High blood glucose levels since change in ratios

[Kimlaah]

On tuesday my consultant changed my insulin ratios from 2 units of novo rapid per 10g of carbs, to 1 unit per 10g. She has also dropped my lantus to 40 from 48 and suggested that I have 20 units in the morning and 20 at night and I am now having 1 unit of fast acting for every 3mmol I am over target. So far my glucose levels have been running between 12-16mmol all day with a hbA1c target of 60. Just wondering if anyone has any experience with this? Should I contact a GP tomorrow or should I stick at it a little longer to see ic there is any improvement?

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[Type1Wonder_]

I also do 1 unit per 10g or if I'm having a snack any thing under 15g of carbs is okay for me not to do an injection and my latest hba1c test results was on the lines of like 89 I think... but my sugar levels are always With in 7-14! I think we have the same issue.. Message me if I can help I'll will try my best..

 

[Eldra]

BS of 7-14 is super high. If I've above 9 I really don't like it. Over 10 is clearly a hyper to me.
I think eventually the best way to manage your diabetes is to own it. I suggest you try to take one of those DAFNE course or so, if you haven't done it already. Otherwise there is tons of information online, including in this website, for insulino-therapy. But basically, I believe it is best that any diabetic learns how to use their BS readings and to adjust their lantus and bolus ratios by themselves, based on their own experience.

1 unit per 10g is actually pretty common I think? Although I am at 2 units per 10g, but I always felt a bit bad because I think it is high hahaha. Ultimately, the right dose is the one that works for you anyway.

 

[azure]

On tuesday my consultant changed my insulin ratios from 2 units of novo rapid per 10g of carbs, to 1 unit per 10g. She has also dropped my lantus to 40 from 48 and suggested that I have 20 units in the morning and 20 at night and I am now having 1 unit of fast acting for every 3mmol I am over target. So far my glucose levels have been running between 12-16mmol all day with a hbA1c target of 60. Just wondering if anyone has any experience with this? Should I contact a GP tomorrow or should I stick at it a little longer to see ic there is any improvement?

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@Kimlaah What was the reason for the change? Were both things changed at the same time? If so, that makes it hard to work out what's happening.

I'd do a basal test if possible to see if that's ok, then I'd look at the ratios.

 

[Kimlaah]

@Kimlaah What was the reason for the change? Were both things changed at the same time? If so, that makes it hard to work out what's happening.

I'd do a basal test if possible to see if that's ok, then I'd look at the ratios.

I havent seen a consultant for 6 years and she said I was having a lot of hypos because I was still running on ratios for a growing teenager! So she is now treating me as a newly diagnosed adult to see how I get along, so far not so good

 

[Kimlaah]

BS of 7-14 is super high. If I've above 9 I really don't like it. Over 10 is clearly a hyper to me.
I think eventually the best way to manage your diabetes is to own it. I suggest you try to take one of those DAFNE course or so, if you haven't done it already. Otherwise there is tons of information online, including in this website, for insulino-therapy. But basically, I believe it is best that any diabetic learns how to use their BS readings and to adjust their lantus and bolus ratios by themselves, based on their own experience.

1 unit per 10g is actually pretty common I think? Although I am at 2 units per 10g, but I always felt a bit bad because I think it is high hahaha. Ultimately, the right dose is the one that works for you anyway.

I'm sure I will get my confidence back with adjusting doses myself but since I'm just getting back on track i want to make sure I'm getting it right! Even though it's all trial and error I know too well my consultant is referring me to a DSN and dietician as well as the DAFNE course so hopefully that will shed some light

 

[Kimlaah]

I also do 1 unit per 10g or if I'm having a snack any thing under 15g of carbs is okay for me not to do an injection and my latest hba1c test results was on the lines of like 89 I think... but my sugar levels are always With in 7-14! I think we have the same issue.. Message me if I can help I'll will try my best..

I never used to inject 15g or under either but the past couple of days I've found my bloods sky rocket if I dont my recent hbA1c was 88 and i have six months to lower them, not impossible but never as easy as it sounds thanks! You too

 

[himtoo]

I havent seen a consultant for 6 years and she said I was having a lot of hypos because I was still running on ratios for a growing teenager! So she is now treating me as a newly diagnosed adult to see how I get along, so far not so good

Hi @Kimlaah
a warm welcome !!
everything you have described suggests your consultant is sort of "starting over" -- an I:C ratio of 1 to 10 is the standard starting point.
just make sure to keep full records of everything and get back to your consultant next week if you have not settled down to normal sort of levels

we are all different so cannot advise on individual doses ,....... just be vigilant.

edit to add -- depending on how long you have been diagnosed -- perhaps "honeymoon period" could be ending too -- which will cause insulins needing to be increased generally.

 

[Kimlaah]

She did say that! I havent been keeping a food diary but I'm going to start tomorrow to see how different foods affect I've been diagnosed for 20 years so honeymoon period is long over!

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[himtoo]

sorry for the "honeymoon " reply -- was not sure !!!!

not sure if this helps --- but every couple of years -- I sort of start out looking at everything to see if everything is still the same -- as we age our requirements can change , our exercise can change , food choices , even the stress levels we have in work ----
basal testing is the place to start to find where you are at ----- https://mysugr.com/basal-rate-testing/

 

[Eldra]

I never used to inject 15g or under either but the past couple of days I've found my bloods sky rocket if I dont my recent hbA1c was 88 and i have six months to lower them, not impossible but never as easy as it sounds thanks! You too

If you feel like it is a difficult task, have a look at the success stories section of this forum. Keeps me up through the bad days hahaha. I'm sure you'll be delighted to discover many stories of people who went from 80-90 HbA1c to 50 or even lower in 3 to 6 months! A bit of motivation can go a long way indeed... It does sound like you are motivated! Confidence always comes back with practice and experience

 

[Scott-C]

@Kimlaah , DAFNE is very useful, but they seem to have an obsession about 1u for 10g being right for everyone, which it plainly isn't.

I'd been toddling along quite happily for 3 decades at something like 1.5 to 10, then at a DAFNE meal, they said, go on try 1 to 10 with that, I said, no, I'd be happier with 1.5.

Anyway, tried 1 to 10 to keep them happy. Guess what happened, ended up at 19, the highest I've ever been in decades (apart from an issue with a roti in a korean place).

To make things worse, the next time I went for a consultation and told them I was running 1.5 I was practically given a row seeing as I'd been told on the course that 1 to 10 was good!

This is a self treated condition. I ignore practically everything doctors tell me about T1, because they just read about it in books. If your ratios were working for you, and their's aren't, I'd just carry on as you were.

Ask your DSN if they'll give you a free trial run of Libre. I've learned more about managing my T1 in the last year with it than I did in the last 28. You can see the whole 24 hour movie instead of just a few strip snapshots.

 

[himtoo]

Hi @Kimlaah

with an HbA1c of 88 -- you could be probably high often( above 10 ) or yo-yoing between high and lows
this reinforces the need to have a real look at the proper basal dose of insulin you should be on ---- do have a look at the link I provided.

it is difficult to get your food insulin sorted if your basal is not sorted first !!!!

all the best !! and hugs too [[[hugs]]]

 

[becca59]

I have different ratios for the time of day. Higher in the morning, less at night. These ratios may alter also, depending on activities for the day (always need less on swim fit mornings, more on sitting in bed and reading mornings!)

 

[j@mez]

these consultants are terrified of hypos so they'd rather have u walking around with a BG of 15 all day than run the risk of a hypo.. hence why u need to learn to calculate and adjust ur own ratios

 

[Daibell]

Hi. Yes, 1 unit of insulin to each 10g carbs is the normal start point and currently what I use as it's right for me. I think as you get your confidence back you need to take on a bit more ownership of dosage ratios etc. Yes, do try to get the Basal right but having now split the dose makes it a bit more difficult; I don't split mine. It sounds like DAFNE may be very useful for you. A final point, beware dieticians as they often haven't a clue and may just follow guidelines they are given based on questionable research. It's your choice but look at guidance around these forums as well including the low carb aspects.