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Erratic Blood Sugars

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slbarron23

Active Member
Messages
38
I have had type 1 for 4 years (I'm 26) and have always felt quite in control until lately.

I have just returned to the UK from a year in Australia and can't quite get my blood sugars on track.

I was having high BG on a morning so upped my background insulin which seems to have helped.

However I keep being quite high on a night before bed - I correct and then find I'm hypoing 1-2 hours later around 1/2am. I then seem to always eat too much! I try to just have 4 jelly babies or 200ml of orange juice and 10-15g of regular carbs but wake up over 10 everyone this happens!

I'm not really sure where to go from here.

I carb count so don't know if for my evening meal I need to up my ratio?

I just seem to be constantly swinging between high and low!

Should I be treating a nighttime hypo the same as a daytime? (Accounting for the fact at night I am not active compared to during the day?

Also I am not working since being back in the UK so am much less active - I thought the answer was upping my background insulin but unsure as to whether I need to change my ration instead for when I eat?
 
Hi @slbarron23
if you have only recently returned to the Uk -- perhaps your insulin requirements have changed ( australia is generally thought to be a warmer climate compared to the UK )

if you are chasing your BG's that will make it harder to get a routine going.

keep posting == a lot of great support available here
all the best !
 
When do you have your evening meal? What's your BS before it and two hours after it?
 
Usually around 7pm.

Tonight I was at 8 before hand.
Carb counted (slight guess)
Two hours after I was at 11, an hour after that I had risen to 13.
I then had 3 units to get me to 7 and just checked now after another two hours and still at 11!
 
This is the story of my life at the moment too i will be waiting for some tips also!! i did start some weight training today and found that i needed less insulin so the less insulin the less scope for errors and hypos!
 
Yeah I'm thinking more exercise and less carbs might be worth trying so that there is less to try and figure out!
 
Do either of you basal test? Ie go without your evening meal and also the bolus to check your basals are right?

This to me would be the first step.

Then once you got your basal evening dose right than you can test if your bolus ratio's are right...

It also of course also depends on the types of food you are eating... Ie I even count the carbs in 15g of fera cheese, weigh out 52g of skinned cucumber and 30g of avocado... And even carb account for a boiled egg to go with that food.. I cannot really talk about real food as my stomach and bowels are so messed up so no longer eat what others do... But I know years ago I found foods and insulin definitely react depending whether fats, carbs etc and heavy lots of cheese etc would really mess me up.

I know you both aren't newbies to T1 but it may be worthwhile doing basal tests and even weighing food to be exact to get everything easier and better for you both...

Definitely worth lowering the carbs... Lower insulin.. Lower errors..
 
If you are struggling with ups and downs, as @donnellysdogs says, basal testing is a good way to start. It will give you an indication as to whether your background insulin levels are correct, and it is much easier to manage boluses when it is. Start from here, which is a good guide to basal testing: http://www.mysugr.com/basal-rate-testing/
 
Thanks I will try the basal testing!
I was at 8.8 at 1am and 6.1 at 4am then woke up at 8am at 10!

So it does sound like not enough basal! Will try and do the test tonight and hopefully that's a step in the right direction!
 
slbarron23 said:
Usually around 7pm.

Tonight I was at 8 before hand.
Carb counted (slight guess)
Two hours after I was at 11, an hour after that I had risen to 13.
I then had 3 units to get me to 7 and just checked now after another two hours and still at 11!
Click to expand...

I find that eating too late can mess up my blood sugar. I personally aim to eat closer to 6pm. I do sometimes eat at 7pm when it can't be helped but the difference in my BS is noticeable.

I can only say what I'd do, but if I'd been 11 two hours after a meal, I'd have corrected then. I'd also have done a small correction/added a small amount to my bolus if I tested at 8 before eating. Again, I find starting a meal with a BS above 7 or so means it's harder to stay in range (if not corrected pre-meal).

How many carbs did you have for your meal? How far in advance did you bolus for it?
 
slbarron23 said:
Thanks I will try the basal testing!
I was at 8.8 at 1am and 6.1 at 4am then woke up at 8am at 10!

So it does sound like not enough basal! Will try and do the test tonight and hopefully that's a step in the right direction!
Click to expand...

That was what was happening with me.. So I have had to go back to pump..dawn phenomenon and then walking phenomenon....trouble is you are dropping from 1am to 4am and more basal may well just affect the dropping even more.

If you could forget dinner/evening meal and basal test till morn you would see if basal right from tea time oneards though the night.
 
Yeah I was worried about too much background!
My overnight levels were fine but I'm not thinking my
Main problem
Is that my daytime background has run out by the time I take my nighttime one (around 8-10pm)

Might sound like a silly question but if I increase my daytime basal will this make it last longer or just make me lower for the same period?

I am going to try bringing my nighttime
Basal forward a couple of hours to try to bridge the gap
 
Increasing dose will make you lower but won't extend the length of time it works..

I had to do mine rigidly at 12 hours apart..
 

You're lucky! I get both too and have just had to get into a routine of waking at 4am to give insulin for the DP and then more half an hour before I get up.

My clinic seem fine with this arrangement and pretty much laughed me out of the room when I asked if I might be eligible for a pump! Seriously considering self-funding if the Medtrum system turns out to be good and reasonably priced.
 

No way!! Thats ridiculous. Did you ask them how they would feel having to do your regime for the rest of your life?

I would be asking for a referral to a different hospital...

My current hospital are pretty backward on their knowledge of pumps and cgms but they do everything to help me. They knew I was so upset with the 640g pump and we worked together with unbelievable speed to get me swopped to the Accuchek pump.

That is truly appaling.
 
They seem to think I should just be content with sky high sugars every morning and "simply" correct with breakfast! It probably doesn't help that my HbA1c is 5.5% and I have excellent hypo awareness so the only argument I can make is QOL...

Bunch of jobsworths!

Glad you managed to change pumps, I remember seeing your posts about the Minimed!
 
No, its not.... NICE states that you should not have to compromise on achieving your targets....

You are compromising your sleep to achieve the targets.

Its actually phrased on the NICE guidelines to say something along the lines of the health teams not compromising on achieving targets ie putting targets to 10..

Worth reading through all the guidelines...
 
Indeed, I've read them and cited them but the consultants opinion was that my target is below 7.5 and above 6% so in her view if I was higher in the morning it would actually help me reach my target of a higher HbA1c.

Of course my own personal target is to stay below 6% and in the non-diabetic range but she's very opposed to this. This is the same consultant who was outraged I was using the Libre because "all that data will just confuse and frighten you unnecessarily" .....sigh!

I actually have a meeting with the pump specialist consultant tomorrow so am cautiously optimistic she might be a bit more helpful. Failing that I'm going get in touch with Input but I can see the whole affair has the potential to be one long uphill slog!
 
My hba1c is 44 (don't know what that is when converted) but I still got pump.. Originally from a driving incident but having come off it and moved CCGs did not guarantee I would get funding reinstated.. My HCP's still had to state the reasons.

Your HCP's are needing to consider how on earth they would feel in your shoes...

I could have (with a struggle) got up at 7am and injected a correction bolus but there was no way I could do that on a long term basis. No way.
 
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