Another change of insulin question

[Ratbag]

Hi there, Well, thinking that I was doing well stopped me right in my tracks. I wonder if anyone can shed some light for me.

Last night I had a Hyper, reading of 19, 4 hours after my jacket potato and chilli dinner, felt like I was going to pass out, warned Paul to phone 999 if I do so. really frightened me.

I managed to get it down slowly during the night but I was so worried about my keetones I thought that I was getting keetoneacidosis, or something like that, so went to the hospital this morning feeling like death. I have no Keetone strips so I thought better be safe than sorry.

I'm on levemir 18 units at night, novorapid when I eat.

Readings in the morning are good. Under 6.
Early afternoon readings are ok, not brilliant.
Evenings reading are terrible. Had 5 readings over 15 in only 10 days.



This has never happened to me before if my readings where high like that when I was on humalog25 (the feeling of passing out). And I was on humalog 25 for near 10 years. Only been on levemer and novorapid for 10 days and it does this to me. what the heck am I doing wrong?

It seems to me that anything over 70 grams of carbs and it takes ages for the levels to come down. I've changed to a ratio of 1:10 now (used to be 1:15) and now my readings today have jumped up and down like some mad thing.

Bloods, Keetones and xray today came out normal. So I'm not ill.

I'm wondering if I should take my novorapid 20 mins before a meal in the evening as my levels in the morning and early afternoon seem ok. And split my levemir in two doses instead of just in the evening.

Any advice would be great, but I will be phoning my healthcare team tomorrow to be seen asap. Yesterday scared me, and the annoying thing is. I don't know why I spiked so badly!

My grammer is shocking, sorry! I'm an artist you see.

Any advice?
And yes, I already like moonstone here. But be gentle with me.

32 years old, with cystic fibroisis. Fun! :?

 

[jopar]

A couple of questions

If your BG's are constantly going high in the evening or after tea there is two possible reasons..

It could be the basal out.. Being caused either by your levimer not covering the 24 hours, but tailing off earlier or your evening needs are a lot higher..

Or it's your Nororapid tea insulin ratio is out, your not having enough to cover the carbs you are eating..

The only real way of finding out is to do an fasting test, have a lunch but don't eat pasta or high fat meal, so that when you start testing you've got no slow adsorbing carbs impacting on your results, then start testing about start testing post meal, and test every hour until late in the evening.. If you feel that fasting is going to be a problem then sugar free jelly is good for curing hunger pangs without impacting on your BG fasting data.. Avoid protein has this will impact on your date..

Do remember though that if you become hypo or hyper, abort the testing and treat appropriately..

If you find that your BG's start raising in the afternoon into the evening, the your levimer is tailing off too quickly and your best option is to split your levimer into 2 jabs a day.. One in the morning and one in the evening.. This should give you the coverage required..

But before splitting your levimer do a morning fasting test, to see what your BG is up to in the morning, this will also help guide you to what sort of spilt you'll be looking at..

I see that you have CF, I know that this involves a lot of medication and not sure if any of these will impact on your blood glucose levels so you need to discuss this with your DSN as some of you evening problems might be linked to your CF medication and what you take at what time of the day..

It's early days, and it does take time to settle down, get your head around your new regime..