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Discussion in 'Type 1 Diabetes' started by Dod95, Apr 28, 2019.

  1. Dod95

    Dod95 Type 1 · Well-Known Member

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    I’m adjusting the dose.
    For eg if I’m gonaa eat an Icecream or something sweet. i increase the dose by 3 or 4 units
     
  2. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Thanks for clarifying.
     
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  3. Dod95

    Dod95 Type 1 · Well-Known Member

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    I expected that my BG would go low bc 10U is considered a high dose. I’m taking 10~12 U before eating rice/ Pasta or any main dish.

    The problem is the timing. And the spike from 90 mg/dl to 280 mg/dl in one hour
    Maybe as you said. I’ll try to avoid fruits at breakfast time. And the split doses. Let’s see what will happen
     
  4. karen8967

    karen8967 Type 1 · Expert

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    Hope you get sorted dod95 when you get your ratios right maybe everything will fall into place i get a big spike from rice or pasta regardless of correct insulin but again im mostly bk in range by 4/5hours so will still have it despite the spike x
     
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  5. Dod95

    Dod95 Type 1 · Well-Known Member

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    Thank you sweetie
     
  6. karen8967

    karen8967 Type 1 · Expert

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    Anytime x
     
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  7. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    If you get raised BG a little while after waking but before breakfast, possibly after your morning routine?
    It could be "Dawn phenomenon" or liver dump pushing blood sugar up. & may not be attributed to the toothpaste..
     
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  8. Dod95

    Dod95 Type 1 · Well-Known Member

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    I guess this could be another possibility. I’ll monitor my BG more frequently to rollout the exact reason.

    If it’s really Dawn Phenomenon, what would be the best way to manage it? Do i’ve to increase the long acting insulin dose? Or to increase the short acting insulin units ?
     
  9. Jaylee

    Jaylee Type 1 · Moderator
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    There are so many variables involved. I don't do breakfast untill late morning.
    During a working week I can wake with a reasonable BG, but by the time I've showered, dressed & walked the dog. I can get a rise of 1 or 2Mmol.? Then it tails off.

    Consult with your diabetes team. However. I would be looking at the foundation of your insulin regime first, by testing your long acting "basal." Before trying anything else in the equation, like not brushing ye teeff...
    https://mysugr.com/basal-rate-testing/
     
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  10. EllieM

    EllieM Type 1 · Moderator
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    But you say you're having hypos rather than getting back to the normal range? Is this just a problem in the morning?
     
  11. Dod95

    Dod95 Type 1 · Well-Known Member

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    Life is harsh with diabetes I’ll try to do so
    Thank you
     
  12. Dod95

    Dod95 Type 1 · Well-Known Member

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    Yup..
    It differs from day to day. However It’s always high after eating for 5 hours or more.
    This my graph for today. IMG_9843.jpg
     
  13. EllieM

    EllieM Type 1 · Moderator
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    What's the second half of the day like?

    EDited to add: sorry, I can see your second half now, (but no longer your first ????). I still wonder if you're having insufficient short acting and too much long acting....
     
    #33 EllieM, Apr 28, 2019 at 10:01 PM
    Last edited: Apr 29, 2019
  14. Chowie

    Chowie Type 1 · Well-Known Member

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    Try having an egg instead of bread. If you must have bread multigrain only. Breakfast messes with me so much I skip it.
     
  15. JAT1

    JAT1 Type 1 · Well-Known Member

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    It doesn't sound like you are very strict with your carb counting. It pays to be as exact as possible (until you're bs is very stable) so that you are taking the right amount of insulin and not just guessing. If you lower your carbs and you lower your insulin, you also lower your margin of error. And the thing about carb counting, even if you use a scale as I do, one piece of fruit may be sweeter because it's riper than another.
     
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  16. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Dod95,
    My my reading/experience, not as professional advice or opinion:
    and whatever is said about diabetes hardly ever works all the time!!
    In conjunction with your Diabetes Educator or Doctor:
    maybe consider doing 'basal testing' as @Jaylee suggested above.

    Basically this means skipping say, breakfast and the humalog before it and seeing what you BSLs do,
    same for other meals/humalog, so 6 hour lots ( I do 12 hours lots so 2 meals at a time to get it over with sooner)!!
    - this helps to see how well your Tresiba is handling BSLs between meals and overnight.
    And ask your diabetes educator about how long a change in say, your Tresiba dose, would take to be working
    ( some people on here say 4 to 6 days )!!

    You mentioned earlier not being able to stick to 'a certain diet' - what specifically is this diet you are referring to?

    Humalog: if you search for 'pictures of insulin profiles - Humalog' you will see something like the pictures below:
    One: The amount of insulin in the blood after injecting Humalog/Lisopro (disregard varies from person to person
    as shown by the range, represented by the vertical lines at each measurement over time

    Two: another approach in this table: so by 4 hours - an average of 70% (49 - 89%) of Humalog has been used up!!

    Three: The effect of larger doses - I could not find a graph for Lisapro/Humalog itself , but if you read any of the short-acting insulin product pages they quote doses per kg of body weight, higher the dose the longer it lasts

    Four: how much insulin a non-diabetic produces to deal with a feed of various types of bread (and this is not measuring the variation from person to person)

    Five: and for 'fun', this is an example of what coffee might do to BSLs.

    Now how well does the appearance of Humalog in the blood (in One:) match the timing of the non-diabetic's insulin response in Four?
    I call this a classical case of mistiming and is just my interpretation - which you would need to check out with your diabetes educator: how can Humalog or any known short-acting insulin catch up with the bread??
    What is likely to happen when a moderate dose of the Humalog kicks in? A hypo later?
    You have seen how the effect of Humalog can vary from person to person on One. Unfortunately we do not have the variation to hand in Four.
    Yes, in this situation I could delay the meal for some time after the humalog dose/injection: But for how long? And if I vary the meal, what then?
    Or do I just increase the Humalog dose to better deal with the rise after the breakfast you described and delay the meal?
    It might work but ? hypos?? Same if adding ice cream, just boost the dose ?? These are what I call chasing the BSL - trying to use insulin doses to 'catch' the BSL rise in time. It does not work for me in a general sense. The more insulin the more risk I have of hypos and then I may suffer a rebound high BSL after a hypo (from the effect of adrenaline and glucagon in raising my BSL via liver stores of glucose (+glycogen) plus anything I eat to combat the hypo --> leads to more insulin to control that rebound hyper - the hypo-hyper see-saw.
    Or: do I try to match the food I eat to the action of the insulin? Yes, I would ideally need to see what effect my short-acting insulin is having - so as to better explain things like the 'late' hypo you described. And how do I alter my diet to achieve this?
    There is a way but I would need to be very convinced that BSL chasing was not likely to work.

    I have been on insulin for 52 years and seen most diabetic diets and tried them. So just my thoughts on the matter and ready to field more questions as a T1D, if and when !!

    At this point I would suggest you see your diabetes educator to sort things further - see what he or she says and advises. You can always come back to ask more questions here !!
    Best Wishes !!

    ....One..............................Two.........................Three............................Four.........................Five

    IMG_6702.jpg ..... IMG_6705.jpg .... IMG_6706.jpg ....... IMG_6708.jpg ...... IMG_6709.jpg
     
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  17. Dod95

    Dod95 Type 1 · Well-Known Member

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    It was almost the same. After food it keeps increasing over 4 to 5 hours before it comes down.
    IMG_9844.jpg

    Yesterday, I took 10U & I had only a banana before sleeping to bring it down. I know this was the most stupid thing I had ever done.
    However I was tired and i wanted my BG to be normal. IMG_9846.jpg
     
  18. Dod95

    Dod95 Type 1 · Well-Known Member

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    So you go directly for lunch? Or you’re taking it late?
    Sometimes I’m skipping my breakfast but every time I’m getting a different outcomes.
     
  19. Dod95

    Dod95 Type 1 · Well-Known Member

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    I know that guessing isn’t the right thing to do. Still I cannot accept what happened in the last two years since I got diagnosed. I’ll try to learn more about carbs counting & my body response.
    Thank you
     
  20. Dod95

    Dod95 Type 1 · Well-Known Member

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    Woow! Brilliant!

    Thinking about it, For the bolus test. I’m not following a certain daily routine. So we can consider that I’m doing this test everyday I’m skipping breakfast & dinner many times and guess what...every-time there is a different outcome, for eg) 3 days ago, I skipped the breakfast & the bolus dose as well. Even that I didn’t eat or drink anything till 2 PM. My BG kept increasing >250 mg/dl.
    Today I repeated the same trial and my BG was in its normal range. I feel there’s no constants in the equation of my life

    I’m thinking of something. Maybe if i tried to decrease the dose of Insulin. My BG won’t go that high? Like maybe my body is going crazy after injecting high dose of insulin. Something like a positive feedback to the liver for producing more glucose?.. IDK this is not even scientific maybe I’m a rare case or something !!

    What I meant by certain diet. my personality is very active. I’m not an organized person. Some days you’ll find me taking my 3 meals on their time. The next day I’ll eat only one meal which high in carbs. Or maybe I’ll not take any meals & I’ll just have a chocolate, chips, popcorn, icecream, etc...
    My adherence to a healthy life style is almost equal to zero! Even Sometimes I’m forgetting to take my long acting insulin!

    I’ll keep on trial & error method till i know my body & it’s response to various conditions/food and maybe I’ll discuss with my physician to change triseba. I guess maybe bc it’s working by “gradually” decrease BS avoiding the sudden drop caused by other long acting agents. maybe in my case i need this sudden drop(maybe in my case it will control my BS in a better way)

    Oooh I’m a coffee addict BTW. I can skip all the meals but not my daily dose of coffee .

    While reading your reply. I felt that you’re a professor lecturing in college. You’re very talented in explaining and delivering the information. Really experience plays a very important rule. & you have a 52 yrs experience in T1D.

    Thank you so much for this detailed explanation. It’s very useful for me
    I’ll try to follow those tips & see what will happen.

    Wish you all the best & have a nice day
     
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    #40 Dod95, Apr 29, 2019 at 1:48 PM
    Last edited: Apr 29, 2019
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