Help with raised blood sugars at my wits end

[Twinkle1710]

I hope someone can help me I am type 1 diabetic and had good control until the last month or so. I take 24 lantus at bed time and that keeps me between 4.5 and 6 in the mornings the problem is my novo rapid when I eat I carb count and have between 70 - 100 carbs per day I am 5'6 and 68 kg. when I eat my bm is raised to between 9 to 11 up to 3 hours after eating but is usually back to around 6 to 7 before my next meal. I am at 1.5 for every 10 carbs do u think I should take it to 2 per 10 carbs or will that be to much I am really scared of hypos as I live on my own and dread to think what would happen if I had one in my sleep luckily for some reason the few I have had I have woke up feeling ill and corrected. Some help from you would really be appreciated.

 

[mrman]

Hi you said you are between 4.5 and 6 in the morning but what are your before bed readings without any qa or food left?. Of you were to change from 1.5 to 2 would prov be too much but maybe ok if ypu wanted better after foods readings as long as you had a snack. Alternatively as you are back to normal before next meal try having qa 30 mins before food so the insulin peaks with the food to maintain better levels.

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[Twinkle1710]

Thanks for your reply. Before I got to bed my levels are around 6 - 7 I don't like them any lower as I said before I live on my own and really scared about hypos. I will try to give half a hour before I eat before I up my dose again. It is just really confusing as to these after meal spikes.

 

[mrman]

6 to 7 is ideal before bed when on basal and should not vary by more than 2, so very good on that count. As you are the same before your next meal looks like you are having the correct amount of qa. finately worth injecting before you eat, do monitor at first though to make sure you don't hypo before, during our after eating. Hope it helps
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[Justine18]

Hi Twinkle,

I'm only writing this because i'm having the same issues too, been running high all day and keep correcting to try and get into the 'normal' range.

Do you have any infections ? are your teeth all ok ? Has your diet or activity changed much recently ?

I'm reading Dr Berstein's book on normalising blood sugars, many have told me about it as it's supposed to be really useful in managing all aspects of your diabetes. To try and manage better BS i've been eating low carbs and no bread/bakery/crisps/rice or potatoes to try and level out the highs, as another side effect is that it's affected my mood swinging high and low all the time. I am also using an Abbott Insulinx which is helping me to correct when I am running high.

I would also get straight onto your DSN tomorrow and talk it through with them, they are your support team too and try and get some advice on this tomorrow so you dont go into the weekend with this on your mind.

Good luck and hope it comes good soon :thumbup:

 

[SamJB]

I used to experience something similar when I ate carbs. What I did was give myself enough insulin to make my 2 hour reading consistent with my before meal reading, then I'd have a snack to maintain my levels. Something like a cereal bar, a biscuit or some nuts.

Are the carbs you eating low or high GI? Low GI should stop the spike and maintain your levels.

 

[Twinkle1710]

Thanks my meals each day consist of one weetabix for breakfast. Salad and chicken for lunch with either sugar free jelly or Greek yoghurt my evening meal is neat or fish with veg salad again sometimes a baked potato. Snacks durning the day are either nuts sugar free jelly or one breakfast bar so nothing really that should cause the spikes and I'm feeling fine no coughs or colds or infections

 

[donnellysdogs]

What gaps do you have between meals and bolus's?

What time do you give your last bolus of the day?

The reason I ask is because your levels are dropping over night, dont get me wrong.. Great levels, but, 4.5 in the morning is a tad too low to ensure you stay hypo free at night. Maybe worthwhile just checking what your levels are at 3am as well for a couple nights and to see if it would be worthwhile having a small carb snack before bed...You may well be lower than 4.5 at 3am...

If you bolus more frequently than every 5 hours for meals then you may well run the risk of hypos if you increase all your quick acting insulin doses.. Do you have any snacks at all?-do you bolus for them?

Do your levels increase after every meal up to the 9's? Just that some foods will cause quicker rises than others.

 

[donnellysdogs]

On a ++++ your levels are prety stable... They may make you feel at your wits ends, but honest... There's a lot of people that would cut off their right arm to have your levels... They need a minor tweak, but its possible.

Please dont let your current levels to worry you too much.. Honest.

 

[Twinkle1710]

I have a bolus with all my meals breakfast around 7 am lunch 12:30 and tea around 6ish and and always high after each one 2 hours after but near normal by the next mealtime. I don't bolus if my snacks are under 10 carbs or if I'm having a little something to get my level up between meals I have just taken it now and I ate at 6 pm it was 9.2 at 8:30 and is now 4.7 I don't usually eat before bed unless it is low like now so I had a riveta with cream cheese and no bolus

 

[SamJB]

Perhaps inject 30 mins before eating as it sounds like your insulin is peaking after your food.

Do you do any exercise? When I go through phases luke this I find a session of cardio sorts it out.

 

[donnellysdogs]

Have you considered skipping a meal to see what happens with your readings 2-3 hours after your normal eating times?

I believe that you may have to lower your basal a unit because you are dropping so significantly after the peak times of meals and lowering by morning.

Having your bolus injection earlier than your meals.. I fear that you may actually go hypo before your meal or shortly after it.

That is why I would consider skipping a meal but still doing a bg 2-3 hours after you would have ate and again before your next meal... Then you will definitely see whether your basal injection is correct.

 

[Twinkle1710]

I tried last week dropping my basal one unit and for 4 days my morning bm was 7+ I have tried skipping a meal and my levels seem to raise 1 or 2 like this morning I didn't have breakfast and at 11:30 it was 8.9. My morning bm was 4.5 and my night time one was the same 4.5 tonight. I know it's just a slight problem as my average bm is between 5 and 7 durning a day. It is just frustrating that I can't seem to keep it level all day. My consultant 2 weeks ago said he wasn't bothered about my level 2 hours after as it was normal before my next meal and if it was lower 2 hours before I probably be hypo by the next meal. Whereas my nurse said se wasn't happy with the 9 and 10 a few hours after ad it should be back to normal levels by then

 

[donnellysdogs]

Non diabetics also raise after a meal. The minimum meal rise on a pump before being able to 'officially'' correct the raise is 2.8 increase... Officially on my pump the minimum rise after eating is a raise of 2.8.

I agree with your consultant that by trying to keep 'level' all day you will run the risk of hypos before you eat and during the night. Incidentally, what was your last hba1c?

When you lowered your basal.. Did you raise your bolus's? You've already probably said you did?? Sorry if I'm asking same questions again...

 

[Twinkle1710]

Well today my level was 4.9 when I got up I took my insulin 30 mins before breakfast and 2 hours later it was 7.2. It was 7.9 before lunch did the same again and it was 7.4 two hours later and 7.1 before tea have taken my insulin 30 mins before Again so see what tonight brings. I'm just a bit uncomfy with this as what if I get way laid and forget I have taken my insulin or something happens and I forget to eat how does everyone else feel about this

 

[donnellysdogs]

You can't get hung up on 'what if's'.. You got to het your diabetes to live with you.. NOT you living your life around diabetes.

No matter what happens.. We all have to manage lives ups and downs.. And we all going to have them with personal happenings, physical, mental etc.

Your levels are not out of control. I would love to have your levels... My fear for you is only the lower levels you get in the 4's... Because you cannot drive at those levels, some blood machines read too high.. Which means you would be less than these 4 figures...

 

[Twinkle1710]

I usually only get a reading of 4.5 in the morning and I eat straight away I maybe need a snack at nighttime to keep it up I'm sure my basal is right cos it is higher throughout the day. I never drive without testing first and if it is lower than 5 or so I have a snack first

 

[Twinkle1710]

Ok so pleased my level was 7.7 two hours after my evening meal so that's a whole day with levels in the 7's so I think that's the answer to take my insulin 30 mins before a meal. I am going to have 2 rivetas for supper in the hope my morning on will be above 4.5. Thanks everyone

 

[donnellysdogs]

Hey.... Superbs!!!! Well done for today.. Thats really good...

 

[SamJB]

That's good news! If this turns out not to work then try donnelly's advice. Could be that your Lantus is too high, is bringing your levels down between meals and your Novorapid is too low.

I had to inject 20 mins before eating a while ago. Requires a bit of forward planning though unfortunately. Best of luck.