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Please help irrational BGLs

O

O_DP_T1

Well-Known Member
Messages
458
Location
United Kingdom
Type of diabetes
Type 1
Treatment type
Insulin
Hi folks,

Hope everyone is well and good here...It's been a while since I posted as things have been OK-ish however over the past 6 months I'm having a few issues that even my Endo team does not seem to be able to help with and pretty much at my wits end!!!!!

Here are the issues:-

Dawn phenomenon - This has gotten worst over the past 6 months and it can start anytime from 3-6am IF i stay in bed after 6am I am looking at levels of anywhere from 8-14. This morning I woke at 8am and it was 11. I have tried to increase my evening dose of Levemir but that leads to major overnight lows even if it's increased by 1 unit, I have also tried to take the Levemir later i used to take it at around 10pm but that was causing causing even bigger spikes so I am now taking at midnight. With all this going on a decent 8hrs sleep is virtually impossible some days

Evening dose of Levemir is 8u

Unexplained 4pm BG rise - Similar to above really after lunch which is usually around 1-2pm I get a dip in BGL and then a rise by itself between 4-6pm and the rise has no consistency it can go to 8ish or all the way 13/14 so it's hard to bolus for. My lunch time meals are about 70g C 20gF 60gP and this has not caused an issue in the past. Between 4 and 6 is also when I like to train so it's hard to quantify doses.

I usually take my Morning Levemir around 12pm which is 18u.

The above are causing major issue through the day as you can imagine, so any ideas or feedback would be great. See the graph beloiw for trends.





thanks
 
Sometimes MDI just doesn’t match what a fully working set of islets would sort out without you knowing. Commiserations @O_DP_T1
If I were trying to find solutions I’d look in turn at diet, doses and activity.
Take diet, you say that you’re training; are you also eating for energy and muscle growth? Some recommended foods for those things, such as pasta, bananas, are hard to dose for as during digestion they release glucose slowly.
We can’t give advice here but we can share knowledge and experience.
I’ve found that if Levemir is given 12 hours apart it creates a more even profile.
Some people find exercise raises blood sugars, some find it decreases them.
I hope others have some relevant experience of their own to share.
 
@thefairygodmother thanks for the above.

tbh my 200g or carbs per day has been the same for about 2 years so no real change, the exercise routine again the same. I've tried adjusting the NovoRapid and I just end up lower if increase it and higher if i decrease it. My Levemir is a 12 hour spilt 12pm and 12am
 
If you haven't tested your basal rate by fasting, that would be my starting point, as this can change over time, as can insulin to carb ratio. Weather, stress, illness etc all affect how much insulin we need, and when we need it.

Have your team suggested a pump at all, as that sorted my dawn phenomenon out. I know some people set an alarm clock and inject a small amount of bolus insulin during the night, but this obviously interrupts their sleep.

Other than that maybe a different basal/bolus insulin?
 
I can give some advice about DP about what works for me is to just eat a couple of spoons of low fat greek yoghurt as soon as I wake, it tricks the liver that there is another source of incoming glucose and this combined with a small correction bolus keeps me below 9, I also eat low carb in the morning too as carbs send me sky rocket and can take till lunch to bring back down, which leaves me knackered.

However that being said, I have recently switched from Novorapid to Ljumjev which starts working straight away unlike novo which has a 20 min minimum lag before any action and recently had a croissant for breakfast as away from home and didn't rise above 9 with that which was an absolute revelation, Ljumjev prevents the post prandial spike for me now. I won't be risking croissant experiments though going forward as it was combined with exercise !

In regards to the afternoon spike - basal fasting test as Hopeful has said, check it's your background that needs adjustment first.
 
Cheers guys all advice is appreciated...

I have tried increasing my morning background day time Levemir but the issue is even a 1unit increase sends me low all day if doing small tasks like walking without any bolus in the system. it's getting highly annoying tbh, and it's never been like this.
 
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