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Can someone remind me of what your BG levels should be

Ellla's Nanny

Ellla's Nanny

Member
Messages
16
Type of diabetes
Type 1
Treatment type
Insulin
I am a type 1 diabetic of 15 years and my last HBA1c was 9.2/85. I am at the moment only seeing a nurse from my GP's surgery and a rep who came in and gave me a 'Accu-Check Aviva Expert monitor, which I came away with with all hope in this machine that it would be a miracle in controlling my blood glucose levels. The rep has set my correction to 1:2 and my nurse told me that my BG levels should be between 4-6, which I think is very tight control. Anyway over the past 5 days my BG have varied a lot and always been quite high before bed and I have had to correct, but last night they were 6.3 before bed with 1.2 or something like that of remaining basal left working. My gut instinct told me that I should of had a snack before bed, but I thought that stick to what my gp's nurse has said and leave it, as I wanted a good level in the morning. Well I did have a hypo in the the night and managed to wake up when it was 3.9 and treated it and they where 10.3 this morning. So could someone please tell me the range of what my bg should be before bed and when should I have a snack. It would be brilliant as well if you could refresh my memory of what they should be before meals and 2 hours after meals and when I should either correct by insulin or a snack. Sorry for going on and on, I am going to get my nurse/dr to refer me back to my local diabetes centre and call there this morning to see if I can go to a drop in session there, but in the meantime I would really appreciate some basic help for now.
 
between 4 and 7 was always the advice I was given from diagnosis away back many years ago, but that is just a guide........

the target you want to achieve should be personal to you, depending on what you need at the time.....

my own BG target is 5.5mmol, all the time, but I will go above this every day, especially after food......

in theory if your basal insulin dose is correct your BG will stay the same overnight, and so if you were in target, you wouldn't need a snack.......so finding out what your basal is doing overnight is a very useful and critical bit of info to have.....

the same 4-7mmol target, should be applied before every meal.........and on insulin injections you should not correct mid meal as your insulin will last between 3 and 5 hours......

ideally your looking for a rise of roughly 2mmol above your pre meal level....it is possible to get this rise lower though....

have you heard of DAFNE?
 
I personally don't agree with the advice you have been given, this is too tight a range, they should also change throughout the day, ideally I try to go to bed below 8mmol/l, I like to wake between 5-8mmol/l. Before eating I like to be below 7mmol/l.

Please also remember these are a guide not a target, having type 1 is not about achieving perfection, I fell into this trap when diagnosed and so would get upset if I didn't achieve the set target. I got me down until I just realised that they are to just guide us and that we wouldn't be judged bad diabetics if we didn't achieve them. Your targets should be set with this in mind, you will get 15mmol/l and you will get low readings, it's all about being able to act on the information given to make adjustments. As @novorapidboi26 has said, get your nurse to enrol you for the Dose Adjustment for Normal Eating course, this will help you learn more about self management and you can meet other type 1's.
 
Here is some information:

http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

I think you'd be better off seeing a consultant and getting some more advice. I too agree that the targets your nurse gave you are too tight and not specific enough. Is the nurse a DSN or just a 'diabetes nurse' from your surgery? I find that if it's the latter, they don't have much experience of Type 1 and aren't able to give sufficient advice.
 
azure said:
Here is some information:

http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

I think you'd be better off seeing a consultant and getting some more advice. I too agree that the targets your nurse gave you are too tight and not specific enough. Is the nurse a DSN or just a 'diabetes nurse' from your surgery? I find that if it's the latter, they don't have much experience of Type 1 and aren't able to give sufficient advice.
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Thank you all for your advice.
At the moment I am only seeing a diabetic nurse from my surgery and no I don't have any faith in her views/advice. I've called my local diabetic centre and they only see people who have been referred , so It may take a while before I can go back there.
I have been there before and the last time was around 8 years ago when I completed a DAFNE course there, but my memory is a bit vague. I can remember the carb counting and how to work out your ratio of carbs to units of insulin. But like everything else that I have tried I would get confused, but I do realise that carb counting is the way to go for me and not to have fixed units of insulin (Novo Rapid) per meal . I'm wishing with my new meter, the stress of calculations of carbs/units of insulin will be elevated.
When ever I have started to try with the help from a professional with getting myself back on track, I do get so hang up on my BG results and feel such a failure when they still are out of range, feeling like a really naughty child!!! Who is going to get in really Bad trouble. Which in turn I give up and go back to not testing, guesstimating how many units of insulin I should take to how I think my body feels, avoiding any professional help there is. I have been a diabetic for 15 years, being diagnosed at 28 as a type 1 diabetic and I'm now 44 years old and I hate/dred seeing the diabetic consults because I get myself so worked up thinking and knowing that they are going to have ago at me for my bg being out of control, so I miss appointments. I do also have a anxiety & depression condition, which in my mind just exasperates things.
Well I have made my mind up to give myself the ratio of 2 units of insulin to 10g carbs at mealtimes and I shall monitor this over 3 days at a time and increase/decrease half a unit at a time. I needed try and take some control over my diabetes for myself and not to make my dr/nurse happy. I also have to make it not only a more important part of my daily life, but to make it more important in my family.
 
Absolutely! Do it for you. Don't worry about anyone else.

Yes, carb counting is crucial. A simple thing I did early on after diagnosis was to work out how much insulin I needed for my regular meals (most people tend to eat the same few main meals). So if I was having pasta plus a homemade sauce, I'd weigh my pasta so I had the same amount each time, and measure out my sauce. I'd then know that, say, 5 units of insulin worked ok for that meal last time I ate it, so I'd remember that and repeat the dose. This gave me consistently and made things easier. I still do that now. I also wrote the carbs per portion on some of my fav recipes so I didn't have to faff about working it out each time. I usually have the same breakfast most days so I know the 'right' dose for that too.

Don't let medical professionals make you feel bad. They don't know how,hard control is.
 
azure said:
Absolutely! Do it for you. Don't worry about anyone else.

Yes, carb counting is crucial. A simple thing I did early on after diagnosis was to work out how much insulin I needed for my regular meals (most people tend to eat the same few main meals). So if I was having pasta plus a homemade sauce, I'd weigh my pasta so I had the same amount each time, and measure out my sauce. I'd then know that, say, 5 units of insulin worked ok for that meal last time I ate it, so I'd remember that and repeat the dose. This gave me consistently and made things easier. I still do that now. I also wrote the carbs per portion on some of my fav recipes so I didn't have to faff about working it out each time. I usually have the same breakfast most days so I know the 'right' dose for that too.

Don't let medical professionals make you feel bad. They don't know how,hard control is.
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Many thanks again for your support and great advice.
 
noblehead said:
Register with the following, it's an on-line carb counting course similar to what is taught on DAFNE:

http://www.bdec-e-learning.com/
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I did that one and learnt a lot from it, my levels are now lower my a1c right down, but not good enough for the consultant I saw the other wk, he told me I didn't have a clue what I was doing as I was doing it all wrong, (carb counting), he asked when I had been on a dapne course, I tried to explain that I hadn't but I had completed the bdec. well I thought he was going to burst his blood vessels in his head, he said I was ridiculous to think I knew what I was doing from that as you cannot know how to do this from an online learning page, very rude man he was, he said he was going to have words with my dsn about it, he said she would be contacting me about it, that was 6wks ago, she hasn't contacted me, she knew what I was doing and was pleased with what I told her I had learned, I hope she put him in his place.
 
First of all if your HBA1c is at 9.2 then that means avg BG is up at 12. Set youself an achievable range eg 6-12. If you can hit that most of the time your HBA1C will drop and you can keep clear of hypo range for now.

For carb counting 'cheat'. I use the Carbs and Cals App all the time (Low Carbing and I have to count all the stuff that used to be free plus protein now!). I used to be bit cynical about Apps but this one is really useful.

Before you play with the bolusses nake sure you understand that the basal is working. If you search the forum for Salford you will get the link. Once you trust the basal you can start looking at the carb/insulin ratios for bolussing.

Dont know what carb regime you are on but while you sort things out I would try and keep carbs at c. 40-50g per meal (dont go lower yet as it then gets complicated again with protein etc) and avoid carby snacks between meals. It all helps to keep things simpler and reduce spikes.

Best of luck.
 
steve_p6 said:
First of all if your HBA1c is at 9.2 then that means avg BG is up at 12. Set youself an achievable range eg 6-12. If you can hit that most of the time your HBA1C will drop and you can keep clear of hypo range for now.

For carb counting 'cheat'. I use the Carbs and Cals App all the time (Low Carbing and I have to count all the stuff that used to be free plus protein now!). I used to be bit cynical about Apps but this one is really useful.

Before you play with the bolusses nake sure you understand that the basal is working. If you search the forum for Salford you will get the link. Once you trust the basal you can start looking at the carb/insulin ratios for bolussing.

Dont know what carb regime you are on but while you sort things out I would try and keep carbs at c. 40-50g per meal (dont go lower yet as it then gets complicated again with protein etc) and avoid carby snacks between meals. It all helps to keep things simpler and reduce spikes.

Best of luck.
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Thanks I shall get the app for 'Carbs and Cals', is it any better than the DAFNE carb portions app?
 
I cant say I only tried the carbs and cals app. Certainly mot everything is there but anything missing I can add in under the My Meals option for next time. I assume DAFNE also gives you similar pictures of portion sizes. Maybe start another thread to get opinions?
 
newest said:
I did that one and learnt a lot from it, my levels are now lower my a1c right down, but not good enough for the consultant I saw the other wk, he told me I didn't have a clue what I was doing as I was doing it all wrong, (carb counting), he asked when I had been on a dapne course, I tried to explain that I hadn't but I had completed the bdec. well I thought he was going to burst his blood vessels in his head, he said I was ridiculous to think I knew what I was doing from that as you cannot know how to do this from an online learning page, very rude man he was, he said he was going to have words with my dsn about it, he said she would be contacting me about it, that was 6wks ago, she hasn't contacted me, she knew what I was doing and was pleased with what I told her I had learned, I hope she put him in his place.
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See consults a very scary people!!!! lol , haha. I'm about half way through the http://www.bdec-e-learning.com/ program and I think it's brilliant, it is a lot like the DAFNE course and I shall always have it as a back up reference tool for my diabetes. I think everyone should have a look at it even if it's only to refresh your memory of the facts every once in a while :)
 
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steve_p6 said:
I cant say I only tried the carbs and cals app. Certainly mot everything is there but anything missing I can add in under the My Meals option for next time. I assume DAFNE also gives you similar pictures of portion sizes. Maybe start another thread to get opinions?
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No the DAFNE app doesn't, I had a look at the trial app and yes it's so much better, especially when you are not eating at home and can't weigh foods. I'm going to download the full app, many thanks for your support :)
 
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