Strange BG results & issues with consultants

[ROE100]

Hi All

Some background to me and sorry for the really long post but trying to get it all down in one go

Type 1 Diabetic for 32 years

Always been controlled by injections and carb counting. Currently on Lantus &

No other diabetic health issues like Neuropathy, Nephropathy, Nephropathy, Retionopathy. Don't have high blood pressure or high cholestrol

Last HBA1C was 53

I eat the same for Breakfast and lunch and on semi low carb diet (100 to 140 carbs a day) so I don't get really high spikes, have the same activity and don't stress. Eat normally a the same time each day.

All sounds great but for the last 6 years I have been trying to address large spike which last for 5 hours then sudden drops down to normal levels.

I done a few fasting days - yes when I first did it I didn't follow the rules on mysugr but when I did follow the rules sort of (the rules I didn't follow was stop after going high and doing it for just 6 hours and stop after going low) I got the following results

6.30am - 5.4 - 7 units of Lantus
7.30am - 6.7
8.40am - 9.00
9.38am - 11.00 - this is when I stat to feel thirsty (if I have a normal day then I can go even higher but don't correct as by lunch should be ok or if not I correct at lunch then I crash down at 4/5pm
10.34am - 11.00 - so looks like I am leveling out - so my Lantus needs to be increased
11.33am - 11.9 - considered a correction but didn't
12.32pm - 10.7 - starting to fall which follows what happens when I eat & inject normally
1.32pm - 9.9
2.30pm - 8.9
3.37pm - 7.2
4.33pm - 7.3
5.30pm - 6.2
6.30pm - 6.0
8.30pm - 4.1 - shld have considered stopping but ate 6 carbs
9.30pm - 5.3
10.00pm - no test - 7 units of Lantus
10.31pm - 3.8 - ate 10 carbs
11.29pm - 2.8 - ate 13 carbs
12.29am - 5.7 - yes I did the 1 hour during the night testing
1.29am - 4.8
2.29am - 4.2 - ate 13 carbs
3.29am - 7.7
4.29am - 5.3
5.29am - 3.7 - ate 13 carbs
6.30am - 7.7 - normal same breakfast 23 carbs 4 units for Fi-Asp and 7 Lantus
End of 24 hour full testing

Conculsion - Lantus dosen't seem to be working as it should???!!

Yes I have brought the being high for 4 to 5 hours and I get one of the following

• You are testing too much and becoming obssesive - with no look at the expamples I have and it was dismissed and told not to worry
  
• A complete change of discussion to something else
  
• Why have you gone high here you need to increase your Lantus - so went up to 24 units currently on split dose of 7 units to make a total of 14 units each day
  
• Once I thought I got through and they changed me from Humalog to FiAsp - this has had no effect on my BG readings
  
• On the DAFNE course told 'we have other people and don't have any time for that and no offer to see them separately
• Saw the specialist diabectic nurse very recently - shown her the result - and was told can't help sorry
• Told by the cheif consultant I can no longer specficially ask for him at the consultation and need to see the other people at the clinic - of which I have done until the last person I saw who was not listening to my answers and kepted asking the same question even though i was anwersing the same so nearly walked out of the meeting.

Thank you for reading this long post and thanks in advance for any thoughts on this.

Regards
ROE100

 

[Deleted Account]

The rise may be due to Dawn Phenomenon and nothing to do with your Lantus.
You only mention eating carbs at 10:31pm. Do you eat anything else? (It is common to find BG rise with no-carb meals).
Some people find eating a small breakfast will reduce the DP affect.

 

[becca59]

When doing a basal test, I wouldn’t fast for so long. It skews how your liver reacts. Do it in chunks.

 

[ROE100]

Hi Helen

DP - on everything I have read it says starts at between 3am and 6am - my rise when i do a normal day of eating a small low carb breakfast (23carbs) & injection I get the same result a high for 4 to 5 hours. Then have lunch normally around 30 carbs and the high slowly drops off. I don't wake up high i buuld from a normal range to a high range over the next 4/5 hours

Yes i ate nothing - no food just water for the full 24 hours so no no-carbs meals for my body to react with.

I have also tried no carbs at breakfast and also rise the same.

But thanks for your thought.

 

[ROE100]

Hi Becca

I appreciate i shouldn't have done the long test but if I had taken the test in the 6 hour stints then it is saying my Lantus is too low. You say if a do a long test it skews how my liver reacts. Liver Reacts to what & how?

 

[Fairygodmother]

Hi @ROE100, it looks to me as if your rise in the morning could be the version of the DP we also call ‘feet on the floor’. When we become active after the inactivity of sleep the liver chucks out some glucose to help get us going.
I always need 1.5 - 3 units of Fiasp when I get going in the morning regardless of what I have for breakfast. The swifter the breakfast food’ll be broken down into glucose the greater the amount of Fiasp I’ll inject. Sometimes it goes in in two stages, one before and one after breakfast.
This is all separate from the Fiasp for the carb content of breakfast itself.
Maybe try experimenting with Fiasp to counteract feet on the floor? Small amounts to begin with in case you enter hypo-land?

 

[Fairygodmother]

Addenda: we can’t tell you how to to address a problem, and I’m not medically trained. The above is only my guess at what might be causing your spikes, and suggesting that you try to counter feet on the floor is just that, a suggestion based on what I’ve found out about myself.

 

[Antje77]

Looks like what happened to me before I figured out to take some quick acting before getting out of bed to counteract the feet on the floor effect. To my thinking glucose in my bloodstream needs insulin to get used, no matter if the glucose comes from my liver or from food.

I wouldn't be happy with numbers this low at night. The morning is the only time your bg is highish and you have to eat carbs to counter the lows at other times. Ideally, your basal should keep you stable during the day, apart from eating (and liver dumps), not make you go low.

Just like @Fairygodmother I want to add this is just what I do, not advise as to what you should do. Whatever you do, be careful when changing things and keep meter and hypo treatment at hand.
Good luck!

 

[ROE100]

Thank you Antje77 & Fairygodmother.

I will consider what you have said.

In regard to nightime readings this is the first time I've testing every hour during the night, last time lastest check has been at 12 nidnight as couldn't stay a awake after that time. I've only rarely woke up in the night low (maybe once a year) so I have no clues if this is normal. Just to note I have been refused a libre as my HBA1C is ok.

Not sure if I can use the readings I have given above to justify as this was an extreme fasting period so not a normal night.

But thanks again for your suggestions and thoughts

 

[Deleted Account]

@ROE100 regarding night time readings, they can be affected by waking up every hour ... another reason why I would not take them into consideration.
It is a huge shame you have been refused a Libre. However, if you want to get to the bottom of this (and have a smart phone), I would recommend purchasing a Libre to get a better idea of what happens overnight. It should also provide good evidence for your diabetes team about what is happening and is nicer to your fingers than pricking them every hour.

 

[hh1]

@ROE100 I can only second what @helensaramay, @Fairygodmother and @Antje77 have said. I too experience feet on the floor rises, though for me it's inconsistent, ie it doesn't happen every day, and when it does, the amount of rise and period it covers can vary. I also agree with @Antje77 about the overnight levels, personally I'd want mine higher than that. I take split doses of Lantus, but my evening dose is 25% higher than the morning dose as without that I'm too high when I wake. Just goes to show how different we all are.

 

[endocrinegremlin]

I'd just like to add these numbers are pretty awesome overall. I understand your desire to improve but you are doing brilliantly so far.

It does look like a slight dawn phenomenon is occurring but the others have provided sound advice there.