Getting bloods under 7.0mmol

[Kerryannhogan]

Hi everybody,

I've been a diabetic for 2 years, the first year I was sensitive to insulin and my bloods was always under 7 but always hypo too. This year has been awful every day after every meal its peaking in the teens, I can get my bloods under 7 but they end up going too low within an hour cause I'm over dosing but if I don't it peaks high,I won't change the amounts of basal insulin because I have to eat with the 7 units I have and if I don't I hypo in the night but if I reduce the amount of Lantus the bloods go too high after meals. I have diabetic neuropathy and background retinopathy and I want to reverse the damage, so I've gone really strict with myself I even think my nerves are damaging when it reaches 8 but I'm also tending to feed my insulin and I don't want to cause any weight gain. With constantly eating sugar to lift out of the hypos, I'm on 7 units of Lantus and I have different amounts of humalog because I carb count. Can anyone also give some examples of what they eat and how it affects their sugars in the hour or 2 hours.

Thanks!

 

[tim2000s]

@Kerryannhogan, it sounds like you are experiencing similar issues to another couple of posters, in that you have come out of honeymoon and now need to reset. I would do a basal test first to confirm that your basal is correct:

http://integrateddiabetes.com/basal-testing/

And then re-address your bolus ratio once you were confident that your basal is correct. This usually gets you somewhere much more easily than comparing foods with other people as you have a very definite set of results and patterns to work from.

If you want a good estimate of how quickly something will affect your blood glucose levels, use the glycaemic index. There's one here http://care.diabetesjournals.org/content/suppl/2008/09/18/dc08-1239.DC1/TableA1_1.pdf

Anything that is 70+ generally will have a very quick action on your blood levels. Unfortunately, comparing with other people is difficult as different people digest foods at different rates.

 

[Kerryannhogan]

@Kerryannhogan, it sounds like you are experiencing similar issues to another couple of posters, in that you have come out of honeymoon and now need to reset. I would do a basal test first to confirm that your basal is correct:

http://integrateddiabetes.com/basal-testing/

And then re-address your bolus ratio once you were confident that your basal is correct. This usually gets you somewhere much more easily than comparing foods with other people as you have a very definite set of results and patterns to work from.

If you want a good estimate of how quickly something will affect your blood glucose levels, use the glycaemic index. There's one here http://care.diabetesjournals.org/content/suppl/2008/09/18/dc08-1239.DC1/TableA1_1.pdf

Anything that is 70+ generally will have a very quick action on your blood levels. Unfortunately, comparing with other people is difficult as different people digest foods at different rates.

Thanks Tim but my basal insulin is fine, it helps me keep my bloods under 7, it's the constant hypos when I'm over doing my humalog cause I'm paranoid the 8 or the 9 is damaging my nerves, I'm trying to view the other link cause that would help a lot but it seems to be not working for me I'll try again later

 

[tim2000s]

@Kerryannhogan as long as you are timing your insulin correctly, 8 or 9 really isn't an issue. Non-diabetics hit those levels. The key is keeping your spikes fairly short, and that is all about the timing. The GI list will help (it is a PDF) but you'll also need some trial and error with testing to confirm.

 

[RuthW]

First, check that when you are going into a meal, your bs is in the right range. If so, and it's is four hours since your last bolus, then your basal is right. Next, get the timing of your bolus right. If you are getting after-meal spikes, leave twenty minutes or more between your bolus and your eating. Then you should be able to take the right dose without the spike followed by the crash. Spike+ crash probably means you are taking too much insulin too close to your meal.

That's not the only possibility. Tim's right. It could be your basal. But we have no information on timing etc, so nobody here can know. If you are utterly convinced your basal is right, alter your timing and reduce the amount of insulin. That may not sound right to you at first because you're worried about the high, but high followed by crash is typically over treating and bad timing.

 

[Kerryannhogan]

First, check that when you are going into a meal, your bs is in the right range. If so, and it's is four hours since your last bolus, then your basal is right. Next, get the timing of your bolus right. If you are getting after-meal spikes, leave twenty minutes or more between your bolus and your eating. Then you should be able to take the right dose without the spike followed by the crash. Spike+ crash probably means you are taking too much insulin too close to your meal.

That's not the only possibility. Tim's right. It could be your basal. But we have no information on timing etc, so nobody here can know. If you are utterly convinced your basal is right, alter your timing and reduce the amount of insulin. That may not sound right to you at first because you're worried about the high, but high followed by crash is typically over treating and bad timing.

My basal is kind of a pain in the backside to be fair, if it take a high dose I have to eat with it but it keeps my bloods steady the next day if I take a lower dose my bloods are in the teens mostly :/ and there's no in between really, unless I still have a bit of a honeymoon period

 

[sillysausage]

What's basil ?

 

[Kerryannhogan]

What's basil ?

Basal is background insulin, for example i take Lantus

 

[noblehead]

What's basil ?

Explanation on basal/bolus:

http://www.diabetes.co.uk/insulin/basal-bolus.html

 

[sillysausage]

Thank you Kerryannhogan & Noblehead.

 

[azure]

Have you spoken to your team about your basal? I see what you're saying with the lows being better than the highs, and I'd probably think the same if I was in that situation. Have you tried any other basal insulins to see if they suit you better? Or would altering the timing of your Lantus help?

I could never control my blood sugar on my basal insulin as my insulin needs vary so much during the day and night, so I have a pump. Is that an option for you?

 

[Kerryannhogan]

Have you spoken to your team about your basal? I see what you're saying with the lows being better than the highs, and I'd probably think the same if I was in that situation. Have you tried any other basal insulins to see if they suit you better? Or would altering the timing of your Lantus help?

I could never control my blood sugar on my basal insulin as my insulin needs vary so much during the day and night, so I have a pump. Is that an option for you?

I'm literally on the way to my appointment with the diabetic nurse, I don't know any other basal insulins, do you know any other types I can suggest to them?

Been thinking about the pump also but doesn't it cause a lot of hypos?

 

[azure]

Levemir or Tresiba? Also, there are older basals that may or may not suit you.

Good luck

 

[azure]

And no, the pump generally causes far LESS hypos

 

[RuthW]

My basal is kind of a pain in the backside to be fair, if it take a high dose I have to eat with it but it keeps my bloods steady the next day if I take a lower dose my bloods are in the teens mostly :/ and there's no in between really, unless I still have a bit of a honeymoon period

Let me guess. You're on Lantus, right? That's pretty typical for Lantus.

You could try Tresiba or Levemir, if they are available to you.

 

[Kerryannhogan]

Let me guess. You're on Lantus, right? That's pretty typical for Lantus.

You could try Tresiba or Levemir, if they are available to you.

Yeah spot on, I'm going to change it cause it's a joke now haha !

 

[RuthW]

Yes, I found that on less than 18 units it seemed to do nothing at all for me. On 20 or more I was hypo all night!

 

[Kerryannhogan]

Yes, I found that on less than 18 units it seemed to do nothing at all for me. On 20 or more I was hypo all night!

That sounds so similar to me, I upped my dose and I had a hypo at 3am then at 5am and then 6 and carried on till 9 ... There's just no inbetween for me haha! Awful

 

[michaeldavid]

The only slow-acting insulin I take is last thing at night: 1.5 units (summer) - 2.5 units (winter) of Insulatard.

Why on earth would I take any more nighttime-acting insulin than I really need to?

Instead, I ensure that I know when the fast-acting insulins I took earlier in the day run out. That is to say: I ensure that, when I go to bed, the effect of those insulins is finished. And since I eat wisely, the food I ate earlier in the evening is finished digesting. (That's excepting the residual effect of the rye bread eaten much earlier, I believe.)

So, no needless 'basal': just Actrapid first thing in the morning; same again at 10.30; then Novorapid at 15.30.

For me, the effects of the last two run out together at 23.30. But I can check at 22.30, and, so long as I've been eating sensibly, I know my BS will fall by 2mmol/l by 23.30; and I know that will be covered by 17g of ordinary wheat bread. (Happily, this coincides with me watching Newsnight on the telly - or, on Sunday, listening to The World Tonight on R4.)

A great deal of variation is possible: eg. if I fancied some regular breakfast I could easily take a shot of Novorapid (in my stomach area, which seems to quicken the effect).

But it's so much easier to keep it all as simple as possible.

Did you try the rye bread?

 

[tim2000s]

@michaeldavid you have what many would consider to be quite an unusual treatment schedule, and please don't take that the wrong way as it clearly works for you. It strikes me as being very similar to the twice daily regime I used for the first four years of diagnosis, which entailed eating to my insulin (which as a growing lad was fine).