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Type 1 Diabetes
Any such thing as too much insulin ?
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<blockquote data-quote="UK T1" data-source="post: 2278720" data-attributes="member: 503751"><p>Oh, non diabetics won't have straight libre graphs, but the key thing my DSN always tries to instil is avoiding the big yoyos. Pre-bolusing has been the key for me. I do manage to minimise mealtime increases that way. If you're regularly yoyoing it can also decrease hypo sensitivity, so I try to avoid it.</p><p></p><p>Always realise that we are all human! It is unrealistic to never have spikes, never yoyo, be 100% in range etc. However, you don't want to allow yourself to miss trends by saying that to yourself.</p><p></p><p>I had my 3 month libre review in Feb, I'd noticed I was waking, having levemir (I split my dose am and pm) but no breakfast, and my bloods were always rising a bit by lunch. It was maybe 1-2mmol never taking me above 7 so I sort said 'not ideal but not a problem'. I'd chuck an extra unit or two into my lunch bolus to bring myself in range again and didn't mind doing that. My team highlighted I might just need half a unit more levemir. I tried it and it worked.</p><p></p><p>By increasing my basal a little I had less total insulin than when I had to correct. This is obviously a small correction but they add up, and could have lead to weight gain. I also think you misunderstood with the basal:bolus ratios. The standard initial trial is usually a 50:50 split. So your bolus doses would add up to your total basal. That is guidance of course and doesn't work for many! A basal test would show you if you are having more bolus than you need to correct for a lack of basal (as I was doing).</p><p></p><p>We were told to have targets between 5.5-6.5 on the libre, but the standard AGP report on libre view says to aim for above 70% of the time between 3.9-10mmol/L with every 5% increase in time in range being 'clinically beneficial'. It also says to aim for a less than 36% variation.</p><p></p><p>I'd personally say that is a very loose aim and would not be happy with those targets. I feel quite ill if my bloods vary lots (headaches, feel sick) but my libre graphs are still no where near straight lines most days!</p><p></p><p>If you haven't logged onto libre view recently then I'd recommend it, real eye opener!</p></blockquote><p></p>
[QUOTE="UK T1, post: 2278720, member: 503751"] Oh, non diabetics won't have straight libre graphs, but the key thing my DSN always tries to instil is avoiding the big yoyos. Pre-bolusing has been the key for me. I do manage to minimise mealtime increases that way. If you're regularly yoyoing it can also decrease hypo sensitivity, so I try to avoid it. Always realise that we are all human! It is unrealistic to never have spikes, never yoyo, be 100% in range etc. However, you don't want to allow yourself to miss trends by saying that to yourself. I had my 3 month libre review in Feb, I'd noticed I was waking, having levemir (I split my dose am and pm) but no breakfast, and my bloods were always rising a bit by lunch. It was maybe 1-2mmol never taking me above 7 so I sort said 'not ideal but not a problem'. I'd chuck an extra unit or two into my lunch bolus to bring myself in range again and didn't mind doing that. My team highlighted I might just need half a unit more levemir. I tried it and it worked. By increasing my basal a little I had less total insulin than when I had to correct. This is obviously a small correction but they add up, and could have lead to weight gain. I also think you misunderstood with the basal:bolus ratios. The standard initial trial is usually a 50:50 split. So your bolus doses would add up to your total basal. That is guidance of course and doesn't work for many! A basal test would show you if you are having more bolus than you need to correct for a lack of basal (as I was doing). We were told to have targets between 5.5-6.5 on the libre, but the standard AGP report on libre view says to aim for above 70% of the time between 3.9-10mmol/L with every 5% increase in time in range being 'clinically beneficial'. It also says to aim for a less than 36% variation. I'd personally say that is a very loose aim and would not be happy with those targets. I feel quite ill if my bloods vary lots (headaches, feel sick) but my libre graphs are still no where near straight lines most days! If you haven't logged onto libre view recently then I'd recommend it, real eye opener! [/QUOTE]
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Any such thing as too much insulin ?
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