Honeymooning

[Type_ffs_]

Hi all, i was recently diagnosed at christmas my bg was 28.9 and keytones was 1.8 hba1c was above the readable amount. I ticked every box when it came to symptoms, i was started on 10 units of lantus and 4/6 units on rapids, it wasnt bringing them down at all, my diebetic nurse gradually increased both untill i was on 14 lantus and, 10/12 on rapids, so far ive managed to get my reading down so much ive impressed myself with how much ive learned like carb counting and what effects my readings and calculating doses etc etc only problem is my lunch and teatime readings, i just carnt keep them up now.. Always dropping to 3.8/3.9 ish with majority of time unable to tell unless its around the 3 mark, my rapids have decreased dramatically im now having 1 unit rapid to 40g carbs breakfast and lunch and 1 unit to 30g tea and supper and this still to much some times.. I took it upon myself to decrease my lantus slowly to see if it made a difference and it didnt realy do much didnt even effect my fbg, i saw a dietician and she suggested i switch to levemir and split dosages small dose in the morn and a bigger one at night.. Still no joy always hypo during the day so this morning i took the plunge and skipped my bi! Im hoping this will stop the hypos im still planing a small dose tonight to see me through as this was the time id have my biggest rises when diagnosed any input or suggestions to avoid these hypos would be much appreciated

 

[catapillar]

so this morning i took the plunge and skipped my bi!

I'm not convinced that completely stopping your basal insulin without medical advice is the best approach here.

When are your hypos happening? Are they after meals and bolus? That would suggest the problem is your insulin:carb ratio. If you think you need a lower dose than 1:30 or 1:40 experiment with a lower dose and see how that works. Do you have a half unit pen as that can be helpful for someone needing small doses.

Have you done any basal testing that might help you see whether your levemir dose needs adjusting? When making basal adjustments you are supposed to trial a 10-20% change and see how that works. You seem to have made a 100% change without exploring whether what your changing is what's actually causing the problem. So keep a close eye on blood sugars today.

If your honeymooning that does make control a bit more difficult as you can just get unpredictable endogenous insulin production. Some people can get away with just one levemir dose, but I'd be doing a basal test to check whether that's is what works for you. If you rule out the basal being the cause of the hypos then it might be time to look at the carb counting and your I:C ratios.

 

[catapillar]

Here's how to basal test - https://mysugr.com/basal-rate-testing/

And here's a free online course on carb counting and adjusting doses - https://www.bertieonline.org.uk

You might also want to look for the book "think like a pancreas" it's a great guide on the basics of what you need to know to manage type 1.

 

[Type_ffs_]

Hi thanks for the reply, its not after meals its just before meal which leaves me scratching my head because im treating my hypos then a hour later dosing for a meal. For example last week my partner had a c section i thought id test my bloods before we went into theatre coz thats the last place i wana mong out lol my bloods where 4.5 this was 11 am i thought id eat two freddos just for a quik boost as i knew id be misding my lunch as these take a few hours anyway about 3 hours later a was still droping i was 4.1 but obviously the ladt time i had rapids was my 7.30 am breki so it had to be my basal right? I have lowered it and had no joy. Then like i say the dietician suggested a change of basal and to split dosage then reduce my morning and up the night time one which ive done but to no joy, im not stoping my basal all together im just going to have my night one which will be half of what i was originally taking if that makes sense

 

[Coopsman1]

Was having similar symptoms myself and after basal testing I have reduced my levemir from 8 to 6, now coupled with my 1:10 carb ratio seems to be hitting the mark with the odd exception. The plan is to give it a week and then try another round of basal testing as it takes a while for the new doses to settle in (for me any how).

I recommend basal testing as you can make basal problems by adjusting bolus, however it can be inflexible.