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too many hypos,,help me

J

jasontaylor1963

Member
Messages
8
Type of diabetes
Type 1
Treatment type
Insulin
ive started a new job,ive gone from being a lazy tattoo artist(12 years) to being a scaffolders labourer(very physical) im 50 years of age,im a type 1 insulin dependant(1998 I was diagnosed) I use 20 units levimar at 5 am,, then I have 20 on route home around 5pm ish, ive had 4 hypos in 2 days while working, do I need to cut down my levimar? as im having loads less nova rapid,,, please help,as I can physically do the job, but hate having the hypo's as nobody there really understands what im going through...
 
help pleaseeeeeeee
 
Yes, I would certainly lower levimir.


Loving life
 
Whate are your hypo's - night and day?


Loving life
 
Was that anywhere within 2-3 hours of your bolus for food? If so it could still mean that your bolus is too much. However if you having night hypos as wel that would indicate levemir....
How many units of quick acting bolus do you have on average a day whilst working?


Loving life
 
well its a new job,very physical, so im having less nova rapid, today at 10.30 I had none as id had a hypo an hour earlier,to which I had lucozade and a banana, then my levels was on 12,i had 4 units of nova,id usually have around 16 if my levels was that high, I hd a sandwich,but still had another hypo at 3.50pm????
 
So is that your total quick acting 4 units all day? Compared to 20 units levimir twice a day..
I would if it was me be lowering your levimir.
I'm on a pump 4 years so not the best one to advise how much by.. But again if it was me I would be considering 15 units night and day because It easir then to adjust from a higher level on mdi rather than battling hypos.


Loving life
 
Just read your other post with whole days details.. Will respond on that. Waking at 19 means not to adjust your afternoon levimir...


Loving life
 
no no no,,I would usually have nova 3 times a day ,it was 10-12 units at breakfast, then 12=16 for lunch and around 24-30 for evening meal,dependingon what I was eating,but this new job is messing my levels up,so im trying to adjust to it,but not sure what to do!!! today I had 6 units at 5am,then a hypo at 9.30am, then a sandwich at 10.30am to which I had 4 units, then I ate again at 2pm,bag of crisps and an apple,but no insulin,then another hypo at 3.50pm, had lucozade, then I had 22 units with my evening meal,,,
 
Hi.... Unfortunately for you baking hot weather is known for causing blood vessels to dilate and make insulin work much quicker causing low bg levels and on top of that, youvr now got a very physical job so a good recipe for hypo frenzy...

Best thing is probably reduce the morning levemir by about 2u and test bg a bit more. Can you nibble a snack while you are working to prevent the low bg? It can take about 30hrs for basal rate adjustments to have an effect so dont overdo the adjusting.
 
jasontaylor1963 said:
help pleaseeeeeeee
Click to expand...
ok thanks,i'll adjust tomorrow,,will let you know,many thanks,,,
 
By the sounds of it you've tailored your levemir for a very sedentary job and now becoem very much more active and the extra exercise will affect your insulin sensitivity. I think you really need to be looking at basal testing over periods of the day to see how it is holding you, so split the day into a few chunks, and be prepared to be hungry.

Sorry if I'm teaching you to suck eggs and you've done. this beforeWhat you need to be doing is taking your basal as normal, then fasting. You need no bolus in your system, so no food/bolus for four hours before.

So for a morning test, no breakfast, BG tests at 7,9, 11, 1pm, then eat again as normal.
For a mid day test, breakfast early, start testing every 2-hours at say 12, 2pm, 4, 6, dinner after 6
Similar pattern for evening and overnight

If you find yourself dropping with no food then you need to adjust the basal, I'd start with 10% at a time.

You may find that you need to do this at weekend and midweek as the physical work may give you different insulin sensitivity. Once you have the basal right then you can play around with the bolus.

Hope that helps
 
levemir can be adjusted a lot quicker than that. I can tailor a morning dose to exercise that morning with no issues.
 
Hi. I agree that you need to get the Basal right before adjusting the Bolus. One simple way but not as good as ElyDave's post but may get you started is to adjust the Basal to have a morning fasting blood sugar between 5 and 7 mmol. Adjust by a unit or two per day (downwards?) and measure to check levels. With regard to Bolus it sounds as if you don't have good control at all. Are you carb-counting? If not this is something you must get into; talk to your diabetes team and ask questions here. It will help avoid hypos if you aren't already doing it. The number of insulin shots implies you may be overweight? If so then reduce your carb intake and reduce your insulin to match; again testing all the time
 
ElyDave said:
levemir can be adjusted a lot quicker than that. I can tailor a morning dose to exercise that morning with no issues.
Click to expand...

Yes..... I too found any adjustment to lantus znd levemir worked fairly quickly but the usual forum advice is to wait a good 24hrs or so to allow for the zdjustment to show full effect which in many ways does make sense. As for basal testing....lol this is going to be hard when ur up to your eyes in muck and filth carrying bricks on a building site isnt it?
 

Absolutely, but can you suggest anything else?

At least he's a scaffie rather than a brickie.
 
I suspect you may just need to keep topping up your carbs while you are working...

You're doing a job that's physical, you are probably fitter and will need more fuel.

I find that even something as gentle as playing golf will require carbs topping up regularly on the way round or I'll hypo,so carrying tubes, climbing scaffolding and so on will burn up the sugar in your blood faster.
 
Difficult to do a fasting check when working as a scaffolders labourer as it's hard graft, you could just cut back on your basal and see how that goes as suggested, start with 2 units off your morning dose and monitor as best as you can.
 
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