Burn Out

[Fairygodmother]

Have you thought about using Levemir instead of Lantus? It has a more even profile and since it’s injected twice a day you can vary the day and night time doses.

 

[Carpe Diem]

Hi

No I haven't and has not been mentioned as an option. Worth asking about thanks. I wonder what the transition would be like. Do you take it?

 

[Grant_Vicat]

Hi Carpe Diem. Just a small tech observation. You stand a better chance of attracting attention if you use the @ sign directly in front of the name, like @Carpe Diem . Once I have posted this, the second reference to your name will turn red.

 

[Fairygodmother]

Yes, @Carpe Diem, I do use Levemir. I like it as it’s easier to adjust if needed. Athough I’ve not tried Tresiba, I did use Lantus some years ago and found its drops and rises in strength difficulty.
I’ve heard that people find Lantus easier if they split the doses am and pm.
But, the common clause, we’re all different.

 

[EllieM]

@Fairygodmmother I thought levemir was being discontinued.... It may not be the best insulin to change to?

 

[Fairygodmother]

Yes, @EllieM, but not until the end of 2026. Still waiting for alternatives to be suggested by NHS Medicine Supply.

 

[Carpe Diem]

Hi Carpe Diem. Just a small tech observation. You stand a better chance of attracting attention if you use the @ sign directly in front of the name, like @Carpe Diem . Once I have posted this, the second reference to your name will turn red.

Thanks @Grant_Vicat

 

[Carpe Diem]

Yes, @Carpe Diem, I do use Levemir. I like it as it’s easier to adjust if needed. Athough I’ve not tried Tresiba, I did use Lantus some years ago and found its drops and rises in strength difficulty.
I’ve heard that people find Lantus easier if they split the doses am and pm.
But, the common clause, we’re all different.

Thanks @Fairygodmother

 

[scoles3]

Hello I’m going through perimenopause/menopause and hormones can have a lot to answer for and give me misleading symptoms. I don’t trust the Libre patches as already mentioned. Doc did mention try having long term insulin in morning rather than at night if getting problems. Good luck. xx

 

[Carpe Diem]

Thanks @scoles3

Yes definitely hormones are part of the equation. I was taking insulin in the morning still had early morning lows. Pushed Tresiba to later in the day in hope that lows would move to at least breakfast time. Running out of options.

Thanks for your message xx

 

[Pam*]

I have been getting lows between 3am and 5am every night/early morning. Has been happening for last few weeks. I'm on Tresiba Degludec (long acting) that I take in the morning, I was on Nova Rapid (fast) but recently changed to Fiasp as it works quicker. Since December 2024 I was put on Lanreotide injections as I have Neuroendocrine pancreatic cancer. Pancreas was removed in 2022 but I have a recurrence, hence having to have the Lanreotide now to slow down the growth. I was on 16 units Tresiba but have gradualy reduced it to 13 but so far I'm still getting the very early morning lows. I put this down to the Lanreotide as it can cause huge BG fluctuations.
I used to be able to go to bed with BG around 10 and it would come down very slowly overnight and still be 5ish by morning. The only way I could have a BG of 5 in the morning now, and not be woken up to eat, would be to have my BG at bedtime at over 20 which is crazy high. I have a diabetic appointment next week so hopefully they can offer some advice.

 

[Carpe Diem]

I have been getting lows between 3am and 5am every night/early morning. Has been happening for last few weeks. I'm on Tresiba Degludec (long acting) that I take in the morning, I was on Nova Rapid (fast) but recently changed to Fiasp as it works quicker. Since December 2024 I was put on Lanreotide injections as I have Neuroendocrine pancreatic cancer. Pancreas was removed in 2022 but I have a recurrence, hence having to have the Lanreotide now to slow down the growth. I was on 16 units Tresiba but have gradualy reduced it to 13 but so far I'm still getting the very early morning lows. I put this down to the Lanreotide as it can cause huge BG fluctuations.
I used to be able to go to bed with BG around 10 and it would come down very slowly overnight and still be 5ish by morning. The only way I could have a BG of 5 in the morning now, and not be woken up to eat, would be to have my BG at bedtime at over 20 which is crazy high. I have a diabetic appointment next week so hopefully they can offer some advice.

I'm really sorry to hear that you have been through so much and are also dealing with lows. I reduced from 17 units Tresiba down to 12 which left me with day time highs. Now on 14 . If I adjusted my Novorapid by 2 it throws me into a low. I start with 6 units and put corrections in of 2 to 3. I feel its an overlap and metabolism. Wondering if anyone adjusts their timings and delay the dose each day by couple of hours. Good luck with your appointment next week.

 

[RTI]

Hi Carpe Diem, hi all,

I am T1d since more then 40 years. Started with 20years.

First thing I have done,
I have accepted my diabetes as part of my body and not as a nasty sickness.

I have to take care on it and not a GP. The doctor can only help me with his knowledge.

My diabetes was very unstable and change of insulin need over every day/year.

I have tested all type of insulin combinations and ended with humalog and lantus 7 years ago and at least 10-12 fingerpricks per day, with a Hb1c ~9-10%.

In 2016 I came into contact with a very good diabetes team, which porposed me to use Freestyle Libre. I hesitated for many reasons but finally accepted it.

It was an eye-opening. At the beginning I have checked 60-70 times.

After a short time I have learned so much about my body and insulin, which haven't realised the 40 years before.

I have learned that,
- I need less insulin over night,
- I need more insulin in the morning (Dawn syndrom)
So I tried to adapt my Humalog and Lantus from one to twice a day, etc.
with limited sucess.

Finally my Diabetes team proposed me to use a pump. I hesitated very much, but finally accepted it. I have choosen the Omnipod.

With my new knowledge with libre2 I have started to readapt my Basal insulin myself and with help from D.-team
- Reducing over night,
- increasing in the morning,
- made non eating in the morning to get basal insulin right,
- the same in the afternoon,
- also taking insulin 15mn before eating to obtain a better Glucose profile.

It took me 2-3 month to get most of the things under control.
-Also with good help of my diabetes team.
-Every day checking/reflecting in the evening 20-30mn.

I am happy to be with a pump and libre2 on my mobile, waiting for close loop to test.

I don't need to look for a close corner/toilette anymore for testing and injections. I can do it everywhere.

My hb1c has improved to ~6%.

I hope my experience with help you,

Ralf

 

[Carpe Diem]

Hi @RTI

Your experiences are very interesting. I did try the pump ended up in hospital very unwell with ketones. Then a couple of months later hospital again with the worst hypo ever on Toujeo.

When initially diagnosed I was on humalog mix just felt awful everyday for a long time. Switched to novorapid which was far better for me than humalog.

It takes time to adjust if I could get the overnight control stable daytime levels would follow.

I've seen a dietician who said coconut is good. Does anyone have coconut in their diet before bed?

Well done in getting your levels back on track. I live in hope.

Thanks for your reply.

 

[Marikev]

I've seen a dietician who said coconut is good. Does anyone have coconut in their diet before bed?

hei @Carpe Diem , I too am on Tresiba and novo rapid. Was only diagnosed 2 and a half years ago and amongst all the advice I was given in hospital was to make sure my bs was 6 before I went to bed, and 8 if I had taken alcohol. Used finger sticks for first few weeks and was aiming to have bs levels around 5 during the day, but realised I felt like sh#%, so now generally work around 6 , depending on what I’m doing. 6+ for driving and 8+ for a walk and 10+ for a swim, let it sit at 5 if lolling in bed or on the sofa!
Check my Libre reading just before bed and take a piece of whole meal bread if below 6, I try not to take any novorapid in the few hours before bed, take my tresiba dose in the mornings, but not always ‘on time’…
I do eat coconut, in the form of bounty bars, when I can get my hands on them and generally find eating nuts evens the bs out a bit.
At my last hospital check up the endo asked if I took correction shots, I don’t. If my bs is so high I feel I need extra novo rapid I always then take some form of carb with it, in my head this is something for the insulin to work with…. Some nights I have a lovely steady straight line, others a definite dip around 3 am. Always have some emergency carbs on the night stand.
Hope you can sort out your levels, horrible being woken up in the night. Good luck xx

 

[Carpe Diem]

Hi @ Marikev

Thanks for your reply.

Your levels are amazing well done. Yes when I'm high I try give the insulin something back too usually half slice of wholemeal bread.

Can you give me an example of your food intake and insulin amounts/times please?

As we are on same insulins I am looking for comparisons.

Thanks xx

 

[RTI]

Hi Carpe Diem,

It seems to be that you a lot of trouble with your Diabetes and your GP seems to make just a kind of try and error testing with you. Excuse if I am wrong.

Have you tried to find a Diabetes team with more experience and which may help you to improve your situation? Courses and direct help.

I have seen that a good Diabetes team with a lot of experience can make a real difference and I was lucky to get in contact with one.

They helped me very much and fast, otherwise I would have had much more trouble in the time I tested to switch to a pump, but they also gave many useful ideas in all other difficulties in my diabetes.

For me they were much more useful for my daily diabetes than all the info in internet.

I don't know which country you are living and if you have the possibilities for it.

I found this Diabetes team as I was moving to UK due to my job.

I hope I could help you and wish you good luck.

Ralf

 

[Carpe Diem]

Hi @RTI

Under NHS UK. They try their best. GP does not have a specialist doctor although get annual blood checks, chloestral etc. I get to see a consultant about every 18 months.

I moved areas which means you are allocated a team depending on where you live. Unless I went privately which I cannot afford.

I keep trying that's the best I can do.

Thanks for your reply.

 

[RTI]

Hi Carpe Diem,

have you already followed some NHS courses ?
This one is online

My Type 1 Diabetes

elearning.mytype1diabetes.nhs.uk

or

X-PERT Health Diabetes Education and Weight Loss Programmes

X-PERT Health offers diabetes education programmes and weight loss education programmes. We are an award winning charity.

www.xperthealth.org.uk

Or have you contacted a special diabetes team in a hospital for more help or advise ? Normally they are always very helpful at any time.

You should be able to get more help then every 18 month, with such difficulties.

I was at the Royal Hospital, Derby.

Ralf

 

[Carpe Diem]

Thanks @RTI

I've been on Dafne course 2016. My team are attached to hospital. Will take a look at links you have sent.

Thanks for information.