Blood sugar levels

[seanreid]

I was just wondering if someone could help me out, I've been diagnosed now for 12 months but I cannot seem to get my blood sugar levels under control. They seem to constantly be higher than usual.

 

[urbanracer]

Hi @seanreid ,

Welcome to the forums, hope you like it around here.

In order to help us help you, you'll need to give us a bit more information mate.

What type of insulin are you on, and what's your regime? (basal/bolus, twice a day, fixed doses or variable, anything you can think of really)

Has anything else in your life changed ? (Lifestyle, exercise levels, illness of any description).

 

[seanreid]

I currently take 12 units of Novorapid after breakfast, 14 after lunch, 18 after dinner and 20 units of levemir before I go to bed..
My readings are always between 13-18 and I don't know what to do, sometimes I don't take the readings or "forget" my meter when going to the nurse because I feel like it'll cause a lot of complications which I cannot handle.
I take 4 meals a day don't skip meals. Normally o would eat a lot of potatoes with my dinner, breakfast usually would consist of cornflakes but a tiny spoonful of sugar, lunch I would have a chicken and bacon baguette and for supper I would have a ham and chesse toastie with tea (no sugar) I used to be a member of the gym attending 3/4 times a week but after being diagnosed I just haven't felt the same and haven't got back into excercise since, it's not that I don't feel well enough I think I've just lost interest.
I need help getting my blood sugar levels under control

 

[urbanracer]

hI @seanreid

OK! so first thing I noticed is that most people take their rapid acting insulin 10 -20 minutes before they eat. I say that in the full knowledge that the instructions that can come with Novorapid (and my humalog) tell you that you can take it immediately before or immediately after eating. The reality is, that for most people it just doesn't start to work that fast.

In theory you can eat whatever you want and bolus for it and some people are successful with this but it doesn't work for everybody. I would question some of the food that you're eating but more about that later.

Back to basics - do you have an endocrinoligist? have you been given dietary advice? or taught how to carb count? worked out your insulin/carb ratio????

I'll ask @daisy1 to send you some light reading.

Don't give up on the exercise - you don't have to go mad but even a walk around the block can help massively with using up that glucose!

 

[azure]

I currently take 12 units of Novorapid after breakfast, 14 after lunch, 18 after dinner and 20 units of levemir before I go to bed..
My readings are always between 13-18 and I don't know what to do, sometimes I don't take the readings or "forget" my meter when going to the nurse because I feel like it'll cause a lot of complications which I cannot handle.
I take 4 meals a day don't skip meals. Normally o would eat a lot of potatoes with my dinner, breakfast usually would consist of cornflakes but a tiny spoonful of sugar, lunch I would have a chicken and bacon baguette and for supper I would have a ham and chesse toastie with tea (no sugar) I used to be a member of the gym attending 3/4 times a week but after being diagnosed I just haven't felt the same and haven't got back into excercise since, it's not that I don't feel well enough I think I've just lost interest.
I need help getting my blood sugar levels under control

I agree with the advice to inject before you eat (unless you've been given a medical reason why you personally shouldn't do that). The injected insulin takes a while to take effect so it needs to be injected at the least just before you start eating not after. If you inject after meals, it will be nigh on impossible to control the high spikes and bring down your high sugars.

Do you count carbs and adjust your insulin to match? If not, I wager that's contributing to your high sugars too.

 

[petepontiac]

15 to 20 minutes before eating based on carb counting seems to work for me. How does the hospital or GP decide what species of insulin you should take?

 

[seanreid]

Thanks everyone

 

[seanreid]

I'm not sure @petepontiac they read my bloods off the meter then adjust it from there, I didn't know that you had to do it before I thought it would've been okay to do it after but now I know, thank you !

 

[petepontiac]

I'm not sure @petepontiac they read my bloods off the meter then adjust it from there, I didn't know that you had to do it before I thought it would've been okay to do it after but now I know, thank you !

Yep seanreid I do a BG test 20 minutes before food, work out how many units based on 10Grms of carbs equals 1 unit insulin. I get nearly all my food carb value from the book Carbs and Cals. If my blood is say 4 before I eat I take 1 unit less. I am by no means an expert but one thing I have learnt from this excellent forum is everyone is different and it has been trial and error in my case. And there are loads of fine people who will help.

 

[azure]

@seanreid You may like to get the book Think Like A Pancreas. It's very popular here and will help you control your diabetes.

You've not mentioned carb counting so I'm guessing you don't do it. Carb counting is crucial for control. If you don't carb count it's like 'driving blind'. You could ask to speak to a dietician about learning it, or ask to go on the DAFNE course to learn it.

It's not hard at all once you understand the principle It always used to be taught at diagnosis, as far as I know, but now isn't in many areas. I cant for the life of me understand why not as there's no way to get the right dose of fast acting insulin for each meal if you don't count carbs and adjust your insulin dose accordingly.

 

[seanreid]

This is very helpful information, thanks

 

[B583]

I'm not sure @petepontiac they read my bloods off the meter then adjust it from there, I didn't know that you had to do it before I thought it would've been okay to do it after but now I know, thank you !

For years I've been injecting after having foods & tend to be eating way too much!! Maybe if I inject beforehand for what I'm abouts to have, this may help my BG & weight too. Though being on Humalog & Lantus, this may work, hopefully.

 

[azure]

For years I've been injecting after having foods & tend to be eating way too much!! Maybe if I inject beforehand for what I'm abouts to have, this may help my BG & weight too. Though being on Humalog & Lantus, this may work, hopefully.

Unless you've been told differently, it's best to inject before meals as the insulin has to get into your body to act. For non-diabetics the insulin is released inside the body and can act quickly, but when you're injecting it from outside it takes longer to act and your blood sugar can spike too high before the insulin gets to work.

When you mention weight, do you want to lose it or put it on?

 

[B583]

Thanks azure. I have been injecting before meals the best I can. I wish to lose the weight & permanently change my appetite & thinking of high carb foods, having low self esteem in this.

 

[Kristin251]

I find if I don't get my insulin there at the same times as my food I get ravenously hungry. I don't eat carbs but I still have this. I inject 5 min before eating but I mostly eat fat and protein. Even just the 5 min earlier rather than right before I eat made a huge difference. Again I don't eat grains starch or sugars but I can see how earlier injections can be the missing piece in your puzzle.

 

[B583]

Yeah I understand that now after so long injecting after eating. Finding it hard to change routine of snacking & foods consumed, but that's another topic!!

 

[JRW]

I currently take 12 units of Novorapid after breakfast, 14 after lunch, 18 after dinner and 20 units of levemir before I go to bed..
My readings are always between 13-18 and I don't know what to do, sometimes I don't take the readings or "forget" my meter when going to the nurse because I feel like it'll cause a lot of complications which I cannot handle.
I take 4 meals a day don't skip meals. Normally o would eat a lot of potatoes with my dinner, breakfast usually would consist of cornflakes but a tiny spoonful of sugar, lunch I would have a chicken and bacon baguette and for supper I would have a ham and chesse toastie with tea (no sugar) I used to be a member of the gym attending 3/4 times a week but after being diagnosed I just haven't felt the same and haven't got back into excercise since, it's not that I don't feel well enough I think I've just lost interest.
I need help getting my blood sugar levels under control

Is your levemir enough? I do 34 units a day, and about 15 units of NR from about 100g of carbs for lunch & dinner (don't do breakfast). Have you worked out how many units of NR you need per X grams of carbs?

 

[donnellysdogs]

Your background basal and your food bolus insulin are not balanced.
Most consultants would expect their "average" Insulin dependent diabetic on MDI to have a 50/50 ratio.
Your bolus qtys are high compared to your basal.
You state your bolus is about 44 units and only 20 units of basal which is way out from equal amounts of basal and bolus... Ie if you take 20 levemir a consultant would ideally on an average day expect you to take about 20units of bolus. Your bolus is double.
You state you are running high.. But is that at night time too? If so it would indicate that a raise in basal could be useful.
Also do you give your levimir once or twice a day?

You need to have some basal testing done and to find out what your levels run at with just basal.
Ie get up. Test. Miss breakfast and not eat till lunch time.
Or get up have breakfast and do not eat for 10hours.
If you go low you must treat the low. If you are high you can still do the basal test but you can just give yourself the correction bolus and see if your levels reach target at 5hours (no eating though).

To me your basal is too low and you need to do some basal testing urgently.

 

[donnellysdogs]

You also state 4 meals a day but only list 3 bolus's.

You need to be truthful with your nurse. She needs to help you and can only do this if you are honest with her.

 

[B583]

I've had days over a week where I've only done BGs once or twice a day. This alleviates worry of scrutinizing my control to reach perfection. If high I correct or feeling low I eat/drink something!! Nice to have a rest & days free for "holidays"etc
Please discuss........!!!!