Increase injections to 5 a day

[donnamum]

Sorry about the following essay. But need to set the scene before I ask the question.

Daughter fairly health diet.( most of you probably now that by now) Levels good.

Morning 4-5.5
Lunch time 6-7.
Pre tea readings 8-10..

Hb1c has gone up to 8.2.

Today went to clinic asked for suggestions on how to bring it down. They are happy with her well balanced variety diet, and couldn’t really recommend any changes.

I have noticed that her levels come down quickly after lunch, and tea, but remain higher for longer in the morning. She has breakfast at 7:30 they remain high ( 15-20) until about 11o’clock but are fine by lunchtime.

As the conversation went on it was commented that her Lantas must be right amount as her waking levels are between 4-6. But if her levels change we would need to consider look at injecting after supper. This would take it up to 5 injections a day.

So horrified by potentially having to increase injection, forgot to ask any questions.

So I’m asking you instead.

Could her supper be the reason for Hb1c being to high?

Would increasing injection be a way of decreasing her Hb1c?

 

[Tinkerbelly]

Sorry about the following essay. But need to set the scene before I ask the question.

Daughter fairly health diet.( most of you probably now that by now) Levels good.

Morning 4-5.5
Lunch time 6-7.
Pre tea readings 8-10..

Hb1c has gone up to 8.2.

Today went to clinic asked for suggestions on how to bring it down. They are happy with her well balanced variety diet, and couldn’t really recommend any changes.

I have noticed that her levels come down quickly after lunch, and tea, but remain higher for longer in the morning. She has breakfast at 7:30 they remain high ( 15-20) until about 11o’clock but are fine by lunchtime.

As the conversation went on it was commented that her Lantas must be right amount as her waking levels are between 4-6. But if her levels change we would need to consider look at injecting after supper. This would take it up to 5 injections a day.

So horrified by potentially having to increase injection, forgot to ask any questions.

So I’m asking you instead.

Could her supper be the reason for Hb1c being to high?

Would increasing injection be a way of decreasing her Hb1c?

Hi

I understand your concern over increasing your daughter's injections up to 5 instead of 4. I am just on 4 injections per day and this includes Lantus before bedtime.

From looking at your message I would say rather than use Lantus twice a day, try increasing the morning bolus up a bit so that the bg is lower by 9.30am rather than 11am. Also, try either increasing the lunchtime bolus or decrease the amount of carb your daughter eats mid afternoon so that her bg before evening meal is lower.

Many people can get fairly good control by using the effects of the bolus insulin to also partly provide the basal as well. If this doesnt do the trick and your daughter doesnt want to do 5 injections, then you might be able to ask for a change to a faster acting insulin such as Humalog or Apidra.

Hope this gives you some info.

 

[l0vaduck]

Sorry about the following essay. But need to set the scene before I ask the question.

Daughter fairly health diet.( most of you probably now that by now) Levels good.

Morning 4-5.5
Lunch time 6-7.
Pre tea readings 8-10..

Hb1c has gone up to 8.2.

Today went to clinic asked for suggestions on how to bring it down. They are happy with her well balanced variety diet, and couldn’t really recommend any changes.

I have noticed that her levels come down quickly after lunch, and tea, but remain higher for longer in the morning. She has breakfast at 7:30 they remain high ( 15-20) until about 11o’clock but are fine by lunchtime.

As the conversation went on it was commented that her Lantas must be right amount as her waking levels are between 4-6. But if her levels change we would need to consider look at injecting after supper. This would take it up to 5 injections a day.

So horrified by potentially having to increase injection, forgot to ask any questions.

So I’m asking you instead.

Could her supper be the reason for Hb1c being to high?

Would increasing injection be a way of decreasing her Hb1c?

Hi

I understand your concern over increasing your daughter's injections up to 5 instead of 4. I am just on 4 injections per day and this includes Lantus before bedtime.

From looking at your message I would say rather than use Lantus twice a day, try increasing the morning bolus up a bit so that the bg is lower by 9.30am rather than 11am. Also, try either increasing the lunchtime bolus or decrease the amount of carb your daughter eats mid afternoon so that her bg before evening meal is lower.

Many people can get fairly good control by using the effects of the bolus insulin to also partly provide the basal as well. If this doesnt do the trick and your daughter doesnt want to do 5 injections, then you might be able to ask for a change to a faster acting insulin such as Humalog or Apidra.

Hope this gives you some info.

You don't say what her bedtime readings are like. If these were my readings I would be increasing my lunchtime bolus as the levels before dinner are higher than before lunch.

The high HbA1c means that there's some high readings some time that aren't shown in what you've told us - maybe she's high all afternoon, or depending on what her bedtime readings are, after dinner.

I'd be adjusting the lunchtime dose and seeing what that does for three days.