• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Out of control - need help

M

maryrachel

Well-Known Member
Messages
98
Location
West Yorkshire
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Beetroot
I was diagnosed 19 years ago and have had resonable control for all of that time up until the last 6 months or so. HBA1c usually 7.2. Last one 7.7. I have had problems with late afternoon/early evening BG (11+ up to 16 more recently) for some years and getting progressively worse over the last 6 to 12 months. During all this time the diabetic specialist have never suggested I split my long acting dose but I learned I can do this from this site and so I did about 6 weeks ago. I have also increased my basal insulin from 17 to 20 now but I am still having problems. Last week I switched from Lantus to Levemir and I am now taking 24 units split 12 each AM and PM but I am still having highs. BG was 5.9 at 5pm today and rose to 8 by 7 pm and I did not eat anything since lunchtime other than a few macadamia nuts. I took 12 units novorapid with my meal tonight and ate a small curry with small portion of rice and a popadum. 2 hrs later BG was 8.9. One hour later still it was 10. Why is it going up?
I am fasting tomorrow to find the correct basal level but I cant keep increasing my insulin indefinately. I am already taking 1.5 times the recommended level of total insulin for my size. Any ideas what I am doing wrong?
 
Hi May Racheal,

My solution is 10 units of insulin per 1.0 reduction required then re test after an hour to make sure the level is good, and not going to low

Hope this helps
 
Thanks Heath. I am assuming you mean 1 unit insulin for 1 reduction? Not 10?
My main probelm at the moment is the night time. Went to bed with BG 6 last night and woke myself at 2.3 to test. I was 17. Still 13 when I woke this morning. i am taking 7 units more of long acting than i was 6 weeks ago but this problem seems to have started since I split my dose. Any ideas?
 
I went through a few phases like that in my time. First of all are you sure that you don't have an unknown infection. My body can sometimes act with high bg's a while before the illness shows any outward sign. I (other than for the above)in the past found my bg was highest in the morning in any case and without any changes to my insulin ( well I did originally lower my lantus by 2 units). I wake up between 4.5 and 5.5. I never, ever eat carb rich foods at night and generally keep lowish in carbs. But for dinner I will have a low carb veg/vegs (weighed to ensure the cabr content) e.g green veg such as cabbage/cucumber/aspargus...and a piece of meat/fish. I then do not snack until 15 minutes or so before I go sleep and have about 8 nuts (pecan usually), this has made sure my morning bgs are great. If I had rice or potato at dinner I would wake up with a bg of 14 or more myself. It might be an idea to try it out just to see if it helps you to. Also, a change in hormones in a woman can make a big difference to control it might be worth having that checked out.
 
Have you tried changing your short acting insulin instead of your background insulin? I always got told to increase my lantus. I ended up with a split dose (pain the you know where!) and taking tons of the stuff, without getting better results. So I went on the dafne course in January and learnt about insulin to carbs ratio. So now I have a ratio of 2 units per 10g carbs at breakfast and lunch and 2.5 units per 10g at dinner. This has improved my control immensely and for the first time in 22 years my HbA1c is within range. Yippee!
I would recommend getting on a dafne course if you can, it's the most useful thing I've ever done. But either way it's definitely worth considering that you may not be doing enough novorapid to cover your evening meal and that increasing background insulin isn't always the solution. Good luck :-)
 
Back
Top