Intensive insulin therapy | Nutrition
In type 1 diabetes, the diabetic does not produce their own insulin and can only maintain a normal state with insulin injections. There is a whole range of insulins, which, according to their time of action, can be divided into three categories: ultrafast and short-acting (3-6 hours), intermediate-acting (10-12 hours) and long-acting (18-24 hours).
With intensive insulin therapy, ultrafast insulins Humalog or Apidra and long-acting insulins — Lantus (up to 24 hours) or Levemir (up to 19-20 hours) are used. Insulins are widely used, which are a mixture in a certain proportion of short and long-acting insulins. For example, if there is a 30/70 “mix”, it means that there is 30% short-acting insulin and 70% long-acting insulin in this mixture. These relationships are very important when developing good diabetic control. In fact, the range of insulins is quite wide and the choice of the one suitable for this patient depends on the skill of the doctor.
Intensive insulin therapy that is most used today.
Typically, a diabetic with this type of compensation makes two types of insulin injections:
Daily Lantus insulin (most often before bedtime) to quench basal glucose released into the blood from the liver. And before each meal, an injection of short-acting insulin of Humalog is given (this insulin is obtained by genetic engineering methods and is akin to human). The time of its action (within 3-4 hours) is just enough to digest carbohydrates from food. In this case, the dose of short-acting insulin depends on the quantitative content of carbohydrates in the food and the level of glucose in the blood at the time of the meal. The key parameter here is the compensation factor. This ratio is the number of grams of carbohydrates compensated for by one unit of insulin. A diabetic can determine it himself with a home blood sugar meter — glucometer. The procedure for its determination is given in my scientific article (I will describe it in the next issue of our page)
It is important to note that this coefficient is individual for a diabetic and does not tolerate the “average” value, as you can sometimes read in some books. Now, to determine the dose of short insulin needed to compensate for the blood sugar from your breakfast, you need to divide the total carbohydrate mass by the compensation factor, usually before a meal. It is important to note that quite often diabetics, who are difficult to compensate, are “overloaded.” Due to very high blood sugar levels, they inject themselves with large doses of insulin, which causes hypoglycemia
About nutrition in insulin treatment.
The main one is a diabetic who injects insulin, especially with intensive insulin therapy, is free to choose his menu. Now almost all experts agree that, with the exception of white sugar, grapes and those products that are not given to a diabetic due to other diseases, the patient may eat what he likes. But … you need to know how much (by quantity) and when (by time). This knowledge is given in the process of learning, self-education and careful control.
It is known that the quality of diabetes compensation is determined not only by the value of blood sugar, but also by daily fluctuations in sugar, and fluctuations can only be judged by measuring blood sugar several times during the day.