Advice on getting back to basics

[Jenny_B_]

Hi
I’ve started using a Libre 2 this week and although I already knew my blood sugars are running higher than they should I’m surprised at how erratic they are. I really want to get back in range and find a way to stay there for as long as possible so thought I should get back to basics but I’m not sure where to start can anyone give me advice on what they would do as a starter.

I’m a carb counter, using 1 unit to 10 grams of carbs however I find even when I’m specific in my carbs calculations I can run high and then struggle to get my level down this is particularly difficult in an evening and overnight. I use tresiba as my basal and have been increasing by 2 units every 2 days to get that fasting morning reading down but as yet I haven’t got to a point where I’m consistently in range .

I’m wondering if it would be a good idea to be really strict and have the same meals at the same time for a week so I can observe what’s happening or if it might be a good idea to increase the unit/carb ratio. I’ve been type 1 for 28 years now and admittedly have never really felt like I’ve got the management of it nailed.

I’ve got a consultant appointment later in the month I just want to make an effort to work out where I’m going wrong at the present time so I can start to improve control now.

Thanks in advance.

 

[Antje77]

I’m a carb counter, using 1 unit to 10 grams of carbs however I find even when I’m specific in my carbs calculations I can run high and then struggle to get my level down this is particularly difficult in an evening and overnight.

Many of us have found we have different ratio's for different times of day, so if you're trying to work out your ratios you might want compare breakfast with breakfast, dinner with dinner and so on.

I’m wondering if it would be a good idea to be really strict and have the same meals at the same time for a week so I can observe what’s happening

This would be a very informative experiment, if it's doable for you!
If you do, don't forget to make notes on exercise and such as well, as it's not only food affecting our blood glucose.

 

[EllieM]

Hi @Jenny_B_

My understanding is that you need to get your basal right first before tackling the bolus. This could take a while if you are on tresiba, as it's so long acting. Bear in mind that you need the morning reading to be the same as the night time one after bolus and food is out of your system.

As you're a carb counter you should find it easy to keep a good carb/insulin/bg diary which will be of enormous help to your team should they want to help you calculate your ratios.

Do you have a correction ratio for bolus to bring your bg down if it starts too high/low eg 1 unit for 2mmol/L

 

[Jenny_B_]

Hi @Jenny_B_

My understanding is that you need to get your basal right first before tackling the bolus. This could take a while if you are on tresiba, as it's so long acting. Bear in mind that you need the morning reading to be the same as the night time one after bolus and food is out of your system.

As you're a carb counter you should find it easy to keep a good carb/insulin/bg diary which will be of enormous help to your team should they want to help you calculate your ratios.

Do you have a correction ratio for bolus to bring your bg down if it starts too high/low eg 1 unit for 2mmol/L

Thanks I didn’t know about the readings needing to be the same morning and evening that’s helpful, I use 1 unit to 3mmol correction I think I need to review that also at this point.

 

[Jenny_B_]

Many of us have found we have different ratio's for different times of day, so if you're trying to work out your ratios you might want compare breakfast with breakfast, dinner with dinner and so on.

This would be a very informative experiment, if it's doable for you!
If you do, don't forget to make notes on exercise and such as well, as it's not only food affecting our blood glucose.

Thanks I think I better get the log book out!

 

[Antje77]

Thanks I didn’t know about the readings needing to be the same morning and evening

Make that approximately the same, don't expect to see the exact same result from the same food and the same insulin every day!
My basal is as spot on as I think it gets. Which means I wake up between 5 and 8, most of the time, even with all other factors being the same.