How often are you high?

[Sophielouise]

I think if you eat a lot of fats with your carbs it sticks you at a number. I find if I have peanut butter on toast I'll stick at 11 a few hours later despite taking some bolus to try correct it, usually takes over an hour to get it to drop at all. It seems like the fats slow down the insulin absorption.

I eat my dinner at 8 too and still usually snack later (with or without an extra jab). I haven't recently though which I think has caused some bad nights. Just a thought, it might be worth trying a unit and 15g of carbs (something whole grain and savoury). I know Drs say don't snack before bed, but they don't really understand that yes going to bed at 7 and waking up at 7 seems to make sense, but oh what a surprise it doesn't work that way.

Do let me know what the dr says tomorrow. I have no 'team' as such here, I've never had any support. Hence signing up to this forum

 

[mentat]

I reduced my lantus 2 units yesterday.

When tweaking Lantus just be aware that the dosage change can take a few days to reach full effect (because Lantus lingers for ~3 days). Back when I was on Lantus, if I wanted to reduce it by 1 unit, I would reduce it by 3 units the first day and then 1 unit after that, to get the desired effect sooner.

It's kind of making me want to go back to running a bit higher because I can't handle this anymore.

You need your wits about you to achieve tight control. You need to be able to think clearly and spot patterns, avoid overreacting AND stay motivated. For that, you need SLEEP!

My advice is to fix your sleep first and keep it that way; that will give you a better chance at succeeding. Occasionally set an alarm at a random hour in the night so you have an idea what your sugar does overnight. This will help you figure out whether to use snacks or basal to manage your sugars overnight. And if you need more basal during the day than the night, either try Levemir, or just take extra small insulin doses throughout the day. Just don't compromise your sleep to run lower during the day.

Best of luck!

 

[EileenWagner]

Hi Sophielouise

You're getting a lot of great advice, so I'll only add a couple things to try.

First, Mrsass mentioned that your food digests at different rates on different days. I find that drives me nuts, too! I can do the exact same thing 2 days in a row, and get 2 different results. It's frustrating, I know.

One thing that may help is to keep a food diary for at least a week, including what amount of insulin you took to eat the meal etc. You can also keep track of how you're feeling, whether you have anxiety, whether you're PMSing, any exercise, etc. It sounds like a lot to write down and keep track of, but you will start to see definite patterns emerge. Most mobile phones have, or you can download an app that you can type notes into, which makes it a little easier as most of us carry our phones with us everywhere. If that's not your thing, definitely go for pen and paper. One of my educators suggested making a graph on paper with boxes so you can see your patterns easier.

Second, I was on Levemir at one point, and it's supposed to last for 24 hours. I found that for me, it was only working for 17 hours. I switched to Lantus, and that works for a full 24 hours for me. So perhaps your bolus isn't sustaining you through the whole day and you may need to change it. That's not to say that Levemir isn't a good choice, it just wasn't a good choice for me.

Keep your chin up. It's difficult being a diabetic, and people who don't have diabetes don't understand that, including doctors and diabetes educators. They think they can tell us to do something, and if it doesn't work, then we're either lying or cheating on our diets, or not taking proper care of our diabetes. It's frustrating! Unless you have diabetes and find out that sometimes no matter what you do, you can't help what your body does, then you just don't get it. You're doing a great job, no matter what anyone tells you. Relax, and give yourself a break. You deserve it.

Best of luck.

 

[Sophielouise]

Hi Sophielouise

You're getting a lot of great advice, so I'll only add a couple things to try.

First, Mrsass mentioned that your food digests at different rates on different days. I find that drives me nuts, too! I can do the exact same thing 2 days in a row, and get 2 different results. It's frustrating, I know.

One thing that may help is to keep a food diary for at least a week, including what amount of insulin you took to eat the meal etc. You can also keep track of how you're feeling, whether you have anxiety, whether you're PMSing, any exercise, etc. It sounds like a lot to write down and keep track of, but you will start to see definite patterns emerge. Most mobile phones have, or you can download an app that you can type notes into, which makes it a little easier as most of us carry our phones with us everywhere. If that's not your thing, definitely go for pen and paper. One of my educators suggested making a graph on paper with boxes so you can see your patterns easier.

Second, I was on Levemir at one point, and it's supposed to last for 24 hours. I found that for me, it was only working for 17 hours. I switched to Lantus, and that works for a full 24 hours for me. So perhaps your bolus isn't sustaining you through the whole day and you may need to change it. That's not to say that Levemir isn't a good choice, it just wasn't a good choice for me.

Keep your chin up. It's difficult being a diabetic, and people who don't have diabetes don't understand that, including doctors and diabetes educators. They think they can tell us to do something, and if it doesn't work, then we're either lying or cheating on our diets, or not taking proper care of our diabetes. It's frustrating! Unless you have diabetes and find out that sometimes no matter what you do, you can't help what your body does, then you just don't get it. You're doing a great job, no matter what anyone tells you. Relax, and give yourself a break. You deserve it.

Best of luck.

I usually start keeping diaries but they don't last more than a week before they overwhelm me and start depressing me. I've just gave one up yesterday because it was causing me so much stress and I've only been sleeping a couple hours a night for the past 5 days, mostly due to hypos so I can keep my sugars down in the day. I'm back my usual Lantus dosage now but was 12.5 all night last night so I could avoid a hypo but still didn't sleep very well, feel pretty awful this morning. My ketones are 0.4 though so I doubt I should be too concerned?

I think Lantus has worked well for me in the past, I'm wondering whether my reduction in carbs per day is causing a bit of the problem. I'm only eating around 80/90g of carbs a day now I have cut out snacking. I tried to introduce snacking back but ran quite high (10/11) yesterday due to being too tired to do any exercise (even low level) maybe.

I've also lost a lot of weight in the past week which isn't great considering I am usually just under 8 stone anyway. So I don't know how I'm suppose to put it back on if I can't get my sugars low enough to snack. No diabetic specialist has ever helped me work this out because they've just said don't snack.

Thanks for your help.

 

[KarenAdamson]

Hi, I'm really struggling to keep my sugars within this tight range, (I believe it's around 4.0-7.9?) so I've just been trying to keep them below 10. Turns out that's harder than I thought it would be, actually.

I've had diabetes for just over 20 years now, I'm 31 and not in the low enough range (7.1% last review) for having a baby so wanted to try sort myself out over the next year. Unfortunately, my Drs and healthcare are really useless and keep telling me conflicting things so I've had to resort to the Internet, which is also very conflicting.

My question is; how often are you going high (my opinion of high is 11-18) a week? Because at the moment I'm hitting 10 once a day and 13 every other day. I've been running the rest of the time between 4.5-8.5. Is this going to set me up for another fail at my review and ruin my body?

I suffer from depression and anxiety and am really unsure of what is safe and normal. I want to give up but obviously I can't.

Hi Sophie louise. I did a four week course before deciding if I would get any benefit from a pump. We kept a daily food and insulin diary. To check our Basal insulin we had to check our overnight BG two nights during the first week. We got up twice during the night and checked our BG. We also checked or BG as soon as we got up. We had a small snack before bed of 15 to 20 gms carb which should mean your BG is about the same level as it was before we went to bed. If however your BG is too low then we adjusted the basal insulin down by a couple of units and repeated the nigh time tests until we had reached a good level before and after sleeping. Once your basal dose is sorted you can then check your bolus insulin ratio is correct. It's possible you need different ratios for different times of day and for every persons ratios are different. Being a woman your hormones can also affect your ratios when you are menstruating but if you know this you can adjust your ratio at that time of the month. You don't mention if your highs are at the same time of day or not every day, but keeping a food diary may help you narrow down where the problem is. I use the Aviva Accu-chek Expert meter which allows you to set different bolus ratios for different times of the day and allows you to set for different life events such as exercise or times of the month by either reducing or increasing the ratio by a certain percentage if you need it. It makes my life easier as once you set you correct ratios it tells you how much insulin you need according to your BG. To use this meter you need your correct ratios and adjustment doses first though so good luck getting it sorted.

 

[KarenAdamson]

I usually start keeping diaries but they don't last more than a week before they overwhelm me and start depressing me. I've just gave one up yesterday because it was causing me so much stress and I've only been sleeping a couple hours a night for the past 5 days, mostly due to hypos so I can keep my sugars down in the day. I'm back my usual Lantus dosage now but was 12.5 all night last night so I could avoid a hypo but still didn't sleep very well, feel pretty awful this morning. My ketones are 0.4 though so I doubt I should be too concerned?

I think Lantus has worked well for me in the past, I'm wondering whether my reduction in carbs per day is causing a bit of the problem. I'm only eating around 80/90g of carbs a day now I have cut out snacking. I tried to introduce snacking back but ran quite high (10/11) yesterday due to being too tired to do any exercise (even low level) maybe.

I've also lost a lot of weight in the past week which isn't great considering I am usually just under 8 stone anyway. So I don't know how I'm suppose to put it back on if I can't get my sugars low enough to snack. No diabetic specialist has ever helped me work this out because they've just said don't snack.

Thanks for your help.

Hi Sophielouise. I used to have a lot of night time hypos and also on the course I mentioned before I was told that I should have a minimum of 100 gms of carb a day so that my body could produce and store the Glycogen needed by my body in case I was hypo. I'm on Lantus as well and that works well for me but please don't stop the diaries as it will really help you sort out your ratios and figure out where the problems are. Exercise can affect your BG for upto 48 hours and doesn't just have immediate affects. please snack before bed time as this will help prevent night hypos.

 

[KarenAdamson]

I think if you eat a lot of fats with your carbs it sticks you at a number. I find if I have peanut butter on toast I'll stick at 11 a few hours later despite taking some bolus to try correct it, usually takes over an hour to get it to drop at all. It seems like the fats slow down the insulin absorption.

I eat my dinner at 8 too and still usually snack later (with or without an extra jab). I haven't recently though which I think has caused some bad nights. Just a thought, it might be worth trying a unit and 15g of carbs (something whole grain and savoury). I know Drs say don't snack before bed, but they don't really understand that yes going to bed at 7 and waking up at 7 seems to make sense, but oh what a surprise it doesn't work that way.

Do let me know what the dr says tomorrow. I have no 'team' as such here, I've never had any support. Hence signing up to this forum

Fats don't slow down the insulin but do slow down the absorbtion of carbs. A baked potato is quite high G.I. but if you add butter or cheese it lowers their G.I.

 

[Nadya123]

If I wasn't testing my blood every hour id be going a lot higher sometimes because I'm managing to catch it in time before it goes higher than 12 usually. It's driving me mad, this can't be right. I don't understand why my sugars continue to rise 3 hours after I've eaten sometimes and drop others. My body is trying to kill me.

Are you on insulin? Did you cut carbohydrates intake? Did you speak with diabetic professionals, that your diabetes is not controlled?

 

[Nadya123]

i have a reading above 10 usually every single day. i don't usually go above 16 every day though, maybe 4 days a week? i don't think you should beat yourself up over going over 11 every day! just as long as you correct and can bring it down x

Your diabetes is not in control. Instead to beat yourself, try control it, if you don't want to get diabetic complications.

 

[ann34+]

Hi, I'm really struggling to keep my sugars within this tight range, (I believe it's around 4.0-7.9?) so I've just been trying to keep them below 10. Turns out that's harder than I thought it would be, actually.

I've had diabetes for just over 20 years now, I'm 31 and not in the low enough range (7.1% last review) for having a baby so wanted to try sort myself out over the next year. Unfortunately, my Drs and healthcare are really useless and keep telling me conflicting things so I've had to resort to the Internet, which is also very conflicting.

My question is; how often are you going high (my opinion of high is 11-18) a week? Because at the moment I'm hitting 10 once a day and 13 every other day. I've been running the rest of the time between 4.5-8.5. Is this going to set me up for another fail at my review and ruin my body?

I suffer from depression and anxiety and am really unsure of what is safe and normal. I want to give up but obviously I can't.

Hi, I notice you are vegan, i was 98% vegan when diagnosed over 35 years ago, and now just mainly vegan, with tiny amounts of some non meat foods. Just my own experience, but i found the fast acting insulins don't suit this diet, so I used the slightly different profile Hypurin pork range, i think the more modern insulins are for the more usual diet, not the slower absorbed vegan one - trying to use human insulins years ago forced me onto sweet stuff just to prevent hypos, or to having injections after meals, not before. I really agree with some of the posts about pumps - for me , now i have at last had a pump for some years, i am very sad i could not get them for most of my diabetic life - you might be very pleasantly surprised if you were to try one for several months. It is not easy, but it is so much easier than injections, and, if you are a model and watching your weight, it would be good for you as less hypos and less need to correct with empty calories. As others say, the changing basals are the big advantage - my most usual is .35, my morning may be .45, part of my night is .2, and for up to 3 hours i only need .15, and even then half a banana to make things safe - any exercise and the basals change again. I now don't know how i would manage with injections at all.

 

[hollyslot]

Your diabetes is not in control. Instead to beat yourself, try control it, if you don't want to get diabetic complications.

really? there i was thinking that was 'normal'. i agree though i have a lot of issues with going both high and low, but each time i go to the doctor (every 6 months) they say i'm doing fine (my hba1c is 6.8). i do worry though because i feel my diabetes affects me too much every day. i do try really hard and count carbs etc, i'm not sure if i really am not in control? sorry if that sounded really confusing!

 

[himtoo]

Are you on insulin? Did you cut carbohydrates intake? Did you speak with diabetic professionals, that your diabetes is not controlled?

@Nadya123
welcome to the forum
as a newbie i can somewhat excuse a post that is not factual in its response due to lack of education but............if you read back through @Sophielouise original post you will see she has been type 1 for a long time so asking if she takes insulin is irrelevant , off topic and reasonably ignorant towards the the original poster.
I would suggest reading the whole topic before you post

 

[Nadya123]

@Nadya123
welcome to the forum
as a newbie i can somewhat excuse a post that is not factual in its response due to lack of education but............if you read back through @Sophielouise original post you will see she has been type 1 for a long time so asking if she takes insulin is irrelevant , off topic and reasonably ignorant towards the the original poster.
I would suggest reading the whole topic before you post

I am a new member on forum , but not a new in diabetes. It is not army here on forum that you order me what to say.

 

[Nadya123]

really? there i was thinking that was 'normal'. i agree though i have a lot of issues with going both high and low, but each time i go to the doctor (every 6 months) they say i'm doing fine (my hba1c is 6.8). i do worry though because i feel my diabetes affects me too much every day. i do try really hard and count carbs etc, i'm not sure if i really am not in control? sorry if that sounded really confusing!

It is important to keep BG level steady. if to calculate insulin intake right BG should be less 8.5mm/l in 2 hours after meal. If calculation wrong make adjustment of insulin. Your nurse has to explain how to do it.

 

[Nadya123]

Thank you for your support, no one has ever told me how to test my basal apart from telling me hypos in the night mean I'm taking too much. Which I'm currently having every night for the last week but am able to run a bit lower usually in the day. So even if I do this I'll still have to work out what to do by myself anyway.

I can't really eat low carb and fat cos I'm under 8 stone and vegan. And I'm not on a pump.

It's insane how little help I've had from professional doctors and nurses. One told me to go to bed at 14 to avoid lows in the night.

I'll definitely have a chat with some ladies about hormones because it's clearly a problem.

Thanks again!

You definitely should discuss your problem with your hospital diabetic nurse. On forum you can get just some ideas what to discuss. Perhaps you will need to increase intake of basal insulin, but only under management of a diabetic nurse and not a forum.
I spent 3 month to adjust intake of lantus ( my basal night insulin).

 

[mentat]

I am a new member on forum , but not a new in diabetes. It is not army here on forum that you order me what to say.

Nadya123, I agree with himtoo. Your posts indicate you have not put in much effort to read and understand the problem, and you are making the assumption that other people's diabetes is as simple to control as yours.

I was also taught that, if you calculate your insulin correctly your sugar should be below 8.5mmol/L after 2 hours. But my body simply doesn't work that way. There is no "correct calculation", just the hope that my body will behave consistently with the last few days.

 

[Diamattic]

I think if you eat a lot of fats with your carbs it sticks you at a number. I find if I have peanut butter on toast I'll stick at 11 a few hours later despite taking some bolus to try correct it, usually takes over an hour to get it to drop at all. It seems like the fats slow down the insulin absorption.

This.

I find that too.. If i eat lots of peanuts/peanut butter my sugars start rise about 3 hours after eating it, very slowly they creep up about 3 units and then freeze there for the next 6-8 hours regardless of what i inject (or so it seems).

To answer the OP - I very rarely see my sugars above 13mmol/L maybe once every couple months. I see them above 10mmol/L maybe 3-5 times per month and when i notice this i immediately take a 'brisk walk' or inject. The only times they reach 10 is when i eat before the gym trying to get them up so that i can workout because i know 20 minutes of cardio will drop them back to 6.

The highest they get without me 'acting' is around 8mmol/l which happens after meals about once a day and lasts a max of 1 hour at which point the insulin catches up and they fall or i take that walk and they fall.

Sometimes if i eat before bed and fall asleep before checking to see what i leveled off at i may spend the half the night at 7.5mmol/L :/

But i would say I am 'High' rarely and within 'normal' at least 85-90% of every day.

 

[Nadya123]

Nadya123, I agree with himtoo. Your posts indicate you have not put in much effort to read and understand the problem, and you are making the assumption that other people's diabetes is as simple to control as yours.

I was also taught that, if you calculate your insulin correctly your sugar should be below 8.5mmol/L after 2 hours. But my body simply doesn't work that way. There is no "correct calculation", just the hope that my body will behave consistently with the last few days.

I understand her problem. We are what we eat. Even taking insulin you have to eat healthy food, not overeating . 60% of food should be raw. Liver which is responsible for getting glucose from glycogen to blood at night doesn't like any animal fat, cooking food and overeating. Eating animal fats and only cooking food is stupid to hope that BG will be not jumping over limits.
And of course correct doses of basal and rapid insulin.
I was in bad condition after Victosa ( this medicine has to be prohibited!). Keaton Acidosis, HBAc-126 mm/m (29.03.15). My GP sent me to hospital in emergency to Diabetic Clinic. I was prescribed insulin and it was just one way to treat my condition, no choice. I am not only taking insulin, I changed my eating life style. I test BG not less than 8 time a day. HBAc- 57mm/m (02.09.15).
I feel better. I had one severe hypo. I know now what is a death. I have scientific analytical mind and education, which help me to control my diabetes. Also now I have very supportive and intelligent diabetic professionals.
My mum died from gangrene just in 10 years after she got her T2.

 

[LucySW]

..

 

[LucySW]

Hi, I'm really struggling to keep my sugars within this tight range, (I believe it's around 4.0-7.9?) so I've just been trying to keep them below 10. Turns out that's harder than I thought it would be, actually.

I've had diabetes for just over 20 years now, I'm 31 and not in the low enough range (7.1% last review) for having a baby so wanted to try sort myself out over the next year. Unfortunately, my Drs and healthcare are really useless and keep telling me conflicting things so I've had to resort to the Internet, which is also very conflicting.

My question is; how often are you going high (my opinion of high is 11-18) a week? Because at the moment I'm hitting 10 once a day and 13 every other day. I've been running the rest of the time between 4.5-8.5. Is this going to set me up for another fail at my review and ruin my body?

I suffer from depression and anxiety and am really unsure of what is safe and normal. I want to give up but obviously I can't.

Dear Sophie,

Poor you. Sorry it's been so miserable.

Look - do the basal test.

Above all, are you recording what you eat (and exercise) as well as insulin doses and BG, and uploading it and looking at the patterns? You probably are - but in my experience, numbers alone, unanalysed, only indicate 'better' or 'worse'. And then you over-compensate.

I really recommend an app for recording the data and uploading that data to your computer. Apps do some organising for you immediately, and that gives a daily picture with averages and standard deviation, which I feel are essential for monitoring what is going on. I recommend DiaConnect, but My Sugr is also good. Try them out.

Then be systematic about when you do the analysis. Once a week? Once you have some organised analyses, you can compare and get so much better a picture if what is going on.

Then look at your data and work out if Lantus is suiting you. If you conclude it isn't, maybe try Levemir twice a day?
It may be you just need to take a correction bolus dose in the morning and lower your night time basal. If you can avoid night-time hypos you'll feel so much better.

And inject Novorapid 30 mins ahead. I use a Libre, and I can see that NR never kicks in till about 35 mins. Injecting in time (and not snacking, my weakness) are the two best things I can do to avoid spikes. And I can. I just have to be smart, not forget, and concentrate.

Good luck girl.