Normal levels

[Jenny's Dad]

Hi all. Have been Type 1 knowingly for 2 years. Previously Novorapid and Levemir but it made me fall asleep..don't know why. Had first hypo (proper one , with flashing lights and being beaten up by the local constabulry). Now at work they know it all and when I say under control and only going up to 15 mmol one hour after lunch they say that not normal .. any views cos I feel they gonna pension me off.

 

[lilibet]

Hi Jennys dad

You are taking insulin still I assume, just not novo and levemir? When you say 'knowingly type 1' do you just mean that it was bam, diagnosed, but you were probably (like all T1's myself included) diabetic before you were diagnosed?

Re the normal levels question - it very much depends on what you want to achieve. Most medical professionals are happy if you start off at levels between 4-7 (though I prefer to be in the 5's or under if at all possible) and then eat, take insulin and come back to where you started. Spikes in blood sugar are unfortunately a problem for T1's depending on diet - the more starchy, sugary your diet is, the more likely you are to get a spike in blood glucose at the one hour point. It may come back down when you test at the 4 hour point of whatever but there is evidence to suggest spikes in bg cause damage too. I hope you dont mind me saying, but I would never hope to be at 15mmol at ANY point in my diabetic life (illness aside which cant be helped) and certainly not at one hour. Accepted medical wisdom is under 10mmol at one hour, though most well controlled diabetics prefer to be under 8. Difficulty isthat as I said, depending on what you eat, will depend on how achievable that is.

Why do your work need to know what you are after eating, bg wise? Why do you think you will be pensioned off? Could you give us a bit more info so we could advise you. Aside from feeling absolutely rubbish ( double figures have me dizzy, fatigued, feeling generally rubbish) what impact on your job should bg have?

 

[Jenny's Dad]

Hi

I am on novomix now but inject before each meal (ie 3 times daily). Initially was on twice (for first two days) but if I had lunch levels rise to 25+. I inject and eat and my spike is in the region of 15-17 and then comes down to 5-7 by next meal. Only way I think I could reduce that spike is to reduce carbs. If I inject more I will come down too early unlesss I snack which is not something I used to do .. maybe that is the answer, up the dose at meal times and have a snack between meals ?? This all may seem obvious to some people but I am still learning and quite happy to admit it. I can't reduce carbs as I am already too skinny.

Regarding work, they asked if diabetes affected work and I just said can tend to get tired (and feel ****) especially in the afternoon. Told them things were getting better as I was bringing afternoon levels down with experimentation/adjusting levels. Told them levels down to 15 now and hoped to bring down to below 10 in time. Immediate bosses both have Type 2 relatives and they were astonished at these levels.

My diabetic nurse has told me I am rather sensitive and my levels sometimes unpredictable .. as you will know its hard to bring it down from 20+ and stop it at 5 within an hour without unusual feelings (ears whistling etc).

 

[hanadr]

Jenny's Dad
I'd go with the controlling carbs rather than increasing medication too.
Hana

 

[lilibet]

Jennys dad
I found that whilst on novomix that i could only control my levels by being low carb- and I mean less than 60 to 70g per day to get a good hba1c. Premixed insulin is notoriously bad at tackling bg spikes if you dont control carbs and also leave you prone to hypos

I was DESPERATE to get off it for a year, as I just wanted more freedom, eat a bit more etc. Its not perfect to be on basal bolus but it is better. My total daily dose was 21 units per day on novomix before they would let me move over

Is there no way you could go back on to basal and bolus insulin but change to say Lantus and Humulin, or Apidra insulin for rapid - which might agree better with you? (funny how levemir and novo didnt as Novo Nordisk make the Novomix too - exact same ingredients mainly). If you are happy as you are then by all means stick with it, but spikes of 15mmol or sometimes 25 is just not healthy.

Also re the fatigue - yes, you will be, if you are anything like me and double figures will poleax you. Lower bg might make you feel better and make working life easier

Give your Clinic a phone, ask to come in and speak to them properly about other regimes, or at least maybe a fast acting to correct higher bg

 

[Jenny's Dad]

Thanks Lilibet

I couldn't conceive of 60g carb per day. My normal lunch which is not excessive is 150g. I am 5 ft 9 and 55kg (8.5 stone) right now. Fell 2 stone over Xmas 2 years ago which is when I knew something wrong. Had bg of 37 and ketones etc. They sent me home with an insulin pen and its been trial and error (mostly error) ever since.

Not able to put weight on but can just about hold it at 55kg. I think I need to work out what is minimum food to stay alive and then work out insulin regime for that. :shock: Thanks again

 

[lilibet]

hmm, lower carbing would have you losing weight likely so I can see your dilemma. What I will say though is that persistenly high bg will have you losing weight too- anything over 16 is likely to get you into ketones territory -and therefore burning off fat

Problem with mixed insulin is that what you take to 'set' it a brekkie you need to eat similar at lunch and if it all goes pear shaped you need to wait until later to sort it by taking insulin (though you cant correct with it and should never try). At the very least, maybe ask for a fast acting correction

No wonder you didnt like novo and levemir if you were left to it on diagnosis. Makes my (slightly sweeter than average :lol: ) blood boil. Carb counting is a MUST on basal bolus and without any notion of how to set basal insulin, then set carb ratios trial and error is useless

By the time they moved me over, I pretty much knew what to do so got very little guidance but there are other ways to do it -DAFNE course, BDEC online carb counting

Maybe give it another try? YOu can always go back the way - everything to gain (including weight perhaps)