High sugars - New T1 (LADA).

[SRO]

Hi All,

Was diagnosed T2 in October 2014. Didn't take it too seriously as I was losing weight (which I couldn't ever do any other way) - so loved every bit of this.
I started feeling pretty ill from around April/May 2015 but done nothing about it!

Over Christmas 2015, suffered a DKA and was admitted to hospital, where a T1 diagnosis was given.

Now I'm taking insulin and properly taking care of myself, got to get my sugars around 12 for the next 3 months, but I'm not entirely sure how to get them to 12.
I have an average reading of 16, and tried injecting a little more than I need at meal times to help bring this down - but it doesn't appear to help (and I don't want to inject too much).
I don't want to start screwing about with my basal dose in case this causes issues at night - petrified of having a hypo! (I inject morning and night of this).

Any ideas what I can do?
I'm not overly keen on cutting carbs - I've just started counting them, so happy to continue injecting as necessary.

Any help appreciated!

 

[novorapidboi26]

Hi,

What insulin's are you using....?

I see your reluctant to make adjustments to your basal but unless this is pretty much spot on, the adjustment of your meal time insulin wont be effective at all.........

so, you don't need to adjust the basal right now...but a series of basal tests at various points throughout the day would be a good idea...

overnight is usually the best place to start as any digesting food and active insulin is gone by that time....

I realise you may not know how to do this, do you?

If not, can your nurses help?

 

[SRO]

Hi,

Levemir as my basal, Novorapid as my bolus.

They have increased by basal recently by 1 unit, but I haven't noticed any change in my sugar.
Do you know where I can find information as to the timings of the slow release, or is it dependent on the person?

 

[tim2000s]

Hi @SRO, it sounds as though you haven't had a proper explanation of the two insulins.

The basal insulin is used to maintain a background level of insulin that, in the absence of food, ensures that normal processes that metabolise protein into glucose don't cause your blood glucose to rise.

The bolus, as you know, is used to manage the carbohydrate that comes from food.

Basal testing (https://mysugr.com/basal-rate-testing/) allows you to determine that your insulin is at the right level to maintain a stable blood glucose level in the absence of food.

Once you can confirm this, you will be able to go back to confirming that you have the right level of bolus insulin. This is usually described as an amount that, 2 hours after eating, ensures that your blood glucose hasn't risen more than 2mmol/l from where it was before eating, and returns your glucose to roughly the same level four hours post eating.

The attached document here: http://www.imperialendo.co.uk/CHO Counting.pdf is very helpful in relation to basic understanding of carb counting, dosage and adjusting insulin, and I strongly recommend reading it. You can also use the BDEC course to learn a similar set of skills.

The Imperial document will also give you an indication how to work out a correction dose allowing you to bring that 16 to 12.