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I haven't seen my BG in single figures in a week now... basal or bolus issue?

C

Catsymoo

Well-Known Member
Messages
301
Location
Portsmouth, United Kingdom
Type of diabetes
Type 1
Treatment type
Insulin
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Having diabetes
Hi all... really at my wit's end here and I feel like I'm starving. I've lost a stone in 3 weeks because my levels have been so bad I'm just not eating very well at all.

I've gone back to taking Lantus once a day and I am slowly increasing it. I saw a DSN last week who recommended not to split it at the times that I was. I've gone from 18 units to 31 units in the last 6 days and I'm seeing no difference in my levels whatsoever. I'm hovering around 14-16 and not seeing it budge. Living off eggs, cheese and meat atm. I was 16 before bed last night, I took 2 units of bolus.. wake up.. still 16. ***? Gonna fast until lunch time today and see what my levels do. I've taken another 2 units. I just don't know if the issue is my bolus or basal. The ONLY time I got a reading of 6.7 was after a night of drinking, for obvious reasons as I know how alcohol effects BGs. I've been offered a different basal last week (Tresiba) but I am not ready to switch just yet. I was too anxious. Any success stories with that?

The heat + no food is gonna make me so cranky today...
 
You don't say what bolus you're taking, but 2 units doesn't seem much to give you're bg a jolt. For me if running consistently high, maybe slight infection or body run down, a good hit of say 8unit fiasp as correction. I like to deal with it fast rather than dithering with a few units.
 
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Hi @Catsymoo, did the DSN suggest a different interval for the split from the times you were using? Just wondering. Lantus doesn’t last 24 hours at full strength and it’s possible that if you’ve begun to rise as the Lantus decreases in power then it’ll have a knock on effect. Are you correcting with a short acting insulin, giving yourself a bolus shot?
Another phenomena that was discussed a while back is that some people seem to become inured to Lantus.
Can you make another appointment with your DSN and if she or your GP can’t fix it then ask to see a Consultant?
 
Another question, if it’s bad now with Lantus could it really be any worse switching to Tresiba? It might be better. Knikki’s flourishing on it. When I switched from Lantus to Levemir the Consultant suggested starting on lowish doses and gently adjusting until the right ones were achieved. I soooooo glad I did as like you the Lantus just wasn’t really working any more.
 

Not sure if you know, but can you get Tresiba in cartridges, similar to Novo/Fiasp for the reusable pens? I want to switch but cant stand the tresiba disposable pens, they are just too big.
 
Of course, you are absolutely correct. Everyone is different and also many types of insulin. We all get frustrated with high bg. If it's ongoing for me, I like to give it a definate hit, that's all I'm saying. I've been on fiasp now for 12months after many years of novorapid. Fiasp for me is fast predictable. Anyway, apologies its off topic as your discussing basal.
 
Have you tried using new pens? I don't know where you live but the good weather we've had recently may have affected the insulin in the ones you are using.
 
Now the question about the Tresiba pen is solved, can we all get back on topic?
Thanks in advance - Mod team.

I deleted the additional answers to minimize the derailing, but decided to leave the original off topic question and it's first answer this time. Mainly because it was short and quickly solved.
 
Sorry guys, I've been working all day. Not had any carbs, lowest I've seen it is 13. I keep injecting 1-2 units a couple of times.

I have been advised by my DSN to only try and correct to 10mmol as I've had a 15mmol before, corrected 3 units, 2 hours later had a hypo of 1.8. I've increased my Lantus again today to 34 units. Going to keep testing and see how I go, and avoid heavy carbs. The bolus I take is Novorapid. I take Lantus once a day around 5:30pm. Used to split it 5:30pm//11pm but was getting weird ups and downs.
 
Hello I’ve switched from levemir to tresiba because of nocturnal hypos. It took me a good 3 months or so to get it right so now I’m focusing on my bolus and I’m not hypoing during the night.

Tresiba is indeed more flat line profile, one injection and it lasts around 36hrs apparently. I’ve never tried to skip my basal so I wouldn’t know if it does last 36 hrs. But within that 24hr period, my bg at night is pretty stable.

I’ve also switched from novorapid to fiasp because I spike horribly during the morning- afternoon. You could enquire about fiasp for your high readings because it kicks into action faster than novorapid.
What I will say is you need the give lantus a window to settle before making another adjustment. I would also agree running above 14mmol/l does make me a bit insulin resistant so it will need more to correct.
Also could I ask is it that time of the month? I know hormones and pms makes me run high during that time.
 
I would like to add if you have a libre, maybe that could help you determine what’s happening. Or if your hospital could loan you their cgm for a week.
 
I just wonder what your exercise levels might be? While everyone is different perhaps you could try taking normal meals and using your last prescribed dose, take a brisk 30 minute walk after breakfast and evening meals, if possible. Also maybe try ramping up your short acting insulin with breakfast and lunch by a unit each and again if no visible improvement. I figure that a rule of thumb is a daily dose in units around half body weight in kilos. Eg weigh 80kg then 40 units per day. Then increase upwards. However, everyone can be significantly different, so what I have always learned is small gradual corrections and follow up with the specialist each visit.
 
Sounds rough! The only time I get this kind of thing happening is when ill (could you have something brewing ?). I had to have extra insulin for 4 days over this weekend and then my levels just dropped back into place again. I hope you feel better soon as it is exhausting to be hot and have high bgs.
 

I too have had higher numbers for many days, yesterday and this morning they were very good. Sometimes, we just don't know why these things happen
 

Sorry to read of all your diabetes woes, how are you feeling today ?
 
Hi again guys,

I think my levels are slowly improving. I'm up to 37 units of Lantus now. I weigh about 13 stone.

Just have another quick question - what is a normal BG drop after a 1 hour walk? I was 13.3 before I left work, 9.9 after 1 hour walk home from work. Just wondering if this is too steep a drop and I need to reduce the Lantus, or sounds about right?
 

I think that is quite personal. I did 30 mins, I went from 12 to 7mmol/l. I think for some people exercise increases their levels.
With basal, you might need to seek out patterns to see whether it is too much or too little, possibly another basal test.
I think 9.9 after an hour walk doesn’t seem too shabby.
 
Thank you! I'm still trialing - I am not seeing a particular rise before my next Lantus is due, meaning it must be providing the correct coverage. Working on building confidence back with the bolus now. It's crazy how a few horrific hypos can mess up your control just because of anxiety. I've been like this for so long now.
 
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