Criteria

Hi!!

I been trialling myself as N=1 for last two days...with my basal rates.

Today has been superb.
However-I only eat once a day and very low carb and fat and calories...

I split my basal in to two doses at night instead of waking up to have to do a bolus to fight the DP and to stop going low at 4amish...

I was on 6 units at 6pm.. I had tried all times at night but hadn't tried splitting it like a pump can do...

So I gave a basal of 2 at 6pm and midnight.... Absolutely superb!!!
2am 6.7
3am 5.7
4.30am 4.9
8.30 am 4.8
9am 5.6
10am 4.5
11am 4.8
2pm 5.4
3pm 4.6..

No DP or symogi or waking effect at all!! Just by splitting the basal and also reducing it.

Not heard or of anybody doing this before and nurses certainly haven't suggested it.

Yes, its just the first day.. and I do have the confidence to play around outside "official" guidance... But this for me after past 4 weeks with pump(s) is heaven.

Yes, its another basal but I don't eat during day so another basal jab to me isn't the end of the world.

I did give my normal 6unit basal this morn but will be putting that to 51/2 tomorrow morn. I also did a 4 unit correction but will be reducing that to 3.5 tomorrow as well as I will be going out walking in the morning...

Would splitting basal (levemir) be an option in the evening rather than bolusing for DP at 4am be an option to consider?

Of course, I'm not a professional. This is only my results from my body...

It may impact more on you in afternoon so you may well have to lower your morning basal too...or your lunch time bolus if you eat..

Incidentally, do you do basal testing?

Hoping you can still get pump though!!

Sweethear66 said:

I have done carb free and basal only a couple of times for the DSNs which is when they were trying to help with DP. Would be a pain injecting at midnight when I have work the following day tho

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You need to actually skip meals not just go carb free, unfortunately protein will shove up you blood sugars as well

Sweethear66 said:

So I should skip a meal or meals to see if basal is right?

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A basal test is a fasting one, meaning no food is to be eaten (even carb-free food), so if your basal testing during the day an example would be eat a low-fat breakfast and start bg testing 4 hours after finishing your meal, if your basal is set at the right dose your bg levels shouldn't fluctuate by more than 1.6mmol/l:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

BTW, look at the INPUT link mentioned earlier, problems with DP come under the ABCD recommendations so you don't have to come under the NICE criteria for pump funding.

Sweethear66 said:

They suggested setting my alarm for 4 or 5 am and injecting a few units of novorapid but that doesnt seem to be a long term solution. Since being told I did'nt fit the criteria I suppose thats what I will start doing from tomorrow

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I also have dawn phenomenon and I was waking at 3am to give a bolus to try and fix it and my consultant told me that I couldn't keep doing that, as the lack of sleep made it unsustainable in the long run!! She told me to go on a pump which I got one year ago aged 54. Whilst I was waiting I tried using humulin I instyead of levemir as my night time basal as it has a small peak - but it didn't help. Now I'm on a pump I don't have the issue but my basal goes up to 3.15 an hour for 4 hours in the morning. It's amazing how much better I feel waking up at 4 and 5 and 6 rather than 14 and 16 and 20!!!

I spent 2 years trying to get a pump from my local hospital due to hypo anxiety affecting my life, but it was such a fight, I'd done everything they asked, carb counting course, kept a detailed diary. In the end I left my consultant appointment in tears as he kept sending me away for 6 more months to think about it. I asked my GP to refer me to addenbrookes and I was accepted for pump at my first appointment, they also bumped me up the waiting list as I'd had such a long wait at my other hospital. They were amazing!!

Fingers crossed for you.

Regards

Martin

Sweetheart66 said:

Appointment at Addenbrookes went well. Consultant has applied for funding for me so just have to wait to see if its granted.

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If a consultant says you need a pump, you need a pump and the CCG can not deny the funding.

Sweetheart66 said:

Dr I saw today said insulin pumps can make control worse! Said it could occlude in the night put me in DKA and I could end up in hospital!

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OK so I've had the pump occlude in the night about 3 times during my 6 years pumping. It didn't get to DKA because my pump alarmed to warn me and I injected right away and changed set. Your consultant sounds like a fool.

I too travel 2 hours each way for this hospital diabetes care.... It is hugely better than previous hospital.

I had my first appt last week and unluckily for me my consultant will be going off sick for a while.... Just my luck!

Not same as mine...