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Can you get your HYPO awareness back
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<blockquote data-quote="iHs" data-source="post: 370187" data-attributes="member: 8799"><p>Tracey</p><p></p><p>Although you meet the NICE TA151 criteria for funding for an insulin pump, you will not get one until youve got a handle on working out your insulin to carb ratios correctly and also your correction factor.</p><p></p><p>You should definately not be relying on your husband like you do to be your rescue when you go hypo. You can, with more frequent bg monitoring, work out the correct amounts of bolus insulin to cover the carb that you eat in your meal so that 2-3hrs after you eat food your bg levels are not going dreadfully low or high. Also try not to use 'guess work' in calculating your correction insulin. Look at the 100 rule to get guidance.</p><p></p><p>What I would do in your shoes is adjust my overnight basal so that when I get up in the morning, instead of having a bg level of 4-7mmol, I would make 7mmol my target and adjust my bolus insulin downwards to allow for any drop below my target of 7mmol. Obviously if you are finding yourself waking up with a bg level way below 4mmol, then treat that with 2 tsp of sugar in a cuppa, wait 20mins for your bg level to rise up and then eat breakfast and bolus afterwards because your bg levels are below the target of 7mmol.</p><p></p><p>Next, adjust your bolus insulin (trial and error I'm afraid) for the carb that you eat and allow for your bg levels to rise to 10mmol 2-3hrs afterwards. On a bg level of 10mmol you will not find yourself going hypo in the following 2hrs and you will not need to eat a snack. Instead, your bg levels should fall back to 6 or 7mmol again, so then you can calculate the bolus for your next meal and again allow for your bg levels to be 10mmol again 2-3hrs later. If, when using trial and error, you find yourself going below 10mmol 2-3hrs after the bolus, then eat a small amount of carb as a snack and dont bolus for it. As a very rough guide, it is thought that 10g carb will raise bg levels up by 2mmol but this is not set in stone and is only a guide. If your mid morning or mid afternoon bg levels are only on 4 or 5mmol, then by eating a 10g carb snack (biscuit) your bg levels should rise up to 6 or 7mmol again.</p><p></p><p>I admit very much that bolus basal carb ratios and correction factors is somewhat mentally taxing but with determination with adjusting insulin, writing the carb eaten down on paper, testing bg levels every 2-3hrs and using targets to base calculations on, most diabetics can find their way. To make things a bit more easier, you can keep to eating 30g carb for each of your main meals and then you will be able to discover that you will need more bolus insulin to cover breakfast, a bit less bolus to cover lunch and then most likely, more bolus to cover your eve meal. Once youve been able to work out the correct insulin to carb ratio to cover each of your meal times, you can then adjust the carb that you eat and use your carb ratios to work out the bolus insulin needed and using the 100 rule, youll be able to work out how much bolus insulin you need to use to lower your bg levels back to the target of 7mmol.</p><p></p><p>Is this all 'gobble gook' to you. If you dont understand anything, then please just say as I am only trying to give you a bit of help</p></blockquote><p></p>
[QUOTE="iHs, post: 370187, member: 8799"] Tracey Although you meet the NICE TA151 criteria for funding for an insulin pump, you will not get one until youve got a handle on working out your insulin to carb ratios correctly and also your correction factor. You should definately not be relying on your husband like you do to be your rescue when you go hypo. You can, with more frequent bg monitoring, work out the correct amounts of bolus insulin to cover the carb that you eat in your meal so that 2-3hrs after you eat food your bg levels are not going dreadfully low or high. Also try not to use 'guess work' in calculating your correction insulin. Look at the 100 rule to get guidance. What I would do in your shoes is adjust my overnight basal so that when I get up in the morning, instead of having a bg level of 4-7mmol, I would make 7mmol my target and adjust my bolus insulin downwards to allow for any drop below my target of 7mmol. Obviously if you are finding yourself waking up with a bg level way below 4mmol, then treat that with 2 tsp of sugar in a cuppa, wait 20mins for your bg level to rise up and then eat breakfast and bolus afterwards because your bg levels are below the target of 7mmol. Next, adjust your bolus insulin (trial and error I'm afraid) for the carb that you eat and allow for your bg levels to rise to 10mmol 2-3hrs afterwards. On a bg level of 10mmol you will not find yourself going hypo in the following 2hrs and you will not need to eat a snack. Instead, your bg levels should fall back to 6 or 7mmol again, so then you can calculate the bolus for your next meal and again allow for your bg levels to be 10mmol again 2-3hrs later. If, when using trial and error, you find yourself going below 10mmol 2-3hrs after the bolus, then eat a small amount of carb as a snack and dont bolus for it. As a very rough guide, it is thought that 10g carb will raise bg levels up by 2mmol but this is not set in stone and is only a guide. If your mid morning or mid afternoon bg levels are only on 4 or 5mmol, then by eating a 10g carb snack (biscuit) your bg levels should rise up to 6 or 7mmol again. I admit very much that bolus basal carb ratios and correction factors is somewhat mentally taxing but with determination with adjusting insulin, writing the carb eaten down on paper, testing bg levels every 2-3hrs and using targets to base calculations on, most diabetics can find their way. To make things a bit more easier, you can keep to eating 30g carb for each of your main meals and then you will be able to discover that you will need more bolus insulin to cover breakfast, a bit less bolus to cover lunch and then most likely, more bolus to cover your eve meal. Once youve been able to work out the correct insulin to carb ratio to cover each of your meal times, you can then adjust the carb that you eat and use your carb ratios to work out the bolus insulin needed and using the 100 rule, youll be able to work out how much bolus insulin you need to use to lower your bg levels back to the target of 7mmol. Is this all 'gobble gook' to you. If you dont understand anything, then please just say as I am only trying to give you a bit of help [/QUOTE]
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