Hypos per week on pump

I've posted about my hypos before. I had a "scare" last year when I had my hba1c done just after returning from my skiing holiday where I'd been eating cake, drinking vin-chaud (hot sweetened wine) & running deliberately high as I was exercising all day. My hba1c jumped to 9.8! I tried to bring it down & ended up on 60+ hypos per month for a couple of months. My hba1c three months later was 6.5, which sounds great until you see the 60+ hypos statistic.

I've been working hard to bring down the numbers of hypos, of which I've always (since diagnosis 18 years ago) had a lot, around 30 per month.

I had my hba1c done last week & saw my consultant today. My latest level is 7.0. She's happy with this as I've got my hypos back to just under 30 per month and I'm happy as I had a four day period over new year where I had set failures & ate loads of the wrong foods & was reading 20s (even to 30s with the set failure). I still suffer from highs after meals (12-15 is the norm after a meal for me, but I return to normal level after 5 hours & repeated basal tesing shows that my basals are right, it's my absorption which is slow) & lows at random points. It is so frustrating. I showed the consultant my log for three days last week: same getting up time, same breakfast, same routine, no exercise the day before to interfere with things. On each day I started at exactly the same level (6.4-6.6), on the first day I was 7.6 3 hours after breakfast 6.2 before lunch. The second day I was 12.4 at 3 hours after breakfast, but back to 6.4 before lunch. The third day I was 3.2 3 hours after breakfast! How can I deal with all of that?!

To that end, she has said today that she'd rather that I ran a little higher even than 7.0 as an hba1c than continued to have so many hypos. I'm working on it!!

She's changed me to Novorapid from Humalog today, apparently that may get going in my system a little quicker & help bring down the post-prandial highs. I'll see what happens over the next few weeks.

Hi MPB,

I am in the same position as yourself re hypos and young children. I too have been told to run a bit higher, and reduce teh numebr of hypos...my consultant was happy with my latest HbA1C of 7.0 (from around 6.2) becasue of teh masssive reduction in hypos. I was not happy though!

I guess it is an indivisual thing..and depends on what happend when you have a hypo. It sounds that you are similar to me...shove a jelly baby in my mouth and keep going, where as I know others can be out of action for hours post hypo. I think they consider it a "quality of life" question. I am trying to reduce my HbA1c, but also reduce teh hypos. I have yet to find my "tipping" point. but I am getting there.

Hi Sugar2

Is there a valid reason why you would like your hba1c to be much lower than 7%? Do you think that you will develop complications if it's higher than 7%.

The tipping point for me with problems like background retinopathy is usually with an a1c of above 7.2%.

I'm fairly happy with an a1c in the very high 6's or low 7's as it also means that my awareness of when my bg levels start to drop (for whatever reason) usually is with a bg level of about 3.8-4.2mmol.

I think a lot of consultants now will be recommending an a1c to be somewhere between 6.5-7.0mmol to ensure that people are safe in recognising hypos before they drop very low. Low a1c usually equals low bg levels when using insulin. A pump is great and does even out the highs and that's why testing is so important.

Another reason for slightly higher a1c is the latest DVLA revelations and driving.

Hi,

I would be happier with a high 6. something, rather than 7.0...just because this is level that the study did, had as the value, above which, the risk of complication rose.I am lucky though, as I do not lose my hypo symptoms if I run a bit lower (although I do if I go very low).

Your point about the DVLA is an excellent one, and is part of the reason for my recent rise in average BG.

It is so individual. I am terrified of complications, as I have already had treatment for retinopathy..so really can not afford to let things slip.

Cheryl - I have exactly the same issue as you with unpredictable levels after eating the same food and sticking to the same regime. Basal fasting test seem to suggest basal rates ar right. Do you panic when you see readings of 12-15 on the pump - Im always terrified of those ketones!!

I'll be interested to see how you get on with Humalog as I'm on novo rapid at the moment too.

Riri- I'm changing form Humalog to novorapid. POicked up the rpescription yesterday, will fill my pump with it tomorrow & see how ti goes. The consultant said that it works slightly quicker than Humalog & is out the system sooner, so may be of benefit. But if your'e on it already & still have those 12-15s, then it may not make much difference, but we're all unique, so perhaps it will work for me.

I am so used to being 12-15 after a meal that I really don't worry about it. There seems to be nothing that I can do & I don't test for urine ketones so have no idea if I ever get them. I also don't start producing blood ketones until I'm well in the 20s. I had a cannula failure over Christmas & hit the 30s (too high for my meter to read so could have been even higher). My blood ketones only reached 1.1%, which according to my meter instructions is still considered low (of course nil is far better!)

I'm a perfectionist in life, so having to deal with less than perfect diabetes control is difficult, but I also know that there's no point in stressing over it as it's not like I don't try.

I had a PM form a chap who is in the same boat as both of us but didn't want to post online who found some comfort in the fact that he's not alone, so we can all take that. My father is diabetic (has been since he was 21), he used to get walking blackouts and do some very strange things when hypo. I don't know what his hba1c has been over the years, but treatment wasn't anywhere near as effective then as it is now. He has no major complications and is 76, so it's not all bad news.

Hi Ladies,
Obviously I have no idea what has been tried or not tried. So a few thoughts.
Basal I assume that is 100% correct or as nr as it can be.
If so then bolus needs to be looked at - as in the timeing and type of bolus given plus perhaps a problem with cannula length.

I have been chatting to a friend from another forum who like you had been having post meal spikes.
When chatting I told him I was getting a lot better results using steel needles and 8mm length. Infact no spikes after meals at all and was having to reduce insulin. He has tried the 8mm as well now and has reported back he has no spikes at all after meals.
Another thing to try is a slower delivery of your bolus and see if it absorbes better. With the animas I can get it to deliver a bolus over 6 mins.
Just a few thoughts to mull over.