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How often are you high?

S

Sophielouise

Active Member
Messages
30
Type of diabetes
Type 1
Hi, I'm really struggling to keep my sugars within this tight range, (I believe it's around 4.0-7.9?) so I've just been trying to keep them below 10. Turns out that's harder than I thought it would be, actually.

I've had diabetes for just over 20 years now, I'm 31 and not in the low enough range (7.1% last review) for having a baby so wanted to try sort myself out over the next year. Unfortunately, my Drs and healthcare are really useless and keep telling me conflicting things so I've had to resort to the Internet, which is also very conflicting.

My question is; how often are you going high (my opinion of high is 11-18) a week? Because at the moment I'm hitting 10 once a day and 13 every other day. I've been running the rest of the time between 4.5-8.5. Is this going to set me up for another fail at my review and ruin my body?

I suffer from depression and anxiety and am really unsure of what is safe and normal. I want to give up but obviously I can't.
 
hi there @Sophielouise
welcome to the forum

all of us are different and what we deem to be high will vary slightly.

for me any blood sugar above 9.0 is high to me.

I have recently started on a pump and have been getting good results but even with that being said i had a 10.0 ,and a 7.8 today amongst my 5's and 6's
in the past 2 weeks I have had a few ( about 4 or 5)results above 10 but nothing above 13 --
try to look at it in small chunks and just concentrate on today --

all the best
 
If I wasn't testing my blood every hour id be going a lot higher sometimes because I'm managing to catch it in time before it goes higher than 12 usually. It's driving me mad, this can't be right. I don't understand why my sugars continue to rise 3 hours after I've eaten sometimes and drop others. My body is trying to kill me.
 
i am currently testing about 15 times a day so my heart goes out to you-- you seem to have hit a nail on the head -- our bodies are trying to kill us

stick with the forum @Sophielouise -- we will all do our best to help

perhaps you could revisit basal testing as a starting point to make sure background levels are right
link here --http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

there are some great female members of the forum that have some insight into female hormonal issues that relate to BG levels as well.
tagging @azure , @mrspuddleduck and @Mrsass and @ArtemisBow for they might be able to shed some insight on your issues right now.

bless you hun I know you are having a bad time of it now but things will get better.
 
Thank you for your support, no one has ever told me how to test my basal apart from telling me hypos in the night mean I'm taking too much. Which I'm currently having every night for the last week but am able to run a bit lower usually in the day. So even if I do this I'll still have to work out what to do by myself anyway.

I can't really eat low carb and fat cos I'm under 8 stone and vegan. And I'm not on a pump.

It's insane how little help I've had from professional doctors and nurses. One told me to go to bed at 14 to avoid lows in the night.

I'll definitely have a chat with some ladies about hormones because it's clearly a problem.

Thanks again!
 
Hi Sophielouise!

You say you are testing every hour. Here are some things you ought to know:

We digest different meals at different rates (even eating the same meal at the same time as yesterday our body can decide to digest it differently). Unfortunately our NovoRapid has a fixed release rate. So, it is designed to release more SLOWLY than most meals (otherwise it would be too easy to go low).

So, if you take the correct amount of insulin to cover a meal, sometimes your sugar will spike very high before coming all the way back down; other times it will rise more slowly and then come back down. It depends on how much quicker you digest your food compared to the release of your NovoRapid.

For most people NovoRapid is "finished" at about the 4 hour mark, which is why your sugar reading 4 hours after a meal is a good way to work out whether you took the right amount of insulin. Your sugar reading 1 hour after eating a meal is highly dependent on digestion rate and is more a question of what you eat and the timing of your insulin.

If you are always high 1 hour after a meal, you can use various approaches to speed up the insulin release, like bolusing earlier before the meal, massaging or exercising your injection area (to increase bloodflow), or splitting the bolus into two sites. Alternatively you can eat a bit less and turn the remainder into a snack (no bolus) a couple of hours later.

If you haven't yet tried downloading your meter history onto your computer, try it. Seeing a graph of your sugars, especially if you are testing ever hour, can help you spot patterns.


I totally get what you mean about your body trying to kill you! I'm a 27yo guy but my insulin needs seem to have a mind of their own, as if I had raging hormones! My most important tools in this regard are my CGM (I pay out of pocket) and intramuscular injections.

Are you on Lantus? If so, have you considered Levemir? It allows you to have different basal levels during the night and day. I'm on a pump and at the moment I need very low basals during the day (roughly .1u/hour) and much higher basals at night (.8u/hour). Otherwise I will seesaw a lot during the day. Although from what you've said, perhaps you need higher basal during the day than the night?

It took me a long time to realise that hypos, especially overnight hypos, make me very prone to depression. Although I don't know if this is a common problem, I would suggest you back off on the basal until you get rid of the nighttime hypos.

Hopefully this helps, please let me know if you'd like me to clarify anything.
 
Hi @Sophielouise, have your bg's always been hard to control or is it just recently? 7.1 is not the end of the world but if you are planning a family it's better for you & baby that it's lower.

Do you go to your gp surgery for your diabetes care or your local hospital? Could you ask to be transferred to somewhere they are a little more bothered about helping you?

Is there a pattern to when you are hitting the 10's & 13's? A certain food you are having, a certain time of day? When you mentioned hormones, obviously this affects bg too, during my time of the month my bg & insulin needs go way down but I know girls on here say quite the opposite so you will have to see which way your body reacts and adjust & test as best you can during that time.

I would follow @himtoo advice with the basal testing as I do think this may help with the day time highs/ night time hypos.

You mention your anxiety/ depression, are you on medication for this? As this can affect your bg's, I suffer anxiety from time to time and when I do it sends my bg's crazy!

Whatever you do don't give up, your diabetic team may be a bit useless but there is lots of people on here willing to help as best we can, we may not be medically trained but we know a bit about diabetes management
 
Hi Sophie

So sorry to hear you are struggling - it's very frustrating when you want to start a family as the targets become even stricter than usual.

First things first, as others have said, you need to try and check your basal rates at all times of the day. If that's ok it's a factor eliminated and you can then move to checking each other bit in turn.

Have you spoken to the nurse about the possibility of a pump? This would help tremendously if the issue is varying basal requirements across the day.

Hormones can play a big role - personally I run high for a few days before and then drop like a stone during my period, but other women have a different experience or no change at all.
 
Hi

Firstly, you sound like you're really putting the work in to control your sugars, so we'll done. The fact you're still having highs shouldn't detract from how hard you're working.

As others have said, do a basal test first to get your basal sorted. That's the foundation of control. If you're still having hypos at night, then you could look at an insulin change if some kind or a pump. Pumps are fantastic for keeping sugars steady overnight.

If you're spiking after meals, try having your fast acting insulin earlier. Move the injection earlier but by bit and cautiously. I find the timing can have a huge affect on blood sugars. It sounds simple but it can work great.

Take one thing at a time and try to improve it. It's overwhelming when things seem to be going wrong left, right and centre, but just go along steadily and sort one thing at a time.

If I have a change of routine or miscalculate carbs I can have a high, but it's usually 10 or under. I only get up to 13 when I have problems with my pump sets. This happens on average every couple of months I guess.
 


I find that my BG peaks at around the 3rd hour after insulin/eating, it will usually come back down if I leave it, but not much. I usually try and inject 10 minutes before I eat if I'm between 5-8 and up to an hour before I eat if I'm more around 10/13 mark.

I'm taking Lantus and have been for most of my Diabetic life. What's Levemir? Is it right that my basal is probably a unit too high if I'm having lows in the night?

I was considering injecting bolus a sort of correction dose half an hour before eating, and then the dose for the carbs I have eaten straight after I eat. I know this is insulin stacking but I wonder if this will help me with my 3rd hour peak, in theory. Because I get quite stressed about making sure I eat the right amount I have injected for and have recently had a few insulin overdoses due to this.[/QUOTE]
 

It was my last review that I hit 7.1, previously I think I was 6.5. So it seems to be recently due to hormones and stress probably. I came off anti-depressants a couple years ago, so seems to have been a problem since then. I am currently not taking any medication for depression or anxiety.

I go to my GP surgery for my annual reviews and blood tests (always normal apart from slight increase in liver enzymes last time but not a concern apparently) and speak to a diabetic nurse who doesn't know anything, and I have seen a specialist consultant at the hospital who told me to stop snacking and insulin stacking despite my problem with eating small portions at meal times due to my anxiety, he then referred me to a Diabetic nurse and Nutritionist at the hospital who told me to eat nuts to my hearts content, and avocado etc before bed. Which I have recently discovered is why I have been peaking due to the high fats. So thanks for nothing. I tried the no snacking plan for 3 days and had panic attacks, couldn't leave the house, was close to fainting. It's just something I can not do and he doesn't understand that.

The pattern of hitting the highs tends to be 3 hours after a meal I don't think I have taken enough insulin for. But it's quite shocking considering the Diabetic nurse calculated I should only need 2 units for 40g of carbs, when now 5 units just about covers that. It should be noted that I am currently PMSing, but it usually lasts for about a week for me and is quite random too, so I have to work out how to deal with it when it strikes somehow.

Thanks for your help!
 

I really can't consider a pump because it would only add to my depression. I am very skinny and do a lot of modelling jobs so it's not an option.

I think I didn't always run high before my period, it's only been since I have been very PMSy that it's been bothersome. But yes, like you, I drop when my period starts or just before.
 

Thanks for your encouragement!

I have sort of tried the night time basal test accidentally because I eat very healthy dinners and then ate nothing for 5 hours and tested my blood and I was low. I also find that if I don't have a snack at about 10 I will wake up low in the night without fail.

I sometimes do have my fast acting insulin earlier and it tends to make me spike at the 3rd hour mark. The times where I have spiked considerably less is actually when I've been already quite low (4.3) and eaten my meal and then injected directly afterwards.

I can't deal with the prospect of a pump because of my depression and my line of work.

It's so shocking to discover that everything you thought was ok for 20 years is actually not ok, I feel like I've just been diagnosed.
 
Spiking at three hours is unusual (to me). Does that happen after every meal or only certain ones? Perhaps you digest your food more slowly than me? Have you considered checking your insulin to carbs ratio?

I know some people don't like pumps - I resisted mine for years. I thought it would brand me and imprison me, but actually it gave me back my freedom. It means I can, for example, have 0.1 units of basal during the night to avoid hypos, and 1.2 units early morning to stop my Dawn Phenomen. Ive worn my pump teaching and dealing with violent people.

I really do think it's your basal you need to examine. I haven't used long acting insulin for years, but there are many, many knowledgable people here who can share what they do

There'll be an answer for you. You just have to find what works best for you as an individual.

I meant what I said about your dedication. You'll get the diabetes beast back in its cage soon
 
i have a reading above 10 usually every single day. i don't usually go above 16 every day though, maybe 4 days a week? i don't think you should beat yourself up over going over 11 every day! just as long as you correct and can bring it down x
 
Hi @Sophielouise, I'm with whoever suggested changing basal insulin. Insulin glargine (Lantus) is known to have a greater coefficient of variance in T1Ds than Insulin Detemir (Levemir) so it should make it easier to control your glucose by swapping. Two doses of Levemir a day is also now the NICE guideline.

If I was you I would go to your team and ask to change over. I did this about a year ago and it made a tremendous difference to my fasted glucose levels. Lantus was very up and down versus a much smoother release profile from Levemir.
 

As a CGM user, I have worked out how to respond to certain sugar curves. This may not be appropriate for you, but it is what works for me.
  • If my sugars are reasonably flat and suddenly start rising around the 3rd hour (e.g. 6, 6, 8, 13) I would increase my basal at that time of day
  • If my sugars rise steadily towards the 3rd hour (e.g. 6, 8, 11, 13) I would increase my meal bolus.

Sophielouise said:
What's Levemir?
Click to expand...

Basically Lantus lasts about 3 days and in theory provides the same basal rate all day and night, whereas Levemir (AKA detemir) lasts about 12 hours, so you take it twice a day, and this allows you to have different basal levels during the day and during the night.




Sophielouise said:
Is it right that my basal is probably a unit too high if I'm having lows in the night?
Click to expand...

Probably. My philosophy around diabetes is "there is no RIGHT answer... there are just options that WORK and options that don't, there are options that are easier and options that are harder". Everyone's body is different, anyway; a good doctor says "because your body is behaving like this, you should try this". A bad doctor says "because you have diabetes, you should be doing this".


Nothing wrong with trying it! Insulin pumps have an "extended bolus" feature that spreads out a bolus over any time period you desire, whether it's 30 mins or 3 hours. Pump users often use this for slow-digesting meals or when they are grazing for hours at a time.

There is nothing wrong with "insulin stacking" except that it can make it harder to draw conclusions from your readings. If you are doing it for good reason and it works, go ahead.
 
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Hi @Sophielouise, i like yourself am wanting to lower my levels as i want to start a family (hopefully) and my last hb1c was also 7.1% (how strange). I am also on lantus (taking twice a day) and was noticing that my levels were always high (about 10) just before going to bed and then i would end up hypoing in the early morning.

My dr decided to give me the dexom to see what was happening (i go to get the drs opinion on what to do next tomorrow). I have myself noticed some things though.

Yes my blood sugar was rising about 3 hours after my meal (no matter what i ate) so im thinking this is something to do with my basal rates running out but i dont want to increase them as things seem ok during the day and i dont want to start having hypos. I also noticed that my sugars were coming down overnight (i experimented by not taking any fast acting to reduce them as she didnt know what was causing my hypos - novorapid or the lantus), i have slowly been reducing my lantus over the 2 weeks and finally went without a hypo last night (although i did still go to bed with a sugar of 11), my next step is to get a normal sugar before bed and see if i hypo on the current dose of lantus and if so i will reduce again (i have gone from 15 to 9 in the past 2 weeks). I also saw certain foods affected me more quickly than others and have made a note of these so i know i need to pre bolus.

I think my dr will recommend a pump personally as i will then be able to have more basal in the evening when my sugar starts rising but i will see tomorrow what she recommends. Keep talking to your team and hopefully you will be able to get something sorted to help you.

Good luck!
 

I think rising 3mmol after eating isn't too bad really, I expect that because it then goes back down if I don't eat anything else, usually.

What's your evening routine? Do you have a snack about an hour before bed? I used to always do that (around 15g of crackers if I was reading below 8) which would reduce the risk of hypoing in the night. But have stopped recently because I assume that it shoots me up high which is why I don't have the hypo.

Last night I had too much bolus for the amount I ate (it wasn't a very nice dinner!) and then was low after. From that point until 6am this morning I was checking my blood every hour and eating biscuits, drinking Coke, eating glucose and my blood sugars refused to go above 10 and would then drop again a couple hours later, and they would drop fast. I should note I did exercise yesterday morning too.

It wasn't until 6am when I ate some oats and hit 10 that I got a few hours sleep and woke up still at 10 because my lantus was running out.

This is quite disturbing to me. I haven't actually slept properly without a hypo or getting woken up early feeling low, for over a week now. I reduced my lantus 2 units yesterday. I'm having another low evening again because my meal was delayed.

It's kind of making me want to go back to running a bit higher because I can't handle this anymore.
 
Mine doesn't go down again and this is the problem (im ending up at 10 for hours unless i correct - which obviously isnt good for the ha1c).

I dont usually eat anything before i go to bed as i always have a carb evening meal and sometimes this isnt till 8pm.

I sometimes have that problem when i exercise, i ran 40mins the other day after not going for 2 weeks due to a cold and it must have been a shock to my system as i couldn't keep my sugar up, even ended up eating 30g of cereal (about 25 carbs + milk) before i went to bed and still ended up hypoing (this was before i lowered my lantus).

I know the feeling, like i say i went nearly 2 weeks without a low in the night/early morning but running higher isn.t really an option for us if we are wanting to get a lower ha1c for pregnancy really, dont you think? we just have to keep adjusting so we end up not having these darn hypos, waiting to see what tonight brings! (and what the dr suggests tomorrow)
 
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