Stuck in a BG rut!

SamJB said:

Hi Hale,
What does 1 unit of Novorapid bring your levels down by? For me it's 2 mmol/l, so if I find myself in the 7s or 8s I'll give myself a single unit. Obviously best not to do this if your out and about, or prone to hypos. Also best not to stack a few correction doses close together or they could all come back to bite you!

If 1u brings you down by 2 mmol/l too, then why not just increase your meal-time doses by 1 unit?

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A half unit takes me down 3mmol/l...... So I would guess 1 unit would drop me by 6 lol the joys of insulin sensitivity! I need to gain a bit of weight so I guess that will improve as the weight goes on, but it's not easy to gain weight and eat healthily AND be conscious of carbs!

qbix said:

Nuts, avocados and cheese are great for getting calories in. My brother is following a paleo diet ATM and makes himself a paleo porridge with coconut milk almonds and cashews. Says it is lovely

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I ADORE cheese. Like really. Almost every meal has cheese on it haha

That porridge sounds awesome. Have to be a weekend treat though, midweek I eat at my desk with porridge from the canteen lol good thing it tastes good anyway

ElyDave said:

very quick, rushed question, I'm not being rude, just short of time.

Who told you to reduce your basal after exercising? I 'm on a higher basal dose than you with 8 at noight and 6 in the morning and I have NEVER yet changed the evening dose even on days of signifcant exercise. I have dropped it from 6 to 3 in the morning when I know I'm going to be doing extended endurance exercise - 2 hours plus of running, cycling etc. At the same time I will drop my Novorapid dose immediately before the exercise to one unit.

Generally, to avoid post exercise hypos, if I'm exercising before a meal I will lower the post exercise meal dose by a factor of 30-50%. I very rarely exercise immediately after a meal, and find that if I run 3hr + after lunch I won't need to change the lunchtime dose.

And like you I can find even walking has an effect, so walking from the Carmelite Hotel to Talisman House has resulted in me testing at <4.0 on arrival because I didn't frop my breakfast dose.

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Carmelite to talisman is a deceptively long walk, most of it is a gentle incline too. Nice choice of hotel though

So take an average day when I'm going to have a run, I eat lunch at 11.30. Usually 1 unit Novorapid with that assuming its from the canteen. Leave work at 4, drive home etc test before run and usually have a Jaffa cake (9g carb) because I know ill drop while running. Ill start my run around 5pm (over 5 hours since lunch bolus) and do 4k usually, about 30-40 minutes (need to improve that!). Test again at home etc. basal at 6pm, reduce by a third, so only 1 unit. Dinner is normally pasta based, 30g portion for me. I reduce the Novorapid here too, take usually 0.5 or 1 unit instead of 1.5 dependant on the meal content. The next morning breakfast at 7am at normal ratios.

Initially I didn't reduce basal, just skipped bolus with dinner. It technically worked, in that I would wake up at a good level but I would obviously have a huge spike before hand. The next day I would have random hypos and generally be a bit of a shambles. I phoned the DSN and she suggested this way around instead. So far so good anyway! Such small doses though.

The other place I know suggests reducing basal is the book "think like a pancreas"

elaine77 said:

Hi Hale,

Maybe ur starting to move ur way out of honeymoon? I think the only options are adjusting basal or low carbing as already mentioned... Or u cud always hit the vodka haha that brings me down by about 2mmol rather quickly! Lol

I think eating a normal amount of carb when ur not in the honeymoon anymore would probably stop u from being able to have such perfect control but obviously as I'm not even on insulin yet I appreciate my input is limited...


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

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I hope it's not ending yet! But you could be right

I believe that for many people low carb is the only option, but I know I couldn't sustain it for the rest of my life. So I need to find another way! My daily carb intake is usually 35g breakfast 30g lunch and 30g dinner. A 5-10g snack is usually needed sometime late afternoon too, but that's to prevent exercise hypo. So around 100g per day. Obviously that differs for various situation bug it rarely goes above 150g. For many people that's considered low carb anyway! (Just not super low carb lol)

I'm able to do basal at whatever time I like, but I choose 6pm because I am almost always at home at that time. I'm 23, I still go out a lot. I figured I didn't want to carry my Novorapid AND my levemir if I could avoid it!

Difference is I only started exercising again in June, as my body gets used to that I imagine I would need to go further and longer before I need to decrease it. You exercised before hand and have just carried on through. My puppy came just a few weeks before my diagnosis so I had no incentive to exercise before.

I'm up at half 5 already for work... If I got up any earlier to run it would still be the middle of the night haha

It does frustrate me that I have to feed the insulin..... Even through there's no Novorapid still acting! I'm at the hospital a week tomorrow so I want to talk about it then

Elaine - it's actually easier once it has happened! I actually first had symptoms 5 years ago and they were passed off as anaemia.... But they never went away. I was one of the few students who would rather take a nap than go tp a party. Even when diagnosis came I had trundled along for 2 months before going to the doctor, and my ketones were only at 0.9. So I think I could have been LADA. But right now it doesn't matter to me provided I'm being treated. I've baked cupcakes for my team at work today. I know I can have one at lunch time provided I count for it, a lot easier than diet controlled!

elaine77 said:

I guess thats true. Im struggling with diet at the moment, not because I cant cope on a low GI healthy diet but because it wont make 1 bit of difference to my diabetes longterm as insulin will be inevitable so im going thru a phase of 'wot the hells the point' at the moment... Ever since I was sent home to 'wait to deteriorate' iv just lost all determination, theres no point. Wish i wasnt autoimmune :-(

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Totally see your point there. With Type 2 I guess there is incentive, in many cases the insulin dependency is possible to avoid. But as autoimmune you know it's coming, it's just a case of when.

I bet you most T1.5 people pass through this phase at some point. I guess if there was evidence that eating low GI etc would delay onset etc you'd have more motivation to keep going! Chin up, relax a little bit with it and I'm sure your motivation will return

Because levemir had a slightly shorter than 24 hour timeline for most people if I injected in the morning I could be without insulin at some point from midnight onwards. Not ideal. So they recommend evening, but anytime in the evening is fine.

Travel certainly has complications with eating out etc! I don't envy you that