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New T1 needs help with highs and lows please

RN25 said:
Ah ok, I will ask about that when I next speak to her. Could it be because I hadn't been eating carbs so she didn't have much clue as to how much I should start on?
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My brother is also on mixed insulin. He was diagnosed T1 in 2020. I wonder whether it's a regional health thing. He's in North Wales.

Edited to add diagnosed.
 
Just an update on this... it seems to be settling a bit now with lower highs after eating, although I'm still getting lows if not snacking regularly.Once it gets towards high 5s it plummets pretty quickly if I haven't snacked for a while. I'm wondering if it could be to do with honeymoon period or if it's normal to have to snack every few hours?
I've been having a more substantial snack at bedtime and that has helped with the overnight lows a bit, and dawn phenomenon seems to be less. Would that be as a result of less highs/ lows the rest of the time making my liver chill out?
I am getting beeped by my cgm at night time when my glucose goes to low 4s / high 3s. -happened about 4 times last night, with me having half/full oat cake each time. Would it be ok to reduce the alarm do you think? I'm wondering if honeymoon period would mean my own pancreas is trying to get me to high 3s, and if I stop eating the oatcakes it would just level out there? Or is it dangerous to let me go that low? I could eat a more substantial snack in the middle of the night but don't feel that's good for me really. I'm going to put so much weight on. And would probably go high too.
Thanks
 
not allowed to give medical advice. I can tell you my DSN set the low to 5 (as 5 to drive) i ended up very frustrated and set it to the default which is less than 4. Speak with your DSN for advice I would be asking what your current target range is (if not listed in your BG monitoring booklet you should of been given one) if its lower than the alarm then ask if ok to set at that value (even if only for night time. You could always set it higher during the daytime hours if your more comfortable with it that way
 
the other part can say CGMs are not to be used for medical decisions, they clearly tell you to check against a finger prick if low/high.
 
I have just had a call with the nurse and she had advised me to reduce my evening insulin to avoid the overnight lows so hopefully that will sort that problem.
She also said I could move to basal/bolus regime from mixed insulin if I prefer so will have to think about that.
 
Its definately well worth thinking about. basal will give you a lot more freedom, and is currently the NICE advice. The idea of long acting insulin is in theory it should keep your BG stable. Then you would then use fast acting with meals. This negates having to eat at certain times of the day and allows a much greater freedom. the long acting insulin would usually be taken roughly at the same time of day.

I can have my breakfast / lunch / dinner whenever I please now due to long/fast :>
 
If you need to snack regularly to prevent/treat lows, the basal part of your insulin is too high, hence the nurse telling you to reduce your evening dose.
This is exactly the problem of a mixed insulin, if you reduce your dose because your basal is too high, you're also reducing your mealtime dose so you'd need to eat fewer carbs to keep the bolus dose for your meal correct.
Please don't set your alarm lower, you need to treat anything under 4. Very annoying but this will get better once your basal dose fits your needs better.
Severe hypos are no joke, you'll want to avoid them.
 
Perhaps treat your lows with a bit of quick acting sugar rather an oat cake. It will get you up quicker rather than dropping into a bad hypo.
Definitely get yourself onto a basal bolus treatment. As I said earlier a mixed insulin is now not advised for type ones. Constant snacking means you are feeding the insulin and is a quick way to pile on the weight. If I need to start snacking I immediately change my doses. Doses never stay the same for ever. Our needs are constantly changing and doses need regular reassessment. Something you will get used to and feel confident to do further down the line.
 
Do it.

I stayed with mixed insulins for much longer than I should have done simply because I'd used them for the previous 25 years and they worked (though they were working less well than they had when I was younger - mainly as I needed to run higher to ensure I could drive, etc.)

Even on mixed insulins I had more flexibility than you have as I could and would select my mixture dosage every morning and evening.

I certainly don't regret changing over, I wish I'd done it sooner rather than dragging my feet, I'd encourage you do to the same.
 
Thank you. I think I will
 
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