My big problem in control of my sugar blood(Hb A1c=8.83)

[Aryan-]

Hello
I inject 20 units lantus at 12:00 P.M and my fasting blood sugar is from 160 up to 210 . But if I inject more units(for example 21 or 22 units) Im gonna have hypoglycemia in 5 at morning or during day(for example at 10:00 A.M to 12:00 A.M and 4:00 P.M to 8:00 P.M).
Also I use 10 units novorapid before breakfast and 2 hours later my blood sugar is 270 !!!
My breakfast is one small piece of biscuit and a cup of hot tee and a glass of milk and small piece of bread with cheese .
And for lunch I inject 20 units of novorapid and I take half of a metformin 500 pill and 2 hours after eating my lunch my blood sugar is from 45 up to 150.
For dinner I inject 20 units of novorapid and I take the other half of metformin 500 pill and 2 hours after eating my dinner my blood sugar is from 200 up to 250.
My Hb A1c during past 2 years are between 8.06 & 8.37 & 8.41 & 8.38 & 8.72 & 8.15 & 8.83.
And my another big problem is 2 hours after my lunch when I my sugar blood is about 50 I get very hungry and eat like a bear and right now I am over weight (Im 25 years of age and my weight is 90 kg and my hight 180 cm and I am a male) and I cant control my eating.
Please help me out to learn how to control my sugar blood and my Hb A1c becomes down to 7.


I really need your help and your guidance.

Thanks a lot and looking forward to hear from you all
My regards
Aryan

 

[darrenh04]

Hi. I am on lantus and Novorapid. Not sure about the metaformin as well though.

Have you tried taking the lantus in the morning when you get up? This way by the evening it is at the back end and will limit night time hypo.

I also us Novorapid to deal with meals to stop things getting too high. Has taken a while of trial and error to know how much to take for different meals.

In terms of feeling hungry I have had that too. Find snacks that work and aren't going to cause too much of an issue. I have a snack with a variety of nuts also a boiled egg is good. Once you are on top of things you could have an apple etc and adjust insulin to balance it out..

I have found having an app to record everything helped. Now I just use the app when I feel I am going off track too far.

 

[ButtterflyLady]

I'm not T1 but I have read T1s saying that carb counting is a good way to go. You can learn how to do it in an online course and there are apps for it, as darrenh04 says.

Basically you calculate your blood sugar reading before the meal and the carbs you intend to eat, and the result is the amount of insulin to inject. This way you are only using enough insulin to deal with the meal, instead of eating to the insulin, which promotes weight gain and unstable blood sugars.

T1s feel free to correct me if I've gotten this wrong.

 

[NannyPoppins]

Hi... I'm on Lantus, novorapid and metformin. Ive struggled with my sugar levels for years... hba1c are 8.2 at the moment but mainly ive struggled with my weight over the last 2 years.

I have just looked into carb counting and i have started this LcHf diet 2weeks ago (not to strict though) and ive lost 5lb and my levels are gradually getting better.

I was all kinds of confused with things untill I joined this forum.

 

[donnellysdogs]

It strikes me that your basal and bolus are out of line....
Most persons are set up with a ratio of 50/50 with basal/bolus.

Yours appears to be vastly different and I think this could be causing you the problems.

To me it looks like you need a split dose of your basal. Looks like you are averaging 20 basal daily and 50 bolus??

You also need a pen that will give basal in 1/2 unit adjustments if whole units are giving hypos.

Increasing your bolus is going to make things even worse.

Have you ever done a basal test?

I know you mention nit controlling your eating.. But are you snacking inbetween without bolusing? Or are you having 3 large meals with no snacks?

 

[Aryan-]

It strikes me that your basal and bolus are out of line....
Most persons are set up with a ratio of 50/50 with basal/bolus.

Yours appears to be vastly different and I think this could be causing you the problems.

To me it looks like you need a split dose of your basal. Looks like you are averaging 20 basal daily and 50 bolus??

You also need a pen that will give basal in 1/2 unit adjustments if whole units are giving hypos.

Increasing your bolus is going to make things even worse.

Have you ever done a basal test?

I know you mention nit controlling your eating.. But are you snacking inbetween without bolusing? Or are you having 3 large meals with no snacks?

Thanks for your respond to my request.
I dont know what is a basal test? please tell me what is it and guidance me how I can do it?
I eat 2 large meals and 3 snacks in between.
please explain to me more about split dose of my basal.I didnt understand it well
Are you mean I must increase my lantus from 20 to 50 unit per day or what?
my doctor told me you can divide 1800 to whole units you are injecting(lantus+novorapid) and then you are going to find out per unit how decrease your blood sugar.Are you agreed with that Suggestion ?
Thanks
My regards

 

[Aryan-]

Hi... I'm on Lantus, novorapid and metformin. Ive struggled with my sugar levels for years... hba1c are 8.2 at the moment but mainly ive struggled with my weight over the last 2 years.

I have just looked into carb counting and i have started this LcHf diet 2weeks ago (not to strict though) and ive lost 5lb and my levels are gradually getting better.

I was all kinds of confused with things untill I joined this forum.

Thanks for your respond.
I want to know what is LcHf diet? and how I can learn carb counting?
you didnt look over weight why do you think you are overweight? did you hear that from your doctor or what?
Thanks
My regards

 

[Markpick]

Is there a novorapid pen that gives half measures?

 

[Aryan-]

Is there a novorapid pen that gives half measures?

Hello
yes sure, there is . but it is for children.

 

[Markpick]

Oh it would really help me a half measure pen, i have good control but there's always a meal I'll eat which is 50gs of carbs or 70 and with me been 20g to 1 unit nova it's always the choice of high or a low after a meal

 

[catherinecherub]

Oh it would really help me a half measure pen, i have good control but there's always a meal I'll eat which is 50gs of carbs or 70 and with me been 20g to 1 unit nova it's always the choice of high or a low after a meal

There are members here who use that pen and it is not reserved for children.

I have tagged
@Robinredbreast, @noblehead as they have mentioned it in some of their posts.

Here is a review,

http://www.healthline.com/diabetesmine/novo-knocks-it-out-of-the-park-with-new-smart-insulin-pen

 

[NannyPoppins]

Thanks for your respond.
I want to know what is LcHf diet? and how I can learn carb counting?
you didnt look over weight why do you think you are overweight? did you hear that from your doctor or what?
Thanks
My regards

Its the Low Carb, High Fat diet. You can look it up online but mainly its just watching your carb intake... im still learning and adjusting but from what I have been told, it works well with weight loss in diabetes and like I said I've lost 5lb in two weeks.

What I do is count the carbs in what I eat and take 2 units of novorapid to every 10g of carbs (I self taught myself from looking it up online) I'm trying to stick to 30g of carbs per day but I'm not that strict about it to be honest. I'm finding it hard to eat foods without carbs. It is different for everyone but this is working for me at the moment.

Have you been offered the DAFNE course by your doctor?

No, I noticed myself that my weight was going up rapidly and I put on 2st in 1 year. I went to my doctors several times and they said "it's all fine, bla bla bla, but im 27, very active and i have low confidence already so i weren't convinced that it was 'just normal' to gain weight that quickly for no reason. I asked to be put on metformin last year and my weight slowly came down but now I'm doing this LcHf diet and again the weight is coming off and my insulin dosages are lower.

I was very confused with this carb counting and LcHf diet last month but people on here can help you.

 

[donnellysdogs]

Is there a novorapid pen that gives half measures?

Yes and it is not just for children!!!!

This is mad that adults are under the illusion that because we are over 18 then we can't or don't need 1/2 unit pens!!

Many, many adults need and use 1/2 unit pens.

The novopen echo is 1/2 unit and available to any adult.

If you are on doses that are under 30 at a time then a 1/2 unit tweak here or there especially when doing corrections or boluses are invaluable.

 

[donnellysdogs]

@tim2000s and @robert72 have you got the links to basal testing instructions please?

Or advice on splitting doses please?

Aryan you need to speak to your health professionals about the possibilty of splitting your doses for your basal.

I can't see how long you have been diagnosed but you need to ask for a DAFNE course or go online and learn from the bournemouth diabetes education centre who have an online course.

You must speak to your hospital professionals.

Are you sticking to set amounts of insulin at the moment or are you confident to adjust your bolus's for the different foods you eat.

Finally, the food that you are eating can have an effect of wanting to eat more. The more carbs you have the more food you can desire. People that eat lower carbs and more protein and fat will not feel so peckish all the time. It also depends upon your lifestyle too. Office work and being a couch potato will generate your thoughts more towards food....(I'm not saying you are by the way). Being active, having hobbies and activities in your life and exercise does minimise thoughts towards food..

 

[darrenh04]

Hi. I use the Echo for my Novorapid and Solo Star junior for Lantus as they can both give half units. I know a few T1 adults that use the Echo too.

Really worth it. I just asked my GP and he prescribed an Echo. For the Solo Star Junior my doctor prescriber the Solo Star by mistake. I just rang the maker and had two sent free in the post.

Apart from the half units the Echo has a digital display letting you know how much you have taken and how many hours ago.

 

[Markpick]

Thanks I'll enquire when I see my dn thanks for quick replys

 

[tim2000s]

Basal testing is described here:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

This states for a pump, but it is the same technique for injected insulin.