Am I On The Right Insulin?

[Pottykates]

I've been diabetic ever since I was 13, 14 years ago. I've never been able to get it fully controlled and have often given up trying with the frustration of it all.

Anyway, me hubby and I are starting to think about babies. We are in no rush, but I want to get my diabetes in the right place so I'm all ready for when the time comes.

I have been given the libre which had already resulted in the best hba1c I've ever had at 68. This is still high but now I'm stuck and I don't seem to be improving any more. Ive recently changed from novorapid to fiasp to reduce my peaks which has helped slightly though i still seem to run high throughout the day.

I'm trying to look for patterns and I'm never sure if it's my background insulin (levimir) that's wrong or my ratios and correction doses. I have the accu-chek expert which works out my doses for me. I've done dafne and I'm fine with carb counting etc.

From what I can see at the minute, one of my problems is that around late afternoon/tea time onwards my blood sugars increase and during the night. I've worked out that this will be when my split dose morning and night levimir will be wearing off. I've increased both to 12 in the am and 16 at bed, but now I'm dropping during the night and in the early afternoon even when I don't have any carbs. I have altered my ratios in the past and I'm currently at 1 unit for 10g at the moment and similarly, 1.5 units to bring me down 1.0mmols. Is that normal? It seems like a lot!

I speak to my diabetic nurse and send my readings every few weeks but my progress is slow.

Would a different long acting insulin be the answer? Anyone else had this and found a solution? How do I fix this?

Please someone help! Thanks for reading!

 

[Jenny15]

Hi Pottykates and welcome to the forum.

I think you would get more replies if you posted this in the Type 1 diabetes subforum:

https://www.diabetes.co.uk/forum/category/type-1-diabetes.19/

That forum is more active than this one and the people with Type 1 are sure to have some ideas that will help you.

 

[Tony337]

Hi Pottykates and welcome

I'm on levimir and novorapid and use the same blood machine.
I'm a bloke aged 50 with 44 years on insulin so perhaps the comparison ends there! lol

However my sister, also a type 1 of many years, fell pregnant despite less than great control and what happened was this....

After years of trying and tests and changes in insulin she gave up trying to get pregnant.
Next thing you know she has a bun in the oven (forgive me I love the expression ) and 20 years on mum and son (not diabetic) are fine and dandy.

I'm not Doctor Spock nor a professor of Diabeticology so can't say what you are doing is right or wrong.
I can only share my experiences and oh BTW I'm a parent too.

I wish you all the luck in the world

Tony

 

[slip]

Sounds as though you've sort of done it but some 'proper' basal testing would be the first step - https://mysugr.com/basal-rate-testing/ (the Libre will help immensely with this)

Then look at your novorapid ratios. 1:10 is the 'norm' (as if we are all normal!). Ratios can vary during the day though, mines 1:7 for breakfast, 1:5 lunch and 1:6 for supper - you think they're not that different but it does make a difference. Your correction factor does seem a bit out of kilter - mine is pretty much the same as yours, but my ratios are a lot higher also.

With the help of the Libre you can fine tune dosage timing.

Split dose levemir gives you a bit more flexibility, depends on what your activity levels are like everyday, perhaps one of the extra long acting ones might help if you're always about the same level.

Have a look at Bertie online just to check/confirm your carb counting skills.

You don't mention hypos, I'm sure you probably have some, rebounds and over treating can keep us higher than we'd like.

 

[Engineer88]

how many carbs a day are you eating? I tend to find smaller caarbs means its easier to notice issues and lowers my hba1c.

Just a thought

 

[CranberryIce]

I am on Lantus and my pre-conception clinic have advised me to switch to a split dose of Levemir.

I started off with a Hba1c of 64 and it has slowly come down. I am still where they would like me to be (48mmol or below) but much closer.

Basal testing helped me so much! I still need to work out if my meal time ratios are correct as I am just assuming I need 1 unit for every 10g of carbs.

Basal testing is a pain & requires patience but it pays off...

 

[CranberryIce]

Then look at your novorapid ratios. 1:10 is the 'norm' (as if we are all normal!). Ratios can vary during the day though, mines 1:7 for breakfast, 1:5 lunch and 1:6 for supper - you think they're not that different but it does make a difference...

Is ratio testing as simple as eat 10 grams see how much 1 unit impacts it? I have just assumed I am 1:10... but now want to make sure!

 

[Q4444]

I was diagnosed as a diabetics the age of 7 and treated for 33 years on once daily insulin zinc suspension Lenten. When my consultant was changed she said I did not fit into any of her boxes for treating insulin and was put on multiple injections daily. Since then my life has been disrupted by these so called human insulins. Now I have been referred to the diabetic specialist nurses who say I am on the wrong insulin. Why have a consultant who constantly says animal insulins do not work (he trained when human insulins had been introduced) I am awaiting developments

 

[robert72]

I was diagnosed as a diabetics the age of 7 and treated for 33 years on once daily insulin zinc suspension Lenten. When my consultant was changed she said I did not fit into any of her boxes for treating insulin and was put on multiple injections daily. Since then my life has been disrupted by these so called human insulins. Now I have been referred to the diabetic specialist nurses who say I am on the wrong insulin. Why have a consultant who constantly says animal insulins do not work (he trained when human insulins had been introduced) I am awaiting developments

It would be worth getting in touch with IDDT who may be able to advise you about staying on animal insulin.
https://www.iddt.org/about/gm-vs-animal-insulin