Insulin dose adjustment

[coco4]

Hi everyone lovely sunny day here in Lincolnshire so makes me feel upbeat. I'm after some advice, I'm Type 1 by the way; as there are no DAFNE courses available in my area I have taught myself to carb count by reading books and reading tips etc on this wonderful forum and also by accessing the online "course" run from Bournemouth as kindly recommended by FergusCrawford. What I would like to know is if my BG reading before going to bed is above 7 what would be the minimum reading above 7 should I give myself a correction dose of fast acting insulin and by how much? Likewise I always test when I get up in the morning before breakfast what sort of reading would a correction dose be considered? Thanks enjoy the rest of the weekend Carole

 

[donnellysdogs]

Do you ever test at 2-3am?

I personally would not change or correct anything without 2-3am readings...

 

[Bethyboo]

Hi I'm a mum to Bethany type 1 since 3 now aged 11. I'd never correct at 7 at bedtime or any other time.

 

[coco4]

Hi Donnellysdogs & Bethyboo thanks for replying. No I have not routinely tested at 2-3am unless I've woken up feeling ill or "not quite right". So if for instance I went to bed with a reading between 7-12 I you saying you would not automatically do any adjusting at that stage Donnellysdogs? Thanks Carole

 

[Bethyboo]

Personally No. My daughter has suffered from night time seizures due to hypos so am always wary of correcting at bed time. Are your morning levels ok usually.

 

[donnellysdogs]

I think from my own experience.. That levels can drop between 2-3 am and them rise...so raising any background / basal insulin may be dangerous until you have checked what your 2-3 am levels are at.

You seem to be level-ish from bed to getting up, but from my experiences only..I would make sure I am safe at night first...

 

[donnellysdogs]

Just supposing you were 5 at 3am..! It may be that alternative thinking would have to be done to make sure you didnt drop to hypoland from increasing basals..

Could be a bit of up and downs and a bit of frustration initially but you cannot afford to drop 10 bg levels in 2 hours... We must keep you safe... From hypoland

 

[iHs]

For me personally, 7mmol is about the lowest level that I go to bed on. If I was higher than 7mmol (like 10mmol) I would give myself a very small correction, but that correction would also be down to what my bg levels do overnight and that can only be determined by getting up in the middle of the night and testing. Some people find that their bg levels drop and some find that they rise overnight.

If you can, try and get your bg levels to always be the same level more or less before going to bed..... get your insulin to carb ratio correct for your evening meal and allow about 4hrs so that the bolus insulin has more or less come to its end and then you'll be able to work out whether you need to eat something when going to bed or can just leave yourself without eating anything ...

 

[donnellysdogs]

For correcting I would be at 9 for bedtime and morning nowadays before correcting.... But thats just me and my levels and a checkup in 17 days time!!!!

But.. Even at bg of 9 I would have to check to see mt mid sleep point reading...

 

[coco4]

O gosh it was as well I asked and thanks for all your knowledge and experience. Sometimes I have given myself 3 units if I have been 11 going to bed. Have woken in the night feeling nauseous but put that down to anxiety. My morning readings fluctuate when I have given myself a correction dose to between 4.4 and up to 10 or 11. I've then given myself a correction dose before my breakfast. I think testing at 2-3am is definately called for. Thanks for the warning re seizures Bethyboo hope your little one is doing ok. Hope your check up goes well Donnellysdogs Thanks also iHs :thumbup:

 

[angieG]

Hi everyone lovely sunny day here in Lincolnshire so makes me feel upbeat. I'm after some advice, I'm Type 1 by the way; as there are no DAFNE courses available in my area I have taught myself to carb count by reading books and reading tips etc on this wonderful forum and also by accessing the online "course" run from Bournemouth as kindly recommended by FergusCrawford. What I would like to know is if my BG reading before going to bed is above 7 what would be the minimum reading above 7 should I give myself a correction dose of fast acting insulin and by how much? Likewise I always test when I get up in the morning before breakfast what sort of reading would a correction dose be considered? Thanks enjoy the rest of the weekend Carole

Hi Carole,
What part of Lincolnshire are you in? I live in Coningsby but I am under a Consultant at Lincoln County Hospital.
I have just done 3 Fridays there on their SELECT Course "Structures Education in Lincolnshire Enabling Choice in Treatment" for people with Insulin treated Diabetes. This is pretty much the same as a DAFNE course I believe and was very informative. Just a small friendly group and we covered all about diabetes, carb counting, exercise, illness, hypos hypers, etc. Over the 3 weeks we have kept food & glucose reading diaries and then analyzed the figures to help improve everybody's control. We then go back in 3 months time for an afternoon to see if it has helped and if there are any further problems.
I would recommend you ask your DSN if you can get on it or one in the area like it if you don't come under Lincoln's remit.
Best wishes
Angie

 

[coco4]

Hi Angie thanks so much for that information. I have not heard of the course that you have been on, but sounds ideal. I live in Morton just north of Bourne, sometimes my medical appointments come under Peterborough & Stamford, but my retinopathy appointments come from Boston Health Authority so I am never sure who to approach, but I think as you say my DSN is probably the first port of call. Thanks again, best wishes Carole

 

[malky]

I think you should be talking to your DNS about this I have been carb counting for about 5 years now and I am only getting to do DAFNE in november. I was not self taught though it was the DNS that told me everything and I went to a one day thing organised by them. Lately we have been trying to fine tune my levels and this has involved me not correcting below 12 and only checking bloods at meal times bed time and if i feel hypo previously i was testing when I woke in the morning as well, I start work at 6am then dont have breakfast till 10am, this seems to have helped. I have alway been advised that 1 unit brings you down 3 mmol, this is obviously different for some. So going to bed at 11 and taking 3 units would in theory put you into hypo. I had the same problem as you when sometime a night time correction would take me down to a good level and sometime do noting