Really down in the dumps , please help?

[alohanicky2009]

Sorry you feel so down but thank you , why? Because like you my sugars bounce around , I call it the "G O K" effect
(- god only knows). At times I feel that the professionals just don' t believe me when I tell them about my BM and what I do and eat , I feel such a failure that I can' t or haven' t got it "right " so I don' t feel so alone .


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[martwolves]

Phew - when I saw the G O K effect I thought it might make you wear silly girly clothes with a daft haircut and go round feeling womens boobs, undressing them and getting away with it, by ending every sentence with girlfriend or gorgeous.

 

[SamJB]

alohanicky2009, perhaps you could start a thread here posting your levels and what you eat. I've found advice from experienced diabetics to be much better than advice I've had from doctors or diabetic nurses. I'm sure people could help!

 

[sue cope]

Sounds to me that you need to increase your NovoRapid, and possibly your Lantus too (I am Type 2, but take 84 units Lantus at night). I take 1 unit of NovoRapid per 2 grams of carbs + 10% at each meal. Try it.

 

[alohanicky2009]

FAO Samjb here goes my diary for the wend. Breakfast berries with L/F natural yoghurt slice granary bread, BM 5.8 3units nova rapid, 11am soya milky coffee, lunch slice dry toasting slice pear, BM 8.3 4 units n,rapid, 6pm sweet potato(small) salad steamed veg, cheese and beans, BM 13.1 8units n,rapid. Banana and orange. Bedtime bread and jam mug soya milk. 10 units levermir. All fine 2am serious hypo 1.2 so biscuits and then toast, This morn BM 5.5 same breakfast but BM 22.9 at 11am . Lunch porridge and 16 units nova rapid BM 18.9 so extra insulin 6 units 6.30 same tea BM was 6.3 so 5 units n,rapidBM at 29,7 so have given 10 units of n,rapid will check which way the BM wants to go - up or down


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[SamJB]

Hi Nicky,
The first thing I'd do is to make sure my basal was correct. As you ate before bed on the first night, this would not give an indication of whether your basal is right. You need to not eat or inject within 4-5 hours of bedtime to get an accurate overnight reading. If your overnight levels change by more than 1.6 mmol/l then you need to change your basal by 10% accordingly.

As you had a bad hypo that night (I feel for you - you must have felt awful at 1.2), you could have experienced a liver dump which may have caused the highs and inconsistencies the next day. I personally haven't experienced this, but its well reported that others have higher levels the day after a night time hypo. For this reason it's best that your basal is correct.

Secondly, are you changing your needles after each injection? If you don't, the insulin can crystallise in the needle or the needle can get deformed; both of which makes the dose less accurate. Are you rotating your injection site? Try to inject into your stomach for the Novorapid as it's the place for rapid insulin absorption, but inject in a different area each time. Also, try to inject your long acting into your buttocks or thighs as it's the place for slower insulin absorption (you don't want all your long acting used up quickly).

Thirdly, you could reduce your portions of carbs. I'm not convinced that it's the carbs causing your highs, but reducing the carb portion size means that you wont go as high as you are.

Edit: Do you test 2 hours after eating? That's the only way to tell whether the Novorapid dose is correct. Also, if your levels are increasing or decreasing between the 2 hour test and your next meal then that is an indication that your basal is incorrect.

 

[Dillinger]

Okay , he seems to think it's insulin resistance , going to try taking an extra metformin in the morning when I eat breakfast and have a little extra lantus , he suggested maybe splitting it , anybody else on split lantus ? people say it can't be done but he seems to think if I take half a hit at night and half in the morning , ill always have the same in my body at any time as its 24 hour lasting

I was on Lantus for a long time and then it seemed to start going wrong for me; I don't know why that would happen, but I switched to Levemir and haven't had problems with it since.

You can split Lantus - just divide by 2 and have one half in the morning and one half 12 hours later.

I'm also on Metformin because I have weird insulin sensitivity; I'm ok with long acting but appear to be pretty insensitive to short acting. I take 2 grams of Metformin a day; i.e. 2 pills in the morning and 2 in the evening with no side effects. So you can always up the dosage you are on.

Keep in mind that your insulin to carb ratio can change during the day; I need much more insulin in the morning to the carbs I eat than in the evening. In fact I'm so sensitive to carbs in the morning (and need much more insulin per gram of carb) that I've stopped eating breakfast which I found very easy to do; I just have coffee and a Berocca fizzy tablet but even on that 'no breakfast' breakfast I still have to take about 3 units of Novorapid to keep my blood sugars from elevating. Weird eh?

What are you eating in the morning - how much carb and how much insulin are you taking for it? I would up the ratio in the morning and keep the ratio at night that you are on.

I'd also change to Levemir - you have nothing to lose and you should also split that.

You said you went of a DAFNE course so you are familiar with carb counting; do you think you need to do a bit of a revision of that stuff? It's the key thing to managing Type 1 diabetes; knowing how to match insulin to carbs/exercise/ stress etc.,

As has been said above; the less carbs you are eating the easier it will be to control all this.

Best

Dillinger

 

[Billietobin]

I know how you feel, I was diagnosed at 3 I'm now 16 and its not getting any better I don't get support from family I only get support frm my boyfriend at the moment and I still struggle I take sneaky moments when I take sweets up in my room or just help my self to things i can't have. I never recieve help from my family when I need it


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[alohanicky2009]

SamJB you suggested to start a thread , how do I do that ? Yesterday a bad day with high BSugars today woke with a BM of 4.4 so a smiley face all day , kept lunch simple just berries yoghurt and toast, will test before and 2 hrs after eating( not been able to as surgery said I was using too many!) how do I know if my basal rate is correct, I have been T1 now foR 18 years and as I don t see the same diabetic nurse or even consultant we never have time to discuss diabetes and changes to managing it that have happened over the years , thank you for you reply


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[SamJB]

Hi Nicky,
If you go to the Type 1 page, find the button with "post a new topic" and go from there really.

To answer your question, I can't recommend enough the book by Gary Scheiner called Think Like A Pancreas. I've been a T1 for nearly 10 years and learned loads from the book. His technique for calculating the correct basal dose (works perfectly for me) is to not eat or inject within about 4 to 5 hours of bed and inject your bedtime basal as per usual. This is so you don't have any undigested carbs or fast acting insulin in you. Then test your BG before bed and again when you get up in the morning. If your levels change by more than 1.6 mmol/l then your basal dose isn't correct, so you need to change it by 10%.

For example, if I went to bed with a BG of 6 mmol/l and woke up at 7.6 mmol/l then my Lantus would need to increase by 10%. So if my original Lantus dose was 10u, then I'd need to increase it by 10% or 1u and give myself 11u the next night. Works a treat.

You should definitely hive the book a go, there's so much good info in there. Without doubt my control has improved my control!

 

[alohanicky2009]

SamJB hi there getting the book, have asked to be seen by another consultant re, pump but means going to the next nearest hospital about 200miles away, the specialist diabetic nurse is cross as I fulfil all NICE criteria for the pump so let's hope they don t take the same opinion as that of the consultant that I am " too I'll" for a pump, most people seem to be refused for being too well! Thanks for your advice. Alohanicky2009


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[Fetchmeacoffee]

Hi all , first of all a big thanks to all the suggestions , it's been a while since being on here , trying to get things sorted once and for all.
I've seen my GP whos specialises in Diabetes and he was really understanding - his words `everybodies different , we just need to find out how different you are and control it. Hammer on the head as such.

So currently I'm splitting my dose of Lantus - 30 at night - 12 in the morning , I'm taking 1 metformin with breakfast and one with evening meal. Morning sugars are fantastic - over the moon with them , my highest bg reading before lunch is 9 - and that's while insulin is still working too - so I have not even come across a peak

Afternoon to evening is still good , and always has been , so no issue their. However evening time , after metformin I'm still trying to wiggle about with my novorapid levels , taking LOTS less insulin , im talking 30 units down to just 6/8 , so the first few days I had some very naughty hypos , passing out just a few times.

Still getting used to it , and obviously my next HBa1C will show how good its working.

Again thanks to everyone whos commented , fingers crossed some of you can get sorted too

 

[Tracey69]

Hi
I know it was a couple of weeks since you put your post up, i hope you have managed to get some help in the mean time.
I have always been what some people would say a naughty diabetic,
I use to drink 8 litres of normal pepsi a day instead of eating a proper diet (not a good thing).
In the last 5 or more years i have have actually managed to get some control.
I have been diabetic 38 yrs on the 4/8/2013.
PLEASE SEEK HELP AS WE ALL KNOW IT CAN CAUSE COMPLICATIONS and i don't want you to suffer in any way.
Diabetes can cause depression even with/without high sugars.
I have started carb counting plus i am on the same insulin as you. I also take 2 x 500mg of Metformin twice a day.
Please don't give up it will even out eventually.
I do sympathise though as this heat isn't helping with my levels i have noticed that have raised quite a bit and i am thirsty all the time.
WE are all here if you need to chat, please don't feel your on your own because you're not.
Take care
Tracey