Help with raised blood sugars at my wits end

Twinkle1710 said:

Morning here are my levels for this morning. I took 19 units of lantus last night bm 6.9 no food since tea. Bm was 4.1 this morning. One weetabix and 3 units of novorapid 2 hours later bm 7.9 again after 30 min delay in eating after injecting.

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Did you get up in the night and test your bg levels about 2-3am to find out whether they had dropped or not?

If this was me, I would make my bg levels a tiny bit higher before bed by altering my carb ratio for my eve meal OR leave the ratio as it was and just eat a small carb snack before going to bed. A bg level of 4.1 is still a bit too low.

I agree 4.1 is a bit low, I'd be a bit shaky then. The difference is smaller than when you were on 23 units, but I'd expect a change of 4u to make more of a difference than that.

I know if I change my Lantus dose, I see the difference it makes by the next morning. Other people on here report that a change of dose takes a couple of days to sink in. So perhaps persist with 19u again tonight and if there's still a noticeable difference then consider dropping it further. I'd be interested to hear what other people have to say on this.

Your pre and post breakfast readings look good to me.

I also have the same opinion about Lantus as Sam in that I notice the changes to my bg levels the next day but some people believe it can take about 2 days to show any effect, so see if the same thing happens tomorrow when you wake up.

Do get up in the night and test your bg level just to see what time Lantus starts to lower.

Please do a 2-3am-ish test for a couple of nights. That time of night can be the most significant time of drops at night.
How have levels been during the day?

Glad you getting steady levels during the day.. Is that after eating too?

Thats hugely better than a week ago... Glad you lowering your basal.. I was really worried about the 4's you were having... Glad the basal and bolus earlier is having such stabilising effects...

Wow, those are good levels... Just makes me wonder what level would have been without Ryvitas and how to minimise it dropping 2bgs from 3am to 7am.. If you had been 5 at 3am onviously you wiuld have been closer to hypoland. It maybe that just the timing of the basal injection would eliminate that drop, but I couldn't say for sure.. Hooe somebody else can give advice.

Pretty **** good though.... Well done..

Twinkle1710 said:

Morning update on my levels for you. 6.6 last night had 2 ryvita before bed. Woke up at 3 am an tested it was 7.2. This morning it was 5.4

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That's more like it Twinkle....... See what eating just a small carb snack can do :thumbup:

I would be inclined to say for you to carry on the way you are now (if you are happy to do so), rather than trying to achieve perfection by altering the basal and not eating anything before bed.

Yep, it may well do.. Although it may then have an impact on day levels... It is going to be suck n see!!

So glad that your determination and perseverance are showing in your results... I would carry on doing a couple more 3am tests...one possibly without a snack so that you an get a 100% pure basal test overnight.. When I did this on injections and pump I woke myself up one night at 3am and the next night at 2 and 4am. ( dont do it now as have a cgm-unless cgm is playing up!!-lol!!)

Like others have said, it's great that you got some consistent readings and changing your basal further might have an impact on your Novorapid dose. I guess this all comes down to you: if you're happy to have a couple of ryvita before bed then carry on as it seems to work.

I personally (and you don't have to listen to me iHS and DD are much more experienced than me) wouldn't want to have to eat before bed to maintain by BG levels. Perhaps drop it by another 2, don't eat before bed and test in the night. I prefer changing my insulin rather than having to eat, each to their own though. I got this philosopohy from Gary Scheiner's Think Like a Pancreas book, very much worth a read.

As I said, if you're happy to have a snack before bed (nothing wrong with it), then carry on.

I mean that by lowering your Lantus, you have less insulin in you. Lantus gives you a steady amount of insulin in your system over 24 hours. When you eat and give yourself Novorapid the total insulin in your system will be Novorapid + Lantus. If you drop the Lantus you will have less insulin in you, so you might need more Novorapid when you eat.

When you inject Lantus it crystallizes under your skin and slowly dissolves over 24 hours. So, say for example that you take 24 units of Lantus, which is 1 unit per hour. If you halve that, you'll only have 0.5 units per hour. If you test before and 2 hours after eating then in those 2 hours you will have 1 unit less of total insulin (2 x 0.5) than when you were on 24 units, so a unit more of Novorapid may be required. It's not quite this simple, but I just wanted to give an example. This is why it's difficult to figure out if your bolus is right, until your basal is right

It isn't for certain that you would need to adjust your Novorapid as if you are only tweaking your Lantus, it might not make much of a difference. The only way to tell is to make sure you've got your basal right, then once that is sorted you need to work on the Novorapid by looking at your pre and post-meal readings. Then once a few of those are consistent you can figure out what your insulin/carb ratio is.

Hope I've explained this right - shout out it I haven't!

I wouldnt want to eat before bed on a constant basis wither.. Thats why my thoughts were to do a test night again without eating.
Having to eat at night, when you dont want to all the time to me is too regimental... But thats me, I like to be able to go against a routine life of eating...
Its totally down to individuals whether they want to have a snack each night etc for safety, but that was more based upon my way of my managing my life...
I'm certainly not experienced to the full on injections... Insulins etc everything and every body keep changing, and so do carbs/no carbs etc.. I so like to be able to see success... And I think twinkle (and everyones help) an absolute star for her attempts and determination to get there..