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High sugar levels AGAIN feeling upset :(

My dr wants me to use levemir once a day. Also as I'm supposed to be using 1 unit for 10g of carbs increasing my bolus Wundt help neither wud reducing carbs as I wud just pass out. I'm beginning to think the basal bolus regime is rubbish it means injecting about 6 x a day lots of things to think of n worse control than what I had before. Think I'm just going to give up n go back to novo mix x2 a day
 
Kal said:
40ish give or take n depending on sugar levels
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that doesn't seem too high for a normal weight T1..most would suggest you start with getting your basal right with overnight and miss a meal basal testing

this online course and workbooks may help with your nurse and future course
 
B
jack412 said:
that doesn't seem too high for a normal weight T1..most would suggest you start with getting your basal right with overnight and miss a meal basal testing

this online course and workbooks may help with your nurse and future course
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basal has been adjusted when it was higher I kept having hypos
 
@kai My bg levels tend to rise up a bit from about 4am in the morning onwards so although I needed to cover the high at 4am with more Levemir,, I also needed to eat some carb before going to bed to prevent Levemir giving me a hypo about 2-3am. Do you have a 0.5u pen at all as that would help you fine tune the Levemir dose at night and can you eat a snack before bed if you go hypo in the early hours? aSomething like a 5 or 10g cracker with no bolus and then get up about 2am to do bg test and see how high or low bg levels have gone with the increase dose.

Bolus basal is difficult at first but with some determination and plenty of bg testing, you can get bg levels in control.

Why have you transferred from twice daily to bolus basal?
 
Kal said:
B

basal has been adjusted when it was higher I kept having hypos
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I'm T2 but from what I have read here, If it was me, I'd still do a basal check, overnight and a miss lunch and test in the afternoon..to give a rough Idea of your 24hr level and if you need to do a full test
 
Kal

On an average day could you just say how much basal you used yesterday and how much bolus for foods and how much bolus was used for corrections?
 
I was ha
I was hypos without warning n I wud pass out.my pens are whole units. I always eat carbs before bed. I've been doin 2am tests for three wks now it's just making me tired. I have hypos at any time of day.
 
Dr
donnellysdogs said:
Kal

On an average day could you just say how much basal you used yesterday and how much bolus for foods and how much bolus was used for corrections?
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dr doesn't want me to correct yet. Average is 14 levemir on an evening n 5-5-7 of novorapid. At my wits end n feeling v depressed
 
Kal

When is your next appt with your doctor for him to review the cgm readings?
 
Ok...

Well you've got the choice what to do.. You can carry on at those levels for rest of week or you can phone them tomorrow... They will not mind as you should not be left at these high levels....

Or you can follow advice from iHs... As a 50+ year person of T1 and having used every insulin iHs does offer **** good advice on going. I know because I have had help from iHs and she saw me through some very tough times....
 
You need to ask for 1/2 unit pens....
 
What was yr bg before eating evening meal and how much carb did you eat? Has it been 3hrs since eating. 20.1mmol is really high and you need to test for keytones. You should really give yourself a correction dose. Look at the 100 rule on the internet. As a very very rough guide....1u bolus should lower bg by 3mmol so if this was me, I would use a correction bolus like 20mmol minus 9mmol (target) equals 11mmol. 11mmol divided by 3mmol equals approx 4u bolus correction. That should start to lower you but of course.....test bg every hour and drink water to flush the sugar build up out in the loo. If you start to feel sick, then phone hospital
 
Totally agree with iHs
 
Kal said:
Dr

dr doesn't want me to correct yet. Average is 14 levemir on an evening n 5-5-7 of novorapid. At my wits end n feeling v depressed
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Kai, if your having trouble with your basal insulin (levemir) then ask about changing to lantus, if you've already used lantus before then ask about Trisiba, this is a new basal insulin that just came on the market last year, there's a couple of members on this insulin and the feedback is very good, it lasts up to 44 hours and is injected once a day.
 
Hi iHs,
Hoping you can help re correction dose. I am very insulin resistant and my ratios using novorapid are 3u per 10g at breakfast, same at lunch and 2u per 10g at dinner. I take a split dose of 23u Lantus. I usually have around 30g carbs per meal ( unless I eat out or have a takeaway). I am finding that 1u doesn't really bring my BG down at all. Given that my ratios are fairly high would this suggest that I would need a greater correction dose?
Thanks in advance
Coleen
 
Coleen, you may want to enquire about Metformin if your becoming insulin resistant, although its mainly given ty tope 2's it is also prescribed to type 1's who have problems with IR.
 
noblehead said:
Coleen, you may want to enquire about Metformin if your becoming insulin resistant, although its mainly given ty tope 2's it is also prescribed to type 1's who have problems with IR.
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Hi Noblehead,
I forgot to mention I already take Metformin as I was misdiagnosed as T2 for 7 year so was already taking it when diagnosis changed. I could be wrong but I blame the misdiagnosis for the insulin resistance as was normal weight when diagnosed.
 

As you are using more insulin bolus for food than the typical 1 to 10g, your correction bolus will not be the normal either... The typical av diabetic is set up on 1 unit to bring down by 3bg however as you are insulin resistant you need to try adjusting an monitoring to find out your own level..

So, ideally you would try next 1 unit for 2.5bg drop. If that doesn't bring you down to normal target number after 5 hours then next time do a correction on a basis of 1 unit brings you down 2bg.

If you aren't at target level at end of 5 hours then you need to keep changing... However, if your levels are above 12 then your correction doses may not work so well as if your levels are less than 12.....
 
@colsan.... for correction doses to work well, the calculation needs to be weighed up on the total daily dose of bolus and basal insulin added together and then that gets divided into 100 to give the correction factor. But, the TDD also needs to be giving bg levels that fall within sensible targets. If the TDD is wrong, then the correction factor wont be quite right either but we all have to start somewhere so thats why the rough guide of 1u to 3mmol is used first of all and then if it doesnt seem to work, it can be adjusted up or down. You could have a go at using 1u to lower by 2mmol and calculate yr correction dose on that and use sensible bg targets to calculate to. Ideally, a bg correction should only be done after 4hrs of bolus unless mega high at the 3hr mark. Once you get yr basal dose correct which ideally is done by doing some fasting and adjusting it up or down according to what bg target you use. then all thats needed is to get the insulin to carb ratio correct by eating something like 20g carb and using a ratio. Most start with 1u for 10g but it can be adjusted up or down to suit the bg targets set out by dsn, doctor or looking at NICE.
 
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