Carb counting and insulin dosing…. Then, for each meal or snack, you will calcul
ID: 3512352 • Letter: C
Question
Carb counting and insulin dosing….
Then, for each meal or snack, you will calculate an appropriate dose of insulin. (use one unit per carb exchange)
Insulin can either be long-acting or short acting, you will need to decide. That is, you will need to give both daily doses for “overnight and basal coverage”, as well as bolus doses for meal coverage.
Keep in mind, you are now a type I diabetic:
What will you do as you exercise?
When will you test your blood glucose?
If you eat a fatty meal and it also has carbs, how is injecting different?
Could you lose weight by not taking your injections? How will this affect you?
Could we put you on a “pump”?
Explanation / Answer
Exercise can either lower the blood glucose levels or raise the blood glucose levels. Therefore blood glucose testing should be important after exercise. Ideally the patient should have a blood glucose test before exercise to know the basal value of glucose and then the patient should go for blood test after the exercise to know the deviation from basal value i.e whether the blood glucose level increased or decreased.
After having a fatty meal which also has carbohydrate then then the patients insulin amount and timing has to be altered. Carbohydrate is digested fast and fat is digested slowly. Fast acting insulin are active only for 3 to 4 hours, so this works better for carbohydrate diet when blood glucose levels increase after two hours of food. After fat diet blood glucose levels inrease after 5 hours hence by that time fast acting (short acting) insulin activity will be over so in the case of fat diet either we have to take long acting insulin or we need to change the timing of short acting insulin or the dose of short acting insulin.
Yes, by not taking insulin a person can loose weight. In the absence of insulin body can not break down sugar from foods to get energy instead the body cells breaks the stored body fats to produce energy. This leads to weight loss.
But while leading to weight loss, it can also lead to nerve damage, kidney damage, osteoporosis, damage to eye, etc.
Yes, Insulin pump can be used because it keeps the blood sugar levels at constant level most of the time. In Insulin pump we can programme the doses of insulin depending upon the type and quantity of food so that the blood glucose levels are constant.