. Maybe the Omni app is only available on iOS, or not in Australia?
One thing I have added more recently to my dosing calculations is carbs on board if I want to snack between meals or to help calculate correction doses more accurately. This is more complicated and depends on the timing and types of meals previously eaten (slow, medium or fast absorbing), but it helps keep my blood sugars in range more often. I use a spreadsheet to do the calculations as I don't think there are any apps to do this. It's still a lot of trial and error though. As you mentioned, it's hard to stay in range all the time because of what life throws at us.
That’s awesome. I’m not as structured about “carbs on board” but I do include it in my mental calculations. But sounds like you’ve taken it to a whole other level 👏🏽
Thanks for the wonderful information 😀
Thank you
Again you have some great info. Just wondering if you have much drifting on your Carb Ratio or on your correction factor. I had stayed at 1 unit for 10 grams on Carb Ration for years and 1 unit for 25mg/dL then it seems like I had a major shift to 1 unit/5 grams and 1 unit for 12 mg/dL.
Yeah, mine does change as well. And pretty awesome that you’ve noticed it so that you can make the appropriate adjustments 👏🏽
For me, it seems linked to my activity level and overall lifestyle. When I’m less active or travel more it will change.
Currently, my carb ratios are ~10 but my correction factor is much lower from around 10 PM through 4 AM than the rest of the day (and that’s relatively new)
Great video as always!❤️can you please tell me what’s the best time to inject the long acting insulin?morning or night?
Thank you
I think it depends. With the super long-acting insulin (Tresiba/Toujeo) it doesn’t matter. For Lantus or Levemir I’d schedule it so it works best for your blood sugars. If you have an afternoon blood sugar peak it might be optimal to take your long-acting in the morning. A morning peak, maybe take it in the evening. I’ve experimented until I found the timing that works best for me but it’s also a great conversation to have with your doctor
Thanks great video ❤❤ so if you didnt inject enough for your meal or your correction you wait at least 2 hours for a correction dose do you use the pen app to figure the dose or by calculating thanks love the channel getting better an better🌸
Thank you. For general corrections, I’ll wait those 2 hours and often use the InPen to calculate the dose. But I don’t always use the calculator
Where can I buy this smart pen ?
the smart pen is called "InPen" and is a Medtronic device. You need a prescription and can only be bought in the US at this time
How to calculate insulin on board please ?
Here's a video on how to calculate insulin on board: ua-cam.com/video/aHZPpQxJ3Ys/v-deo.htmlsi=sk8EqNKTUguuqImt
@DiabetesStrong thank you so much you are amazing, love u ❤️
Thank you for your videos. Type 1. Underweight, 5'7", 110 lb female.
I take Tresiba, long acting. I'm low carbohydrate and no sugars. I still stay high all day around 155-180 ... after 11 units Tresiba and meals like an avocado, or broccoli soup, or almonds, or celery.
I then crash all night long ... 50 - 55. I'm not doing the meal time injections because I'm low carb, on the Tresiba long acting, and crashing all night.
Can anyone advise?
You’d have to discuss it with your doctor but I guess that you need less Tresiba and small doses of rapid-acting when you eat, even if you eat low-carb
@@DiabetesStrong Thank you so much.
Hello their, how many units of long acting
Do you usually take morning and during evening time?
Mine i take morning time only @8 AM
10 units of tresiba.
Thank you
How much long acting we each need is highly individual, so comparing doses really makes sense. But, because you asked, usually around 20-21 units split into two doses
@@DiabetesStrong i really appreciate your response you are such an inspiration to me
Thank you so much 🥰
Love from the Philippines 🇵🇭
Ma'am, I am an Indian and i eat oily-food everyday. I don't do a particular diet, how many units of insulin should I take? Please reply
I can't guide you on that but these might be good resources for you:
diabetesstrong.com/carb-counting/
diabetesstrong.com/insulin-to-carb-ratios/
@@DiabetesStrong Thank u
I have questions I am using lantus how can I get the last bit of lantus out my pen
I made a short where I showed how I get the last drops out some time ago, this is the link ua-cam.com/users/shortspCbP57jpNts?feature=share
Ma'am, I'm Alice, I am having type 1 diabetes since the age of 6 . now I'm 13 and I'm taking 14 units of rapid acting insulin Apidra penfill, because my blood sugar is always high it always stays in 390 mg/dl.that's why I'm taking 14 units of Apidra, my lantus dosage is also 14. My doctor didn't tell me to have 14 units, but I'm taking 14 units apidra because my blood sugar is always high... please tell me how much units I should take Apidra and lantus... Please ma'am , your 1 reply is a lot for me🙏🏻
I can’t give you dosing guidance, only a medical professional is allowed to do that, but it sounds like you need your doses adjusted. Try asking your doctor for guidance or (if possible) ask for a referral to a diabetes educator.
You might also find this article helpful diabetesstrong.com/insulin-to-carb-ratios/
My mom is 91 amd we just started long acting insulin which she never wanted to start but the meds weren’t controlling her blood sugars adequately ie rybelusus,metformin and prandin.she hates needles and is frail and is sensitive to psin.I found the thinnest shortest needles ie 4 mm w 32 gate and sge only wants shots in back upper arms..refuses all other areas… she feels psin all the time w each shot and grimaces and sometimes screams…her blood sugar is now great but any suggestions on reducing pain? I wipe aria w alcohol wipes, wait till it dries , go in quickly at 90 degrees after pinching area ( w or wo pinching sge feels pain)
I'm sorry, that sounds traumatic for both of you.
Look into getting er an iPort (from Medtronic). You change the port every 3 days and inject insulin through it. So not needle piercing her skin on a daily basis, only a pinch every 3 days.
@@DiabetesStrong thank you but she would hate having this on her skin - she hates anything attached to her body...we only inject once per day ...so probably not a fit for her right now......
I want a smart pen
Don't eat any sugar at all!