Carb Counting problems

[victry77]

Hi, just wanted to ask the carb-counters out there a question.

I recently completed a CC course (not DAFNE but very similar run by my diabetes centre) and the first week that I treid CC properly for the first time it was brilliant. I had really good BG readings & managed to incorporate foodstuffs that I'd previously steered clear from with no problem at all.

I finished the course really pleased with how things were turning out. However, a week & a half later, my BG has been all over the place. Unexplained hypos & random highs that just don't tie in to the amount of carb eaten/insulin injected. I'm keeping my diet sensible (I haven't gone carb beserk), I split my doses when I feel it necessary, and as I say, first 7 days were brilliant. Now,for nearly 2 weeks, things just seems to be no different as to before with the lows/strange spikes.

I take Novorpaid with meals and am on a 1:10 ratio at all times as I am pretty insulin sensitive. But, I dunno, I just seem to be getting really random numbers.

Any tips or advice to help me get back on track?

:?

 

[noblehead]

Are you ill or coming down with something?

 

[kellyrae]

Premenstrual maybe? I know my blood sugars seem to have a mind of there own a week or so before.

 

[victry77]

Nope, don't appear to be coming down with anything & not pre-menstrual (was actually pre-menstrual during the week I had great control while CC).

I'm not going massively high, but just ridiculously high given what I've eaten & injected. Then I could have the exact same meal a few days later & I'm perfectly fine. Then the same applies with hypos.

Grrrr :evil:

 

[noblehead]

You may need to look at your insulin ratio's again or it could be injection site problems that are making your bg unpredictable, insulin ratio's do change over time as do basal requirements, have a word with your diabetes team and see if they can help you.

 

[SamJB]

When ever this happens to me - and it has happened this week - I need to adjust my Lantus. Once I've got that correct, my short acting ratio returns to normal. To see if your Lantus dose is correct don't eat anything 4-5 hours before bed and see if your morning BS is higher than your before bed one. If do your Lantus needs to go up.

 

[Etty]

What foods did you incorporate on their advice? Have you lowered your carbs much, and insulin as well?

 

[Pneu]

Have you done fasting or 'no carb' days to check your background insulin? would be my first step make sure the base is solid.. if you have nice stable background blood glucose then I would start to look at the ratios of the rapid

 

[victry77]

Hi, thanks for the replies, everyone :thumbup:

It really has just been getting more ridiculous the past few days. I'm going to have to give DSN a ring. Just going stupidly high after meals. I'm now not even carb-counting so much as doing my old thing of guessing the amount of insulin to take with each meal & just hoping I get it right. I was given a 1:10 ratio before every meal. Tried 1.5:10 this evening ~ sent me well hypo.

I did the basal test last night. Seems like I'm taking way too much Levemir, though, as my levels dropped by 6.2mmol overnight. I was told to take my Levemir once before bed but now I'm reading that it's best to split the dose. Is anyone able to give me any info on this. I may try this out but not sure what times the doses should generally be taken.

It's funny, I've been T1 4.5yrs now & this is the highest & most randon my BG's have ever been. Always been quite insulin sensitive & able to tolerate carbs pretty well. I'm wondering if I've had some mega-extended honeymoon period that I'm now coming out of.

roblem:

 

[Icklemonkey]

Hi,

At the risk of offending...there's no chance you could be pregnant is there? Hope that's not an awkward question but that could be a reason for your crazy levels?!

 

[Robinredbreast]

Hi, thanks for the replies, everyone :thumbup:

It really has just been getting more ridiculous the past few days. I'm going to have to give DSN a ring. Just going stupidly high after meals. I'm now not even carb-counting so much as doing my old thing of guessing the amount of insulin to take with each meal & just hoping I get it right. I was given a 1:10 ratio before every meal. Tried 1.5:10 this evening ~ sent me well hypo.

I did the basal test last night. Seems like I'm taking way too much Levemir, though, as my levels dropped by 6.2mmol overnight. I was told to take my Levemir once before bed but now I'm reading that it's best to split the dose. Is anyone able to give me any info on this. I may try this out but not sure what times the doses should generally be taken.

It's funny, I've been T1 4.5yrs now & this is the highest & most randon my BG's have ever been. Always been quite insulin sensitive & able to tolerate carbs pretty well. I'm wondering if I've had some mega-extended honeymoon period that I'm now coming out of.

roblem:

Hi there I am Insulin sensitive as well. My BS have been all over the place, eratic, and my DSN has know got me reasonably stable ( well most of the time, but still find it very hard at times and extremly frustrating :x ) to stay on 6 to 10 readings, but I still have highs even though she gave me a fantastic carb counting book. I feel like you, sometimes, that I should just go back to how I used to do it, last year that is, but I am deterimed to conquer this battle and hopefully win the war. I wish you lots of luck and I know exactly how you are feeling :shock: RRB

 

[iHs]

Hi, thanks for the replies, everyone :thumbup:

It really has just been getting more ridiculous the past few days. I'm going to have to give DSN a ring. Just going stupidly high after meals. I'm now not even carb-counting so much as doing my old thing of guessing the amount of insulin to take with each meal & just hoping I get it right. I was given a 1:10 ratio before every meal. Tried 1.5:10 this evening ~ sent me well hypo.

I did the basal test last night. Seems like I'm taking way too much Levemir, though, as my levels dropped by 6.2mmol overnight. I was told to take my Levemir once before bed but now I'm reading that it's best to split the dose. Is anyone able to give me any info on this. I may try this out but not sure what times the doses should generally be taken.

It's funny, I've been T1 4.5yrs now & this is the highest & most randon my BG's have ever been. Always been quite insulin sensitive & able to tolerate carbs pretty well. I'm wondering if I've had some mega-extended honeymoon period that I'm now coming out of.

roblem:

Hi

Before you decide to inject Levemir twice daily instead of just once, be guided by how much bolus insulin to carb you need in the morning and at lunch. If you are needing to use a lot of bolus insulin at lunchtime against an amount of carb that's not that high, then its possible that you will need to do a morning injection of basal. You say that your bg levels dropped by 6.2mmol overnight.... did that cause you to have low bg levels this morning and if it did, you will need to reduce the Levemir (evening) so that you are a bit higher. You will of course have less Levemir controlling your morning bg levels though, so will need to possibly increase your bolus to compensate. When adjusting basal insulins its best to make the change and then wait for a day or so before you make another change to the basal. Just compensate with your bolus insulin. As with everything regarding bolus/basal.... your bg meter and frequent testing will guide you on getting your bolus and basal doses better balanced.

Insulin to carb ratios can be dealt with in 2 ways..... one is to keep the 10g carb the same and adjust the insulin, the other way is to keep the 1u bolus the same and adjust the carb. You say that 1u to 10g is not enough but 1.5u to 10g is too much. You could try a ratio of 1.1 or 1.2u to 10g and see what amount of bolus insulin that equates to and then just round up to the nearest half unit......... or use a ratio of 1u to 8 or 7g carb and then calculate the amount using that method. Do whatever is easier for you to work out.