High blood sugars but low GI eating. Max 100g-120g carbs a day.

80 Levemir /day seems really high for a lean and active T1 on a low carb diet.

As your diet is low fat that suggests a significant proportion of your macronutrients are coming from protein, and in particular you are probably deriving carbs from protein. So in effect you may be on a Medium Carb Low Fat diet, which is probably not what you intended.

I would do a 12 to 24 hr fasting test to validate your basal rate is correct and not too high. You may find that your basal rate is high, that you need to increase your bolus ratios, carb count for you bolus, and possibly protein count your bolus as well.

Having said that some kind of hormonal change is worth getting checked out for.

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pennyjwills said:

I get a lot of my carbs from low gi fruit and veg and vegetarian protein sources. Where do you get your fat from? I eat nuts like almonds and I buy meridian peanut butter as the only ingredient is peanuts etc

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That peanut butter's got, what, 10-15% carbs?

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pennyjwills said:

I'm not aiming for low carb just not going ott on them. I have the peanut butter about 1-2 tablespoons a week so its not a big impact. I could send screenshots of my myfitnesspal diary so you could see i'm not low carbing but just trying to not eat fast acting starches. My fat averages on 30-35%, protein on 35-40% some days and rest is lowsugar hitting starch. I eat a lot of lentils, beans and pearl barley. I make pearl barley risottos and lentil dahls.

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Ok my guess would be you need to get the basal dose down and the bolus ratio up. You've got around 80% of your daily insulin as basal and unless you are on a low carb diet, that's unusual. Can you do a 12 or 24 hour fast to check your basal? The fast should help with your weight loss goals, as a bonus.

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pennyjwills said:

I can live off tofu and green veg broth for a day this weekend. That should do it maybe?

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Well not ideal But it should at least show if your basal is very high. Is it a broth with no bits in, a clear consume? Could you skip the protein? For 12 hours even?

If you find it very difficult to fast, that in itself suggests your basal may be too high (as one possible explanation).

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What insulin:carb ratio and correction ratio are programmed into your Accu Chek's bolus calculator?

For the egg white omelette, that's nil carb, so am I right in thinking the 8u Novorapid was purely a correction dose for the 13.3 mmol/L reading prior to the omelette? Roughly 1u = 1 mmol/L correction ratio?

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What was your carb estimate and basal insulin dose for the 7.30pm meal, what was your BG before that meal, and what time was bedtime? Asking because so far it looks like either your basal is too low, which would be very surprising, or your food and/or correction ratios are too low, which would be less surprising.

Despite the 40% carb macro, with your 30% protein macro you may need to bolus dose for protein. That's a possible explanation for the slow rises a long time after meals.

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I also find I need to do a bolus dose 2 hours after eating protein as I've found protein to typically hit me 3 to 5 hours after eating.

One other interesting thing to note is that the profile of Levemir is not as flat as Lantus. The way in which Levemir is absorbed is different to Lantus which likely explains the difference.

Here's a link which shows how the profile and duration of Levemir changes with different doses (marked as units per kg of body weight)
http://www.lantus.com/hcp/about-lantus/vs-detemir

Note, this is a rival firm providing this info but I'd like to think there's no deception going on.

I take Levemir and it took me a few years to figure out exactly how its profile and duration work.

Might I also suggest that taking 40units in one go might be causing you some issues as well. I was on a similar dose pre pump, and kept having to up it and up it as it appeared it just wasn't working. when i changed consultants to go on the pump she suggested that I split my already split dose into 2 lots of 20 at the same time but it just reduced the pooling effect and helped to stabilise the highs. Also I would be inclined to suggest oher sites as well. Try different length needles for different areas of your body, to see if that helps as well as carefully examining before you inject. I know from experience it's so easy and your arms and hands go to similar type places that they are used to. Your basal does seem to high in comparison to your bolus at first glance so I'm wondering if because of the PCOS some metformin might also help? I would eat a similar sort of diet to you have a similar BMI and would take 22units basal and up to 15-20 units bolus a day (albeit on a pump) I also have PCOS and 4 ovaries, so know what a pain in the bum hormones are! I would try and improve your sites and see if that makes a difference, if it doesn't I'm always inclined with ladies to think hormones either through stress or just being a lady.
As for losing the extra bit of weight (I'm also on a bit of a mission myself after 6 months in front of a computer and going to class/ stress munching). Whenever I hit a bit of a plateau I find it helps me anyways, to change excercise, so that you are excercising different muscle groups etc, and also to step it up another gear just to shift that last little bit you want rid of. I've always had to do it, For example I've easily lost 3.5kg in a couple of weeks but fo the past 3-4 weeks I've just stayed the same. Time for me to switch from cycling to swimming then maybe running, every time when I hit a flat increasing the intensity.
Just a few suggestions don't know if it helps,
Laura

Spiker said:

What was your carb estimate and basal insulin dose for the 7.30pm meal, what was your BG before that meal, and what time was bedtime? Asking because so far it looks like either your basal is too low, which would be very surprising, or your food and/or correction ratios are too low, which would be less surprising.

Despite the 40% carb macro, with your 30% protein macro you may need to bolus dose for protein. That's a possible explanation for the slow rises a long time after meals.

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I'm guessing but it may be a slowly absorbed protein, because it is locked up in a low GI carb. lentils, beans etc

I am curious about your high protein intake. Why do you prefer to eat so much protein? And so little fat? If you cut 10E% protein and had fat instead that might help with your bg.