High all day

[ConradJ]

Try dark chocolate instead of milk - NOT the rubbish stuff, like Bournville or any sort of 'Everyday essential' version, but higher quality stuff. If you "don't like" dark chocolate, or you find it a bit harsh to begin with, then try some of the flavoured varieties, such as those with mint, raspberry or caramel, as they will get you used to the difference in taste, texture and results.

Aldi and Lidl both sell good ranges at £1.09 per pack, and then there's always Lindt or Green & Blacks.

 

[Heathenlass]

I started novo rapid at 6 U, with my meals, then one hit of levemir 8U, over a few months it went up N: 16U L:18U, now I'm on a carbs meter it tells me how much novo rapid to take with meals, and split my LEvemir.
I've been in hospital with DKA a few times within the year, and since have attended a DKA education course, have clinics, but that's all I've had, was even rushed to a&e from the doctors as had ketones and high BG and spent 2 days in hospital with no treatment!!


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Emma, can I ask you about your meter?
Which one is it ?
Are you taking the dose of insulin that it recommends , and if so , are you still running highs ?

I'm assuming that the meter is something like Insulinx , if so are the settings correct ? Because if they are not, the dose it suggests will also be wrong .

Signy

 

[ConradJ]

i have had for the last couple of years weeks like this my diabetic nurse and consultant have no idea why my blood sugars wont come down below 20 and it makes my hba1c very high to last one was 12.4. It gets very frustrating as i feel ill all the time and i cant really talk to my other half because she doesn't know very much about diabetis and that makes ne upset as she wont learn about it she just wants to think she knows all about it. I have been to Drs to try sorting it and to hospital and also did carb counting course and do correction injections all day but nothing helps at all. My last blood sugar which i did at half past six this evening was hi and my meter only goes to 33.3 then it just says high.

Hi @bexley,

I was in the same boat as you - way back in 2001/2, but I remember those days oh so well. I was put onto Lantus, from Insulatard, but this didn't work for me - if anything, it all got worse... and I became horrible to know. My consultant mentioned moving me onto a 'new' insulin called Levemir, but it wasn't available at the time. But then, I sort of struck lucky and they offered me a pump, which I started in 2005.

However, it's not been plain sailing for me: too many extra-curricula issues that were impacting upon my diabetes (stress at work and home, frequent bouts of illness owing to **** control, manic attempts to rectify - all by guesswork, etc., etc.) Also, diabetes education regarding carb-counting and pump use was not offered, so what I received was the technical how to operate the machine, but little else. It was a bit like giving neanderthal man a computer and expecting him to calculate the theory of the universe

Anyway, enough about me . You need to bring the high levels down, but you should do so carefully and sensibly - DON'T panic or stress about it (yes, I DO know how impossible that seems) because that only worsens your body's resistance to the insulin.

As @corbettc said, contact your Diabetes Specialist Nurses asap and request a 1-2-1. In the meantime, get hold of a diary and start logging EVERYTHING you do and when: what you eat, how many carbs are in each meal, your bolus dose, your BG levels before meals and 2 hours after, your BG level before bed and the one first thing in the morning. Next, try doing a couple of 'basal' tests on different days so that you and the DSN can review what's happening with your basal insulin and adjust accordingly. ( www.diabetes.co.uk/insulin/adjusting-basal-bolus-insulin-doses.html )

Above all, be open and brutally honest with him/her about the need and desire to regain your control - most DSN's spend the majority of their time banging their heads against the wall trying to convince people about taking control; he/she will almost certainly be delighted to meet another who really wants to take control and will do all they possibly can to help you get there. (But they are constrained by time, resources and NICE guidance so don't expect miracles.)

Keep it up - and keep posting; we will all support you in your journey to take control of it.

 

[jack412]

There is an online course for a refresher. Register and login
http://www.bdec-e-learning.com/

There is also some downloads on carbs and dosing

http://www.diabetesinscotland.org.uk/Publications/9224 Overview of Carbohydrate Counting.pdf
http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf
http://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf
http://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

 

[Emma2688]

Sorry Conrad, I take my levemir around 10 every night, with readings of 12>15, then wake up at about 10>18.. It seems abit all over the place. I have put it up by a few units last night and did feel better this morning with 9.8!
I do keep my monitoring diary and update at every reading, and I also keep a diary to write what I eat and when and with how many units and readings.

 

[ConradJ]

I have had a lot of stress since being diagnosed, which doesn't help.Sent from the Diabetes Forum App

Hi @Emma2688,

As the saying goes, 'stress is a killer'. And for people like us, stress can really screw up control: it did me in for about 5 years as I couldn't pull my head out of my backside and realise that I was stressing about poor control, which was worsening the poor control and which caused me to stress even more! And then, I starting stressing about the stress - talk about being completely f@"!£%$£"!!!

I strongly suggest writing a letter (or email) to yourself telling you all about the things that have been going on and wrong in your life to make you stressed, etc. Imagine yourself to be a Victorian lady, writing a letter to her dear sister (or something like that), telling her all about the 'goings on at home'. It may help you to focus on the issues and stand back from the worry long enough to help you put things into perspective; then seek help / support with the issues that you can't solve yourself.

If my experience is anything to go by - and we seem to share commonality in the way stress affects our levels - then tackling the causes of your stress will help you regain control and better levels.

Best wishes.

 

[Emma2688]

Hi @Emma2688,

As the saying goes, 'stress is a killer'. And for people like us, stress can really screw up control: it did me in for about 5 years as I couldn't pull my head out of my backside and realise that I was stressing about poor control, which was worsening the poor control and which caused me to stress even more! And then, I starting stressing about the stress - talk about being completely f@"!£%$£"!!!

I strongly suggest writing a letter (or email) to yourself telling you all about the things that have been going on and wrong in your life to make you stressed, etc. Imagine yourself to be a Victorian lady, writing a letter to her dear sister (or something like that), telling her all about the 'goings on at home'. It may help you to focus on the issues and stand back from the worry long enough to help you put things into perspective; then seek help / support with the issues that you can't solve yourself.

If my experience is anything to go by - and we seem to share commonality in the way stress affects our levels - then tackling the causes of your stress will help you regain control and better levels.

Best wishes.

Thanks. That sounds like a good idea, I will defiantly give it a go.
Stress is awful and like you said you stress over the stress.


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[Emma2688]

Emma, can I ask you about your meter?
Which one is it ?
Are you taking the dose of insulin that it recommends , and if so , are you still running highs ?

I'm assuming that the meter is something like Insulinx , if so are the settings correct ? Because if they are not, the dose it suggests will also be wrong .

Signy

I've got an accu check. Which I've been using for about 2 months now, which I put in how many grams of food I eat and tells me how much novo rapid to take etc. I was previously using a true test meter. I give how much insulin it tells me and then check after 1/2 hr - hr then if still high I correct it and keep checking.


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[ConradJ]

Sorry Conrad, I take my levemir around 10 every night, with readings of 12>15, then wake up at about 10>18.. It seems abit all over the place. I have put it up by a few units last night and did feel better this morning with 9.8!
I do keep my monitoring diary and update at every reading, and I also keep a diary to write what I eat and when and with how many units and readings.

Hey, no worries!

Have you night-time tested at all? If not, I strongly suggest doing so. As you take your Levemir at 10pm, I would test at 00.00, 02.00, 04.00 and then at 06.00. This will give you some indication as to what the levemir is doing to you at night.

The good news is that the insulin is working. The question is, just how well? It could be sending you low (according to your body's revised settings as to what low actually is**) or it may be that it's just not enough. Without the 2-hourly tests, none of us will know and you and your DSN will be just guessing what to do next.

I'd also run a basal test for two evenings to see what's happening to your evening levels with just the levemir: your daytime levemir could be running out too soon or it could be too much, or your I:C ratio is out for your evening meal, which is then sending you high, or low with a subsequent rebound.

**Your body will reset it's boundaries for hypoglycaemia if you've been running consistently high for a period of time. If your average has been 12, then your hypo warnings could be around 9mmol/l - therefore, if your night-time levemir drops you down to (say) 6mmol/l in the middle of the night, your body may react thinking it's going hypo and then chuck out glycogen and force a rebound.

One clue to this is: when you wake up in the morning, do you feel like you have had no sleep and a bad hangover in the morning?

 

[Emma2688]

Emma, can I ask you about your meter?
Which one is it ?
Are you taking the dose of insulin that it recommends , and if so , are you still running highs ?

I'm assuming that the meter is something like Insulinx , if so are the settings correct ? Because if they are not, the dose it suggests will also be wrong .

Signy

I started on a true test meter, now I'm on an accu check carb meter, I give how many units it states, then check 1/2hr -hr after and if still high I correct it and inject more and keep doing so as it comes down.


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[Emma2688]

Hey, no worries!

Have you night-time tested at all? If not, I strongly suggest doing so. As you take your Levemir at 10pm, I would test at 00.00, 02.00, 04.00 and then at 06.00. This will give you some indication as to what the levemir is doing to you at night.

The good news is that the insulin is working. The question is, just how well? It could be sending you low (according to your body's revised settings as to what low actually is**) or it may be that it's just not enough. Without the 2-hourly tests, none of us will know and you and your DSN will be just guessing what to do next.

I'd also run a basal test for two evenings to see what's happening to your evening levels with just the levemir: your daytime levemir could be running out too soon or it could be too much, or your I:C ratio is out for your evening meal, which is then sending you high or low with a subsequent rebound.

**Your body will reset it's boundaries for hypoglycaemia if you've been running consistently high for a period of time. If your average has been 12, then your hypo warnings could be around 9mmol/l - therefore, if your night-time levemir drops you down to (say) 6mmol/l in the middle of the night, your body may react thinking it's going hypo and then chuck out glycogen and force a rebound.

One clue to this is: when you wake up in the morning, do you feel like you have had no sleep and a bad hangover in the morning?

No, haven't tried night testing, but I'll give that ago as of tonight.

Yes a few mornings have woken up still very tired and sometimes a headache. On that note I think it will be good to night test.

I was doing some cleaning and felt shaky and funny so tested an was 11. And I thought I was going in to a hypo, so maybe I have got a high hypo level?!




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[Heathenlass]

I started on a true test meter, now I'm on an accu check carb meter, I give how many units it states, then check 1/2hr -hr after and if still high I correct it and inject more and keep doing so as it comes down.


Sent from the Diabetes Forum App

Righto - has your DSN inputted your carb ratio according to time of day (if needed ) and what your correction dose should be , again at different times of day ? Out of interest, did you have the problems you are having now when you used your other meter?

Signy

 

[Emma2688]

I had my meter set up for me, worked out the blockers, ratios etc. I feel a lot better than the start of the year as I had DKA, and haven't had any problems even with my high readings since. Every now and again I check for ketones, but seem to be fine. I don't think the heat at the moments helping either. X


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[Juicyj]

Having good control doesn't have to be so difficult, it's just a case of going through the basics again - are you doing your readings before you eat ? Or when you feel like it ? If you can wait 4 hours until the last dose of quick acting has worn off to get an accurate reading. Check your carb content and adjust your dose of quick acting accordingly, write a diary and look for patterns this can indicate if it's you basal that needs adjusting and if in doubt try eating carb free meals or fasting to gauge better accuracy of this. As mentioned before with Levemir it best to split the dosage and if you regularly get high readings in the morning it's worth considering changing your quick acting ratios in the morning.

Try not to adjust your doses by more than .5 to start and write that diary it's so important to spot trends - good luck

 

[Emma2688]

I test every time before I eat, and then if I feel a bit funny just to be sure. I have split my levemir, I guess it's just getting the right balance. I always write in my diary and food diary. Thanks for all your input it means a lot.


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[ConradJ]

Having good control doesn't have to be so difficult, it's just a case of going through the basics again - are you doing your readings before you eat ? Or when you feel like it ? If you can wait 4 hours until the last dose of quick acting has worn off to get an accurate reading. Check your carb content and adjust your dose of quick acting accordingly, write a diary and look for patterns this can indicate if it's you basal that needs adjusting and if in doubt try eating carb free meals or fasting to gauge better accuracy of this. As mentioned before with Levemir it best to split the dosage and if you regularly get high readings in the morning it's worth considering changing your quick acting ratios in the morning.

Try not to adjust your doses by more than .5 to start and write that diary it's so important to spot trends - good luck

Well, that's a rather one-dimensional review of someone without access to all the facts and variables!

Balancing diabetes can be one hell of a mountain to climb if your life is not structured around the Mon-Fri 9-5, 3-meals a day, I only drive 2 hours after eating and bolusing scenario. And then if you chuck in other aspects like illness and/or stress, etc., you can forget your "If you can wait 4 hours until the last dose has worn off..."

For example, I'll test first thing in the morning, then maybe get a chance to do a little exercise, then have breakfast, etc., but some mornings I need to drive less than 2 hours after eating and bolusing. So, I test my BG and guess what? Yes, you got it, I'll be way above my target range!

Well, if you're struggling with control you can easily get blinded by and lost in the sheer volume of data - and so, if you're not perfect (and who is?), you can find yourself reacting and over-reacting to BG results that really shouldn't be recorded,but have to because DVLA require it.

Yes, I know, one could have a second meter specifically for the car, but then you may have to find a GP who's willing to prescribe more than one set of strips (if the meters aren't the same)... and you'll have to remember to order them as they run low (or maybe you'll have to buy them), and what if that meter is not so accurate because you're faced with buying them and you're not a big earner and so you go for a low-cost model?

One size does not fit all.

Yes, getting back to basics is an essential element to gaining and retaining control, BUT it is not as easy or as straightforward for everyone as your reply implies.

 

[jack412]

How did you go? Did you manage to wake up or did you snooze back to sleep, when the alarm went off

 

[Emma2688]

How did you go? Did you manage to wake up or did you snooze back to sleep, when the alarm went off

Lol!!!! I managed to do one reading around 1am which was 9.6.... Then fell back to sleep until my kids rudely woke up at 5:30! But did deal a lot better this morning.
I also increased my levemir by 2units last night! Will have to keep this up!

 

[Emma2688]

I just wanted to share... I've just tested and guess what.?!? 6.0!!!!!! Lowest it's been in months!


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[jack412]

That's brilliant and In range, how was your morning reading today, if you uped your basal you might need to cut your bolus a bit for now if too low after meal