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Diabetes Discussion
Type 1.5/LADA Diabetes
Bolus/ Basal question
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<blockquote data-quote="Old’un" data-source="post: 2598435" data-attributes="member: 567096"><p>I have been on Lantus and Novorapid for many years now and in my experience there are just far too many factors that influence blood sugar levels to be able to control it precisely. Some diabetes clinicians seem to think that a mathematical approach should work but it will only ever be partially successful. I find that there are too many variables that cannot be quantified for an accurate dosage level to be calculated and it has to be largely down to experience and guesswork.</p><p></p><p>Some days when I am particularly active I need no Novorapid at all and still have to snack several times between meals. Other days when less active I need insulin and no snacks. Stress can push the blood sugar sky high as can illness. Some medication can also elevate sugar levels or cause hypoglycaemia. I even find that the weather affects it a bit and in the summer I generally have four units less Lantus than in the winter. I find that when I am tired the blood sugar tends to run higher even if I am forcing myself to be active.</p><p></p><p>The choice of food also has a profound effect as refined carbohydrates are absorbed far quicker than unrefined ones and a fibre rich meal will take longer to digest. The fat content of the food will also have an impact on the blood sugar levels and if you have very large amounts of protein then some of that will be broken down by the liver and also raise the blood sugar level.</p><p></p><p>For me as well there is another issue that can play havoc with my blood sugar levels as I have a degree of autonomic neuropathy and as a consequence the passage of food through my digestive system is somewhat variable. Sometimes with all other factors the same as far as I can judge, a meal can be digested fairly quickly but another day an identical meal could still be in my stomach sixteen hours or more later. I have also found that I never regained the control I once had since having covid last year.</p></blockquote><p></p>
[QUOTE="Old’un, post: 2598435, member: 567096"] I have been on Lantus and Novorapid for many years now and in my experience there are just far too many factors that influence blood sugar levels to be able to control it precisely. Some diabetes clinicians seem to think that a mathematical approach should work but it will only ever be partially successful. I find that there are too many variables that cannot be quantified for an accurate dosage level to be calculated and it has to be largely down to experience and guesswork. Some days when I am particularly active I need no Novorapid at all and still have to snack several times between meals. Other days when less active I need insulin and no snacks. Stress can push the blood sugar sky high as can illness. Some medication can also elevate sugar levels or cause hypoglycaemia. I even find that the weather affects it a bit and in the summer I generally have four units less Lantus than in the winter. I find that when I am tired the blood sugar tends to run higher even if I am forcing myself to be active. The choice of food also has a profound effect as refined carbohydrates are absorbed far quicker than unrefined ones and a fibre rich meal will take longer to digest. The fat content of the food will also have an impact on the blood sugar levels and if you have very large amounts of protein then some of that will be broken down by the liver and also raise the blood sugar level. For me as well there is another issue that can play havoc with my blood sugar levels as I have a degree of autonomic neuropathy and as a consequence the passage of food through my digestive system is somewhat variable. Sometimes with all other factors the same as far as I can judge, a meal can be digested fairly quickly but another day an identical meal could still be in my stomach sixteen hours or more later. I have also found that I never regained the control I once had since having covid last year. [/QUOTE]
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