hi everyone has anyone got any suggestion as to what i can do my blood sugars have been all over the place for the last couple of weeks a typical day is = b/b 14.2 b/l 3.3-5.1 b/t 4.9 b/b 7.8 then this morning 33.3 .this is how it has been typical for the last couple of weeks some day im having a lot of highs then other days im having a lot of hypo's. im using levemir and novorapid.i have been as low as 1.7 then 2 hours later 25. im 39 and weigh less than eight stone im not carb counting what should i do help please :?
help!!! bg's all over the place
- Thread starter marie.T1
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i had blood tests and saw the dr last week i have no infections. i have got an appointment with my dsn this afternoon ( got a cancelation) i feel like i cant win at the moment its driving me mad so flustrating !!!!
It must be so frustrating, you must be feeling horrendous. I had a few weeks like that and it turned out both my background and my short acting had to be increased (I can only assume my Diabetes had progressed on a bit further) my lovely DN sorted me out but she back on to the fixed short dose approach and I stuck to it for a couple of weeks to let things settle then went back to carb counting as my eating habits are changeable.
Hope your nurse sorts you out.
Hope your nurse sorts you out.
marie.T1 said:
Marie..
Can you give us a little more information..
Reference your insulin can you tell us how much you are taking and when..
what does a typical day look like for you food and exercise wise..
hi sorry its took so long to get back to you , i have 2 weetabix for brekkie and take 18 units of novorapid i have a sandwich for lunch wholemeal bread ham or chicken with salad an take 16 units n/r for dinner i have meat potatoes and veg and take 20 units n/r i have split doses of levemir 20am 20 pm . i dont do any vigorous exercise but i walk eveywhere .i work fulltime in a well know supermarket so really busy. i do a lot of differnet shift tho so my meal times do vary. i saw my dietician on monday and she has got me on a carb counting course .
ChrisMaleType1
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It's definitely worth going on a carb counting course. It's nice also to meet some other diabetics. Have you tried kellogs all-bran for breakfast? Weetabix always had a bad effect on my sugars and all-bran seems to work for me. Have it with semi-skimmed milk though! You might be told on your course to reduce, or cut out completely, having normal potatoes and wholemeal bread. It's hard, I know. Try Anya new potatoes from Sainsbury's mashed up.
Patch
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marie.T1 said:
I'm sure it's hard for a T1 - but you HAVE to understand that the reson for a hypo is over mdication, and the reason for high BG is eating too many carbs.
It's a tough balancing act - but injecting the same amount of insulin everyday regardless of what you're eating is not the way to deal with it.
Best of luck to you - the carb counting course is a step in the right direction. :thumbup:
hi thanks for replies 
this is where it is so confussing my dsn and my dietician are telling me im eating the right foods . i have been told that the amount of carbs i should be eating should be the size of a clenched fist . this is the amount that im having . i weigh 7st 12 im only little so my fists are small. i went to see my gp on monday as bgs are still allover the place !! he said that he wasnt going to anything about it because he said too many cooks spoil the broth!!!! he said he gonna leave it to my consultant to sort out!!!
this is where it is so confussing my dsn and my dietician are telling me im eating the right foods . i have been told that the amount of carbs i should be eating should be the size of a clenched fist . this is the amount that im having . i weigh 7st 12 im only little so my fists are small. i went to see my gp on monday as bgs are still allover the place !! he said that he wasnt going to anything about it because he said too many cooks spoil the broth!!!! he said he gonna leave it to my consultant to sort out!!!
phoenix
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Marie, I think (and on the amount of info I have it isn't much more than an educated guess) that you are possibly taking too little basal (glucose rising overnight) and that during the day you are often using too much bolus to compensate. Sometimes it works out right because by chance you have eaten the right amount of carbs for the insulin and your glucose level but it's very hit and miss.
You really do need to learn to carb count and how to adjust your own insulin accordingly. I know that your dietitian has put you down for a course but you might like to start learning about it whilst waiting.
This page from the charity DUK has a brief explanation and links to 2 resources that could help you get started.
http://www.diabetes.org.uk/Guide-to-dia ... -counting/
On the right is a link to a downloadable booklet called carbs count
There is also a link to an online course created by the diabetes team at Bournemouth.
Read them very carefully, taking time to understand them. If you start doing the course/reading book now, you'll be able to practice carb counting and be in a position to discuss what you've learned about dose adjustment with your consultant at the end of next month.
If after doing the course, you do make any adjustments to your insulin ,make them very gradually (tiny steps). Its much safer that way )
You really do need to learn to carb count and how to adjust your own insulin accordingly. I know that your dietitian has put you down for a course but you might like to start learning about it whilst waiting.
This page from the charity DUK has a brief explanation and links to 2 resources that could help you get started.
http://www.diabetes.org.uk/Guide-to-dia ... -counting/
On the right is a link to a downloadable booklet called carbs count
There is also a link to an online course created by the diabetes team at Bournemouth.
Read them very carefully, taking time to understand them. If you start doing the course/reading book now, you'll be able to practice carb counting and be in a position to discuss what you've learned about dose adjustment with your consultant at the end of next month.
If after doing the course, you do make any adjustments to your insulin ,make them very gradually (tiny steps). Its much safer that way
)hi patch i understand that carbs make bgs high and medication lowers bgs . i alter my insullin according to patterns but is seems to make no difference. i was in hospital about 4 weeks ago because of my fluctuating bgs . i didnt see my consultant but another consulated said my bgs are really eractic. he has suggested the pump! it seems no matter what i do i cant get a good control :?
hi phoenix i have tried altering my levemir at night even just 1 unit more makes me hypo threw the night! iam looking forward to the carb counting course as i really hope it helps i start it on the 2nd august
Dillinger
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marie.T1 said:
Hi Marie,
It can be very confusing and annoying can't it? Blood sugars aren't random though; we just need to work out what is going on.
I'm glad you've excluded an infection. I also agree that carb counting is essential, and from the look of what you've said I agree with Phoenix that that looks like too little basal insulin over night.
However, I see that you've just said that if you increase your basal you hypo in the night.
So, I think you need to find out what is happening over night; if you can over a couple of weekends set the alarm for 3:00 am and test then.
You could be having a very heightened dawn phenomenon; if you are ok at 3:00 am (and you'd ideally want to do a few tests to be sure) then that could be the answer. What time are you taking your evening Levemir? If you are suffering from DP you might want to take the evening as late as possible; just before bed and the morning as early as possible.
I think the day time blood sugars you show aren't too bad, but the amount of insulin you are taking seems very high. Perhaps you are compensating for the constant morning highs?
Looking at your breakfast you are having about 35 grams of carb (25 for the weetabix and a guess at 10 for the milk). For that you are taking 18 units of insulin; so almost 1 unit for every 2 grams. The starting point for most people is 1 unit for 10 grams of carbs. But that's fine; there is quite a range of ratios. For lunch a wholemeal bread sandwich (assuming thick slices) is about 40 grams of carbohydrate and you are taking 16 units of insulin; so a ratio of 1 unit for every 2.5 grams. Of itself that sounds about right (if your insulin ratio is right). Your before lunch and before dinner and before bed blood sugars seem to suggest you are taking the right amount of short acting.
So, focus on what is happening at night and in the early morning as that sounds like it will be the key.
Make sure you are not forgetting to take insulin, make sure you change the needle and injection sites regularly and until you get this under control I would change as few things as possible; so whilst alternative breakfasts might be a good idea long term it'll only confuse things whilst you are doing the Sherlock Holmes investigations...
Best of luck
Dillinger
Hello Marie
From looking at your messages in this thread it does look as though you are injecting possibly too much bolus insulin for the carb that you are eating. Carb counting and using an insulin to carb ratio to work out how much insulin to inject can be gained by testing your bg levels b4 br, mid morning, b4 lunch, mid afternoon, b4 eve meal and b4 bedtime. By using sensible targets like 5-6mmol b4 br and then being on 7-8mmol mid morning will enable you to adjust to work out a ratio of insulin that will work for you. The same can be done for all the other meals that you eat. You also need to work out a correction dose of insulin that will safely lower yr bg level back to a target level. The links that Phoenix posted will explain things a bit more to you if you are confused.
Do ask your dsn about having an insulin pen for the Levemir and Novorapid that will deliver in 1/2 unit increments as that can make a fair amount of difference and also think about whether you should try injecting Levemir in the morning as well as the evening. By doing so, you wont need to use such a high bolus.
Good Luck.....
From looking at your messages in this thread it does look as though you are injecting possibly too much bolus insulin for the carb that you are eating. Carb counting and using an insulin to carb ratio to work out how much insulin to inject can be gained by testing your bg levels b4 br, mid morning, b4 lunch, mid afternoon, b4 eve meal and b4 bedtime. By using sensible targets like 5-6mmol b4 br and then being on 7-8mmol mid morning will enable you to adjust to work out a ratio of insulin that will work for you. The same can be done for all the other meals that you eat. You also need to work out a correction dose of insulin that will safely lower yr bg level back to a target level. The links that Phoenix posted will explain things a bit more to you if you are confused.
Do ask your dsn about having an insulin pen for the Levemir and Novorapid that will deliver in 1/2 unit increments as that can make a fair amount of difference and also think about whether you should try injecting Levemir in the morning as well as the evening. By doing so, you wont need to use such a high bolus.
Good Luck.....
hi dillinger, i have done some 3am tests for few days to try find out what is going on .i will give you my readings. day 1 b/b25.2 b/l 18.0 b/t3.1-5.4 b/b16.7 3am9.4 day2 b/b 27.5 b/l 20.4 b/t 7.8 b/b 9.8 3am 16.0 day 3 b/b 12.7 b/l 23.0 b/t 5.1 b/b 3.7-6.0 3am 16.3 hope you can make sense out of this
Dillinger
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marie.T1 said:
Hi Marie,
Are you taking correction doses of short acting insulin for these highs?
Are you injecting into areas that might have bumps/fatty deposits? I find it quite easy to get into a habit of injecting in exactly the same place and that can cause difficulties; now what I do is try and only inject bolus in my legs and short acting in my stomach/arms.
If you hadn't said that you were getting night time hypos I would have said it looks like your evening levemir is too low; when do you take that? Are you taking carby snacks at all during the day? Also, are you saying that you stick to your novorapid at the levels you said before for every meal?
Best
Dillinger
i split my levemir 20am 20 pm i have my morning one at 8am and my night one at 11.30 pm . i work till 11.15 pm so i take my insullin as soon as i get home . i dont miss insullin i feel shocking enough without missing meds !!!!
i will give myself an extra 2 units when im high like this morning bgs b/brekkie 24.9 so i took 20 units of n/r instead of 18 bgs now 23.5 im so scared at the mo because i dont want to get ketones or dka . i have been dka before i was an hour off dead the drs told me .
