>I just tried to widen my knowledge and wanted to research a very
>simple question: is insulin during its action "consumed"=destroyed?
[quoted text clipped - 4 lines]
>it seems to me, that insulin is not destroyed and that it is released
>back to the blood stream after the reaction with cell receptors.
Insulin has a relatively short life in circulation, similar to
C-peptide, which is why C-peptide is a good surrogate, and why
intermediate and long acting insulins have to be stored in a
biologically inactive intermediat form until needed (proinsulin, or as
a hexamer attached to a Zinc Protamine molecule).
>Does anyone know, why do the "carbs per unit of insulin" rules work
>(if they do)??
>
>Igor
Minimed at least to claim the 1500 rule. Take your daily insulin
requrement, 1500 by the number of units, and you have the grams of
carbohydrate 1 unit of insulin will cover.
Peggy Tatyana - 20 Jan 2004 03:50 GMT
> Minimed at least to claim the 1500 rule. Take your daily insulin
> requrement, 1500 by the number of units, and you have the grams of
> carbohydrate 1 unit of insulin will cover.
In case anyone is wondering, the missing word in the paragraph above is
"divide" -- as in, "divide 1500 by the number of units." At least, that's
what it says on the Minimed site.
P-T
Mack - 20 Jan 2004 15:29 GMT
>> Minimed at least to claim the 1500 rule. Take your daily insulin
>> requrement, 1500 by the number of units, and you have the grams of
[quoted text clipped - 5 lines]
>
>P-T
you also need to keep in mind that this is a "safe" starting estimate.
This formula is not 100% accurate and in most cases still needs to be
adjusted to the individual's actual responses.
Mack
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org
In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.
Igor wrote in message ...
>I just tried to widen my knowledge and wanted to research a very
>simple question: is insulin during its action "consumed"=destroyed?
[quoted text clipped - 9 lines]
>
>Igor
AFAIK, insulin is destroyed very rapidly after release to the blood. I
have seen at least one medical citation to that effect but Lord knows where.
By "carbs per unit of insulin" rules, I assume you are talking about the
1500 rule, the 1800 rule, and the 500 rule.
These are wholly arbitrary, totally empirical, and only approximate rules.
They are good starting points. They were devised by a genius** of a doctor
whose name I have lost. I think he practices in Atlanta. He figured out
these rules which the CDE I know use all the time.
(** In his spare time, I think he writes reference books on economics)
A way to look at them analytically:
1800 rule:
a. A 200 lb male T1 might be expected to eat 300 gram of carb per day.
b. Each gram of carb contributes 3 mg/dL to his daily blood sugar.
c. That means he needs a daily bolus containing enough insulin to handle
300 x 3 = 900 mg/dL
d. If he is anywhere close to control, then one can calculate his
bG/insulin response by dividing 900 mg/dL by his daily bolus
e. However, it is easier, and more accurate if he is using a peaky basal
like NPH, to just sum all of his daily insulin and use that in the
calculation.
f. In theory, his basal is about 50% of his total daily insulin.
Therefore, to simplify the calculation, double the 900 mg/dL and divide
by the total daily insulin. q.e.f. a simplistic derivation of the 1800
rule.
Therefore, divide 1800 by his total daily insulin to determine his
"tweak" ratio, or how much insulin he must shoot to knock down a peak.
500 rule
a. Assume the diabetic eats about 250 gram carb per day (last ADA diet I
saw said aim for 200 - 300 gram/day)
b. To calculate his carb to insulin ratio, divide 250 by his total daily
bolus (assuming he is close to control)
c. See "e" and "f" above. It is easier and more accurate to sum his
total daily insulin, double the 250 gram of carb per day, then divide the
resultant 500 by his total daily insulin to derive his carb per unit insulin
ratio for calculating a bolus.
Derivations full of "If's , assume's, guesses and sort of's" but they work
well as **** Predictive Starting Points ****.
Regards
Old Al
.
willbill - 21 Jan 2004 03:58 GMT
> Igor wrote in message ...
> > I just tried to widen my knowledge and wanted to research a very
> > simple question: is insulin during its action "consumed"=destroyed?
> AFAIK, insulin is destroyed very rapidly after release to the blood.
doc biggs (and secondarily mickey too) gave the
best answer a couple of years ago
the half life of insulin for "normal" people, once it's
in the blood stream, is something like 8 or 10 minutes.
i'm not sure if it's the kidneys or the liver that gets rid
of the active insulin that's in the blood or if it simply
gets used up in the cells (or all 3)
if you are a diabetic with SERIOUS complications
(kidney???), then that is when the half-life of
insulin *lengthens* (significantly!), and is when
you (mainly t2s) can run into needing a *lot*
*less* insulin
if you have serious diabetic complications
(i don't), you'd be best to ask your doc
about this. be SURE to get a 2nd
opinion too. :)
bill, t1 since '57
Frank Roy - 21 Jan 2004 19:06 GMT
> doc biggs (and secondarily mickey too) gave the
> best answer a couple of years ago
[quoted text clipped - 10 lines]
> you (mainly t2s) can run into needing a *lot*
> *less* insulin
There have been a number of threads on this topic. Dr. Biggs response on
the next one was excellent.
http://tinyurl.com/yvo3t
Google group archives search using terms -
"half life"+insulin++Dr.+William+Biggs
Frank
Igor - 23 Jan 2004 13:31 GMT
> There have been a number of threads on this topic. Dr. Biggs response on
> the next one was excellent.
[quoted text clipped - 3 lines]
>
> Frank
Thanks, few more centuries and I will learn how to use the group. It
was the first time I tried to search the archive and the result was
suprisely good.
One of the most interesting results of the search were the Dr. Biggs
messages about intravenous insulin shots. It seems to me now that IV
insulin should be relatively safer compared to insulin injected under
the skin (from hypo perspective). Has anyone realy tried IV
injections??? --- I know, it is not recomended, but who likes the
recomendations :-)
Igor
Charly Coughran - 23 Jan 2004 16:54 GMT
>> There have been a number of threads on this topic. Dr. Biggs
>> response on the next one was excellent.
[quoted text clipped - 15 lines]
> recomendations :-)
> Igor
On the contrary, an IV shot of insulin is much more likely to cause
hypoglycemia than a subcutaneous shot. Remember that your blood glucose
level is a balance between the incoming glucose and incoming insulin and
that the concentration of insulin in the bloodstream at any given time is
low. If the insulin arrives all at once via an IV injection, it will
scrub available glucose and produce hypoglycemia.
When IV insulin is administered, except in extreme situations such as
diabetic ketoacidosis, it is titrated in slowly. This means, if you
wanted to control your glucose from a meal for example, you would have to
be hooked up to an IV for a number of hours, depending on the overall
glycemic index of the meal, have a titration pump, and require frequent
bg determinations.
IV administration is good for an closed loop pump/bg sensor system to
minimize time lags in the automatic delivery system, but that is still a
ways off.

Signature
-------
Charly Coughran
ccoughran@DELETE-TO-RESPOND-UCSD.EDU
> I just tried to widen my knowledge and wanted to research a very
> simple question: is insulin during its action "consumed"=destroyed?
[quoted text clipped - 9 lines]
>
> Igor
Analogy time. You have 10 super soldiers. You're facing an army of
5000. Each guy takes out 10 of the evil Carbohydration army before
they die.
Both questions answered. The transference of sugar to fuel burns up
the insulin completely as it hits your bloodstream over time.
And the 10/1 rule? Been using it for about 8 or 9 years, but my level
is more like 1/12, whist my wife's is more like 1/8. You'll figure it
out by trial and error, but do take the time to do so. It's handy for
those unexpected snack sessions...