Tips on lowering levels.. ?

[bigboi]

I think i can say im now confident in using lantus and nova rapid from using two injections a day. My carb counting seems to be right for the most part, the dsn and i are still testing getting my background better, it does seem that my levels have evened out but they stay level at around 12 - 14, does anyone else have this issue? Sounds like i need more background insulin? I am at 24 and told not to put it up to see how things run first...

 

[Garr]

using lantus and nova rapid from using two injections a day

Hi @bigboi, if you're carb counting and using basal/bolus, why are you only injecting twice a day? Are you on set amounts of Novorapid?

 

[azure]

I think i can say im now confident in using lantus and nova rapid from using two injections a day. My carb counting seems to be right for the most part, the dsn and i are still testing getting my background better, it does seem that my levels have evened out but they stay level at around 12 - 14, does anyone else have this issue? Sounds like i need more background insulin? I am at 24 and told not to put it up to see how things run first...

When exactly do you get the 12-14s? Is it all the time, just after meals, in the morning, etc?

 

[bigboi]

Hi @bigboi, if you're carb counting and using basal/bolus, why are you only injecting twice a day? Are you on set amounts of Novorapid?

Sorry i mean i used to do 2 injections a day.. Before moving on to this
And right now its 1.5 per 10g carbs. Today i woke up with 6.6, fine by me.. I had eggs for breakfast and took 1 unit.. Before lunch it has went up to 12.. It really looks like i need more background but i needed your guys thoughts

 

[bigboi]

When exactly do you get the 12-14s? Is it all the time, just after meals, in the morning, etc?

Hi, it is mostly lunch - tea - sometimes bed, before morning is my good point now, before it was my worst point, now its the good side lol

 

[bigboi]

I do correction doses all day (carefully timed) and it sometimes lowers it to what i want.. But now always :/

 

[azure]

Are you testing two hours after meals to make sure your bolus was correct for that meal?

The first place people usually start in trying to sort blood sugars is to do some basal testing. Eg as described here:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Once you get your basal right, then that gives a good foundation to build on. If your basal is wrong, it can make things harder to sort.

Once you've got that right, then you can check your insulin to carbs ratios for each meal and make sure they're ok.

 

[azure]

I do correction doses all day (carefully timed) and it sometimes lowers it to what i want.. But now always :/

If you're having to correct so much, it does suggest something is a bit 'out' somewhere.

 

[Garr]

Personally, I'd do a basal test to see if my basal was keeping my sugars level, (nothing to eat or no injecting for 4 hours and then test every hour). If that was good I would then look at increasing my bolus, insulin to carb ratio. A lot of hassle and testing I'm afraid but worth it to fine tune. To get a rough idea, if you don't eat or bolus 4 hrs before bed, how do your sugars compare when you go to bed and get up?

 

[bigboi]

Personally, I'd do a basal test to see if my basal was keeping my sugars level, (nothing to eat or no injecting for 4 hours and then test every hour). If that was good I would then look at increasing my bolus, insulin to carb ratio. A lot of hassle and testing I'm afraid but worth it to fine tune. To get a rough idea, if you don't eat or bolus 4 hrs before bed, how do your sugars compare when you go to bed and get up?

Ive actually done that kind of things, i skipped lunch, tried low carb, ate less, etc and tbh it still seems level .. It doesnt change too much example it doesnt go over fifteen and wont go under 10, and in the mornings i am single figures from 6+ usually

 

[bigboi]

If you're having to correct so much, it does suggest something is a bit 'out' somewhere.

Sound like the background needs more??

 

[bigboi]

Personally, I'd do a basal test to see if my basal was keeping my sugars level, (nothing to eat or no injecting for 4 hours and then test every hour). If that was good I would then look at increasing my bolus, insulin to carb ratio. A lot of hassle and testing I'm afraid but worth it to fine tune. To get a rough idea, if you don't eat or bolus 4 hrs before bed, how do your sugars compare when you go to bed and get up?

Umm more accurate example, before bed yesterday 10.5, hour or two later 8.9, woke up 6.6

 

[Garr]

If you're dropping by over 4 mmol/l a night without injecting 4 hours before bed, I wouldn't increase the basal as it shouldn't drop by more than 2. I would look at your carb/insulin ratio.

 

[Natalie1974]

I find that I also need to inject for protein,,.especially for a meal of eggs and bacon...I know there are a few people here that do. Found the following link to a thread discussing this which you may find of interest

http://www.diabetes.co.uk/forum/threads/insulin-sensitivity-on-a-low-carb-diet.34164/

 

[bigboi]

If you're dropping by over 4 mmol/l a night without injecting 4 hours before bed, I wouldn't increase the basal as it shouldn't drop by more than 2. I would look at your carb/insulin ratio.

Isnt 1.5 per 10g carbs high amount already?

 

[bigboi]

I find that I also need to inject for protein,,.especially for a meal of eggs and bacon...I know there are a few people here that do. Found the following link to a thread discussing this which you may find of interest

http://www.diabetes.co.uk/forum/threads/insulin-sensitivity-on-a-low-carb-diet.34164/

Very interesting thanks for that

 

[Garr]

Isnt 1.5 per 10g carbs high amount already

It's that old 'everybody's different' thing again, personally I'm roughly 1 per 10g, my older brother is 2 per 10g.

 

[azure]

Sound like the background needs more??

Not necessarily. It could be your meal ratios are wrong, for example. Lots of people have different ratios for different meals, so it may be that those need looking at.

You said you were on Lantus. When do you inject that? Could it be that your Lantus works well overnight but is dropping off during the day, causing highs?

There are lots of things to check out, including simple things like double-checking your carb counting is ok for particular meals.

If you and your DSN feel your basal insulin may be the issue, you could ask about trying a different one.

 

[Natalie1974]

Very interesting thanks for that

Probably not the best thread...I know there are others that explain it in a bit more depth...well worth doing a forum search on it though...was a real eye opener for me personally and helped to make my control a lot more stable.

 

[bigboi]

Not necessarily. It could be your meal ratios are wrong, for example. Lots of people have different ratios for different meals, so it may be that those need looking at.

You said you were on Lantus. When do you inject that? Could it be that your Lantus works well overnight but is dropping off during the day, causing highs?

There are lots of things to check out, including simple things like double-checking your carb counting is ok for particular meals.

If you and your DSN feel your basal insulin may be the issue, you could ask about trying a different one.

That makes sence thanks ! I take my background insulin around 6pm.. Which is when my numbers start to get better, so i see what you mean