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Not injecting due to fear of hypos

i'm losing all patience. I'm considering getting registered back at my home practice - I very rarely need to go and my mum can pick up prescriptions for me and bring them when she visits or I can get them when I come home.

Need to discuss it with family and see what their advice is but that's what I'm tempted to do.

Well my levels before bed were 5.0 and normally they're a little higher. I was pleased with 5.0 though as I've been more tight on controlling it, so might go down even further on basal if my pre-bed reading is similar tonight. First time I've had such a nasty one at that time, woke up drenched in sweat and feeling really nauseous, not had one that bad before
 
I guess the first thing to do is to check to make sure your basal is correct...

The easiest way to do this is to have a no carb day.. the better way is to do a series of fasting tests (i.e. morning fast one day, afternoon the next and then evening the day after)... without doing these tests you can think your background is correct but it may not be... This will also show how 'flat' your profile is and if you need to make any adjustments or for instance split your background dose to give you a better profile..

I very much suspect that perhaps you need to split your dose and drop your background but without doing the fasting tests or no carb day tests is going to be hard to tell..
 
Pneu said:
I guess the first thing to do is to check to make sure your basal is correct...

The easiest way to do this is to have a no carb day.. the better way is to do a series of fasting tests (i.e. morning fast one day, afternoon the next and then evening the day after)... without doing these tests you can think your background is correct but it may not be... This will also show how 'flat' your profile is and if you need to make any adjustments or for instance split your background dose to give you a better profile..

I very much suspect that perhaps you need to split your dose and drop your background but without doing the fasting tests or no carb day tests is going to be hard to tell..
Click to expand...
Could you explain the fasting tests a little more for me please? I really want to get sorted.

So from what times do I not eat and then at what time do I test, and what would the results show me?

Many thanks
 
So my typical 4 day test plan looks like this, I tend to do this once every six months just to make sure I am still ok:

Day 1: Wake up and don't eat anything until 12:00.. I just drink water (or diet drink with no carbs in)... from the time you get up through to 12:00 test every hour.. you should not see more than a 1.0 mmol/l between the highest and lowest readings..

So 'stable' blood glucose will look something like this:

7:00 - 5.0 mmol/l, 8:00 - 5.2 mmol/l, 9:00 - 4.6 mmol/l, 10:00 - 5.4 mmol/l, 11:00 - 4.9 mmol/l, 12:00 - 5.1 mmol/l

'unstable' blood glucose will look something like this:

7:00 - 5.4 mmol/l. 8:00 - 5.0 mmol/l, 9:00 - 4.1 mmol/l, 10:00 4.6 mmol/l, 11:00 - 4.2 mmol/l, 12:00 - 3.8 mmol/l

Generally if your blood glucose is 'unstable' then you will see a trend up or down..

Day 2: Wake up and eat as usual... (make sure you then leave 5 hours post any rapid injection for breakfast).. better eat a no carb breakfast like omelet. At 13:00 begin your hourly tests and run through until 18:00

Day 3: Breakfast and Lunch as usual.. and then at 19:00 start the hourly tests and run through until 12:00

Day 4: Eat during the day as usual and run hourly tests overnight..

What you should end up with is a 'flat' profile where over the day you have no more than a +1 mmol/l change in blood glucose.. if this is the case then your background is correct...

If you have a trend of downwards blood glucose then you are injecting to much, and upwards means to little..

Some people will find that the background doesn't last the whole 24 hours and therefore they get a spike towards the end of the action.. this is normally resolved by spiting the dose so say 1/2 @ 8pm and 1/2 @ 8am... you can keep doing the fasting checks and changing the ratio's until you get it exactly right..

This is A LOT of work and many people don't want to go to the effort but it is totally worth it... once your background insulin is right diabetes is that much less challenging..
 
No worries... any questions feel free to ask in here or via PM.

If you want to post your results for 'review' then please feel free... if I am about I'll offer an opinion if not I am sure one of the other experienced type I's can offer some insight.

Just a note to my first post... if during the fasting you hypo or start to run high bloods then stop the testing and administer a correction.. you will not quite quickly by that point anyway that something is wrong!
 
Hi just read your problem and the answers give. To be honest with you you may end up in a complete muddle with all the answer but my question to you is (unless I have not read all this correctly) have you been on a DAPHNE course drug adjusment for normal eating. I was having serious issues for years with long acting insulins having hypos and as you know if you have one you are gauranteed another The daphne course opened my eyes to how the insulins actually work if you are on long acting and quick for meals push push push for the daphne course
 
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