morning levels

[pinkscaffold]

Hi this is my first communication. I am feeling pretty low. I have been type 1 for 44 years but in the last year I have had problems with night hypos. I was changed to tressibo from Levimir and this has helped the hypos, less frequent but my morning readings are always 14 to 18. Don't know what to do

 

[becky.ford93]

Has anyone ever spoken to you about a pump? Or have you considered it yourself? I've heard that having significant dawn phenomenon which cannot be solved by insulin adjustments alone can make you eligible for one

 

[himtoo]

hi @pinkscaffold
welcome to the forum
43 years here -- tis a bit of a long time isn't it ??

I suppose the very first thing is to have a look at basal testing -- link here http://integrateddiabetes.com/basal-testing/

to make sure you are actually on the right dose

i see you are on tresiba which is an ultra long acting insulin that you will take once a day ( am assuming )
have you discussed with your DSN the possibility of moving the time of the injection - even though this insulin has a flat profile the time shift in injecting could possibly help.

glad to have you here

 

[pinkscaffold]

hi @pinkscaffold
welcome to the forum
43 years here -- tis a bit of a long time isn't it ??

I suppose the very first thing is to have a look at basal testing -- link here http://integrateddiabetes.com/basal-testing/

to make sure you are actually on the right dose

i see you are on tresiba which is an ultra long acting insulin that you will take once a day ( am assuming )
have you discussed with your DSN the possibility of moving the time of the injection - even though this insulin has a flat profile the time shift in injecting could possibly help.

glad to have you here

I know this sounds ridiculous but I think having been diabetic for so long I have not been updated on all the terms used, I don't know what basal and bolus mean? the time for my tresiba was changed from evening to morning but hasn't solved the high morning tests?

 

[robert72]

hi @pinkscaffold

43 years here too

I have been on Tresiba for about 18 months and find it very flat.

Basal is the background insulin and bolus is the mealtime insulin. It would be a good idea to do some basal testing to make sure you are on the correct dose of Tresiba. This link explains how to do it - it's written for pumpers but works just as well for us: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

You might find that you're affected by 'dawn phenomenon' where your BGs start to rise from around 4-5am, or you might get a rise when you wake up like I do. You will only really know what's causing your high morning BGs by doing some overnight testing.

 

[pinkscaffold]

It does look complicated but I will talk to my DSN and see if he thinks its a good idea, I will try anything to get it right. I had a letter from my surgery saying I need to have a recent urine sample test repeated in 3 weeks as there was blood? I know at times the test I do in the night is not particularly high but is higher first thing before breakfast

 

[pinkscaffold]

Has anyone ever spoken to you about a pump? Or have you considered it yourself? I've heard that having significant dawn phenomenon which cannot be solved by insulin adjustments alone can make you eligible for one

Nobody has ever suggested a pump? I have always thought it would be difficult for me as I do tend to thrash around at night?

 

[himtoo]

Nobody has ever suggested a pump? I have always thought it would be difficult for me as I do tend to thrash around at night?

I just went on a pump 5 weeks ago -- it is called an omnipod and has no tubes to dislodge whilst doing the 2am boogie in your sleep
it is certainly something to consider

 

[pinkscaffold]

Thank you will bring that up as well, is the cost prohibitive?

 

[himtoo]

are you in the UK ??
if so it is funded by the NHS and as becky said the inability to get BG's controlled could be the factor that gets you approved for using a pump.
generally if your HbA1c is high and cannot be controlled using multiple daily injections or if you have impaired hypo awareness - these are the criteria used for determining pump eligibility.
there is usually a requirement to have done a DAFNE course ( carb counting ) too

there is also a commitment to testing BG's frequently too.

 

[pinkscaffold]

are you in the UK ??
if so it is funded by the NHS and as becky said the inability to get BG's controlled could be the factor that gets you approved for using a pump.
generally if your HbA1c is high and cannot be controlled using multiple daily injections or if you have impaired hypo awareness - these are the criteria used for determining pump eligibility.
there is usually a requirement to have done a DAFNE course ( carb counting ) too

there is also a commitment to testing BG's frequently too.

Impaired hypo awareness? my HbA1c is high, I haven't ever been on any courses. I spoke to a dietician a few years back who was very young and I felt expected a very strict regime. Any ideas what the blood in the urine could mean?

 

[pinkscaffold]

Impaired hypo awareness? my HbA1c is high, I haven't ever been on any courses. I spoke to a dietician a few years back who was very young and I felt expected a very strict regime. Any ideas what the blood in the urine could mean?

Sorry I am in the UK and at the moment I test 4 times a day

 

[himtoo]

blood in urine can be a urinary infection which could in turn elevate Blood sugars

get to GP asap on that

Impaired hypo awareness is where you don't always know you are going low before you test and find out you are low -- as though th symptoms you should have at 3.9 -4.1 have disappeared -- slightly sweaty brow , shaky feeling , a bit upset or angry are a few of the common ones

 

[pinkscaffold]

blood in urine can be a urinary infection which could in turn elevate Blood sugars

get to GP asap on that

Impaired hypo awareness is where you don't always know you are going low before you test and find out you are low -- as though th symptoms you should have at 3.9 -4.1 have disappeared -- slightly sweaty brow , shaky feeling , a bit upset or angry are a few of the common ones

I was just told to retake the test in 3 weeks? I'm pretty sure I am ok on hypo awareness, sorry I sound so thick, I'm not really I just feel I have let myself meander along for too long

 

[Daibell]

Hi. Basal/Bolus means you take both a Basal e.g. Levemir and a rapid Bolus for meals e.g. NovoRapid. Do you have both insulin types; this is essential for T1s? Do you carb count for meals if you do use the Bolus? Your blood suagr level would cause glucose in the urine. What is your BMI like? Do let us have more information.

 

[himtoo]

well you're in the right place to get motivated and there lots of great people on the forum to support you.