Here I go again!!

[kelp84]

4 years ago I posted on this forum about how rubbish my levels were ....

They are still awful ( I am between 15-21 on a usual day!)

Last week I purchased a free style libre it's fantastic but makes it very hard to ignore how bad my levels are .... I did dad me 4 years ago and I struggle to remember the principles .... So am hoping to pick your brains ....

Fast acting insulin (novorapid) .... Am I right in thinking this lasts 3-5 hours .... So if I'm high 5 hrs after a meal I can probably correct?

The starting assumptions are .... 10g carb will bring your sugar levels up by 2/3 mmol and similarly 1 unit of fast acting will bring you down by 2mmol

I asked to be put on lantus 6 months ago after being on levemir for years .... I read a scary article about lantus being associated with cancer? Is this valid or a load of rubbish?

I split lantus 14 at night and 14 in the morning ....

I can safely assume that my levels are so erratic that none of my ratios or lantus amount is correct ...... Which would you test first? I am going to go in with 2 units to 10g of carb and then maybe in a day or so do some fasting long acting tests ...

I wish I could paste my sugar level graph in here I am determined to get a hba1c below 9 this year



Thank you in advance to anyone who can offer any tips or refreshers .... Much appreciated!!!!

 

[Mrsass]

Hi, well done on getting a libre and taking control, you need to basal test, as you're saying if you are high 5 hours after eating you can correct, yes you can but your basal should be right to keep you in check when you're not eating, I think your carb ratios maybe do need tweaking too but the basal test should smooth out a lot for you

 

[kelp84]

I am going to try this tomorro
I will eat breakfast at 7am then skip lunch and test hourly from 12

Thanks for your post xxx

 

[mentat]

Hi kelp84,

You can upload a photo of your readings by clicking the "Upload a File" button underneath the post box.

Some people need different ratios for different meals. My breakfast is currently 1u:5g, lunch is 1:8, and dinner also 1:8 but a few weeks ago it was 1:11.

So for instance for breakfast I divide my carb count by 5 to get the number of units.

If everything is all over the place, one thing you can do is eat consistent meals for a few days and just find the right rapid dose to cover them by trial and error, then work backwards to get a carb ratio.

Good luck!

 

[kelp84]

That's a pretty good idea .... Will take the variability out
Thanks

Kelly

 

[himtoo]

hi @kelp84
welcome back !!

basal testing is the cornerstone to gaining good control -- can be a bit tiring though

here is a link http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

important to remember it is a marathon and not to expect miracles over night -- stick with us here for support and we'll get you there !!

all the best !

 

[kelp84]

Thank-you! I intend to stick with it this time

Did my first experiment last night! Ate dinner at 7pm and at bedtime 11.30 I was 15! I assumed all novorapid had left my system .... Did 2 units and my nighttime lantus dose!
Woke up at 3! Normally 2 units would bring you down 4-6 mmol ... So I don't know why i dropped so much but ...... One step at a time going to focus on the day one with a fasting test today and see how I get on!!

Thank you for the link .... Really helpful!

Kelly xx

 

[steve_p6]

@kelp84 @himtoo is spot on, getting your basal right is the top priority. If you post your Libre graphs here or on the Facebook group for Libre you will get some good advice on interpreting the trends.

 

[novorapidboi26]

it sounds to me like you have retained quite alot of the basics of DAFNE which is great news............

so as others have pointed out, the basal is the first to be checked and adjusted............then you can move on to the meal time insulin/carb ratios.........

you can come over to the DAFNE Online website, sign up and with a code supplied by your DAFNE trainers, you can access the course handbook, which will help you remember some of the principals and adjustment techniques...

 

[kelp84]

Thanks! I do not still have the code, would be great if I could get one so I can go on the website?

I did the test today and these are my results ( and I am Starving

Time Machine Freestyle
12pm 10.7
1pm 9.2
2pm 8.4
3pm 7.6
4pm 6.9
5pm 7.0

I think you are not supposed to drop more than 2, in which case mine seems like it could be a little too high a basal dose,
So do you think I should just drop it? or is it wiser to test it again another day?

I have also attached my levels from my Freestyle today ( thanks for the tip mentat)

Any advice about the basal adjustment would be greatly appreciated

Thanks

Kelly

 

[Juicyj]

Hey Kelp, well done on posting, hope the hypo wasn't too bad.

You say you are on lantus, is this a split dose ? Also when do you take your background ?

 

[kelp84]

Yes it is a split dose
Take night time at about 10.30/11pm and take morning at about 6.30/7am

Low wasn't too bad thanks xx

 

[Type1Bri]

I would repeat the test a couple of times and look for a pattern, best not to make changes based on just one set of test data. This will rule out any other factors, I.e high fat meals, illness, exercise, stress etc etc

 

[Juicyj]

If your splitting your dose then this shouldn't be causing you an issue as your lantus will be lasting from about 18 hours onwards, unless your not taking enough. Looking at your hypo how did you treat this as your rise started from that point ? Bri has made a good point, it is worth doing this again to see if this is a pattern, particularly with your hypo today, also what caused your hypo ?

 

[London36_]

Good luck Kelly! You've inspired me...*off to google how much these libre things are*

 

[robert72]

Good luck Kelly! You've inspired me...*off to google how much these libre things are*

WARNING! They are addictive I bought a starter pack 18 months ago just to see what it was like, but now can't imagine not having it.

 

[steve_p6]

If your splitting your dose then this shouldn't be causing you an issue as your lantus will be lasting from about 18 hours onwards, unless your not taking enough. Looking at your hypo how did you treat this as your rise started from that point ? Bri has made a good point, it is worth doing this again to see if this is a pattern, particularly with your hypo today, also what caused your hypo ?

Looking at the graph both the night time and daytime drops look quite steep. Were these just from basal or were there some correction bolusses in there too?

 

[kelp84]

My levels are all over the place ( I know this is obviously something I am doing, which is why I am trying to fix it- although not too sure yet what "it" is )

Last night I ate dinner at 7pm, at 11.30 I was 14.3 (after 4.5 hrs I assumed the Novorapid was prob out of my system) so I did 2 units ( had been high for days!) hoping this would bring me down 4-6mmol and I would wake up at a normal level.

I woke at 6.45 low, I corrected with a carton of fresh orange ( the small cartons so 20g) then I had my breakfast ( 2x Weetabix approx. 30g and a banana 20g) I did 12 units ( I normally do 1:2.5 did a little less due to the low.

I did 15 Lantus, and then ate nothing all day til 6pm.


I have attached some of my other days levels......

 

[steve_p6]

I think your overnight drop could easily have been the Novo, overnight on other nights is not showing any indication of big drops. You are spiking quite high which can make it hard to bring bloods down again - try and keep carbs to 30 per meal while you try and get control, fight one battle at a time if you can . Went through all this when I got a Libre, it just takes a little time to sort the wheat from the chaff but you will get it.

 

[kelp84]

thanks Steve, that is very logical, so lower carbs will create lower spikes,
Thanks for taking the time to reply : ) much appreciated! (same to everyone who has offered me great advice!)