Type 1 Struggling to control levels

[G.Donald98]

This is my first post on this and thought i would give it a try. I am a type 1 diabetic and got diagnosed when i was 16. For quite a while now i been struggling to control my sugar levels and have been fluctuating quite a bit even though i feel like im taking my insulin at the right time and also using the correct does of novorapid when its high which a lot of the time doesnt even come down. Ive been told fats in food can effect it quite substantially and was wondering if anyone has any tips how to solve that. Ive been told to take like half of my insulin before my meal and the other half after if the food contains a substantial amount of fat?

Also i want to mention I play football regularly during the week and when i play on a saturday no matter what i eat or take insulin wise before the game it is always high and when i try to take more it still doesnt go down. Like for arguments sake there was once i took like 15 units for 2 bits of toast and some scrambled egg as i was getting frustrated and by the time i started my warm up the reading would be over the roof and would be like that till after the game.

Would be much appreciated if i could get any feedback on this

 

[MrsA2]

This is my first post on this and thought i would give it a try. I am a type 1 diabetic and got diagnosed when i was 16. For quite a while now i been struggling to control my sugar levels and have been fluctuating quite a bit even though i feel like im taking my insulin at the right time and also using the correct does of novorapid when its high which a lot of the time doesnt even come down. Ive been told fats in food can effect it quite substantially and was wondering if anyone has any tips how to solve that. Ive been told to take like half of my insulin before my meal and the other half after if the food contains a substantial amount of fat?

Also i want to mention I play football regularly during the week and when i play on a saturday no matter what i eat or take insulin wise before the game it is always high and when i try to take more it still doesnt go down. Like for arguments sake there was once i took like 15 units for 2 bits of toast and some scrambled egg as i was getting frustrated and by the time i started my warm up the reading would be over the roof and would be like that till after the game.

Would be much appreciated if i could get any feedback on this

Just saying welcome. It might be a bit late to get too many replies tonight, but am sure you'll get responses in time. I can't help... not my area

 

[Antje77]

Would be much appreciated if i could get any feedback on this

Hi @G.Donald98 , welcome to the forum.
For me, it starts with having my basal (long acting) dose right. How are your numbers when fasting or eating no carb foods? Have you done any basal testing lately?

Do you use a CGM like Dexcom or Libre or are you depending on finger sticks?
CGM's are very useful to find patterns, but it's possible with fingerpricks as well, provided you test a lot around meals.

Ive been told fats in food can effect it quite substantially and was wondering if anyone has any tips how to solve that. Ive been told to take like half of my insulin before my meal and the other half after if the food contains a substantial amount of fat?

It all depends on the person. Yes, high fat carby meals hit slower than low fat carbs, hence our using straight glucose/dextrose to treat hypos most effectively.
But the timing of insulin is highly personal, and you'll need to find your own sweet spot.
Some need to prebolus by more than 30 minutes, others are fine dosing and eating, and like you said, things depend on the fats slowing the carb action as well.

Most of us find we need defferent amounts of insulin for the same amount of carbs depending on time of day as well, you might want to see what patterns you can find there as well.

Also i want to mention I play football regularly during the week and when i play on a saturday no matter what i eat or take insulin wise before the game it is always high and when i try to take more it still doesnt go down.

The extra stress from the game as opposed to training can cause higher blood glucose. For what it's worth, I take an extra dose of insulin in the parking lot before my endo or dentist appointments because I know from experience they will raise my BG...

 

[EllieM]

Hi @G.Donald98 and welcome to the forums .

Firstly can I check whether you are on a pump or a basal/bolus system and if the later, which basal are you taking?

I find that both basal and bolus rates can vary with time (and time of day) so it's worth reviewing them every so often. My understanding is that it's best to get the basal rate right first because it's much harder to get the bolus rate right if the basal is wrong.

I also find that I am a lot more insulin resistant when my bg levels are over 10. I'm using humalog but once I go over 10 I have to inject a lot more for the same drop than if I'm less than that. eg my personal correction ratio is normally 1 unit of insulin brings me down by 3mmol/L but when I'm at 11 or 12 it's more like 1 unit per 1 mmol/L . (Note please don't use my ratios, your figures will be completely different). Yes, I still occasionally "rage bolus" when nothing I do appears to bring my levels down though it's much easier not to go hypo when I do that now that I am on a pump.)

And to be honest, if I eat anything when my bgs are already high it takes even longer to get them down again, so I try (but don't always succeed) to wait till they are lower before I eat.

I urge you to try to keep some good records to show your team. I am lucky enough to have a good dietician who can use my records to make helpful suggestions about my (many) ratios.

Stress definitely affects my levels too, I need more insulin when stressed (eg when playing bridge at my local bridge club and I've just sat down opposite a terrifyingly good player who has been playing longer than I've been alive - I just started this year so am definitely one of the weaker players.)

 

[Nixere1#]

I'm a total newbie here but are you moving your injection sites around? If not try a new site for a couple of days and monitor the results.

 

[Hertfordshiremum]

This is my first post on this and thought i would give it a try. I am a type 1 diabetic and got diagnosed when i was 16. For quite a while now i been struggling to control my sugar levels and have been fluctuating quite a bit even though i feel like im taking my insulin at the right time and also using the correct does of novorapid when its high which a lot of the time doesnt even come down. Ive been told fats in food can effect it quite substantially and was wondering if anyone has any tips how to solve that. Ive been told to take like half of my insulin before my meal and the other half after if the food contains a substantial amount of fat?

Also i want to mention I play football regularly during the week and when i play on a saturday no matter what i eat or take insulin wise before the game it is always high and when i try to take more it still doesnt go down. Like for arguments sake there was once i took like 15 units for 2 bits of toast and some scrambled egg as i was getting frustrated and by the time i started my warm up the reading would be over the roof and would be like that till after the game.

Would be much appreciated if i could get any feedback on this

Hello. Lots of good suggestions already however I found Novorapid took at least 1.5 hrs to kick in with me and when I switched to Fiasp things were so much better. Have you asked to try a different insulin to see if it might suit you better? I’m now on Admelog and find that works well but for me personally Novorapid jut left me running too high for too long. I hope you find the answer.

 

[G.Donald98]

Hello. Lots of good suggestions already however I found Novorapid took at least 1.5 hrs to kick in with me and when I switched to Fiasp things were so much better. Have you asked to try a different insulin to see if it might suit you better? I’m now on Admelog and find that works well but for me personally Novorapid jut left me running too high for too long. I hope you find the answer.

Ye im exactly the same with my novorapid. I have mentioned before to my specialist to try a different pen but they weren’t helpful and said it shouldnt make a difference even though ive heard different from many people with diabetes that it made a difference changing pens

 

[G.Donald98]

Hi @G.Donald98 and welcome to the forums .

Firstly can I check whether you are on a pump or a basal/bolus system and if the later, which basal are you taking?

I find that both basal and bolus rates can vary with time (and time of day) so it's worth reviewing them every so often. My understanding is that it's best to get the basal rate right first because it's much harder to get the bolus rate right if the basal is wrong.

I also find that I am a lot more insulin resistant when my bg levels are over 10. I'm using humalog but once I go over 10 I have to inject a lot more for the same drop than if I'm less than that. eg my personal correction ratio is normally 1 unit of insulin brings me down by 3mmol/L but when I'm at 11 or 12 it's more like 1 unit per 1 mmol/L . (Note please don't use my ratios, your figures will be completely different). Yes, I still occasionally "rage bolus" when nothing I do appears to bring my levels down though it's much easier not to go hypo when I do that now that I am on a pump.)

And to be honest, if I eat anything when my bgs are already high it takes even longer to get them down again, so I try (but don't always succeed) to wait till they are lower before I eat.

I urge you to try to keep some good records to show your team. I am lucky enough to have a good dietician who can use my records to make helpful suggestions about my (many) ratios.

Stress definitely affects my levels too, I need more insulin when stressed (eg when playing bridge at my local bridge club and I've just sat down opposite a terrifyingly good player who has been playing longer than I've been alive - I just started this year so am definitely one of the weaker players.)

Im currently using novorapid for my fast acting insulin and levemir for my slow acting. Thank you for all the information i will definitely tell my specialist nurse about my basal to see if that can be adjusted

 

[G.Donald98]

Hi @G.Donald98 , welcome to the forum.
For me, it starts with having my basal (long acting) dose right. How are your numbers when fasting or eating no carb foods? Have you done any basal testing lately?

Do you use a CGM like Dexcom or Libre or are you depending on finger sticks?
CGM's are very useful to find patterns, but it's possible with fingerpricks as well, provided you test a lot around meals.

It all depends on the person. Yes, high fat carby meals hit slower than low fat carbs, hence our using straight glucose/dextrose to treat hypos most effectively.
But the timing of insulin is highly personal, and you'll need to find your own sweet spot.
Some need to prebolus by more than 30 minutes, others are fine dosing and eating, and like you said, things depend on the fats slowing the carb action as well.

Most of us find we need defferent amounts of insulin for the same amount of carbs depending on time of day as well, you might want to see what patterns you can find there as well.

The extra stress from the game as opposed to training can cause higher blood glucose. For what it's worth, I take an extra dose of insulin in the parking lot before my endo or dentist appointments because I know from experience they will raise my BG...

I recently tried a carnivore diet to see if something like that would work and give its due it did help my readings quite a fair bit but there was still the odd high readings which i found a but confusing but eating no carbs did help but the cravings were off the chart.

So would you say to take the other half of fast acting insulin 30 minutes after a fatty meal?

 

[Antje77]

So would you say to take the other half of fast acting insulin 30 minutes after a fatty meal?

I would never give specific dosing advice. It's not allowed on the forum and it would be quite irresponsible.

We're all different in how we react to insulin, in both the amount we need and the timing.
I need to prebolus by at least 30 minutes for most meals but my friend can dose and eat right away. If she would do what I do she'd be hypo before finishing her meal. If I did what she does I'd be high for hours after my meal.

So I'd have a look at what happens with your bg around meals to see if this tells you something about the timing.

 

[Gardevoir]

I also find that I am a lot more insulin resistant when my bg levels are over 10. I'm using humalog but once I go over 10 I have to inject a lot more for the same drop than if I'm less than that. eg my personal correction ratio is normally 1 unit of insulin brings me down by 3mmol/L but when I'm at 11 or 12 it's more like 1 unit per 1 mmol/L . (Note please don't use my ratios, your figures will be completely different).

It's very nice knowing someone else also experiences the same. You helped 2 people in 1 thread

 

[Jantype1]

This is my first post on this and thought i would give it a try. I am a type 1 diabetic and got diagnosed when i was 16. For quite a while now i been struggling to control my sugar levels and have been fluctuating quite a bit even though i feel like im taking my insulin at the right time and also using the correct does of novorapid when its high which a lot of the time doesnt even come down. Ive been told fats in food can effect it quite substantially and was wondering if anyone has any tips how to solve that. Ive been told to take like half of my insulin before my meal and the other half after if the food contains a substantial amount of fat?

Also i want to mention I play football regularly during the week and when i play on a saturday no matter what i eat or take insulin wise before the game it is always high and when i try to take more it still doesnt go down. Like for arguments sake there was once i took like 15 units for 2 bits of toast and some scrambled egg as i was getting frustrated and by the time i started my warm up the reading would be over the roof and would be like that till after the game.

Would be much appreciated if i could get any feedback on this

I too struggle with my levels when I do any sport - I play tennis and I can be hyper or hypo. I thought it was to do with my reading before starting to play so I have been experimenting with food to try and get within the green zone (libre view) at about 9 and keep it that way. This is proving difficult as it tends to go up rapidly (as high as 15) at the beginning of the game, which I think is the body's response to intense physical exercice, then sometimes it will drop after about 50 minutes and once I get to around 7 I have to start taking glucose in order to stay in the game. This week for the first time ever I stayed around 8 the whole time! This is since changing to Levemir which I inject in the morning (20 units) and Novonorm 4g per day. I was previously on abasaglar which was causing nocturnal hypos.
Obviously the change in meds has helped me but I think that as regards sport it's not just what you eat immediately prior to playing but also what you have during the day of play. I've started to do high protein starting at breakfast with eggs, meat, veg and hey a bit of pasta for lunch and a small ham sandwich an hour before playing with more ham than bread. Lots of tennis players chew on a banana during play - I cannot as my sugar goes way too high! My normal regime on days when I don't play tennis would be veg, fish, veg soup, and virtually no added carbs. Please note I only eat wholemeal carbs, any white bread or pasta is a nono.
Good luck with getting your levels stable and keep playing football - I am convinced that tennis keeps me sane !