Sugars all over the place

[Ruby1982]

My bf is 29 and has bee type 1 since he was 14. We have been together just over a year and in that time I've seen him take about 6 hypos. Recently his sugars have been very low and he's had a few hypos over one week, he went to see his diabetic nurse who thinks his liver is not storing s reserve of sugar causing his sugars to drop. He has changed how he takes his insulin.p and has reduced it slightly. He takes his lantus at morning and tea and novo rapid at lunch this only changed last week, he used to take his lantus and novo rapid and lunch and then lantus again at tea. This week his sugars have been very high when he's woken up, 19 being the highest and today when he got home from work lower than 2.5 but he was fine and didn't show any signs of hypo. I'm a little confused by the levels being so high then so low. He has his lunch between 1-1.30pm and is home by 4.15pm, can his sugars drop so low in 3 hours? He has been referred to get a monitor fitted to keep track of his sugar levels for a week but still waiting on appointment coming for that. He has been using his monitor to test his sugars as he didn't before. It's all a little over whelming for me so any help/advice would be greatly appreciated.

 

[TorqPenderloin]

Are you saying he only takes his Novorapid at lunch?

Hopefully, that's just a misunderstanding, but if it's not, that's almost certainly the source of his issues.

Novorapid is a bolus (fast-acting) insulin and is used to correct for blood sugar increases caused by carbohydrates (and to a lesser extent protein and fat). It's (nearly) impossible to have good control only using it once a day and the dosing should match his insulin:carb ratio.

We each have our own insulin: carb ratio. For some people (like me) it could mean 1 unit of insulin (novorapid) for every 25g of carbs I eat. For other people it could be 1 unit of insulin for every 5g of carbs they eat.

If he doesn't know how to carb count then he's guessing and it's impossible to have good control guessing at how much insulin you need.

Hopefully this helps a bit. Probably not what you want to hear, but it's what works for most of us.

 

[Lynz84]

Hi Ruby!

Super impressed with the knowledge you have gathered about the condition thus far! Its complicated isn't it? Does your BF do carb counting as a way of managing his insulin? If he doesn't, direct him to the diabetes uk website and it has big sections on carb counting and ratios etc. That's how I learnt about it, very useful! If his sugars are dropping between his lunch and home time, maybe he needs a snack to sustain his sugars and prevent them from dropping.
My insulin changed in Oct and for the first week or two I was an absolute mess trying to get things in order, one minute high, the next I'm nearly being scraped off the floor, but it does even out so hang in there!

 

[Ruby1982]

Are you saying he only takes his Novorapid at lunch?

Hopefully, that's just a misunderstanding, but if it's not, that's almost certainly the source of his issues.

Novorapid is a bolus (fast-acting) insulin and is used to correct for blood sugar increases caused by carbohydrates (and to a lesser extent protein and fat). It's (nearly) impossible to have good control only using it once a day and the dosing should match his insulin:carb ratio.

We each have our own insulin: carb ratio. For some people (like me) it could mean 1 unit of insulin (novorapid) for every 25g of carbs I eat. For other people it could be 1 unit of insulin for every 5g of carbs they eat.

If he doesn't know how to carb count then he's guessing and it's impossible to have good control guessing at how much insulin you need.

Hopefully this helps a bit. Probably not what you want to hear, but it's what works for most of us.

Maybe I have them round the wrong way, which I hope I do, I will have to check. What your saying make total sense, if I'm honest I need to understand it better, which I'm doing a rubbish job at if I don't know what insulin he takes and when! He said he had to reduce his insulin to 36 from 38 but that was all. I ask too many questions to him which annoys him but I think it's better for me to ask than be in the dark and not know

 

[Ruby1982]

Hi Ruby!

Super impressed with the knowledge you have gathered about the condition thus far! Its complicated isn't it? Does your BF do carb counting as a way of managing his insulin? If he doesn't, direct him to the diabetes uk website and it has big sections on carb counting and ratios etc. That's how I learnt about it, very useful! If his sugars are dropping between his lunch and home time, maybe he needs a snack to sustain his sugars and prevent them from dropping.
My insulin changed in Oct and for the first week or two I was an absolute mess trying to get things in order, one minute high, the next I'm nearly being scraped off the floor, but it does even out so hang in there!

It is complicated and I find it hard sometimes esp when he has a hypo. I just want to be able to understand it more and help him. I can recognise the signs when is sugars are low so that's a bonus, he takes lucozade sport to try and bring them up but I'm sure there's something out there that works quicker, just haven't found it yet. I will have to ask him if he carb counts, he has said he adjusts his insulin based on what he eats but sometimes he likes to have a cake. It's only been this past week they have dropped between lunch and home time, usually he can last until teatime, he will have something if he needs it. He's very stubborn though. He didn't eat breakfast first thing either he would have something about 10ish but now he has to eat breakfast. I'm hoping its just with the change that his body's just getting used to and it settles down. hopefully he can get this monitor fitted sooner rather than later and the hospital can see what's going on.

 

[TorqPenderloin]

Maybe I have them round the wrong way, which I hope I do, I will have to check. What your saying make total sense, if I'm honest I need to understand it better, which I'm doing a rubbish job at if I don't know what insulin he takes and when! He said he had to reduce his insulin to 36 from 38 but that was all. I ask too many questions to him which annoys him but I think it's better for me to ask than be in the dark and not know

It sounds like you’re doing an excellent job of caring about him so don’t beat yourself up. Anyone would be lucky to have a partner who cares about their diabetes management as much as you seem to.

Lantus is a basal insulin which means it’s slow acting and meant to last throughout the day. If his Lantus dose was perfect, his blood sugar would stay level if he fasted (didn’t eat) for half of a day. If his Lantus dose is not perfect (and I doubt it is), his blood sugar would slowly increase or decrease over time which would lead to hypers or hypos.

Novorapid is a bolus insulin which means it’s meant to be fast acting and to “correct” for blood sugar increases cause by food that converts into glucose. Every well-regulated insulin-dependent diabetic (that I’ve ever met) knows EXACLY what their insulin:carb ratio is. Again, there is no standard and each person is different.

I’m willing to bet that your boyfriend is annoyed by your questions because he doesn’t know the answer to most of them.

 

[noblehead]

@Ruby1982, is your bf aware of basal testing? It might be his lantus doses are wrong..............hence the high bg in the morning and the hypo late afternoon.

 

[Jaylee]

It is complicated and I find it hard sometimes esp when he has a hypo. I just want to be able to understand it more and help him. I can recognise the signs when is sugars are low so that's a bonus, he takes lucozade sport to try and bring them up but I'm sure there's something out there that works quicker, just haven't found it yet. I will have to ask him if he carb counts, he has said he adjusts his insulin based on what he eats but sometimes he likes to have a cake. It's only been this past week they have dropped between lunch and home time, usually he can last until teatime, he will have something if he needs it. He's very stubborn though. He didn't eat breakfast first thing either he would have something about 10ish but now he has to eat breakfast. I'm hoping its just with the change that his body's just getting used to and it settles down. hopefully he can get this monitor fitted sooner rather than later and the hospital can see what's going on.

Hi,

You sound like a caring person.. Get yer BF to sign up & ask first hand..
Also he needs to keep records to help the docs help him.. There are some great phone apps for this...

 

[Ruby1982]

It sounds like you’re doing an excellent job of caring about him so don’t beat yourself up. Anyone would be lucky to have a partner who cares about their diabetes management as much as you seem to.

Lantus is a basal insulin which means it’s slow acting and meant to last throughout the day. If his Lantus dose was perfect, his blood sugar would stay level if he fasted (didn’t eat) for half of a day. If his Lantus dose is not perfect (and I doubt it is), his blood sugar would slowly increase or decrease over time which would lead to hypers or hypos.

Novorapid is a bolus insulin which means it’s meant to be fast acting and to “correct” for blood sugar increases cause by food that converts into glucose. Every well-regulated insulin-dependent diabetic (that I’ve ever met) knows EXACLY what their insulin:carb ratio is. Again, there is no standard and each person is different.

I’m willing to bet that your boyfriend is annoyed by your questions because he doesn’t know the answer to most of them.

Thank you! He takes 32units lantus in the morning and his novo rapid at lunch and tea. He used to take the lantus at tea think that's where I was getting confused. His nurse said to take 30 units from 36 but his sugars have been so high during the night/morning, getting up to the toilet 3/4 times a night. Last night just once so slight improvement. I think once he gets the monitor fitted and the Drs can see themselves what's going on it will sort it's self out.

 

[Ruby1982]

Hi,

You sound like a caring person.. Get yer BF to sign up & ask first hand..
Also he needs to keep records to help the docs help him.. There are some great phone apps for this...

I don't think he will sign up he's not very technology minded lol! A phone app sounds like a good idea, any in particular?

 

[Jaylee]

I don't think he will sign up he's not very technology minded lol! A phone app sounds like a good idea, any in particular?

I use an app on my iPad (just like a big phone.) called Diaconnect. But there are other apps that are just as capable..