Struggling....

[lynde89]

Hi There,

Firstly I am new to the forum, so Hi!! :wave:

I'm a T1 & will have been for 20 years in October! But seem to be struggling at the moment.....

I didn't really have a smooth handover from the pediatric clinic so not sure if something went amiss there. At one point I was on 45 units of Lantus a day plus 18 of Humalog with meals as a starting point, and with a new nurse we soon realised that was way too much for my weight etc. I am on lower doses for both insulin types & am trying to alter the fast acting with carbs etc (I am due to go on DAFNE this year). My sugars seem to be fine sometimes but can raise quite high for no apparent reason, which is really getting to me! For example last night before bed my bloods were 14, I woke up this morning at 6.7 but not hugary & feeling a bit funny so didn't eat, by 2 hours later they were at 15.7 so I did some correction. I am working on this with an insulin specialist at the moment but wanted to see if anyone else had experiences with this or had any ideas?
My main thoughts are background insulin and doses? I know this may be a bit of a stupid question but is it possible that if the background insulin is too high the liver could be kicking in & sending out glucose, hence the highs??

I'm just at a bit of a loss at the moment so looking for some advice & support from people who understand, so any comments/ideas welcome!!

thanks!

 

[LauraJayType1]

Hi There,

Firstly I am new to the forum, so Hi!! :wave:

I'm a T1 & will have been for 20 years in October! But seem to be struggling at the moment.....

I didn't really have a smooth handover from the pediatric clinic so not sure if something went amiss there. At one point I was on 45 units of Lantus a day plus 18 of Humalog with meals as a starting point, and with a new nurse we soon realised that was way too much for my weight etc. I am on lower doses for both insulin types & am trying to alter the fast acting with carbs etc (I am due to go on DAFNE this year). My sugars seem to be fine sometimes but can raise quite high for no apparent reason, which is really getting to me! For example last night before bed my bloods were 14, I woke up this morning at 6.7 but not hugary & feeling a bit funny so didn't eat, by 2 hours later they were at 15.7 so I did some correction. I am working on this with an insulin specialist at the moment but wanted to see if anyone else had experiences with this or had any ideas?
My main thoughts are background insulin and doses? I know this may be a bit of a stupid question but is it possible that if the background insulin is too high the liver could be kicking in & sending out glucose, hence the highs??

I'm just at a bit of a loss at the moment so looking for some advice & support from people who understand, so any comments/ideas welcome!!

thanks!

I had a similar problem with my sugars on the morning.. They could be between 5-7 and i wouldn't eat then hours later they would be 14-17. My nurse said its because of wake up hormones and said even if i didn't eat breakfast i'm best off taking a few units of insulin to cover the hormones. As far as i know if the background insulin was too high you would be having a lot of hypo's through the night. Hope I've helped a little


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[lynde89]

Is that the dawn phenomenon? I have heard the term but not 100% on what it is.
Do your sugars seem to go up a bit toward the end of the day too?
I'm just worried that I will end up on a ton of insulin /.
Thanks for the response )


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[Faith*]

I have a similar problem if i don't eat. My sugars will slowly creep up. I've gotten round that by eating at certain times of the day, small snacks pretty much every 2-3 hours.

The dawn phenomena from my understanding is where your going to bed with reasonably good sugars and maintaining this through the night until you get a release of hormones just before waking, this then increases your sugars drastically. I need to do a little research in to that though because I didn't have that problem, mine was purely my background insulins. Hopefully someone will be along shortly with advice about this.

I definitely recommend the DAPHNE course or similar, it will really help you to understand how carbs work and enable you to get just the right about of insulin for each foods - eventually anyway, takes a while to get used too.

Hope this has helped a little.

 

[LauraJayType1]

They used to go up towards end of the day and my doctor said to take my long acting insulin at the same time every day which helped. Do you do that already?


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[SamJB]

I get the dawn phenomenon but it just means I need more insulin at breakfast. Never skipped breakfast because I get too hungry! Since I need more insulin then it probably means my levels would rise.

If you didn't eat or inject within a few hours of bed then I'd say your basal is too high. Best thing to do is eat the same breakfast, lunch and dinner, at the same time each day. Write down your levels before and 2 hours after eating. Also bedtime and morning levels. You should then be able to spot patterns and adjust accordingly. Feel free to post your numbers on here I'm sure lots of people can help.

Most important thing is to get your basal right as it will be difficult to figure out the correct bolus dose otherwise.

 

[lynde89]

I definitely need to get on DAFNE!

I try to but it's not always the case, I think I may have to pick a time & set a reminder to get back into the routine.

Sometimes I feel like I need a refresher although I've been doing it for a long time! & looking back it has all changed a lot. How long have you guys been diabetic?

Thanks again for the replies


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[LauraJayType1]

I've been diabetic nearly 9 years, i think i need a refresher on some things too. Like injecting insulin as i've got some bad habbits when injecting ect :O


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[donnellysdogs]

Diabetic T1 since 1986. No complications.

Going back to original details of going to bed at 14, dropping to 6 then back up to 15.. That is some quite considerable swings in bg levels ..are you normally 14 bg before going to bed? Did you guve a correction to bring it down to 6? Are levels consistently running like this?

 

[cranium]

Hello all, I am new to this forum & diagnosed T1 in August 2012, I am told by the diabetic team I may be in the"honeymoon " period, so far I eat what I want, but in moderation & I still eat Magnum ice cream but a small portion x every 1-2wks


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[cranium]

Ps I have also just downloaded this forum app to my phone & wanted to try it lol


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[lynde89]

There was no correction to get it down to 6. Sometimes I will wake up higher than I have gone to bed & sometimes lower. I know I really need to get my head around the carb counting or just trying to cut it out. & maybe regimented meal times till its more sorted but there always seems to be something else going on!

Do you all really think that insulin requirements can vary so much from person to person? I am doing 27 of Lantis at the moment before bed.


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[donnellysdogs]

Yep I do think everbody varies so much with their insulin and I believe thsts why Consultants and Doctors can get it so wrong with treatments... As their advice is based on theory and 5 minute snapshots of people's lives. They dont live our lifes knowing whether we are active or sat around etc... Some wont even know what jobs we do... So when first diagnosed they have to find a starting point that is 'safe' for us to improve from there on.
Only you know your life and activitys.. And they can vary day to day... And they will against everybody elses too... Even if you had a twin your requirements wouldnt necessarily be the same for insulin..

 

[lynde89]

Very true! I haven't exercised for a while now as was told not too if my sugars are too high (above 9) so am itching to do something!!

I am just doing some steak & green beans for dinner, my bloods were 15.6 (not too pleased) so I have done 4 units of humalog based on not having any or minimal carbs so I hope this will work!


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[mrman]

Hi, Ive always been told not to excercise if above 13. 9 should be ok to excercise and even then you might need a snack depending on the length and type of excercise and also how much qa insulin left. Was told that on the dafne course.

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[lynde89]

Hi Brett, thanks!
Do you find different exercise effects you differently? When I played football my sugars would always shoot up & drop back down later on. I was told this was due to the adrenaline & release of glucose by the liver


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[mrman]

Yeah same while doing any cardio I do go up as my body thinks I need more energy but within an hour of stopping it wants it back lol, so I always need to snack afterwards.

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[Belteshazzaruk]

Dafne is really helpful, but i found that even then my numbers often don't add up or make sense. When i tried a pump for 2 weeks in january my figures were so much better, applying all the principles i'd learnt on DAFNE. The background can be adjusted to match daily spikes caused by hormones. If you haven't already discussed pumps then ask to -they're not just for people who don't like injections (in fact they're potentially more hassle), they are just a lot more like a pancreas.

 

[Geri]

hi, not sure if I can be of any help but ...
i was put onto 2 small injections of basal insulin to help control morning sugars, could this help you? I take one injection at 6pm and then another with m ymorning bolus or quick acting insulin.

Also, I sometimes get a rise of B/S in the morning after being fine the night before. My diabetes specialist nurse mentioned that if sugars are low during the night, especially when on low doses of basal insulin, then if hypo occurs the liver releases sugars? that will raise blood sugar levels in the morning. This sometimes occurs with me, especially when i feel hypo but go back to sleep - and then wake up with high blood sugar. I am on quite a low does of basal insulin - 5 or 6 units, so its quite low. Im not sure whether youre dosage would account for this? but I thought it was worth mentioning.

Im also on a strict carb counting diet and find that sometimes blood sugars are affected by things that Ive eaten a day before .

ive had diabetes for 42 years and have had many ups and downs with control. hope this gets sorted out for you. 8)

 

[dave howard]

There is no such thing as a typical diabetic,we are all individual and as such have our own tolerances to both foods and insuliins. The most a diabetic specialist can do is offer assistance. You need to take their advice and learn from trial and error as well. If you know what each of your insulins are supposed to do then you should be able to try things out and adjust according to the outcomes. Keeping a record is a huge asset. I find that I need to eat with my fast acting insulin for it to work. E.g. if I am late eating breakfast and my waking 6.2 has crept up to 10 taking 6 of fast acting does nothing unless i eat something small with it.