FUDiabetes

Tdd?

How much insulin do you take (total daily dose)?

Me: F, 5’6”, 132lbs, 41 years old I’m averaging about 30 units a day TDD (basal + boluses). I eat probably 60-100 carbs a day…ish? Striving of late for keto, but I stick to it only here and there.

I have a sedentary job (desk job), but do intense exercise most afternoons or mornings for an hour or longer.

Do you think that’s a lot or a little or average for my stats? Curious…

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I don’t know, but as a T2DM on MDI my total insulin dose is the same total units as you. However I’d be curious to know what your basal dose. Mine is 25u, with bolus 6 to 8 units. This might reflect insulin resistance and still secreting some insulin.

Our carb load is about the same and I exercise daily.

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My basal is about 22 per day.

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Then we are very close, You use a bit more bolus and a bit less basal.

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If it works for you and you attain your BG/A1C goals, then it’s the right amount!!

T1s can also have insulin resistance or high insulin sensitivity, which would mean another person with your routines would require a different amount.

Many women see drastic changes during parts of the month, while others see no or minimal change.

Amount of carbs per day will also lead to many variations. A low carber/high protein diet would also influence total units.

If you have what works for you, GREAT!!!

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My son eats medium carb, weighs 185 pounds, and uses approximately 40 - 45 units a day. So by weight it is about the same as you. I will say that his diet influences his dosing much more than anything else.

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My son, Liam, has a TDD ranging from 20 most days to, on extreme days when we’re partying hard, 40 or 50 units…but average is around 20u. We don’t restrict carbs…he eats what everyone else in the house eats. He’s 7 and probably around 50 lb…haven’t weighed him since the last Endo visit…so last March. lol

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I use between 9 and 12 units for basal depending on my hormones, and 25-30 units per day for eating. TDD of 34-42 units usually. I shoot for about 150g of carbs per day over five total meals/snacks.

I paid attention to TDD when I first started on insulin to keep an eye on what my providers were recommending to keep me out of trouble. And that proved VERY helpful and necessary bc they were pulling dosing numbers out of their hind quarters to the tune of 3x the amount of basal that I actually needed…which thank goodness I didn’t listen to my endo. (Like seriously…I’d taken around 11 units of Lantus for nine years and he wanted me to start on a pump using 1.2 units per hour. What?!)

And I pay attention to TDD for sick days and suspected illness (or COVID vaccine monitoring).

Otherwise, I think I fall into the category of “needs very little basal but a whole lot more for food” by Gary Scheiner’s charts since I’m a 25% basal and 75% bolus split.

If you’re curious about it by weight, I’m 130#s.

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I will say that when it comes to insulin dosing, the doctors have to give us a starting point as we are all different in how our bodies react to carbs and insulin.

When I started MDI back in January, my doctor gave me a sliding scale, bolus doses determined by prepradial BG. That didn’t work for me because my before meal BGs tend to be near normal but would rise sharply postprandial.

I had to learn my personal unit to carb grams ratio by the half units as well as learn how long Humalog lasted.

For years I have split Lantus into two doses before I started Humalog. This decreased nocturnal hypos and allowed me to delay the morning dose prior to bike riding. I have been injecting Lantus 3 times per day because no matter the bolus before lunch, 2 to 3 hours after BG would rise as the Humalog levels decreased.

This has worked very well. My 14 day average glucose is currently 108mg/dl 99.5 in range with a couple of faux lows ( I finger stick if Dexcom reports a low without symptoms).

I’m just going on and on, when I just wanted to agree with you about doctors unable to accurately prescribe basal/bolus doses.

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I agree that the doctors can’t predict everything.

But, I was most disappointed in my endo bc I had a decade’s worth of Lantus experience and he didn’t even look at my Lantus dose or my weight or my TDD when he made up 1.2 units per hour for my pump as a starting point. And I was the person who kept a daily log of everything. Forever. He had so much info at his disposal and he was too lazy to look at any of it.

He could have referred to my basic Lantus needs or my weight or my TDD for the ballpark starting point for my basal. I know Scheiner’s book covers those approaches for getting safely started on a pump. And Scheiner himself said my endo could have killed me trying to start me at 300% of my demonstrated need.

But my endo did none of those things. I was sitting there in the appointment and he just said, “Try 1.2 units per hour and we’ll see what happens.”

What?! LOL, that’s literally the most insane approach ever!

So I do think there’s value in knowing your TDD, especially when transitioning between therapies. It can protect you from out-to-lunch doctors! I’ll stick to 0.4 units, thank you very much! LOL

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I have one experience with an endo. We only have two in my area as far as I now. This guy was too full of himself to listen to my history. I was in very good control as a type 2 DM for years with diet, exercise, Metformin and Lantus. Knowing that T2DM tends to progress I wanted to have an endo on board.

This guy wanted to throw out the Metformin and Lantus for some new drug. It pissed me off so much that I walked out of his clinic never to darken his doorway again.

My opinion of endos has not been improved reading diabetes forums. Some are great and some think they are great.

Well the bike is waiting for me. The humidity is high and soon the temperature will rise to near 100° F today, so I best get rolling.

°

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I love this sentence. Spot on!

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I actually suspect I’m over dosing basal and under dosing bolus. I have always been really scared of aggressive blousing, which I’m trying to get past.

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I’m of the mindset that there’s not one absolute best approach for anyone. I think each of us could accomplish what we want using five different approaches each meal, each snack, each day, etc. Including when looking at basal and bolus split. I don’t think there’s a secret “right” answer that we’re all trying to discover. I think there are lots of avenues that can get us where each of us wants to go.

I do think TDD and the basal/bolus split can be helpful to be aware of for certain things. But I don’t think one split is best for anyone over another.

No matter what, I hope you find what makes you comfortable and successful in the ways that you define them both!

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I weight 170 lbs and do a lot of sports every week. I use 45 to 60U in TDD most of the time, more often mid 50s. My basal is 20-30U per day: I Loop/Autobolus, so Loop will suspend me when I go down. I eat a good amount of carbs every day. When I don’t exercise, I tend to use 25/45/45 carbs per day, but when I do exercise, which is almost every day, I refuel with normally 80+ carbs per dinner, and more carbs at other meals. So most days I am probably around 150-175 carbs, not counting carb corrections for being low, which is pretty often for me.

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I’m 35 and have 11month old twins. Former crazy athlete. As low as 12u basal and as high as 24u. (not counting pregnancy – see that thread 4x as much and ate a few easy 100u meals) No idea what carb counts are anynore but need to shape up before my first endo appt in a year (first in person and first since babies). My a1c is probably still 5.9-6.2 but I Know I’m in trouble for not paying any attention to my own health. its a 5u meal, an 8u meal or a 10u meal these days. all pretty high carb.

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I for one will be giving you a pass. If you can maintain that A1c and not pay any attention to your health, great for you. In just 3 more years (assuming you don’t have any more children) I will start judging again. Keep up the good fight, and enjoy the motherhood milestones (they come fast and furious at your kids’ age).

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I basal 60-65u every day and generally use 40-60u of rapid acting insulin throughout the day for meals and corrections. I’m 42 years old, 6’-0" and 240lbs T2 for what its worth, but not sure body size makes a difference with sensitivity and resistance levels.

Anecdotally, I was recently hospitalized for 3 days with unspecified pneumonia (I think it was a breakthrough covid variant but who am i to argue with a hospital)… anyway, every time I ate in the ICU the nurse would come in and be like “here’s 5 units of novolog” and I’d just chuckle and be like “I’m eating pudding here and on steroids that jack my sugar, we might want to revisit the dosing.” LOL

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Hospital dosing never makes sense to me. They wanted to give me 16 units before lunch (I rarely take more than 2 for any meal). I just started to cry. It surprised me too, but it scared the bejeezzes outta me.

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