I really need some advice from all the experts on here.

[kevinmartin]

I was diagnosed nearly 2 years ago at the age of 39 with type 1 diabetes.In that time I have really tried to get my BG under control but I know that it could be better.I have almost resorted to eating the same foods at the same times in order to make it easier,but it still isnt as good as it should be?

I have 50g of Cornflakes in the morning and inject at a ratio of 2.5g carb to 1 unit of novarapid.Basically after 2hrs im in the 4-6 mmol range.However today injected in my buttocks & it was 9! I know its slower acting in that site but should it be that much slower?

The problem I have is after the first meal of the day after the 2hrs my BG drops rapidy maybe 4 points lower by the 3rd hour.Is this normal? So i have to consume probably 2 weerabix and a couple of fruit juices (90g carb approx) to counter the drop.

Then on my main meal 6-7 hours later I have to change the ratio to 6g carb to 1 unit of novarapid to get within the 4-6mmol 2 hrs after.Thats normally fine but after the 2hrs there is no drop like for the first meal.Again dont know if this is normal?

Before I go to bed I have a few ryvitas & inject at a different 4g carb to 1 unit ratio
So its gone 2.5, 6 then 4.Plus I inject 27 units of insultard at this time before bed.

If anybody could give me any advice on how they keep there BGs pretty much in check I would be most grateful.I will do anything to solve this problem.

Thank you

 

[Pneu]

No doubt someone with more experience will come along but you need to consider the following...

Your novo works for around 4 hours and therefore will continue to have an effect (abit lesser) after two hours..

Your morning issue I would guess is one of speed release.. those cornflakes are going to convert to glucose pretty quickly... probably within the first two hours.. so your novo is acting on those carbs and reducing you back down.. post two hours you are getting no effect from those cornflakes and therefore the novo is just reducing your BG.. I would try and eat a breakfast that has a slower release of carb rather than a rapid spike..

I would guess on your main meal you are eating carbs that are releasing slower.. i.e. you are eating carbs with fat and protein which slows down the release.. rather than just a straight carb meal.. hense you aren't seeing this rapid spike and then drop

Change in carb ratio over the day is totally normal

 

[jopar]

I very much suspect that it's your background insulin that is out and might be causing a large potion of your problems..

Novorapid, by 2 huors 80% of your dose will be used, if your dose is correct for what you eat, your 2 hour BG will be very slimilar to your pre-meal BG, the remainly 20% will have only a slight affect on lowering your blood glucose..

Looking at your background insulin

I suspect that your dose is too high, and at points of the day you are swimming in insulin, hence the large drop....

Our basal (background) profile will be a serries of troughs and high's as the liver flucuates the amount of glucose it delivers to the blood stream... what we try to do with our background insulin is to level off this as much as possible.. If the your background dose is wrong, the at certain points there isn't enough insulin to control BG, and it will rise, when you hit a trough then the background insulin will lower the BG.. Fasting tests are the only real way of finding out if you have your dose correct if correct, your BG what move from the starting BG by anymore than +/- 2mmol/l..

Because of the nature of MDI the profile can't be totally flat, so we use carb-quick acting ratio's to over come some of this...

It sounds as though your dose is too high, you need to check the correctness of the background, it may be that as well as reducing you might have to split your background dose, to better control the morning from afternoon/evening a lot easier..