strange readings

What time and what meds do you take? When's your last eating time at night?

If you've tried the reduction over 2 weeks and it isn't lowering your bg, surely it sounds like you actually need more levemir? Not less!? i know dp may require some jiggling and possibly less insulin, but you've tried that and its still high.

You should call your dsn & relate your readings, they may try a new tactic...

If it was me, I'd go back up to 12 and monitor for 3 days. If I was still over 10 on waking then I'd increase to 14 for the next 3 days.

Apologies if I've missed something...hope you get it sorted!


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I agree. If your levels are increasing overnight then it means you need to increase your insulin dose. For every change of 1.6 in overnight levels then you need to adjust your long acting by 10% - that's the rule given by Gary Scheiner's Think Like A Pancreas book. Works a treat for me.

SamJB said:

I agree. If your levels are increasing overnight then it means you need to increase your insulin dose. For every change of 1.6 in overnight levels then you need to adjust your long acting by 10% - that's the rule given by Gary Scheiner's Think Like A Pancreas book. Works a treat for me.

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Spot on (I just read that chapter haha)

Have you tested through the night also?

Hi, just read your post, having Mae my topic on exactly the same thing! I can help with any advice right now but if I find out anything will let you know!

Rob

So it sounds like that hypo was due to over correction (too much quick acting insulin)? If you had more levemir then maybe you'd be more in range on waking and wouldn't have to correct???


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Your liver tends to dump more glucose into your bloodstream at night which results in an increase in BG levels - and you obviously do not have enough insulin (basal) present to counter-act this. I don't personally agree with the DN who told you to drop the levimer but this may be due to a misunderstanding regarding how you came to a hypo before (seems most sensible to assume over-use of fast acting in an attempt to correct).

I would take your levimer up 1iu at night and see what it is in the morning, then the following night adjust another unit if necessary, etc until you acheive good levels. You are unlikely to have a hypo at night doing this.

J

Really sounds as if you need to increase your levimir.

Please make sure that when you do any increases overnight that you do check your levels at 2.30 or 3am.
Dont adjust more than 2 units at a time.

Be aware that altering your basal insulin WILL ALSO. Affect your levels during the day. So make sure you test regularly.

To increase your basal to get better levels at night, may well knock your levels down during the day, which would then mean lowering the insulin you have with your meals..

In your situation I'd up the levimir. It's obvious from your increased glucose levels in the middle of the night that your dose isn't enough. Also maybe stop eating after 8 p.m so that you'll be able to know if it's your levemir that's causing the problem. But I'd be wary of hypos during the night, so maybe if you're increasing your long-acting insulin at night have something like dextrose and a banana or a couple of digestive biscuits beside the bed.

Best of luck,
Isobel

carlos37 said:

thankyou for your replies it really has me miffed I ve been on insulin 5 month now take 9 units of levimer in the morning and now 10 at night take novarapid for meals through out the day sugars are very good even at night mostly before bed 6.0 t0.9.0 mostly 6.0 occasionally have the odd high one I do correct in the morning and it very quickly drops within 3 3 half hrs to 7.0 5.0 this is why the dn told me to drop the levimer as one day had a bad hypo woke at 17.0 corrected it and within 4 hrs it was 2.5 and this is why they think its going low in the night but have tested it and its high during night

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I was told by my doctor that each unit of novorapid brings the blood sugar down by 4 points. So say if you were 17.0, if you took 3 units you would eventually be 5.0 or thereabouts. Also maybe you waited too long after the 17.0, especially if you woke up with that reading. You would have had nothing whatsoever in your stomach so you would have gone down very fast. When you have a low, believe it or not, you do need to take a little whack of insulin after you take the sugar/carbs to deal with it, maybe half an hour after eating. I know it doesn't really make sense, but remember a diabetic doesn't produce sufficient insulin to bring your sugar down-- you'll just keep going up.

NOOOO don't take extra insulin after consuming carbs to treat a hypo! You'd end up hypo again!

Hope someone can back me up here...you shouldn't inject extra insulin in that situation surely? Isobel, does this work for you? I have specifically been told by more than one dsn, not to have any correction (I.e.bolus of fast acting insulin) after a hypo, even if bg overshoots.

Carlos37 was saying he had a hypo AFTER correcting too vigorously after a bg of 17, which resulted in 2.5 (? Or 2. Something).


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I was given the same advice not to take insulin to cover carbs taken for a hypo.

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Isobel94.. Taking more insulin after treating a hypo is dangrous. The thing is as well with us diabetics that everyone is different. The OP HAS to be able to correct from a high to bring bg levels down to normal target range by the end of 5 hours. Any earlier than 5 hours depending what the cause of hyper is and what activity they are then doing could well ram straight into hypo, and a very bad one.
My advie is to establish, what level of quick acting will bring OP down to target at end of 5 hours.
The other thing is that all type 1's should know is how much their bodies need to bring themselves back to normal range and to be able to sustain it without bounding back up into hyper again. For example, last night, my level was 4.1 before I went to bed, I had 7 dolly mixtures and at 3am this morning I was 5.2. I get up early, so even at 5am this has maintained itself.
It would be so dangerous, if for example somebody took this info to give more insulin after treating a hypo.. When they were driving any sort of machinery or exercising....or at anytime to be honest.... As that person does not know how low they would actually be sinking to pre hypo stopper.....
In brief a t1 should have correct dosage of insulin to combat a hyper based on their correction factor... Yours may well be 1 unit to 4bgs, mine is different according to day or night and whether I am ill or working. The same for hypo's with me... 7 dolly mixtures good at night but during the dsy I would also have a shortbread to sustain my normal levels when they came back up. Dvla are exact on waiting 45 mins if you have a hypo... So why would you wish to give another jab at 20 mins when it is so strongly advised to wait at least 45 mins before driving for example.

Hope these corrections make the difference. I know it is very frustrating to have dp. All the effort, care and attention during the day kind of blows up in your face when your body just does its own thing at night. Stick with it and you'll get there. The problem with doctors giving info such as 1 unit decreases bs by 4 is that these are 'average' figures from the 'reliable' medical texts. They will work for some but its too much of a roll of the dice. As mentioned above we each need to know our adjustment factor and this is a matter of trial and error. There is no 'one size fits all'

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