Mentally exhausted

[linda_b]

Hi all,

This is going to be long winded one so bare with me. Just need a bit of a vent!

So I was moved from Humalin M3 to Novorapid and Lantus about 15 years ago. My Basal dosage has always been a struggle for me. I posed a thread a few weeks back to say I had been moved on Levemir which I have wanted for a while.


I didn’t expect results overnight but I’m at screaming point at the moment. I haven’t woken up with a single figure reading since 28th April.


My Levemir dosage has been split into two. I take 9 units at 8am and 8 units at 8pm.


During the day it seems to be working fine. Even if I miss a meal by bloods remain stable and don’t rise.


The night-time dosage is a completely different story. First the 8 units seemed too I woke up twice during one night with low bloods that weren’t even readable. When I spoke to my DSN she recommended taking the dosage down to 5 units which I did that evening. This had the complete opposite effect. Going to bed on stable blood sugars then they just rocket throughout the night. I have a Libre so I can check on the graph what’s going on. I left it a few days to see if it adjusted itself to no such luck. So I took it back up to 7 units then 8. Woke up this morning bloods were 12.2. When looking at the graph on my Libre I was in the red (below 4) for an hour or so then they slowly stated rising between 3am and 5am.


I am honestly at screaming point. Nothing I do works. I also don’t see how the dosage can be so right during the day and so wrong at night.


I have another DSN appointment next Friday but I have a feeling all she will say is lets take it down a few units or lets put it up a few units.


All I want is to wake up one morning and not feel wiped out from high bloods (I feel worse high than I do low).


Anyways, we will wait a see what happens. Thanks for listening!

 

[DunePlodder]

Adjusting by one or two units is the best approach. The Libre is very helpful.
When you dropped the Levemir dosage down to 5 what did the graph look like? Was there a dip?

With 7 units it looks as though it could be too much - it's going low then in response you are having a liver dump which is sending you up to 12.2. I'm assuming you hadn't bolused late in the evening?

It's a tricky one especially as you use very small amounts so increasing by one unit is a big percentage. For comparison my Levemir dose is 47 units in the evening! I get a lovely horizontal graph on my CGM though.

It's best to stick with a changed dose for a while - say 3 days - before changing. However since you are going low using 7 units it may be as well to drop down to 6?
Can you discuss this with your DSN over the phone before the appointment?

 

[fletchweb]

I have another DSN appointment next Friday but I have a feeling all she will say is lets take it down a few units or lets put it up a few units.
All I want is to wake up one morning and not feel wiped out from high bloods (I feel worse high than I do low).
Anyways, we will wait a see what happens. Thanks for listening!

One thing you may want to try - the time and carb intake of your last pre-bed time snack or meal. I discovered a few years back that I could stabilize my BGs during the sleeping hours based on the timing of my food. For quite sometime I was just focusing on insulin dosage and once I tinkered with my pre-bedtime food intake things seemed to get a lot easier in regard to stabilizing night time BG levels.
Having said that I'm on Lantus and take one shot in the evening - 22 units (also on humalog). I tried a split dosage but it wasn't all that beneficial.

 

[tim2000s]

Hi @linda_b what's likely to be happening is that your daytime levemir dose is ranging over into the evening/night a little, so that your night time dose added to its tail is causing the low. The other alternative is that you are suffering from a tail with bolus insulin taken for later eaten food.

The best way to determine what's really going on is a fasted basal test, which is much easier with the Libre. Basically split the day into four sections and don't eat for 6 hours at a time. If your glucose levels go up and down during that period then you'll find out if your basal is correct.

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

 

[jasmine1616]

At one point after I was diagnosed, I was mentally exhausted. I let my parents know what was going on and they told me to go to school the next day. If I started getting a little emotional or stressed, I should go home. I started feeling stressed, I went home, and had a day to myself without worrying about diabetes. My parents counted all of the carbs for me, checked my glucose, and gave me shots (back when I needed them). On my diaversary, we do the same thing, except sometimes I am willing to do some of the stuff.

Sometimes, you just need a break from Diabetes.

 

[noblehead]

@linda_b

As mentioned in your other thread when starting on levemir, if matters don't improve then ask your DSN if you can try Tresiba, it's a once daily dose and is said to last up to 42 hours, if I were to go back to MDI this would be the basal I'd be pushing for.

 

[linda_b]

@noblehead I've just been looking at the Tresiba website. I'm definitely going to ask my DSN about this on Friday. I've woken with 17.5 today when going to be on a 7.5.

 

[noblehead]

@noblehead I've just been looking at the Tresiba website. I'm definitely going to ask my DSN about this on Friday. I've woken with 17.5 today when going to be on a 7.5.

I had a bad experience with levemir, just couldn't get the dosage right at all.

There's a couple of members who use Tresiba, one is @robert72 & the other is @mahola