Another question for the diabetics here tha... - Kidney Disease

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Another question for the diabetics here that are on insulin.

jodaer profile image
14 Replies

I've just been put on insulin. I take it before each meal and then a long lasting one before bed. My question is, how do you manage when going out to eat? Do you inject at restaurant? Skip a dose or before or after you get home. Not asking for medical opinions just how do you manage this? It would seem to me that doing it in a public bathroom would be somewhat unsanitary.

Thanks, in advance.

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jodaer
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14 Replies
kellyscats1 profile image
kellyscats1

take your insulin with you and give it before the meal comes..

Bassetmommer profile image
BassetmommerNKF Ambassador

Good question. My husband needs to do his sugars before meal. He just DOES IT. He lifts his shirt and right into the gut he goes.....and everyone will get over. We got him a nice canvas kit holder with his shots and meters. Now he has the type of reader that there is a device on his arm that reads. Much more accurate. If you have not been told, do your testing more than once. And use an alcohol wipe on the finger and let it dry. Sugar and stuff on your fingers really makes a difference. Waitresses are used to seeing this done so don't worry. If a fellow patron stares at you, just smile and say nothing. People are ignorant. If they say something, just tell them you are a junkie...lolol

jodaer profile image
jodaer in reply to Bassetmommer

I like that. I'm used to checking my numbers but have been on meds until yesterday. I'm supposed to go out of town for a lunch next weekend and I'm not sure how to handle it. Not sure I want to bare my belly, but I do have 2 arms. My endo suggested a Dexcom, but I told her to wait on that. Get used to one thing at a time. Thanks

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to jodaer

If you wear a button down the front shirt, just unbutton the bottom one and in you go. Or lift it slightly if it is a pull over. No one gives a hoot and if they do... You can cover it with a napkin if you're shy Trust me, you need your meds and its tough if people have an issue. My husband felt funny at first but he would go to the bathroom.... but yuck. After a while, you won't give a hoot. The Dexcom is the bomb. Go for it as soon as you can. So much easier and so much more accurate.

barbara55109 profile image
barbara55109 in reply to jodaer

I agree. My Dexcom has saved my life. Because I'm on Wegovy, the weight loss dose of Ozempic, my blood sugars are now in the normal range. I get serious lows. That beeping meter lets me know I need to eat a smartie if I don't want to pass out. It is so much nicer than finger stabs. I type for work and knit and crochet for pleasures. The finger sticks were such a pain.

darkstar1974 profile image
darkstar1974

For me it depends on what I did before and will be doing after the meal, and what the meal is.

Do you already have you carb/insulin ratios worked out? If not get those sorted as it will assist greatly in know how much insulin to take.

If I was active earlier in the day I will take slightly less bolus insulin with the meal because my insulin sensitivity is likely higher due to exercise.

If you're going to be active after the meal I'd opt for not taking any insulin because the first hour or two after the injection is when the bolus insulin is most active. If you go for a walk after the meal you could end up with a hypo. Keep a tube of sugar tablets with you.

When they put me on insulin I was told to take 5 units with each meal. Having not done a ton of research I took the Dr. instructions. Sat down to a meal of Salmon, Veggies and a few roasted potatoes. 45 minutes after the injection I start feeling funny. Check the BG and it was 64. Had to chomp a bunch of sugar tablets to get it back to normal.

Also note with CKD your body will metabolize the insulin somewhat slower than non-CKD. This means it will last a bit longer.

Oh yea, and I just do the deed at the table if needed. There are ways to be discreet enough.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to darkstar1974

Folks, please don't prescribe especially something as sensitive as insulin. And you do not know what type of insulin he is on. Long acting or not. Jodaer is new to the process and needs to follow the doctors order exactly. Never tell a diabetic to skip a dose. And yes, the sugar tablets are a good idea to have.

Jodaer, you will learn that certain foods will spike you and others will not. It is a process and a very personal process.

darkstar1974 profile image
darkstar1974 in reply to Bassetmommer

As someone who has been taking insulin for a very long time and has interacted with jodaer in previous posts I can say that my advice was not off base or incorrect. Perhaps I should've disclaimed the response as only my personal experience.

I followed my doctors "guidance" when they first put me on insulin and it put me into a hypoglycemic event. So I did research and sought real world advice from fellow insulin users. It is not unsound real-world advice to tailor fast acting insulin dosage to prior and pending activity and carb intake. And yes, if the situation warrants skipping or delaying the insulin dose.

A person taking insulin would be foolish to "follow the doctors order exactly." Take 5 or more units of insulin after a moderate carb meal then go for a walk right after.

When jodaer said " I take it before each meal and then a long lasting one before bed." This most assuredly Bolus/fast-acting insulin (Humalog) for meals and Basal (Lantus) at night.

Clearly from their post history, being on pill based diabetes medication and posting prior A1Cs jodaer is a T2 diabetic not a T1.

Have a good 4th of July

Darlenia profile image
Darlenia in reply to darkstar1974

Omg, I so agree with you. One can't just "follow doctor's order", one needs to constantly adjust, adjust, adjust insulin (particularly short lasting insulin) depending on blood sugar levels. Yes, carbs and sugar intake matters hugely. Yes, physical activity matters. My hubby takes his readings constantly, particularly before and after eating and exercising and makes changes as needed. Preach on.

darkstar1974 profile image
darkstar1974 in reply to Darlenia

Absolutely. It is an ever changing math problem multiple times per day and sometimes the same variables and inputs will yield different results.

Banishing diabetes would be most welcome.

barbara55109 profile image
barbara55109

I inject at the table. I can do it discreetly. When my husband, who is also diabetic, would need to pull his shirt out of his pants he goes to the men's room.

jodaer profile image
jodaer

Thanks everyone for your comments and support. I think I should have also mention in my original post that while I'm new to insulin I've been a diabetic for 20 plus years. I'll add now that I'm on a Kwik pen, 4 units before meals. It seems to be premeasured and my doctor has said nothing about balancing my carbs with the insulin. I'm on Lantus, 4 units before bed.

Darlenia profile image
Darlenia

Hi Jodaer. My hubby is a diabetic and has been on insulin for many years, then totally got off with stringent dieting, and is now back on it after transplant meds brought it roaring back into his life. You're apparently taking long-lasting (Lantus-24 hr.) and short-lasting (the Kwik pen-3 to 6 hrs.) insulin. My hubby is very familiar with insulin and is using the same types as you are.

When we're going out to eat, my hubby often injects himself before leaving the house since it takes about 30 minutes for insulin to register inside the body. (Our restaurants aren't far away.) Occasionally, when he can't inject before the meal, he will do so immediately following the meal since it takes his body around an hour or so to react to the meal. (Important: Your body may be different!) My husband also has leeway to adjust his short term insulin in response to the number of carbs and sugars he expects to ingest. If there's a lot of "white stuff" like rice, pasta, potato, bread, and so on in his meal, then he administers more, not less. So that's where carb and sugar awareness is very important. Those items can raise blood sugar shockingly high. The most accurate readings are "blood" data from old-fashioned "finger sticks" so you're well prepared in that regard. But those finger pricks get old over time so you'll want to consider wearing either a Dexcom or Libre sensor system down the road. (Insurance picks up the cost for those on insulin.) While they're less accurate, they're generally close enough. The Dexcom is much easier to apply and can be worn in more places on the body than the Libre. The Libre, on the other hand, doesn't have to be changed out as often. My hubby tried both and prefers the Dexcom for ease of use. Just a word of caution - insulin produces strong results, so it's also very volatile. Please take readings often. Darkstar makes great points re hypoglycemia, exercise, and more. My hubby passed out behind the wheel - his new car saved him by braking and putting on the hazards. And that's why he now wears a sensor. We are beyond grateful to technology. I just wish it would banish diabetes, it's such a curse. Hope springs eternal! :)

jodaer profile image
jodaer

Thanks everyone for your support and advice. It's much appreciated. I understand now that while I've been diabetic for a long time the rules have changed due to the changeover to insulin. You've given me a lot to think about. And just so you know I follow my doctor's advice until I think she's wrong. Happy 4th to the people in the US

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