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Erratic BG's

Tanny35

Tanny35

Well-Known Member
Messages
136
Location
nottingham
Type of diabetes
Type 1
Treatment type
Insulin
Not sure if anyone can help - but I'm getting really frustrated now.
So wondered if anyone has suffered similar issues and what they did t rectify it if so.

So my BG is often erratic (I have been a diabetic for 30 years). And I try so hard to control it the best I can.
I am on basal/bolus insulin. And take 12 units slow acting morning and night. This was increased to 14 but I had continuous hypos when o did the increase so put it down to 13 the hypos continued, so now as advised by DSN I'm on 12 twice a day.

A typical example of what I mean by erratics are yesterday and today.
So the night before last I went to bed on a 10.5 - did no correction dose as if I do I always go in to a night hypo. So did the usual long acting of 12.
Woke at 4 am and tested and was a 5.7
Woke at 6:30 and was a 3.8
Had lucozade and 2 toast for breakfast and 2 units novorapid
(Ate the toast and novorapid given at around 8:30) at 8:50 my bg was 3.6
So had more lucozade.
At 10:20 bg was now 10.0 did no correction as I was moving heavy furniture.
At 11:50 I was 12.0 so I did 1 u it novorapid
At 12:20 I was 9.0 I had a sandwich and 2 units of novorapid

At 3:20 I had dropped to 3.7 had some more lucozade and then did a walk to pick my daughter up (about 20 mins each way) I had around quarter of a bottle of a 330ml bottle (which is usually the right amount for me)
Got home re-tested and I had gone to 14.4
Did 2 units correction and had some crackers and cheese as was going to a play - I didn't want to be hypo so had the crackers normally I wouldn't eat if high and correcting

Got home at around 8 pm and tested bg and was 6.6 so as id had a mad day I had some cheese on toast (2 bread and cheese) 3 units of novo. Less than 15 mins after I ate the cheese on toast I was 2.9 so I ate some Frosties.
Finally went to bed at midnight on a 6.
Woke up this morning at 5 am and my bg was 21. So I did two units correction (usually 1 unit will bring me down by about 2-3 so I do it gradually or I end up hypo.

At 6:30 my bg was 2.9

Retested just now I've had some cornflakes after the hypo as was walking a lot today - just got back and I'm 9.0

Now yesterday wasn't an average day for me food wise etc. But even when I am having a normal day and eating properly and not rushing around - I get these night time spikes and lows. I feel I'm in a no win situations, if I go to bed on anything less than a 9 I am guaranteed a night time hypo.
I've been to bed before on a 16 and not down a correction to see what happened - and I woke on a 2.4
Ideally I would like a CGM but at the minute it's not an option for me. Has anyone had anything similar, it's really starting to get to me now.
I don't carb count (not sure if this is why - maybe that may help)

These erratics have happened to me probs over the last year or so - but they seem to be getting worse. DSN has asked me to fill out a sheet of what I'm eating/doing/injecting. To see if we can work out why.
But just wondered if anyone else had suffered these type of erratics



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Continual night hypo's means your basal dose is too high and needs adjusted, looking at those readings I would definitely start with some basal testing and work from there.

Wonder if the new basal insulin Tresiba would be a better option for you @Tanny35 than a split-dose.
 
I'd have to agree with @noblehead @Tanny35 - the numbers you are showing suggest your long acting doses are not set correctly, and you should test it. A good guide for this is here: https://mysugr.com/basal-rate-testing/

You also state that you don't carb count and this will make using the fast acting really hit and miss, and will be contributing to your issues. Take a look at the resources below to help you understand how to do this more effectively.

This guide will hopefully explain the basics to get you going on how best to manage your insulin:http://www.imperialendo.co.uk/carb2012.pdf

The online course called BDEC will help with carb counting and insulin dosing:http://www.bdec-e-learning.com/- this is due to be updated soon.
 
I will do some basal testing - I'm currently taking levemir, so will mention to DSN next week about giving tresiba a go as well! Thank u


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Heya @Tanny35 I feel your pain ;)

A couple of points to think about.. firstly have you done any basal testing ? Your overnight is dropping so it looks like your on too much basal, it would be an idea to set an alarm at 3am to check your overnight. Your second overnight high is down to the cheese on toast, fat delays or prolongs the absorption rate of the carbs, so the 21 was when the fast acting had run out.

Your figures remind me of mine, it's all sortable, I am very reactive to exercise so if I need to drop my BG levels I do some gardening or get the bike out.

Sorry just read replies above - already been covered, Tresiba could be a much better option for your basal, one injection and flat profile, perfect.
 
Juicyj said:
Heya @Tanny35 I feel your pain ;)

A couple of points to think about.. firstly have you done any basal testing ? Your overnight is dropping so it looks like your on too much basal, it would be an idea to set an alarm at 3am to check your overnight. Your second overnight high is down to the cheese on toast, fat delays or prolongs the absorption rate of the carbs, so the 21 was when the fast acting had run out.

Your figures remind me of mine, it's all sortable, I am very reactive to exercise so if I need to drop my BG levels I do some gardening or get the bike out.

Sorry just read replies above - already been covered, Tresiba could be a much better option for your basal, one injection and flat profile, perfect.
Click to expand...

Sorry to sound awful here (it's not meant to come across that way) but I'm so glad I'm not the only one.
I am deffo going to do the basal testing. And deffo speak about changing the insulin.
I didn't know if changing the time of the night time basal would make much of a difference or not.

When I went from two injections a day to basal/bolus - there was no real set guide about what time I should take it, I just got told breakfast and bedtime. And I've never (even tho I should have) thought about it until just now.
I usually take my morning at around 7:30 and night time one at around 10:30


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Tanny35 said:
Sorry to sound awful here (it's not meant to come across that way) but I'm so glad I'm not the only one.
I am deffo going to do the basal testing. And deffo speak about changing the insulin.
I didn't know if changing the time of the night time basal would make much of a difference or not.

When I went from two injections a day to basal/bolus - there was no real set guide about what time I should take it, I just got told breakfast and bedtime. And I've never (even tho I should have) thought about it until just now.
I usually take my morning at around 7:30 and night time one at around 10:30


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Click to expand...

To be honest there's an overlap with the doses on levemir so even a few hours out doesn't make any difference, the fact tresiba has been suggested is because your having night time hypos, tresiba is flatter and is recommended for anyone who has night time hypos, this is why you should try it, it's is really important to avoid night time hypos, so once you tell your dsn you are experiencing these they should change your prescription.

It's also nice for me to know i'm not the only one who has these erratic levels too, I find lots of things can throw my levels and it's only experience which tells me what works and what doesn't, also it's easier looking at someone else's patterns and analysing them than looking at my own ;)
 
Tanny35 said:
I didn't know if changing the time of the night time basal would make much of a difference or not.
Click to expand...

Speaking as someone who was just on one basal injection (lantus) I found the timing made a difference, I use to inject just before bed and experienced a few nigh-time hypo's despite some basal adjustments, DSN suggested moving the injection back to early in the evening so I started taking it around 6pm and after that the hypo's were very few and far between.
 
Juicyj said:
To be honest there's an overlap with the doses on levemir so even a few hours out doesn't make any difference, the fact tresiba has been suggested is because your having night time hypos, tresiba is flatter and is recommended for anyone who has night time hypos, this is why you should try it, it's is really important to avoid night time hypos, so once you tell your dsn you are experiencing these they should change your prescription.

It's also nice for me to know i'm not the only one who has these erratic levels too, I find lots of things can throw my levels and it's only experience which tells me what works and what doesn't, also it's easier looking at someone else's patterns and analysing them than looking at my own ;)
Click to expand...

Deffo going to give that a try. Plus it's one less injection a day too :)

I hate night hypos. I had a really bad experience with one last year - and it's scared me to the point I'm afraid to be on my own whilst sleeping. I used to work away often, and it bothered me so much I won't stay away from home now knowing I'm on my own. So I feel as though I've lost a bit of independence too. It was my worst hypo by far, and I think it was simply so bad as I'd slept through it. I haven't had another as bad as that, but I am still getting them. So if I can eliminate them I will relax a bit more!
My hands for your advice :)


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noblehead said:
Speaking as someone who was just on one basal injection (lantus) I found the timing made a difference, I use to inject just before bed and experienced a few nigh-time hypo's despite some basal adjustments, DSN suggested moving the injection back to early in the evening so I started taking it around 6pm and after that the hypo's were very few and far between.
Click to expand...

Ahhh that's interesting - I will give that a go from tonight then - see if it does make a difference :)


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Tanny35 said:
Ahhh that's interesting - I will give that a go from tonight then - see if it does make a difference :)
Click to expand...

I would move it back in stages and perhaps run it by your DSN first, as Juicy alludes to they'll be a overlap between your morning and night dose so you need to be careful.
 
I'm seeing DSN again next week - so will chat to her before I make any time changes, and hopefully she will give me the go ahead with the other insulin for trial


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