Help with raised blood sugars at my wits end

[donnellysdogs]

Blimey..

 

[Belteshazzaruk]

Have you considered a pump. Sounds like a lot of the problems could be fixed by a more bespoke background such as that provided by a pump. Sounds like your body's dealing with the hypos ok so try not to worry .

 

[Twinkle1710]

Hia so i have dropped my lantus to 19 my bm was 5.4 this morning I am still taking my rapid 30 mind before meals at a 1.5 to 10 carb ratio my levels have gone from
6 - 7 two hours after a meal to 9 - 10 two hours after but drop to 6 - 7 two hours after that and before my next meal. So do I increase my ratio or ignore the reading two hours after food and just test before lunch

 

[mrman]

Hi been following this with interest. Think your doing great at the moment. 9to 10 2 hours after is not too bad at all. If.you'd like tighter control you could increase nova rapid slightly to get under 8, but may need a snack between to stay steady or if you do have a snack already a slightly bigger one.

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[Twinkle1710]

That's the thing I don't want to have to rely on snacks to get my levels right. My consultant said at the beginning he wasnt worried about the 9 and 10 two hours after food as they were back to normal before eating and he was worried I would just get more hypos by getting my levels lower two hours afterwards. So I think my friends with all your help and support you have got me to the best I can hope for at the moment you have all been really amazing and I think I'm just going to ignore the two hours after eating and rest just before my meals and bedtime

 

[mrman]

Previous post suggesting a pump if you can get one would short this out probably as it could bolus a small addition to keep you lower without needing a snack. I have recently been approved for one and waiting anxiously for it.

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[Twinkle1710]

I'm not sure what the criteria is to ask for a pump also I know I do have pretty good control. I don't really know the benefits or differences of having a pump and also what argument I would put forward as to why I would need one

 

[mrman]

I was the same but after discussing with my diabetic nurse said I could have one simply because I have such a varied day that I could not get my basal correct as it kept putting me too low when active even if I snack. By having the pump when I'm more active I can temporarily reduce/stop basal to allow for it. I was surprised myself when she said out would be ok for me to have one as generally my control is ok and hba1c of 6.9 on last visit.

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[SamJB]

This is the chasing your tail bit that I was talking about! Dropping between meals is a sign your Lantus is too high, which is what we suspect. Try drdropping it by 2 tonight and if that isn't enough drop by 2 the night after. My bet is that you need to drop it by 4 in total.

A pump does sound like a good idea mind.

 

[Twinkle1710]

That's what is confusing me Sam it's not dropping it's going up around 6 -7 before meals then 9 - 10 two hours after and back to 6-7 two hours after that so back to normal before a meal

 

[mrman]

What I think sam is suggesting is with less basal you might need more nova rapid at meals, not go so high and.not need a snack.

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[SamJB]

So before meals it's 6-7, two hours after it's 9-10, then before the next meal it's back to 6-7? I don't think I explained myself properly. What I meant by "between meals" is between the two hours after meal reading and your next pre meal reading. If that drops it's a sign that your Lantus is too high. The two hours after meal tells you whether your Novorapid is right.

 

[SamJB]

Spot on brett! I need to explain myself better! Sorry!

 

[Twinkle1710]

Yes that's what I said earlier do I infinite to reading 2 hours afterwards as it is normal before meals or increase and risk having a hypo before I eat

 

[SamJB]

I wouldn't. I'd wait until the Lantus dose is sorted, then increase your Novorapid because you'll go hypo otherwise. 9-10 is ok after meals, once your Lantus is correct you can then aim to reduce those readings slightly.

 

[Twinkle1710]

God this had to be the most frustrating illness in the world lol I have already given my 19 lantus for tonight so I will test in the night again and in the morning and see what it throws at me this time lol

 

[SamJB]

Tell me about it! You will get used to what your numbers are trying to tell you, don't worry. Took me long enough!

 

[donnellysdogs]

Yep, I agree too on that..

Forget your actual levels twinkle, just look at the drops from 3-5 hours after a meal... That indicates that your lantus is still too high.

Your increase at 2-3 hours after meal indicates it is your bolus is too low.

By altering both you stand less chance of hypo-ing because your lantus is feYeding you less, when your bolus will be more.

To be sure on this try to start on a good level such as between 5 and 8 and dont eat or bolus... Skip your meals, go as long as you can without eating/bolusing....
On a pump we have to have times of doing this to get our basal levels right. Just eat or correct if levels start to drift below 4.8 and above say 9. If you did that from say midday to 10pm you would ( be **** hungry-i always am when I do this!!!) find out just what is happening to your levels just with your basal injections.

It also gives you a bit of a confidence/freedom boost in someways too.. Because you'll know that if your bgs stay reasonable that you dont have to be rigid with eating times and bolusing...

In someways I do agree with consultant about levels of 9 not being too much to worry about... But its actually just that there may be a better way that'll just tweak it right...But you do have to live too...

Do you drink water or coffee with your meals?

 

[Twinkle1710]

Well I do agree I need to drop my lantus and will drop it again by 2 tomorrow and then I will have to look at my novorapid and maybe use a 2 to 10 carb ratio. I don't drink coffee with meals usually diet coke but I do drink coffee in between meals

 

[Twinkle1710]

Hia just a update on my progress. Well I have altered my lantus to 14 units per day and increased my bolus to 1.7 per 10 carbs and my morning levels are between 5-6 and staying steady 2 hours afterwards And before meals at 6-7 I have stopped taking them 30 mins earlier and take it as I eat as I wasn't comfy with that but seems the increased ratio has corrected my little spikes. Thanks very much for all your help I hope it continued this way