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Hi, New member ----- a long time diabetic

Discussion in 'Type 1 Diabetes' started by smc4761, Jul 21, 2014.

  1. smc4761

    smc4761 Type 1 · Well-Known Member

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    Hi folks,

    After years of not bothering to look at diabetic forums, decided to have a look around and this forum does seem very helpful.

    I have had Type 1 for almost 35 years now, and still do not know enough about the condition.

    Over the past 6 weeks or so after a visit to the dietician and diabetic clinic, I have probably started to look at monitoring my BG levels and have got a bit of a shock if i am honest

    I inject Humalog at meals typically 3 times a day, and a dose of Lantus around 10pm, bedtime. I have really been watching what carbohydrate I have been eating and adjust my insulin accordingly. Most BG are not too bad typically 7-9, slightly high I know. There does however seem to be no real pattern to my morning BG reading

    Typically when I do a test at 10 pm just before my Lantus my bg is around 6. The last time I eat is usually around 6.30 pm When I get up and test about 7 am some morning my BG can be 11 plus others its still around 6/7 despite there being no difference to my routine. More often than not it rises by about 3 or 4 points. As I say though there is no pattern to this.

    Anyone have any thoughts, the dietician at clinic was unsure about this

    Thanks
     
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  2. amberzak

    amberzak Type 1 · Well-Known Member

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    Hello and welcome.

    You think 7-9 is quite high? Oh how I would wish for your readings. I'm on multiple injections (novorapid and levimer). My sugars fluctuate, and no matter how hard I try, I still have highs. And lows.

    Anyway, I don't have much to offer, as I have the same problems in the mornings as you.
     
  3. Jess33marsh

    Jess33marsh Type 1 · Well-Known Member

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    Hi
    Are you female? The reason I ask is apparently we release hormones that elevate our sugars around 4 -5am that could be responsible for the rise. Usually if my sugars are higher than 10 in the morning I suspect a night hypo that didn't wake me!


    Sent from the Diabetes Forum App
     
  4. smc4761

    smc4761 Type 1 · Well-Known Member

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    No i am a 53 year old male.

    What is annoying is that for the past 6/8 weeks i have really stuck to correct intake of carbohydrate and insulin and my morning BG is much higher than normal. previously I would have my meal about 18.30 then perhaps a kit kat around 8 pm and even a packet of crisps at about 9pm. and my BG was around 8 each morning. Now I do not eat after 18.30 until my breakfast about 7.00 and my BG is around 10. GRRRRRRRRRRRRRRRR
     
  5. mo1905

    mo1905 Type 1 · BANNED

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    Hi and welcome to the forum. There are a couple of reasons why your levels in the morning are typically 3 or 4mmol higher than bed time reading. It could be dawn phenomenon ( Google it ) or it could be that your basal is too low and your levels are creeping up overnight. Have you tried a daytime basal test ? Ensure all QA insulin is out of your system then take BG levels every hour. This is best done on a day you can skip a meal, if not, have a zero carb meal if poss. Try and do this for 5-6 hours if poss. If your BG levels remain fairly stable, it's about right. If levels start to steadily rise, your basal is too low, and vice versa.
     
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  6. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Hello and welcome to the forum, I am pleased you found us and anything you would like to know or just have a moan about, somebody normally comes along with some helpful advice and support :)

    Take care and best wishes
     
  7. smc4761

    smc4761 Type 1 · Well-Known Member

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    Thanks for the advice. Is the internet not just simply wonderful. All the info you need and probably a whole lot more you dont at the touch of a keyboard
     
  8. smc4761

    smc4761 Type 1 · Well-Known Member

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    So for the past 6/8 weeks or so my diet has been just about perfect, however I am finding my BG particularly through the night and probably until around lunchtime are a bit high, Typically 6 when I go to bed but overnight at 3 am its around 8.5 going up to arond 11 by 7am Taking Humalog with my breakfast to cover the carbohydrate but by lunchtime still a wee bit high at around 9 . Only time I seem to get a decent reading is just before 10pm when I take my Lantus. Even tried a carbohydrtae free meal and BG went from 8 to 10.5 between lunch and dinner

    Over the past few years I have been eating more carbohydrate tham i am now and my BG were never this bad. Spoke to my diabetic dietician who suggested that I need to increase my Lantus by around 10/20 %. Now I can understand the logic in that as my BG are increasing even when I am fasting, eg overnight, carbohydrate free meals

    2 things I can get my head round are

    Previously I never had this issue with high BG, especially just before breakfast. If my Lantus needs to increase as it seems not to be effective with the dose I have, why is my BG reading just before bed, 24 hours after I have taken my last Lantus dose a "normal BG reading.

    Apart from cutting my carbohyrate intake from around 230 g per day to around 180 per day, my lifestyle/work has not changed.

    Any thoughts
     
  9. Adele99

    Adele99 · Well-Known Member

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    Possibly because the previous fast acting dose you had has kept your level down to that point ?
     
  10. Nyxks

    Nyxks Type 1 · Well-Known Member

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    To me it sounds like your lantus dosage isn't high enough to sustain you though the night and during the day with your boils at meals … it does sound like you might be experiencing dawn issues but that wouldn't explain the reading though out the day that your dealing with, which is why it sounds like you don't have enough base line insulin onboard to keep your system level/stable.

    Do you eat to your meter? as in eating a meal then testing 30min 1 hour 1.5 hour and 2 hour after to see how you rise/fall after the meal or snack - giving yourself an idea as to how your body handles the types of carbs your giving it (process high sugar carbs take a lot more for the body to process then natural sugars - a carb might be a carb but the body does treat complex and simple carbs differently.

    You might try keeping a food diary with a log beside each meal/snack of your glucose reading so you can track and see what meals/snacks cause spikes and which ones doesn't cause as much of a spike.

    For myself I'm on 100 units of lantus at bedtime (which varies from midnight to 3am depending on what time I go to bed - work night vs non work night). but regardless of what time I take it I wake around 3.7 to 4.2 (tad low but not bad) and for the rest of the day I stay around the 5 to 6 mark even not taking my meal time insulin on occasion because I don't need to do so. I eat between 150 and 300 grams of carbs a day (all plant based, nothing from animals and no gluten).
     
  11. jack412

    jack412 Type 2 · Expert

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  12. smc4761

    smc4761 Type 1 · Well-Known Member

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    Hi guys thanks for the replies. I have also been on Metformin which i take twice a day and have done so for aroun 8 years

    NYXKS, Wow 100 units of lantus, that seems like a lot, typically I take around 32 units and have done so for years, although i am now increasing this to 40 units. What is confusing is that until I started to fairly rigidly sticking to carb intake about 6/8 weeks ago my Lantus dose seemed to suit me very well and my BG control was much better
     
  13. Nyxks

    Nyxks Type 1 · Well-Known Member

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    @smc4761 so you are saying that until you change how you where eating your control of your glucose was much better? or am i reading that wrong?

    I've insulin resistance thanks to PCOS along with my T1 issues - so a higher dosage of insulin seem's to be the answer to getting my body to work (though for some strange reason the IR is going down the older I get or feels like it since my bolus are lower then they use to be - its either because the lantus is taking care of it correctly or something else is going on that we don't yet know about.
     
  14. smc4761

    smc4761 Type 1 · Well-Known Member

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    Pretty much, my control has got worse especially my pre breakfast BG. Previously I would have my meal the night before around 6pm then eat around another 20 grams carb and take 32 units of Lantus around 10pm. Most mornings by BG was around 7.

    Now I dont eat anything after 6pm was taking 32 units of Lantus and BG most mornings is around 11. Going to bed my BG is typically 7

    I have upped the Lantus to 40 units on advice of dietician and will see how that goes.

    I have been type 1 for 33 years
     
  15. czj

    czj Type 1 · Well-Known Member

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    Hi. I often have similar trouble. I've been diabetic 40+ years, but recently went on a DAFNE-type course (it's called HEIDI where I live). It was really helpful and my daytime readings are brilliant - but mornings...

    From your posts it looks like you are now eating a bit less but taking more insulin - wouldn't that just suggest that you are going low overnight?
     
  16. smc4761

    smc4761 Type 1 · Well-Known Member

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    That what I would expect. My total carbs for day have gone from about 230g to 180 g but for some reason my BG especialy in morning is high
     
  17. czj

    czj Type 1 · Well-Known Member

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    That seems a pretty significant reduction in carbs over the day. I definitely think a lower Lantus does is called for.

    I find it hard to cut my night-time dose. The first week on the HEIDI course the team suggested I up my daytime doses, to use a ratio of 1 and a half to 10 units of carbohydrate. A week later we reviewed the results and my daytime readings were in the 4 to 7 range consistently. However my morning readings varied - always over 10, sometime over 20 which hasn't happened for years.

    Aha they say - low during the night - cut the 12 of insulatard down to 10. Could I bring myself to do it? - no. I think I have a Pavlovian response. High blood sugar - take more insulin. Over the last few weeks I have managed to convince myself to do it, down to 10 and somedays 8. My morning readings are better (11 -1 4) so clearly I should be cutting back more. I know they must represent a night-time low, as if they were true highs then I'd be thirsty and needing the toilet. So, onward and downward.

    I'd be keen to know how your morning readings are doing.
     
  18. smc4761

    smc4761 Type 1 · Well-Known Member

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    Been offline for a few days now. On Wednesday i started off with a pain in my left ear, which by lunchtime was getting worse. BG at 1 pm was 9.2 so took my usual dose of Humalog and had lunch. By 2 pm my BG dropped to 6.5 and by 2.15 dropped to 4.7.

    I took a cupof coffe with 4 sugars and a biscuit. 10 minutes later my BG was down to 3.9. More and more sugar followed, are you ready for this, 16 spoonfuls of sugar, bottle of lucozade, 2 cans of coke, and a bar of chocolate over a 45 minute period. My BG went from 3.9 to about 4.6 back down to 3.5 then finally around 4pm it settled at a BG of about 6.5, despite that huge sugar intake.

    Next day off to doctor as ear was much worse. Turned out I had a severe ear infection. Got anti biotics and anti inflammatory drugs, but did not help that much. back to doctor next day and had a wick full of anti biotics stuffed deep into my ear as well as ear drops. The wick was removed the following day and replaced by 2 more, very very painful.

    During that time I did not eat a great deal but continued with my insulin but my BG have been veru high typically 12---15

    Felt better yesterday and ate as normal, going to bed with a BG of 9.3. In the past few months my morning BG has typically been around 3 units higher than my bedtime BG. Of course this morning it went from 9.3, down to 3.5. Sometimes I just want to scream. There seems to be no pattern to my highs and lows

    My biggest concern is, if I have a low sugar normally a cup of coffee with a couple of sugars and a biscuit, sorts me out within 5/10 minutes. Yet I took a huge amount of sugars and no real change over about an hour
     
  19. czj

    czj Type 1 · Well-Known Member

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    Sorry to hear about the ear infection. Sounds pretty bad, glad you persevered and got more treatment, and it is on the mend.

    The long, low blood sugar is a worry. The fact it went on so long suggests you might have too much Lantus working away for hour after hour. I still think, apart from the days when you had the infection, you must be having far too much Lantus. Your carbohydrate has gone down from 230g to 180g, that's clearly a drop of 50g. (about 20%) But you are taking 40 units of Lantus, 8 units more than your usual dose (a rise of 25%). That doesn't make sense.

    With that drop of over 20% in your CHO, wouldn't you expect to have to reduce your original Lantus by say 6 units, down to 26?
     
  20. smc4761

    smc4761 Type 1 · Well-Known Member

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    What a difference a week makes. This time I was in considerable pain with a real severe ear infection so was loaded up with anti biotics and anti inflammatory drugs. Despite eating near normal and taking my normal insulins my BG wouls not come down below 12.

    On Monday feeling back to normal, if a little deaf in one ear, I have stuck rigourously to my carbohyrate intake and insulin and BG are near perfect. Previously I would go to bed with a BG of 7 and by morning this would go up to around BG 10. Now BG before bed is 5.5 and by next morning its only 6.0. Even during day and evening it is around BG 6.5. Even had a couple of lowish BG of 3.5

    Only adjustment I have made is to now take either 36 or 38 units of Lantus, depending on my evening BG

    My big concern now is I tend to go out walking a lot to fairly quiet places and on a couple of occasions BG at 6pm has been about 8.5 half an hour after my meal, however an hour later this has dropped to 3.5. Thank goodness for lucozade

    Slowly but surely starting to get there the ear infection I had was maybe much worse than I thought
     
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