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Blood sugar Control

B

BertSmyth1

Well-Known Member
Messages
45
Type of diabetes
Type 1
Hi
Could do with some advice please
So I was in a pump since I was 19, worked well. Since around May control wasn’t so good by July I was having bad hypos in the night, had dropped my basal down to 0.350 (Humalog I used for pump) lows would mean big rebounds for me in the morning
Unfortunately I had a an accident due to a bad hypo-my licence has been revoked
I have been off the pump to regain some control?!! So on pump holiday til things settle down a bit!Since 20th July been back on injections
The issue I am having is the highs when j eat food (I carb count & don’t eat masses of carbs & active)
My night time sugars are better, taking some adjusting. On nova rapid & Tresiba
Normally my lunch at work is 3 corn cakes-1 banana
I take 3 units for this bit been told by my nurse to increase my dose by 2 as having such bad highs
My numbers are normally around 7, I tend to have an early lunch as my break is around 11.30 am, by 12.05 I was 14.7 & rising
Today I hit 19.7 by 1pm, I gave 3 units to correct,I was high til around 5pm- 16.9 & dropping, had a light tea, gave correct insulin at 7.10 pm I’m 19.2
I have felt absolutely wiped
This is a regular occurrence on workdays for me, really struggling
My nurse says it could be my injection sites, I do rotate my sites

Just battling with this & feeling wiped out by these very high numbers

I feel like I had a lot more control on the pump
 
Sorry you're having such a rough time. Just a few thoughts, hopefully others will be along to add to them.
How long before your lunch are you giving your insulin? May be worth giving it a while longer after you inject, before you eat?
Maybe your carb ratio at lunch time has changed?
Perhaps you could miss out the banana for a few days and add something different in, as bananas would spike me high too.
Have you done a basal test through the day, as it could be your basal that's not right.
 
These highs are happening on my work days, can’t really inject any earlier
Bananas I’m fine with
My nurse thinks it could be my sites, had diabetes 17 years now
To me. Seems now my control is worse than when on the pump
 
This am started ok 7.9 - level
Had usual breakfast-face correct dose within 3 hours of having breakfast I was 12.2 & rising
Then it was 11.6 with no correction 45 mins after that
9.30 it was 13.7 & rising, gave correction dose
Just been rising & rising got to 20.2 & rising
I’m struggling with this!!!
 

Just a thought: As well as long-acting Levemir in the mornings, I usually also have 1 unit Novorapid to deal with the dawn phenomenon. I don't have breakfast as a rule, but have lunch at around 12. This usually means my DP is well controlled.
 
My nurse has just replied saying I need to look at increasing my breakfast insulin as this is not covering the rise in blood sugars
I never had this much trouble on the pump
I’ve just done a bm - 24.2 & rising
 
Numbers super high today aswell just from usual breakfast
My nurse has emailed me saying look at increasing my breakfast insulin
I have tried increasing it with no luck
When I was taken off the pump it was originally for few weeks (pump holiday) that was 3rd August
This was with 2 nurses - 1 pump nurse & a diabetic nurse
Does anyone feel I should get hold of the pump nurse as currently only in contact with diabetic nurse?
Many thanks
 
Hi, have you tried a carb free day to check basal rates? Is it one basal injection or do you split it a.m. & p.m.?
I would contact the pump nurse to see if they can provide alternative guidance.
 
It is one Tresiba injection in the evening
This has stopped the night time hypos
Then I am on nova rapid, 1 unit for every 12 grams carb
This am bm is 7.8
Yesterday I left work as felt unwell
I am hoping for a better day today
 
Yesterday unfortunately wasn’t a good day with blood sugars
I emailed pump nurse, she said trying Fiasp may help
Was told decision regarding recommending the pump will be with the consultant now due to the accident?!!! I feel a little bit let down by this- first I was told a pump holiday for a few weeks, then a few months- feel lied to
Also going back on pump at present may complicate things so need to see how I get in with the fiasp
 
Having a carb free day would let you see whether its your background insulin that's in need of attention. Showed me that I needed to increase my Tresiba considerably
 
Hi
So control is no better, carb free days I’m fine
On the Fiasp insulin to which I am not seeing a benefit for me
Today started off ok, usual breakfast, was sitting at 8, within seconds scanned again on the Freestly Libre app & it showed 10??
Anyway went for a 3 mile walk had a latte & 1/4 of a sandwich-gave 3 units (more than enough for what I ate!!) walked back, thought I’d do a BM just to see- 28
When I scanned with the Libre it said 16.9 & rising
I really don’t know what is going on at the moment, can’t remember when I haven’t had a day in double figures!!
I eat sensibly & normally quite active
Sorry for the rant just fed up with this
Injecting about 6 times a day. Do not see any benefit being off the pump- which I’ve now been told I’ll have to wait til next clinic to see whether I can get back on the pump
 
Hi
So control is no better, carb free days I’m fine
On the Fiasp insulin to which I am not seeing a benefit for me
Today started off ok, usual breakfast, was sitting at 8, within seconds scanned again on the Freestly Libre app & it showed 10??
Anyway went for a 3 mile walk had a latte & 1/4 of a sandwich-gave 3 units (more than enough for what I ate!!) walked back, thought I’d do a BM just to see- 28
When I scanned with the Libre it said 16.9 & rising
I really don’t know what is going on at the moment, can’t remember when I haven’t had a day in double figures!!
I eat sensibly & normally quite active
Sorry for the rant just fed up with this
Injecting about 6 times a day. Do not see any benefit being off the pump- which I’ve now been told I’ll have to wait til next clinic to see whether I can get back on the pump
 
I have the same problem with good and bad days with my BS and insulin. My highest was 21 mmol a couple of days ago! Even with my Libre 2 I rarely have a predictable BS result. I keep my carbs down and go to the gym and I'm slim. You are not alone....
 
Bear in mind that Libre has a tendency (but not always) to over-read when in double figures. My experience is that it is most accurate between about 4 and 8. So, it may say 18 when a finger prick is nearer 14.
For this reason, I always double check a high Libre reading before making a correction.

I also find that the speed at which Fiasp works is very dependent upon my current level - Fiasp is almost instant when my levels are in the 4s but can take an hour to work if my levels are in double figures.

Your morning rise could well be related to Dawn Phenomenon/Foot on the Floor (liver dump) rather than a problem with Fiasp. It is common to be more insulin resistant first thing in the morning which means we need more insulin and it takes longer to start working, plus we are dealing with the glucose dump from our "helpful" liver.

I was advised that exercising with high levels can cause them to go higher. For me, a level of 6 or 7 is my sweet spot for exercise. Any higher and my levels get too high making me feel sluggish.
 
Thanks for the reply’s
I feel it’s more of a struggle without the pump tbh
Been running high all day- currently sitting at 15.8 & had 6 injections
I rotate my sites (been diabetic 17 years)
My nurse feels this is the problem
2 bits of toast, 2 corn cakes & a coffee all I’ve had so far today but a bucket load of insulin!!
 


I am relatively new to diabetes and insulin. I worked out my daily requirements based upon 0.5 u per day and came out close to 40 u. I thin started at a low Lantus dose and increased until I could maintain a level fasting BS 5 hr after novorapid. The took 1 u of insulin per 10 gm of carbohydrate and watched. I tried working out the dose of insulin to reduce a high bs but found it varied so looked at the [previous days bs at meal time and carbs, how much insulin I took and then worked out if I needed more or less this time. If I have a low bs (5 to 7) then the bs on FL2 tends not to rise high but if 10 then it does. I give 20 mins between insulin and food and simply watch what happens. I give no further insulin for at least 3 hrs whilst nr working and ensure 5 hr between nr and Lantus does. I find that i can make gradual changes. Also worth noting that the FSL suggests a 3 mm change in bs with a vertical arror, 2 with a 45 degree on and 1 with a level one. So you BS may be going up or down 2 mm per hr with a level bs reading. I always check bs when FL2 shows BS of 5 or less to ensure I am not going hypo.

My dosing changes I was 79 kg now 75. Lantus dose has reduced form 16 to 12. So I devote a lot of time to monitoring.
 
From experience, coffee/ caffeine does raise BG for some people

Some people experience dawn phenomenon

Some people - exercise makes them high

Quite possibly be a bad day,
 
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