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Feeling fed up...high levels, hypos, diet, exercise....rant alert!

lcarter

lcarter

Well-Known Member
Messages
513
Location
Nottingham
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
My pancreas
Evening all...

I am feeling really fed up at the minute. I eat whatever I want and take insulin for it by carb counting....I manage ok in the day but before bed my bgs are always 12/12mml.....then I am waking with 13/13 mml even if I take insulin to combat it.

I will admit cluelessness here. I am reading that most people tend to eat 'low carbs' and eat certain meals...I eat bread, pasta, potatoes, and just carb count. I eat chocolate, crisps and a variety of fruit and veg....my point is, am I doing this right?!

I did slimming world and lost 10lbs which took me nearly three months. I was SO good and my sigar levels were great,,,,but then hey ho everything has changed. Today I had 120g of carbs (pitta bread and houmous) and as my ration is 1 unit to 10g carbs I took 12 units. Didn't do anything strenuous and guess what happened? Levels of 3.4. ARGH!

I have also been running for 6 weeks three times a week but this is simply making me so hungry, and I have tried porridge, weetabix and brown toast with eggs,,,,,I am still starving.


Basically fed up and want a moan. sometimes be nice to kick back without all this bloody worrying eh.


Sorry and thanks for listening if you got this far!!!
 
Hi there. It's good to have a moan.

It sounds like your basal dose is too low, and possibly also your insulin to carb ratio is too high. The running may have changed your insulin sensitivity. Are you confident adjusting the doses and ratios by yourself (eg from a DAFNE course or similar)?

But yes you also might want to think about low carb, as getting insulin doses right is much easier on low carb.

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Not sure about basal being wrong as there is only a difference of 1mmol between bed and waking ? Certainly your ratio's for QA insulin are either wrong or you're possibly underestimating/overestimating carb content in meals ? Your recent increase in exercise may well have made you more insulin sensitive too. Difficult to say really with so little info. I would start a detailed diary recording BG readings, carbs eaten, insulin taken and include exercise as well. On days you run, your insulin ratio will probably be different to other days for instance. Show all this info to your doc/DSN for advice or post here. Lastly, I know it's tough but try not to make insulin an excuse for a poor diet. Yes, you can inject for anything but these are still unhealthy foods. The more carbs you eat, the higher the margin of error when carb counting and injecting.
 
Sorry, Mo is quite right, it's more likely that the ratios are wrong, though it's hard to tell from the data given whether they are too high or too low or what.
 
Oh blimey!! At end of day you have to find a lifestyle of food that maintains a good weight and is sustainable.

Sorry, all the WW, slimming world ate not sustainable....

Its great to get ideas how people manage. 120carbs isn't humungous... Especially if exercising etc....

However, whatever you do has to be sustainable on a long term basis and keep you healthy. Its no good doing low carb if you hate the foods... Better keeping to having moderate etc..

There is nothing wrong with occasional treats.... I eat the same as friends when going out for meals or picnics etc...I think I'm a moderate of everything eater. Actually just raising my fats as wasn't eating enough....

No good being miserable over food.. And low carb isn't for everyone.. But moderate carbs should be... At end of day, its what suits YOUR body and brain.

Good ideas on here replacing weetabix etc with berries n yogurt for breakfast.

Lots of suggestions will come along. Believe me, you're not alone!!






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Hi Icarter, you rant away, no need to say sorry at all. No wonder you are feeling fed up, I think quite a lot of people have gone through the same at some point. I have and my levels were up and down like a yoyo. even though I am a very active person always on the go, and don't drive. Have you made an appointment to see your DSN for advice and help? as it can be hit and miss, until it all comes together. So I decided I was going to reduce my daily carb intake ( not low carb though, between 80 and 100) and it has worked out much better for me, it's not 100% perfect, but its better. If I have a curry and rice I only have 96grams of rice ( 30 carbs) not a great amount, but putting it around the edge of the curry it's looks more, Spag bol?, hardly any pasta with it, but more mushrooms and chunky ones, which adds bulk and texture.
These have helped me, but everyone is different and what works for one, wont work for another. I do hope you can find a solution that's right for you,it could just be changing the dose of bolus or basal. Sometimes its a lot of trial and error :-( But good luck and all the very best x
 
Hey lcarter,

First off having a good rant/moan is good so quit apologising, I suspect we all understand it anyway :)

Next, what basal insulin are you on and how do you take it? Also when do you take it?

With a rise of 1mmol/l overnight that means your night time basal is pretty perfect so clearly you are doing brilliantly. Are you correcting at bed time or just letting it run for fear of dropping low overnight? If you are correcting but still waking up at 13 then maybe Spiker's first response was in fact right.. I think we need to get nosey and pester you for more information (sorry about that).

As for eating what you like and carb counting, nothing wrong with that at all (says he who just polished off 50g of crisps and enjoyed every crunch, but covered it with a dose of course).
Low carbing can work for some though I know it is much more common with T2's since it helps them more.
As for the always hungry have you tried to introduce a little more protein into your diet, maybe reduce the processed carbs and bring in some seeds and pulses? I found that helped with the hunger and I ended up eating less and wasn't hungry.. or I got busy so didn't notice.. life is like that I guess.

Are you just having trouble with this rise in the evening and then the overnight staying up there or is it jumping all over the place a bit all day?

Either way I hope that you can figure something out and if it comes to it we can help you along the path a bit.

Keep your chin up, rant now, get it out and move on. :)

/A
 
Thank you all so much for your responses.

Ok, I am on Lantus, I take 30 units at 9pm every evening. I have kept a short diary and I DO correct before bed, usually 5 units as standard to bring it down..it is always around 11-13mml before bed. I wake up to anything from 9.7-14 mml.

I am active more first thing so I notice that my levels are around 8mml throughout the day but yes this can jump around. I had a hypo yesterday and today from using the ratio of 1 unit to 10g rule for my fast acting. I am taking novarapid.

Mo- you are absolutely right, I do use any excuse to eat ****, and its awful to admit. But that is why I am here to get an idea of what I should be doing, what everyone else seems to do and what I can take from that to make myself healthier.

In terms of low carbs/moderate carbs- How do you begin such an adjustment? I mean I don't want to be having low levels which I always tend to do when I have for example, an omelette with a few mushrooms.

Really appreciate all your responses and you have made me feel less alone and unsure. It is a mindfield and I am feeling like I'm losing the battle.

Thank you all.
 
Hi. I suspect your Basal may be slightly low and your carb ratio may need some adjustment. Your biggest problem however is having too many carbs.This can cause high blood sugar swings. Get the carbs down together with balancing the insulin and I suspect things will improve. I aim for 150gm/day for carbs or less. Others aim for even lower. Go for low-GI carbs where you can
 
Hi again, with an omelette and mushrooms you have virtually no carbs, with a curry and a small amount of rice you have carbs. Even though I am a small build and take about 30 units of Insulin, (that includes the daytime x 3 and night time x1) per day, I have always been a big eater, I like my food and I burn it up quickly, but with me. reducing the carbs has helped me a lot. You could try to exchange different foods, crisps for a handful of nuts, seeded bars, ( I have Coeliac disease so I like and eat a lot of seeded bars) a children's small yogurt, I eat Frubes, its a yogurt in a tube, a smaller amount of fruit, sliced bread could be the smaller loaf size etc, but some of these are a few of my preferences and I personally find it better ,I'm sure you will get to a good place with your diabetes management, some times the diabetic fairy has a wicked sense of humour and just doesn't play ball, no matter what you do:banghead:
All the very best and I'm sure you will get there.
 
What are your novorapid ratios at the moment?

I originally started on Lantus + Novorapid but I used to see odd issues where if I changed my Lantus I would have highs at one point and lows at others. The theory was that it wasn't lasting quite well enough and I was covering it with my novorapid.

What are your levels like during the day and how does your novorapid work during the day?

It does look like maybe your Lantus is not behaving quite right, maybe moving it's time might work, though be aware that any changes to Lantus in terms of time and quantity can take a few days to settle.
 
Daibell said:
Hi. I suspect your Basal may be slightly low and your carb ratio may need some adjustment. Your biggest problem however is having too many carbs.This can cause high blood sugar swings. Get the carbs down together with balancing the insulin and I suspect things will improve. I aim for 150gm/day for carbs or less. Others aim for even lower. Go for low-GI carbs where you can
Click to expand...
Snap. I tend to do around 100-150g a day but it's actually quite a bit to be honest.

Even with the bowl of crisps this evening as a treat (since we all need a treat or we would be miserable- my dieticians words) I came out at 167g for the day and right now I feel stuffed.

As Robin said the omelette is near on carb free so you can actually use that as a meal for testing your basal is right.
Are you eating that for dinner and still rising or staying level with a dose of novorapid?
All things pointing to Spiker getting it on first instinct (show off!)

You will get there, it just takes a while sometimes. If it was easy they Dr's would get it right and this forum wouldn't be needed ;)
 
Hi Andy,

My ratio for Novarapid is 1 unit/10g carbs. My daytime is where I can get hypos easily....I have higher levels in evening.

Example from my diary two days ago.....

Levels on waking 630am: 13.5, took 6 units of novarapid to bring this down,
Slice of wholemeal toast and jam for breakfast 8am, levels taken at 8am were 13.3.
Levels at 1030am 8.6.
1040am slice of toast, beans, mushrooms eggs total carbs 66g. took 6.5 units of insulin.
1240pm levels 6.3.
levels 1330 were 5.2.
2pm 88g carbs of rice, fruit and yoghurt. no insulin taken here,
Levels at 4pm were 10.1.
Pre dinner eve 710pm levels were 8.4
2 hours after dinner of jacket pots and beans levels were 12.1...took 3 units of insulin. (i didn't take any with my meal as I wanted to see when they would appear in my bg of that makes sense....)
2 finger kit kat before bed, waking sugars following day were 9.7.

Hope this helps, just a random day but should give more of an insight. I have had a hypo today of 3.4, after having 120g of carbs (white pitta bread) and taking 11 units of insulin. Ate food and took insulin at 4pm, hypo occured at 545pm. I had no idea it was happening, just happened to be a random check!

Please let me know if I can give more information.....thank you all so much.

Lynsey
 
Hi Lynsey

30 Lantus at 9pm, hypos in the mornings, highs in the evenings, my first guess would be that the Lantus is too strong in the mornings and running out in the evenings. I would suggest you split the Lantus to 9pm and 9am. It would be great if you could do a fasting test for a day or half day, or failing that, a carb free day or half day. Test every 2 hours during fasting, or no less than every 4 hours, and that will show if your basal is right. Keep track of any carb corrections or insulin corrections you need during the day for lows or highs, but try to avoid doing either until the fasting period is over, if possible.

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Hi Lynsey,

Okay the first observation I have, or rather question, is why are you not covering your carb intake at each meal?
Let me take this step by step in order but please don't take this as a criticism, I'm afraid I have a tendency to be a bit blunt and I promise I mean no offense by anything, I just tend to look at the data (yes yes.. I know **** engineers ;) )

Waking: your levels are up but 6units seems a bit steep, also it is often better to simply tack your correction onto your dose for the meal you are eating (unless like me you don't eat breakfast... long story)
Breakfast(toast and jam): Did you take any insulin after breakfast?
10:40 (toast and beans): This looks good, nice work :)
12:40 - Nice level
13:30 - Still good
2pm (Assume lunch?) - Why didn't you take any insulin here? - By your ratio you should have taken 8.5 perhaps?
4pm - 2 Hours after lunch I would argue is too soon to really use for any practical adjustment
Pre Dinner - Actually not too bad, Given you didn't take insulin with lunch (??) I wonder if your ratios are not even across the day.. unless you had some other food or insulin in here that I am missing.
Dinner - What was dinner and what did you take to cover it?

If this is an average day for you then I think we can't really make any solid decisions since it is all a bit chaotic with taking insulin either perfectly to cover or skipping doses to see what happens. I can understand why you are doing this since I did sort of the same thing when I was diagnosed but you need to be a little more methodical about it.

As a general rule you need to do the following:
  • Have an idea in mind what your target level should be before each meal (don't worry about other times except dinner time)
  • Test before each meal
  • Calculate your carbs in each meal and inject insulin to cover that meal
  • If your levels were high before the meal, add the correction on to the dose for the meal (you will end up with less needle sticks each day this way)
Have you taken any formal training such as DAFNE or something similar?
If you want to get started with something online you can take a look at this: http://bdec-e-learning.com/

Do you know what your correction doses should be? In other words.. do you know how much insulin you need to add to bring your BG down by a set amount? For example.. if your target is 6mmol/l and your test before a meal is 10mmol/l how much insulin should you take, on top of that for the food you are eating, to bring you back down to 6? This is an important number to work out since it will take a great deal of the guesswork out of things for you.
If you know what your correction factor is and then the different ratios (if you need different ones) and also what exercise does to your BG then things will clear up and become simple for you... and you really can have the treats that you want.. if you want them :) (and let's be honest who doesn't?)

Take a look at the above link, see if you can get on a DAFNE or equivalent and things will make a lot more sense. It can seem like an awful lot of complicated maths but it is actually fairly simple and just a case of adding and subtracting.

Best of luck and I hope this makes some sense to you.

Andy
 
With a follow on. If you do take your novorapid to cover each meal I think we may find that Spiker is right about your Lantus.
Be sure to have some hypo treatment available while you start to make changes since you may see a few more hypos while you make these changes but bear with them, as long as you remain safe and be sure to check in with your DSN if you have one.

They will help you with these sorts of adjustments and in my experience are far more practical and helpful than GP's or specialists.
 
Just a brief reply as I am falling asleep typing!!

I have a school run in the afternoon at 3pm with ny two young children and I walk there and back, about a twenty min walk with a buggy...I really worry about hypos. You are totally right and I need to be taking some!!

I have done an edward course about three years ago...surprisingly!! Not critical, no offense taken. Will reply with more detail in the am.

Thanks to all again...have been referred back to hospital and hopefully will see a specialist nurse there. Just waiting on an appointment.

Good night from me!



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Ps Andy- that was lunch, no insulin taken either. This is why I didn't take any as I end up with hypos.....
Thank you in advance!!

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Ah... so you skip the lunch novorapid because you fear the hypos. Understandable.. they really do suck and having to look after a couple of wee 'uns that can't be fun dealing with a hypo too.

Keep a good diary and take it with you when you go see the DSN.
I think there is a lot going on here including possibly high Lantus and your Novorapid ratios may need tweaking.

Please understand it may take a few weeks or months to get just right but you will be able to get it right, it will just take a bit of work and effort for a while. Once you get things figured out you will be able to settle a bit.

In the meantime I really suggest you find yourself something that you can carry with you, either on your person or in a buggy when you are walking that you can use to treat a hypo, or even better.. head it off before it hits.

You will get there, and in the interim, when you do hit rough patches along the path always feel free to drop in and have a good vent, moan, grumble or whatever... I'm pretty sure we all know what it is like.

The key is to take it one day as a time until you find that sweet spot.

Have a great weekend in the meantime
 
Bread,pasta,potatoes, if i had those my readings would be sky high,cut out carbs and you will see an improvment, stay off carbs and you wont have to count them,lantus dose would also be able to be reduced, it works for me,
Take care and stay positive.


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