High of 14+ at the end of day

4mum_

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125
Type of diabetes
Type 1
I've only been t1d since May (55yo) and carb counting for 6 weeks. I do my last BG and Lantus about 10pm. Recently I've had the occasional 14+ but if I take a correction dose of 2 units I find I have a hypo either early hours or the first BG of the day. I eat my evening meal around 6pm so would hope it's not that. Tonight I made burgers and had 1 in a wholemeal sandwich with some cheese and salad and had 5units of novarapid which I calculated to be enough. Any thoughts please.
 

karen8967

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Hi 4mum i was only diagnosed t1 myself in april i am (50) sometimes b4 bed my bgs are around 14/15 i dont do a correction dose as i find by morning my bgs are bk to normal range which is around 6ish for me i did post a thread on this subject azking the same as you sometimes it could be the fat or protien in your food having a delayed reaction hence the high bg when you dont bolus are they normal by morning ? X
 
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4mum_

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125
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Hi Karen. I wondered if it was something like that but I generally eat veggie and have still had similar. It's only recently it's happened so considering if I'm coming out the honeymoon period. I know I can call my DSN but I'm due appointments with her and the dietician next month. Thanks for your thoughts. I won't bolus and let you know what happens in the morning. X
 
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slip

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I guess another possibility is it could also be your basal (Lantus) running out towards the end of the day - only way to check would be to do a basal test - somewhere on the forum is a link to how to do that - I don't have it at hand at the mo.
 

GrantGam

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I've only been t1d since May (55yo) and carb counting for 6 weeks. I do my last BG and Lantus about 10pm. Recently I've had the occasional 14+ but if I take a correction dose of 2 units I find I have a hypo either early hours or the first BG of the day. I eat my evening meal around 6pm so would hope it's not that. Tonight I made burgers and had 1 in a wholemeal sandwich with some cheese and salad and had 5units of novarapid which I calculated to be enough. Any thoughts please.
Excellent advice from @slip, I would also second your Lantus not lasting 24hrs as the likely culprit of your high evening BG's. The easiest way to find out would be to have a late lunch around 2pm: I'd recommend something low in fat and with the CHO content on the packaging, as to get as accurate an estimate as possible. Eat nothing between 6pm and midnight and test, test, test to see what's happening.

Eating at 2pm will will mean that all active bolus insulin is more or less used up by 6pm, allowing the time period between 6pm and midnight to give you an indication of how your basal is performing by itself.

https://mysugr.com/basal-rate-testing/

The above link is a detailed explanation of how to basal test fully. And there's also a cool picture of a Pug that looks like Yoda, so it must be legit:)
 
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4mum_

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125
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Type 1
Thanks for your thoughts - all new and confusing to me. My DSN told me the basal lasts about 18hrs so as I take it at 10pm may make 4pm the following day. So it makes sense that perhaps I need more than my 15 units. I'll see if I can try the test at the weekend, not practical when you are in the 'classroom.
 

slip

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You could possible split your basal, most who are using levemir do (me included) some HCPs don't advise splitting lantus - but then again some do, may be have a word with yours to discuss this idea, providing you find it is the basal running out towards the end of the day.
 

GrantGam

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Thanks for your thoughts - all new and confusing to me. My DSN told me the basal lasts about 18hrs so as I take it at 10pm may make 4pm the following day. So it makes sense that perhaps I need more than my 15 units. I'll see if I can try the test at the weekend, not practical when you are in the 'classroom.
Again I agree with @slip. I split my Levemir and can say first hand that it works well; afraid I'm unable to comment on how well it works with Lantus though.

I have seen a few T1 members here who stick with a "once daily" evening basal dose and increase their dinner I:C ratio to compensate for the lack of coverage from the basal between 18-24hrs. Food for thought, you have options:)
 
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therower

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Hi @4mum_ As a lantus user I'll try to give some advice. Obviously don't undertake any changes to your regime without consulting your DSN first.
Lantus lasts between 18/ 20 hrs and a lot of users do split there lantus injections BUT it's done over a 12 hr period, for me 6 a.m. and 6 p.m.
It took me a while to get my head around it when I was first told to do it prior to doing a DAFNE course ( carb counting)
I was taking 24 to 26 units once a day but under the advice of DSN / DAFNE nurse I was told to split into two injections of 15 units each. It needed a bit of tweaking but got there eventually by basal testing as @GrantGam has so kindly provided a link to.
It did make a big difference and far more stable sugars.
It's obviously something for you to consider.
Good luck.
 
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4mum_

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125
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Hi @4mum_ As a lantus user I'll try to give some advice. Obviously don't undertake any changes to your regime without consulting your DSN first.
Lantus lasts between 18/ 20 hrs and a lot of users do split there lantus injections BUT it's done over a 12 hr period, for me 6 a.m. and 6 p.m.
It took me a while to get my head around it when I was first told to do it prior to doing a DAFNE course ( carb counting)
I was taking 24 to 26 units once a day but under the advice of DSN / DAFNE nurse I was told to split into two injections of 15 units each. It needed a bit of tweaking but got there eventually by basal testing as @GrantGam has so kindly provided a link to.
It did make a big difference and far more stable sugars.
It's obviously something for you to consider.
Good luck.
Hi. I intended to call my DSN today but was busy and its awkward to receive a return call if i miss her. I'm only on 15 units in the evening so maybe that needs looking at too. I'm also wondering if I'm coming out of the honeymoon period. I've increased my water intake even more today (I do drink a lot of it) and I've had lower BG, my evening meal one had also been creeping up into the 9s, just need to wait for the later one. I will have to read up on the basal testing and discuss it with my DSN and perhaps try it. Thanks for your advice
 

fletchweb

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Prefer not to say
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I've only been t1d since May (55yo) and carb counting for 6 weeks. I do my last BG and Lantus about 10pm. Recently I've had the occasional 14+ but if I take a correction dose of 2 units I find I have a hypo either early hours or the first BG of the day. I eat my evening meal around 6pm so would hope it's not that. Tonight I made burgers and had 1 in a wholemeal sandwich with some cheese and salad and had 5units of novarapid which I calculated to be enough. Any thoughts please.
I think it's pretty normal to have the most difficult time with early morning and waking morning BG levels. I've always had troubles with this and I've been living with Type 1 for a very long time. It takes a lot of time and experience to figure out the best solution so don;t get too frustrated. You seem to have a greater sensitivity to insulin than I do as 2 units doesn;t seem to make a whole lot of difference with me.
Anyway - the approach I took with high morning BG levels was to take tiny steps - so where I used to wake up with BG levels of around 16 - instead of shooting between 4 - 8 I just try to keep it below 16, than 15, than 14, than 12, than 10. Over about a year of slight adjustments I managed to get it down within a normal range most of the time - it did require tweaks to my insulin dosage and diet but I was able to do it because I took my time and did it in small steps.
I find Doctor's tend to want immediate results and place that expectation on their patients - try to avoid those type of expectations if you can.
 
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4mum_

Well-Known Member
Messages
125
Type of diabetes
Type 1
I think it's pretty normal to have the most difficult time with early morning and waking morning BG levels. I've always had troubles with this and I've been living with Type 1 for a very long time. It takes a lot of time and experience to figure out the best solution so don;t get too frustrated. You seem to have a greater sensitivity to insulin than I do as 2 units doesn;t seem to make a whole lot of difference with me.
Anyway - the approach I took with high morning BG levels was to take tiny steps - so where I used to wake up with BG levels of around 16 - instead of shooting between 4 - 8 I just try to keep it below 16, than 15, than 14, than 12, than 10. Over about a year of slight adjustments I managed to get it down within a normal range most of the time - it did require tweaks to my insulin dosage and diet but I was able to do it because I took my time and did it in small steps.
I find Doctor's tend to want immediate results and place that expectation on their patients - try to avoid those type of expectations if you can.
Thanks. You make sense in what you say and it is all still new to me. My tough times have been pre evening meal and pre bed. If I literally drown myself drinking water it does make a difference but it's hard going to keep up the intake I need. I'm due a few appointments soon so will discuss it. I am sensitive to the extra insulin and also exercise as in extra walking! Crazy times!