I'm taking myself to hospital

[plantae]

4.2, which is not hypo but I can't get myself above it. Was 4.3 before lunch and even skipped bolus. Pretty embarrassing.

 

[plantae]

Ugh. I can't drive because I'm below 5.0. Thinking

 

[plantae]

Neighbour is going to help

 

[JoKalsbeek]

4.2, which is not hypo but I can't get myself above it. Was 4.3 before lunch and even skipped bolus. Pretty embarrassing.

Embarrassing how? Your blood sugars are acting up (or down, as the case may be), and it sounds like you're feeling like a bad parent to it or something. You're trying your damnedest and you're taking care of yourself, so yay, you.

I hope you're feeling better by now. Might want to get some hypo treatment stuff that's fast acting, like honey or something... You might've already tried that, but you know, thought I'd mention it, just in case. Again, I do hope you're feeling better by now, and I'm glad your neighbour was around to help.
Hugs,
Jo

 

[Jaylee]

Hi @plantae ,

Best wishes on a speedy recovery.

I feel you made the right decision regarding a designated driver. From what I’ve read from your recent experiences..

Good luck.

 

[Antje77]

How are you @plantae ?

 

[plantae]

Sorry I took so long to reply everyone I'm home now. 7 days (6 nights) in hospital. I was home the other day but have been too tired to even turn on the computer. I still can't add up properly but I think I'm just tired, nothing to do with BSL

I went to 2.7 (or something like that) in the ambulance and was in the 3's for most of the first night in hospital, so it was the right call. They took me off all food, put me on bariatric/clear fluids only for 2 days, withheld all my insulin completely then adjusted my lantus before starting me on food again. Everything seems better now but the novorapid doesn't seem to work as well -- takes 4-5 hours for BSL to come back down to "baseline" after meals now so that might need further tweaking -- I'm not sure. I'm still within range: just in the 7's during the day instead of 5's or 6's like I was before. I wish they'd just let me count carbs for bolus but I need to be patient. My BSL is 7.8 now about 3 hours after lunch, which is higher than what I've been used to but maybe that's normal I dunno (it's in normal range at least). Fasting BSL throughout the night is now roughly 4.8-5.2 and doesn't drop into the 3s like it had been just about every night for the last 3 months.

@JoKalsbeek I was embarrassed because I've been in hospital 3 times this year and felt like I was "wasting" people's time. I guess 6 nights in hospital means I wasn't. I did try honey and it didn't do much

 

[EllieM]

It's good to hear you are out of hospital now @plantae.

I know some superhuman T1s manage to keep their levels in non diabetic range all the time, but personally I don't make my expectations that high. And honestly the hypos are my least favourite part of using insulin. so in the past I've had to aim to run high to avoid them (I personally lost hypo awareness when my hba1c went much below 7% or 50 so my team encouraged me to not aim lower). Now I have a cgm I find the alarms invaluable because I can treat when my bgs hit 4.4, or just notice that they are drifting down and treat even before that.

But I'm guessing the creon situation makes your situation much more difficult and I really hope your team help you get control of your levels soon.

 

[plantae]

It's good to hear you are out of hospital now @plantae.

I know some superhuman T1s manage to keep their levels in non diabetic range all the time, but personally I don't make my expectations that high. And honestly the hypos are my least favourite part of using insulin. so in the past I've had to aim to run high to avoid them (I personally lost hypo awareness when my hba1c went much below 7% or 50 so my team encouraged me to not aim lower). Now I have a cgm I find the alarms invaluable because I can treat when my bgs hit 4.4, or just notice that they are drifting down and treat even before that.

But I'm guessing the creon situation makes your situation much more difficult and I really hope your team help you get control of your levels soon.

Thanks.
Yes, now you mention it I do recall now my diabetes educator wanting me to run my levels higher a few weeks ago anyway (I may have mentioned this is another thread) to improve my hypo-awareness which you may as well say is currently non-existent. This is perhaps the very reason why the hospital is happy with the sevens -- it didn't occur to me at the time to ask. My hypo-awareness might be starting to develop already actually because yesterday I felt drunk and gave somebody my own phone number incorrectly three times but I was aware of it (so I checked my BSL; I wasn't hypo but I was below 5). A few weeks ago I very much doubt I would have noticed feeling any different at all; I didn't feel different in the 3s! I really did feel drunk yesterday. So, in the long run this is probably a good thing.

Edit: Before this week I was relying on my Libre alarms and I think they adjusted the thresholds in hospital. Low is set to go off at 4.4, I'm not sure what it was set to before... I think it was lower than 4.4 low. The alarms aren't going off all night now, though, because my fasting is higher so I'm sleeping better as well

 

[Antje77]

to improve my hypo-awareness which you may as well say is currently non-existent. This is perhaps the very reason why the hospital is happy with the sevens --

Any endo will be happy if a T1 (or T3C) on insulin is in the 7s, 8s or 9s, it's considered pretty much perfect control.
Many people who are starting on insulin are told to aim at 6-10, not lower, and many people will make sure to be at 8 before bed to prevent nighttime hypos.

Now after time (not like 3 weeks but after many months), some of us can safely go lower, once they have a clear understanding on how their bodies react to different food, insulin, activity etc. And some of us need to keep aiming for 6 to prevent sudden hypos.

 

[JoKalsbeek]

Sorry I took so long to reply everyone I'm home now. 7 days (6 nights) in hospital. I was home the other day but have been too tired to even turn on the computer. I still can't add up properly but I think I'm just tired, nothing to do with BSL

I went to 2.7 (or something like that) in the ambulance and was in the 3's for most of the first night in hospital, so it was the right call. They took me off all food, put me on bariatric/clear fluids only for 2 days, withheld all my insulin completely then adjusted my lantus before starting me on food again. Everything seems better now but the novorapid doesn't seem to work as well -- takes 4-5 hours for BSL to come back down to "baseline" after meals now so that might need further tweaking -- I'm not sure. I'm still within range: just in the 7's during the day instead of 5's or 6's like I was before. I wish they'd just let me count carbs for bolus but I need to be patient. My BSL is 7.8 now about 3 hours after lunch, which is higher than what I've been used to but maybe that's normal I dunno (it's in normal range at least). Fasting BSL throughout the night is now roughly 4.8-5.2 and doesn't drop into the 3s like it had been just about every night for the last 3 months.

@JoKalsbeek I was embarrassed because I've been in hospital 3 times this year and felt like I was "wasting" people's time. I guess 6 nights in hospital means I wasn't. I did try honey and it didn't do much

It's better to go to the hospital on ten occasions for naught, than once too few. And yes, obviously you weren't wasting anyone's time. You deserve to be cared for properly, and you deserve the help you're getting. Took them long enough, but finally...! Hope you'll feel better soon!!!!

 

[plantae]

It's better to go to the hospital on ten occasions for naught, than once too few. And yes, obviously you weren't wasting anyone's time. You deserve to be cared for properly, and you deserve the help you're getting. Took them long enough, but finally...! Hope you'll feel better soon!!!!

Yes, once too few might be, well, once too few
I think they did it better this time by taking me off all food and getting my basal "right" first. This is just my opinion, though. Last time they kept me on hospital food, which doesn't resemble what I eat at home at all really, and worked out my bolus doses and then on the last night started me on the basal which I assume they calculated somehow rather than measured. This time by taking me off food and measuring the basal after two days of clear fluids only I think the basal is better; only after that did they put me back on food and adjusted the boluses. I'm running higher than normal but this way seems more intuitive to me but I'm not a doctor Also when I went back on food I got the doctor to put me on the "normal menu" rather than the "diabetic menu" so I could choose meals which were closer to what I eat at home. The "diabetic menu" at the hospital restricted food choices so much I was choosing meals that I'd either never eat at home or only eat at home once a year. The normal diet made more sense (to me, and obviously to the Dr as well because he allowed me to have it)

 

[JoKalsbeek]

Yes, once too few might be, well, once too few
I think they did it better this time by taking me off all food and getting my basal "right" first. This is just my opinion, though. Last time they kept me on hospital food, which doesn't resemble what I eat at home at all really, and worked out my bolus doses and then on the last night started me on the basal which I assume they calculated somehow rather than measured. This time by taking me off food and measuring the basal after two days of clear fluids only I think the basal is better; only after that did they put me back on food and adjusted the boluses. I'm running higher than normal but this way seems more intuitive to me but I'm not a doctor Also when I went back on food I got the doctor to put me on the "normal menu" rather than the "diabetic menu" so I could choose meals which were closer to what I eat at home. The "diabetic menu" at the hospital restricted food choices so much I was choosing meals that I'd either never eat at home or only eat at home once a year. The normal diet made more sense (to me, and obviously to the Dr as well because he allowed me to have it)

It does sound like they're on the right track now. Every doc seems to have a different tactic, so I'm glad you were heard and they tried this.... Your previous numbers were low, but for someone on insulin, a tad too low. Better to run slightly higher within the normal range, than hover so close to hypo's all the time. Not sure if that's exactly right, as I'm not jabbing myself, but it was true for our T3c cat who was on Lantus. He'd be fine and then just do a weird "MEOW!", and topple over on his side when he'd hypo. Better to err on the side of caution.

 

[Antje77]

Thanks.
Yes, now you mention it I do recall now my diabetes educator wanting me to run my levels higher a few weeks ago anyway (I may have mentioned this is another thread) to improve my hypo-awareness which you may as well say is currently non-existent. This is perhaps the very reason why the hospital is happy with the sevens -- it didn't occur to me at the time to ask. My hypo-awareness might be starting to develop already actually because yesterday I felt drunk and gave somebody my own phone number incorrectly three times but I was aware of it (so I checked my BSL; I wasn't hypo but I was below 5). A few weeks ago I very much doubt I would have noticed feeling any different at all; I didn't feel different in the 3s! I really did feel drunk yesterday. So, in the long run this is probably a good thing.

Edit: Before this week I was relying on my Libre alarms and I think they adjusted the thresholds in hospital. Low is set to go off at 4.4, I'm not sure what it was set to before... I think it was lower than 4.4 low. The alarms aren't going off all night now, though, because my fasting is higher so I'm sleeping better as well

Are your doses still being adjusted?
I noticed your fasting BG has been 4.2 for two days in a row, which sounds uncomfortably close to hypo with your history.

 

[plantae]

Yes, they are very uncomfortably close to being hypo. I've been asked to take a unit less of lantus if things are not about 6. So I'm reducing lantus tonight. It's frustrating because 2 days ago my "baseline" (without) bolus) was about 7. Reduced lantus tonight and will see what happens. 4.2 is too low because my alarm is set to 4.3 and it keeps me awake all night plus it can drop very, very quickly

 

[plantae]

Adding: 4.2 is WAY too low for me. My DN wants my "baseline" (before bolus) to be in the sixes, mostly because if I go 4 I will drop into the 3s or 2s really fast. Plus she wants me to become hypo aware which currently I'm not really aware of at all. I'm 6.3 at them moment which seems like a good number, but the bolus will wear off in maybe an hour. I will reduce lantus again tomorrow if necessary (this is not advice for anyone else, just what I've been told to to do for ME). I have an appointment with her on Tuesday

 

[plantae]

This is what's not right. In hospital this didn't happen. We'll work it out on Tuesday. There is food at that 3U injection I just forgot to enter it. 7.8 to 3.2 is pretty silly. Edit: that was novorapid. Lantus was at about 9:30PM... maybe I should have skipped lantus but that's something I have to ask about

 

[plantae]

And all those 4 readings in the 3rd column are 250ml of orange juice. Barely raising it at all. We'll get there

 

[Antje77]

4.2 is too low because my alarm is set to 4.3 and it keeps me awake all night

How do you treat when the alarm goes off at night?
If you eat something but it goes too low again later, you may need to eat some more long acting carbs to keep it from dropping again.

This is what's not right. In hospital this didn't happen. We'll work it out on Tuesday. There is food at that 3U injection I just forgot to enter it


View attachment 59453

Looks a lot better than just a short while ago!
Sounds like you and your nurse are doing all the right things too.

In this graph it looks like you injected mealtime insulin at around 5m. You dropped too low an hour and a half later, so around the peak of the mealtime insulin, so that looks like the dose you took for your meal was too high for that particular meal. There may well have been more carbs in the hospital meal than in your own meal, making the dose correct for the hospital meal but too low for your own.

You also seem to have done a perfect catch of the hypo!

 

[plantae]

How do you treat when the alarm goes off at night?
If you eat something but it goes too low again later, you may need to eat some more long acting carbs to keep it from dropping again.



Looks a lot better than just a short while ago!
Sounds like you and your nurse are doing all the right things too.

In this graph it looks like you injected mealtime insulin at around 5m. You dropped too low an hour and a half later, so around the peak of the mealtime insulin, so that looks like the dose you took for your meal was too high for that particular meal. There may well have been more carbs in the hospital meal than in your own meal, making the dose correct for the hospital meal but too low for your own.

You also seem to have done a perfect catch of the hypo!

During the night if the Libre alarm goes off and I'm, 4.2 or lower I set an alarm reminder to check again in 15 minutes. If it hasn't gone up (compression low?) I drink orange or apple juice and set the reminder for another 15 minutes. Most of the ones at 2 or 3 AM are false alarms. Means I don't get much sleep some nights.

Yeah, the hospital meals have much more carbs in them for dinner than I eat at home. Last night was uncrumbed fish and salad. I need to talk about this with my DN. I don't actively avoid carbs but I just don't like them much. For a few months I was adding rice or potato to my meals even though I don't like them. That drop is almost certainly due to lack of carbs I think. But it's a big drop for just 3U of insulin (but what do I know, I'm new). This can be fixed I think.

I didn't know what to do about the lantus, so took it anyway at about 9:30PM. I was wide awake and monitoring fairly constantly so took the risk. It didn't drop my BSL much at all so that was maybe the right call. Lantus doesn't drop me fast. If I skip lantus my BSL the following day is crazy high. I'll ask about that as well but it doesn't worry me as much as the dramatic falls from novopaid.

I do think that the doctors have got my doses right this time, despite that craziness last night. Well, the basal is probably right anyway I count carbs every day so am going to ask about adjusting my bolus based on them

Edit: yep I caught it I think