Honeymoon problems

[LaughingHyena]

Over the last couple of days I've been having quite a few hypos, generally only just dipping under 4 but still not good and seemingly not very predictable. Last month I was having problems getting my levels down!

We'd assumed my levels were creeping up as my honeymoon ended (diagnosed a year ago this week). Now it looks like it's not quite over.

Is there any good way to handle these slightly random numbers. I dropped my lantus down a little last night, but should I change my ratios for novorapid as well? Grr I just thought I had all my ratios sorted out for a bit.

 

[Snodger]

they really shouldn't call it a honeymoon, should they? it's so much harder to cope with than a properly failed pancreas.
Sounds to me as if you are doing the right thing. I would probably leave it a couple of days now you've dropped the lantus, to see what happens to your other ratios, but it will depend what your pancreas is doing. If it's decided to just dribble out insulin all day at a low level, then reducing the lantus should help, but if it's decided to try and respond to the meals you eat, then maybe you'll need to reduce the bolus dose as well.

If the pancreas is trying to respond to the carbs in your diet, I wonder if trying low carb for a bit might help smooth out what it is doing? I'm not a low carber so I really don't know if that would work, but maybe someone else on here might be able to advise on that.

 

[LaughingHyena]

Well dropping the lantus didn't help that much, still had a couple of lows yesterday. I suppose it might take a bit longer to see results.

For now I've gone back to the ratios I had working a couple of months ago, we'll see what happens.

I had thought about low carb to see if that helps but for now I've been sticking to the same few meals that I know the count of pretty accurately.

 

[RussG]

Hi LaughingHyena,

I started on insulin in December 2010 and have had a similar experience. I have had on average 15 hypos a month for the last 3 months, but these have been slowly dropping off and this last week I have suddenly gone the other way and my insulin requirements have jumped. In discussion with my DSN I moved from twice daily levemir to once a day, and that did seem to help with lunchtime and early evening hypos. I also dropped my apidra doses, if not the ratios per se. I was having the same breakfast every day and dropped from 8u to 6u in the morning (strangely I now seem to need 12u, but there you go!). I've never had night time lows and my morning levels are stubbornly high, at about the 7ish mark, so it was breakfast to dinner that was the problem.

For me, this was a basal problem, but it's not like the different insulins know exactly which bit of glucose they are targeting so bolus also comes in to play. The standard advice seems to be change lantus 2u with at least 3 days between changes. I don't think this is terrible advice, and would leave a few days but might personally be inclined to be a bit more adventurous with the amount of lantus. I dropped fairly quickly from 24u levemir per day to 15u and this did really help. You need to make a decision based on your results though, obviously. What worked for me might not work for you.

Are you getting much advice from your DSN? Most of my changes were done after phone discussions with DSN and a face to face meeting to try and bottom out the problem.

 

[Fallenstar]

It is hard the honeymoon period, though as I'm sure you have read all over these boards it is not that much easier with fluctuating levels even when the Pancreas has given up the ghost for a lot of people...sorry to be the bearer of bad news but that is the difficulty with trying to replicate a natural delicate process that is influenced by so many different things....but we try

I agree with Russ, the standard advice is to move the Basal by 2 increments and wait and see...sometimes you do need to be a little more adventurous like he said, in how much you adjust it by. Though certainly wait the three or so days before another adjustment or you may get in a muddle and the Bolus does have a bit of a back log effect so you won't get a true result if you do not give it a good few days.
I need to really adjust my Bolus by a big jump backwards every month at the TOTM otherwise I am living in Hypo city :shock: but I am used to the self adjustments now..Too much Bolus really can have a massive effect on your basal routine and make it a lot less controllable, so I have learnd to now adjust this back and go from there and it seems to be working, well for me anyway but we are all so different and it is trial and error and a lot of finger pricks!
Good luck I hope things settle down in time for you....sooner rather than later

 

[LaughingHyena]

I'm kind of inpatient in general, I don't like waiting for changes to kick in :lol: Still helpful to here that they probably will do at some point.

I haven't spoken to my DSN about the current changes, was at the hospital with the consultant a couple of weeks ago discussing increasing insulin as my numbers were going up! If things don't settle in a couple of days I'll give her a ring. Though generally I find I get more useful day to day advice from folks on here.