Can't seem to get it right...

Hey TallGirl,

well first of all well done with getting back on track with your control on your blood sugar levels I'm currently getting back on track of mine after nearly 8 years of rebelling and just not wanting to know about my health.

The hypo thing I can honestly understand as I'm finding myself having the odd hypo through the day but luckily I catch it in time. You say you see no pattern in your hypo's do you think you may be doing just a little too much insulin when doing your injections?
for the mean time what I've been told to do by my nurse specialist is to maybe lower my unit of insulin when it comes to taking it after meals and that might help ease the hypos.

if I'm totally wrong then it's probably best to wait what your Dr will say.

hope I've helped

MadameHope x

Hi Tallgirl,

Good move getting referred back to the hospital diabetes team!

Ask them about the carb counting course DAFNE (dose adjustment for normal eating) which many type 1's have been on and achieved excellent control as a result, you may want to look at the following site that does a on-line version of DAFNE although you do need to register first:

http://www.bdec-e-learning.com/

Hi Tallgirl, went through a period of a lot of hypos myself a couple of weeks back. I lowered my basal dose just slightly.
A thing I discovered through testing was that the hypos occurred after meal-spikes. My bolus dose was correct but badly timed - didn't know before that this could have such a big impact! By taking the bolus about 10 minuts earlier, the carbs and the insulin peaked more at the same time, keeping bs steadier.
Not sure if this is helpful, since I don't know your meds. I'm on levemir and novorapid injections.
Take care!

Hey TallGirl,

Glad to hear you are trying to get on track. One question that does occur to me is do you know for certain that your Lantus dose is correct?

The biggest thing with DAFNE is you need to get your basal insulin right first otherwise you will just be chasing your own tail and won't get enywhere except feeling like ****.

If you find that you are going high in the late afternoon, before you do your lantus, but then are going low overnight, in the mornings and midday then it could well be that the Lantus is not lasting. It may be worth asking your DSN if a split dose would work though they would more likely switch you to Levemir in that case since it is a lot more flexible.

If you do adjust your Lantus don't forget that you need to give it 3 to 4 days for everything to settle before you can decide if it worked or not, so essentially you only get 1 change a week with it.

Good luck and hope you get back on track soon.

/A

Hey TallGirl,

Hope that it becomes clearer for you. Are you keeping a full log of your blood sugars, food etc?
You said you had DAFNE so I assume you are keeping it in that precribed format (which peronsally I feel is lacking since you can do much more detailed testing than you can record in that format) so you should see som patterns that that your DSN's and specialists should be able to undertand.

I used to be on Lantus and was swapped to Levemir just over a year ago.
What I was seeing was Hypos in the morning and early afternoon and then high in the evening around dinner. (I took Lantus, 42U in the evening)
That profile indicated that I was running too much lantus. The thing was if I reduced it then my evening highs would be even worse. The breakthrough was a DSN suggesting that maybe I needed different basal insulin at different times of the day.
Essentially the lantus wa snot lasting a full 24 hours and the additional I needed to take to push it almost that far was making me low at around the 12-15 hours mark.

I am now on 12U levemi in the jmorning and 32U in the evening and my levels are prety consistent.
While that worked for me it may not be the case for you but if you are struggling with really odd levels of high at one end of the day and low at the other I really suggest you speak to your specialist and DSN and see if a different insulin regimen or split dose would work better for you.

I know what the rollercoaster of up and down is like and I knwo what it took out of me so I hope that you m manage to find a stable point soon.

Please feel free to PM me if you wish.

Bets of luck

/A

Ooh I forgot to mentioned.

Don't forget your levels will be out of what for a few days while it all changes with the lantus change.
You will find that you need to do corrections to your QA doses up or down and once things settle you may need to alter your ratios to suit.