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Greetings

Discussion in 'Greetings and Introductions' started by Buena, Sep 18, 2019.

  1. Buena

    Buena LADA · Member

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    Hi everyone. |i am 61. Type 1.5 x about 30 years. Never been properly controlled.Being totally fed up has caused me to restart visiting this site to see if I can be encouraged in some way to gain some amount of control. I've never had an A1C less than 7.2 and at that point ( some years ago ) my Doc said I was doing well..thats because thats the best it had been in years. I would love to feel better etc. Anyway I am making a chane as of this afternoon ( now 2.30pm) and this is my first step.
    I take insulin with meals and a basal of about 13 units. I take 2500 metformin. . This morning BG before breakfast was 10.7 mmol, 3 hrs after eating 18.1...duh...the swings have me feeling down...
    Anyway ..glad to meet y'all. Will update ant improvement accordingly.

    Buena
     
  2. therower

    therower Type 1 · Well-Known Member

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    Welcome to the forum @Buena .
    A lovely positive post. I’m sure with little steps you’ll soon be taking massive strides.
    I’ll tag @Antje77 and @Japes who will hopefully be able to offer some useful tips.
     
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  3. Diakat

    Diakat Type 1 · Moderator
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    Hi @Buena
    What was lunch and when did you inject? Sometimes injecting a while before helps. But if the meal is fatty you may need a split bolus.
    Nice to have you join up.
     
  4. Antje77

    Antje77 LADA · Moderator
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    Hi @Buena , welcome to the forum!
    Thanks for the tag, @therower . I'm ridiculously tired, so not much useful input from me today, I'm sorry.

    Can you tell us a bit more about how you decide how much insulin you take for your meal? Are you counting the carbs and adjusting your insulin or are you on fixed doses per meal? Something else altogether?

    Anyway, good luck, and I think it's wonderful you're trying to improve things!
     
    • Agree Agree x 1
  5. Buena

    Buena LADA · Member

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    Thank you..
     
  6. Buena

    Buena LADA · Member

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    Hi. Lunch was a small plum (filled my hand) half cup lentils(from can) peanuts and cashews lightly salted and roasted.(about 2 handfuls..maybe too much but just love nuts) a big glass of skimmed milk. Took 9 units of insulin...I'm supposed to be about 1U for 5 grams carb, but then I had to correct for the 18.1 mmol I started off with. Now 2 hrs.just checked.At 16.1mmol.
     
  7. Buena

    Buena LADA · Member

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    Hi. Thanks for responding even though you are tired. I carb count 1 use 1U to 4 carbs in morning and 1 to 5 for lunch and dinner.
     
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  8. Japes

    Japes LADA · Well-Known Member

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    Thanks, @therower and welcome to the forum @Buena !

    Like @Antje77 I am ridiculously tired and also just persuading my bloods to stay above 5 before I go to bed any minute now, but I'll have a think and reply properly tomorrow.
     
    • Friendly Friendly x 1
    #8 Japes, Sep 18, 2019 at 10:05 PM
    Last edited: Sep 18, 2019
  9. Kim Possible

    Kim Possible Type 1 · Expert

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    Hi @Buena welcome to the forum,
    When checking our insulin doses are correct, it is a good idea to check our basal levels first. We do this through basal testing - check our BG level remains level over a period of 8 hours or so when there is nothing that could affect our BG (no eating, drinking, exercise).
    Once basal is sorted, we can check insulin to carb ratios.

    I mention this because, given your BG is high, I wonder if you have the correct basal dose.
     
  10. Antje77

    Antje77 LADA · Moderator
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    I agree with @helensaramay , you may want to look at your basal insulin. Often people typically use about as much long acting or basal in a day as they use quick acting insulin. It's not a rule, and it can be way different for individuals.
    In your case, you take a lot more mealtime insulin with your ratio of 1 unit to 5 or 5 grams carbs than your 13 units of basal.

    Also, some people find they need to split their basal because not all basals work for the full 24 hours, making bg go up in the hours before the next dose. This is especially true for Levemir, but many find the same effect for Lantus.
     
  11. Buena

    Buena LADA · Member

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    helensaramay and Antje77 thank you both for responding..

    thought about the basal and last week I tried to up it to 18U lantus. I added about 2 U every couple days till I reached 18. I had so many lows at nights ( I take lantus around 7pm,shortly after dinner) I had difficulty keeping levels above 4mmol and was eating a lot of sweets at nights. Got frustrated with the lack of sleep etc so cut the units back to 13. I know this sounds like my situation is a mess but any more insights would be appreciated.
     
    • Informative Informative x 1
  12. Antje77

    Antje77 LADA · Moderator
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    Ah, with lows at night you're definitely right to lower your basal, like you did!
    I don't have a solution for you (wish I did!) but maybe some things you want to look at.
    - Have you heard of dawn phenomenon and 'feet on the floor effect'? You can use the search bar on the top of the page to look for threads about it. Or do a Google search.
    I don't have much of a dawn phenomenon while I sleep, but I do have a strong feet on the floor effect. If I test right after waking up, in bed, I usually wake up with decent numbers. But even if I don't do anything besides waking up, cooking coffee, feeding the chickens, whatever, so no food involved, my bg will rise well into double digits. So your rise could have been from your liver dumping glucose in your bloodstream to get you going for the day, rather than from your breakfast.

    - When I'm on the higher side I need more insulin to lower my bg or to cover food. I seem to be more resistant when having high bg, and I've seen a lot of others mention this as well.

    - I see you already have different carbs to insulin ratio's for different times of the day. For me (it's different for everyone!) I need over twice as much insulin for the same food in the morning than I need in the evening. Maybe you need to get your ratio's fine tuned.
    I also find it almost impossible to eat more than a couple of grams of carbs at breakfast without spiking high before coming down again. Works a lot better later in the day for me, so I tend to avoid carbs in the morning.
    Should you try this, it will also tell you if it's the food that spikes you or something else, like dawn phenomenon.

    Should you decide to try new things, please test an awful lot and keep hypo treatments at hand!
    You could also try to get a CGM or Libre. It gives you way more insight in to what happens when, and why than finger pricks. They don't work perfectly but they make finding patterns a lot easier, and they also make it easier to keep a close eye on your bg to react to highs and lows before they're even there.

    Good luck!
     
  13. Buena

    Buena LADA · Member

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    Antje77 thanks for insights. Only one hypo last night..3.2. 2tsp of pure glucose then back to bed. Morning bg was 8.8. By breakfast about 1hr after 10.7. One hour after breakfast was 10.4. I physically felt much better. Had energy to clean microwave, was dish cloths, tidy kitchen...things that have been on hold because of how I felt.
    Breakfast was canned mackerel, one cup stringbeans with garlic cooked in a bit of coconut oil and half cup papaya chunks.I took 6.5 U for this.
    I got a Libre and it has been really helpful with trends. This type of breakfast is easier on my body than the grain and fruit combo I used to have regularly. Maybe I will go back to that once stabilised.
    Thx everyone for the encouragement. I really feel welcomed and WANT to do better because of the input. Sometimes it is so good to talk with persons who know what you're going through. Priceless. Thanks.
     
    • Optimistic Optimistic x 1
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