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Any ideas to what's happening.

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Hi all any ideas as to what's happening, at the minute I am on levimir twice daily 18 and 16 and various nova rapid. I usually have around 30/40 grams of carbs per meal, just realling struggling, crying like a baby at 42 years of age, can't see out of one eye, yet another op in a couple weeks, I know we can't discuss medical opinions on here but consultants etc are nearly none existent in my case anyway, and getting access to the new technology or pump etc seems out of reach. Looking for any input at all, iam unsure if it's my background insulin is out or ratios etc, just today sugars was at 17 at 12pm then crashed to 10 in an hour I had 3 units of nova and 30 grams of carbs so can't understand the crash so fast today, never happened yesterday, so panicked as didn't know when the crash would stop, been battling rest of the day with HI bg levels, as it's so unpredictable iam reluctant alot to do correctional doses with my meals as I don't know when these random crashes will happen, it is usually in the afternoon. I haven't a clue if it's the ratios background type of food, the timing of injections, or even sometimes if I am injecting into a fatty lump I don't know about. Diabetic burn out is an understatement. As I don't have the confidence all the time to have correctional doses with meals as I don't know if it will crash I usually do them a few hours after my last injection. So I have around sometimes 7/8 injections a day, I scan around 100 times a day on the libre and test around 15 times a day on finger pricks, I don't drink smoke have coffee and compared to what I used to eat, have quite low carb foods as I am constantly battling high and erratic sugars, I've heard of a test for your background insulin but I never get my sugars in single figures to be able to do one. Just unsure what to do, iam trying everything but nothing seems to work everyday seems different, and I try and eat similar carbs and foods. Getting any access to a consultant or a pump seems impossible so any tips or tricks I can try or what's worked for you would help massively, been type 1 for 32 years and cut out loads of things and trying everything I can think of but losing hope at the minute. Anything you could help me with id be truly grateful. Thanks for listening and sorry for long post but getting desperate now.
 
On 1 unit to 10 grams of carbs but no days are the same all over the place and ideas etc would help.
 

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The fact you feel that your not getting any help from diabetic medical personnel means it is time to crack this yourself.
From my point of view looking at your graph, if it was in the blue band it would be pretty good. The rises and falls looking similar to mine. The problem is it is in the sky. I could suggest all sorts, but you need to go back to basics. Buy ‘How to think like a pancreas,’ by Gary Scheiner. Yes he is an American, but he is both a Doctor and diabetic. He shows in detail how to go about getting the basics right. Starting with basal and then moving to bolus. It is also a good read.
 
Thanks for reply I will look into it thanks, was a nightmare trying to bring sugars back down again yesterday still in the high teens, going to start off by writing things down abit more of a plan when things go abit crazy so I don't panic and over do the carbs etc. Realising there's a lot more that can effect your sugars from the timing of injection, is the basal set right, foods, injection sites and how fast or slow the insulin is absorbed, insulin sensity, activity etc. for many years I was just used to having two injections a day and eating regular, but I understand to get on top of things I am going to have to write little notes down to get a better understanding of what's going off and to stop me panicking when things go off track. Il keep any updates of things I've found out, thought after 32 years I'd have cracked it by now one possitive is most of my blood tests coming back ok so we keep on trying.
 
The fact you feel that your not getting any help from diabetic medical personnel means it is time to crack this yourself.
From my point of view looking at your graph, if it was in the blue band it would be pretty good. The rises and falls looking similar to mine. The problem is it is in the sky. I could suggest all sorts, but you need to go back to basics. Buy ‘How to think like a pancreas,’ by Gary Scheiner. Yes he is an American, but he is both a Doctor and diabetic. He shows in detail how to go about getting the basics right. Starting with basal and then moving to bolus. It is also a good read.

My mum gave me the Think Like a Pancreas book years ago and I never read it. It's next on my list now!
 
Completely agree with @becca59 Get the book it's available on Amazon, but every t1 should read it, I have a copy too.

You need to be getting in the blue zone, if you were already in the blue zone then this would be normal, can you remember when you were last below 10 ? Graphs with rapidly falling arrows are misleading as they can stop and level off out of range in no time, which means you can hit 12 mmol/l and stick there, you need to be hitting the blue as your primary focus, crashing to 10 isn't crashing it's a drop yes but you need to be focused on when the arrow stops falling not when it starts, it looks like you have a fear of hypos, is that right ?
 
Hi thanks for the replies again, this is what's happening today got it to around 14 at dinner time, had just 2 units of Nova rapid 40 grams of carbs, and had my injection 30 minutes after my sandwich etc. It's it stayed around the 14 ish mark before my tea which I have around 4/4.30, anyone know if the back ground is too high etc as although still high I've had double the carbs to insulin and ate well before my injection to stop these crashes I've been having. Or would i be better off just sticking to the morning background insulin and adjust the nova rapid accordingly thanks.
 

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The trouble is @DannyH you are eating when very high. I personally never eat more food if above 9. Even if it means not eating full stop. I set about getting myself back in range.
You were 14, ate first and injected later. I cannot see a correction dose in that equation. The fact it stayed around the 14 mark shows your bolus was correct for that meal. It was just far too high to start with.
 
Yes, I would second that. My control is not as good as I'd like it to be but I aim for it to be 5 to 7 before a meal.

If you're going into a meal when it's already high, it becomes an uphill struggle because it will always go up further before going down. For me, if I started a meal at 14 I'd end up being out of the target range for several hours because it would go even higher before having a chance of coming down.
 
Hi Danny,

This is how I would manage this situation.

If was running at 14 mmol/l i'd be really hungry as my body would be craving energy, however if it was me i'd do the following:

If I didn't have to eat - then just a correction.

If I had to eat- Pre-bolus at around 20 mins and include a correction to address the high of 14, so get the quick acting working first, then eat low carb and then watch, but do nothing until I could see my levels dropping to around 6 mmol/l, you panic at 12, but you need to start becoming more relaxed, you are not hypo at 12, you are hypo at -3.9mmol. You may feel shaky as your body is not used to running in range but you will get used to this.

Do you know what your correction factor is ?
 
Hi I do feel hungry alot, I probably do have hypo anxiety as I live alone, and being on this regime sometimes I feel it can be unpredictable, I found with twice daily injections everything happened more slowly, even hypos then I wasn't too worried as it was slow but finding this regime after some months things can happen quickly etc. Ie last night my libre said it was 5 then checked my sugars and they were 19 only just replaced my sensor and seen its best to leave it 24 hours before activating it, it like iam learning all over again. What I do notice is the morning seems around the 1 unit to 10 grams of carbs and any extra unit may bring it down 2/3, unsure in midday feels like I'm more sensitive or something else ie basal is bringing it down so Iam ABIT reluctant to correct in the afternoon, then in evening around 4/4.30 iam usually having 1 unit to 10 grams of carbs again, with 1 unit to bring it down by 3 but unsure if that's right, sometimes my sugars seem to spike after my meal a few hours later, then I am doing correction doses only 2 units or so at a time, sometimes it brings it down a little or sometimes I need to do another couple of units this can go on through the night, but I've also noticed through the night when it does come down a little it does stay down, until around the 7 o'clock when I get up and the dawn thing kicks in. I have around 30 grams of carbs per meal. I sometimes I have left it and the crash when it happens does level off etc. But like yesterday in the afternoon I had only 2 units and 40 grams of carbs, and it still came down about, although not hypo it leaves me reluctant to correction dose on top. I will be honest as I've been high for a long time when I do correct iam aiming to get it down to at least the low teens etc and not the 5.6.7s etc which sounds ridiculous I know. IAM pretty new to the basal bolus regime but over the years my control was getting worse just on the two injections a day so had to chang. This regime in principle sounds good once I've learnt more. IAM not sure if the eye drops iam on are having an impact just yesterday my blood pressure went too 178/110 leaving me feeling rubbish and shaky, on steroid eye drops and another which has a better blocker In so could be side effects from that, but unsure if these drops effect sugar levels too. Just a few things going off at the min but I am trying thanks for the replies.
 
I've been an avid reader of your posts since you came on the forum.
You have not been helped by your medical professionals.
But, from what I've got from your posts is the single figures make you nervous.
Single figures is what keeps the body intact, normal BG goes from 3.9 to 8ish after eating, you are just letting +10 numbers hit a wrecking ball through your body.
It's no wonder you've already lost vision in one eye running numbers like that.
Embrace single figures with your meds or push for a pump.

You've been running too high for too long
 
Hi yep agree numbers are far too high, last night got them down to around 12 and they stayed like that through the night, iam not saying Iam being let down as iam seeing a a specialist at the hospital but at the minute she is off sick so not seen her for a while, not lost sight completely in right eye yet got another op soon, then there giving me a different injection in it but it's not licenced for that use in my hospital so it means I've got a little traveling to do each month but not far, kidneys have come back being effected so got to have another test in a month or so. The libre is ok but could do with some access to a consultant or the newer technology ie pumps or closed loop systems, not exactly sure what the criteria Is these days to access these things as I can't certainly self fund it, some diabetics do see consultants or get access to pumps or new technology but I've just found it difficult. I've not gave up ism doing around 7 injections a day, count carbs eat low carbs, don't eat rubbish, don't drink or smoke, iam probably just another statistic that just gets lost in the system and forgotten about, having access to better services etc may well have prevent alot of the complications iam getting. But like I say iam just a statist, but il keep trying the best I can.
 
The advice from other people, whether here on this forum, from books or diabetes health care professionals and services, is only as good as the use you make of it. Ultimately it is only you that will bring your blood glucose down to the healthy range and prevent further damage to your body.
 
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