Help Managing My Blood Sugar

[Cole89]

I've been trying to get this area of my life sorted out, for the past few weeks I have been trying to record my blood test levels as much as possible, as well what I eat and the injection amounts.

I am currently only 4 injections a day, taking novarapid 3 times and a levemir at night. Typical injection amounts include 55 units for a nighttime injection, and novarapid of 17-18 units before tea. Other injections vary dependent on when I get up and what I eat.

I've uploaded my blood test results and am looking for suggestions on how to improve my blood sugar control and what other users may recommend.

* It seems I can't upload an ODT file, so apologies for the long list below but this is the only way I can display all my blood sugar results.

Blood Test Results

Monday 28th February

9:46 – 4.9
Orange Juice/Apple
12:16 – 7.6
14:33 – 6.4
19:00 – 15.4 Injection 19
22:13 – 7.3

Tuesday 29th February
12:41 – 4.9
Orange Juice
14:15 – 11.2
Injection 10
16:00 – 13.9
Injection 4
18:42 – 7.3
Injection 19
22:00 -8.7
2:00 – 18.3
55 levmir injection

1st March

12:41 – 4.9
14:15 – 11.2
16:01 – 13.9
18:42 7.3
23.34 – 8.7
02.03 – 18.6
55 injection

2nd March

9.50 – 7.2
13.02 – 4.9
18:54 – 12.8
21:57 – 6.0
23:48 10.4
Toast x 2 + Soup
24.4
Novarapid 3 units
Levimir 55 units

3rd March 2011
12:49 – 11.9
Mild Mushroom Curry
Injection 17
19:09 – 5.9
21:47 – 4.0

4th March
10:27 – 8.4
15:32 – 8.3
18:26 – 13.9
19:35 – 3.1

5th March

08:49 – 9.4
10:50 – 3.9
13.44 – 5.4
16:37 – 12.1
02.59- 4.4

6th March

21:18 – 4.1
02:13 – 8.6

7th March

14:43 – 11.3
18:21 – 19.3
21.23 – 7.6
22:27 – 13.6

8th March

11:16 – 16.2
17:52 – 8.1
Injection 19
21:10 – 5.3
00:30 – 23.2 (Injection 10)
02.30 – 14.6
Levimir 55

9th March

11.43 – 4.7
Orange Juice
14:06 22.6 (Injection 16)
Soup/Bread/Apple
17.21 – 11.0 (Injection 4)
18:47 – 7.3
19:01 7.0 (Injection 18)
19:50 – 5.6
21:38 – 4.8
Toast + Exercise
23:31 – 15.7
Injection 6

10th March
11:12 – 3.3
13:56 – 11.7
15:27 – 8.0
16:31 – 8.0
17:19 – 9.1
Tea Injection 18
19:43 – 4.8
Crisps/Chocolate
22:25 – 25.8 Injection 10
02:20 – 20.4
Levmir 55

11th March
12:51 – 5.4
15:23 – 15.6
17:45 – 7.3

12th March
08:47 – 13.7
11:46 – 19.1
13>35 – 18.1
14:09 – 17.6
16:37 – 17.6
02.10 21.3
Long Term 55

13th March
13:26 – 12.2
21:13 – 16.9
02.33 - 20.7
Levmir 55
Injection 3

14th March
11:54 – 6.8
Orange Juice/Toast
14:04 – 16.7
Injection 10
17:06 – 13.1
19:06 – 10.1
Injection 19
21:22 – 4.2
Eggs/Toast/Grapes Injection 10
1:07 – 8.7
02.31 – 10.7
Levmir 52

15th March

12:14 – 7.9
13:46 – 5.9
16:12 – 17.0
18:47 – 3.5
19:36 – 7.7
22:07 – 7.4
00:42 – 19.4 (Injection 5)
02.46 – 15.2

16th March
09.47 – 3.6
11:29 – 11.6
14:19 - 16.7
17:16 – 3.1
22:10 – 6.1
23:19 – 15.4
01.37 – 11.6

17th March

12:51 – 5.2
16:23 – 4.4
17:30 – 7.9
18:54 – 8.2
19:57 – 2.7

18th March

13:51 – 15.2
23.27 – 16.2
01.49 – 13.8
Levmir 55

19th March

13:14 – 6.6
Orange Juice
16:11 – 16.9 Injection 5
16:44 -13.1
Hotdog
18:59 – 13.2
Injection 18
Pasta Tea
Mars Bar – felt low
22:15 – 3.1
Jam Sandwich
11.30 – 10.6

 

[daisy1]

Hi Cole and welcome to the forum Some insulin users will be along soon to look at your levels and give their advice.

In the meantime here is some basic advice the Forum Monitors have written for new members' information and I hope you will find it useful:

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS.
Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.

 

[cugila]

Cole.
Welcome to the Forum.

You have given us a very long list but it is short on detail....... :|

What would be more helpful is just a typical days readings together with your food intake showing your fasting levels and times, pre meal levels and times, 2 hrs post prandial (meals) and pre-bedtime results.

You need to include when and what you inject and what foods you eat so that if Members wish to they can analyse your day. We would need to know how many times a day you eat and when.

All you can tell from your list is that your BG levels fluctuate from high to low, you probably already know that ? To help you to obtain better control the information needs to be targeted and concise.

 

[anna29]

Hi. Am due to vist the diabetes specialist nurse this week n am yet confused with the basal n bolus regime. Have been swotting up on it n grasped the basal , its really the bolus I am unable to grasp its sooo complex. Simple question - if you basal with levemir as a split dose twice daily [ to get best action with levemir ] do you always HAVE to bolus???? or can you just use levemir on its own???? help n advice needed as am well confused. Nurse has said I am to stay on victoza with added levemir to try n tweak my high BS down. Am currently on 1.2 dose of victoza n BS still 10.9 [fasting morns] n fluctuate 14-20 2-4hrs after meals n pre bed times. I wish to be well prepared with correct facts prior to seeing the nurse this week. thanks Anna.

 

[Geoff]

Hi Anna,
The mode of action for Basal insulin is to control the background rise in your bs throughout the day while you are between meals, if you do not eat at all during the day, you bs will start to slowly rise, this is because your liver will dump glucose into your blood stream.

The trick with using a basal insulin is that you inject just enough units of insulin to stop this rise happing. Too little insulin and your bs rises, too much and you go hipo! Do not let yourself get caught by confusing the process by adding or subtracting rapid acting insulin to control this.

Rapid insulin is only injected to counteract the effect of your bs rising by eating, how do you use rapid insulin,. you need to know your body’s sensitivity to the rapid insulin that you inject, this is called your insulin to carbohydrate ratio, this is not fixed in stone but varies from person to person and by the time of the day. E.g. for every 10grams of carbohydrate there is in your meal, you inject 1unit of insulin, so a typical dinner containing 40grms of carbs, you inject 4units of rapid insulin.

So to answer your question, first calibrate your body to the correct basal level, (fasting bs before breakfast should be no more than 6.1mm/lt) when you have got this in the right zone, then you can start to work out the correct insulin to carb ratio to get the correct amount of rapid insulin with each meal that you eat. If you are going to see you Diabetic nurse soon, ask her to help you with a program to achieve this objective, then you will be well on the way to good control.