Over night highs

[Bishop]

Okay, starting to make sense. The 1st couple of days were strange with some lows and corrections whilst I got used to the new regime.

I have one overnight basal of 15u instead of a split dose of 9u am/pm
Over night highs not as bad, typically peaking at 12 instead of 15-18
Morning BG still OK @ 4-6
Averages dropped from 10.1-8.8
Time in target up to 60% from 48%
Estimated A1c down from 64 to 61 (its been 64 for the last couple of yrs)
Carb insulin sensitivity 20/1

I was expecting to be using more bolus, but that's reduced too, typically 7-10u as opposed to 10-12u. Total daily insulin down to 22-25 as opposed to 30u.

Basal is supposed to be around 50% of total requirement. Mines closer to 70%, but I don't feel like tweaking it much more.

All in all very satisfactory. The libre is a revelation, looking forward to going onto a pump.

Have you tried to skip dinner once and see how your numbers are?

 

[Richard F]

Have you tried to skip dinner once and see how your numbers are?

No I've been using dinner till breakfast (1900-0800) as my fasting time.

Something I don't understand, if basal is busy chugging away in the background keeping things straight. Then start doing things out of the ordinary, like skipping meals, doesn't it send things a bit haywire?

 

[Richard F]

Since reducing my basal my sugars are easier to control, less swings and over night better. Thanks for advice so far.

One thing I noticed last night my sugar increased, starting to level out around 8am. The only thing different was I had some cheese after dinner, around 7pm. I know the GI in pizza affects things, but would eating cheese as a separate course?

It may just be just one of those things.

 

[becca59]

In theory as long as you are not doing any unusual strenuous activity, if your basal is working correctly you could go for 24 hours without eating a meal and things should just tug along nicely. Eating should be controlled totally with your bolus.
Cheese is a pain it slows everything up when eaten with carbs. When eaten on its own it still raises levels. I still love it though.

 

[Bishop]

No I've been using dinner till breakfast (1900-0800) as my fasting time.

Something I don't understand, if basal is busy chugging away in the background keeping things straight. Then start doing things out of the ordinary, like skipping meals, doesn't it send things a bit haywire?

That is an excellent question!
The point of basal insulin is to only cover the amount of sugar that is spilled in your body by your liver across the day. Think of it as a background task. That is happening because our body needs fuel across the day to keep ongoing.
Saying this - if the dosage of basal is wrongly calculated if you fast for a long time, you will drop. When we are in fasting state we shouldn't drop below any safe values. It's ok to be slightly lowish but still steady and safe.

To cove the new carbs which we ingest when we eat we use fast-acting insulin. This should only deal with the carbs from the food.
I just put this here to clarify in case you are not sure how it works.

 

[Richard F]

That is an excellent question!
The point of basal insulin is to only cover the amount of sugar that is spilled in your body by your liver across the day. Think of it as a background task. That is happening because our body needs fuel across the day to keep ongoing.
Saying this - if the dosage of basal is wrongly calculated if you fast for a long time, you will drop. When we are in fasting state we shouldn't drop below any safe values. It's ok to be slightly lowish but still steady and safe.

To cove the new carbs which we ingest when we eat we use fast-acting insulin. This should only deal with the carbs from the food.
I just put this here to clarify in case you are not sure how it works.

 

[Richard F]

Thx, I've been T1 for 40yrs. And still learning.

Does the liver release glucose in a uniform linear rate? Or will it vary dependant on resting, active, sleep etc?

 

[UK T1]

Thx, I've been T1 for 40yrs. And still learning.

Does the liver release glucose in a uniform linear rate? Or will it vary dependant on resting, active, sleep etc?

It will vary, yes. Common examples throughout the day are hormones, stress, excitement etc which you often can't predict too.

Have you managed to talk to your diabetes team? They will have better insights and a better picture of your situation.

It is always worth remembering any changes especially to basal doses take a few days to even out. I take levemir not lantus, but I'm always told to leave it 3-4 days to see the effect of a dose change. That is, unless it's a night hypo, because it's better to be a tad high and bring it down carefully than risk being too low of course (and hypos are horrible at the best of times so hope it soon changes for you!)