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Type 1 Diabetes
Tresiba, Dawn Phenomenon, Split Dosing
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<blockquote data-quote="LooperCat" data-source="post: 1802284" data-attributes="member: 468055"><p>Thank you for such an informative and well thought through suggestion, [USER=468714]@kitedoc[/USER] - it’s all so complicated, isn’t it? I think my body is very uncooperative, because it doesn’t seem to follow the rules on DP. </p><p></p><p>If I am a little higher than I want to be at bedtime (around 2200), I’ll take a small correction dose. This works at my usual evening ratio of 1u:3mmol - a correction would be around half a unit, never more than 1u. I’ll then sleep solidly until I get woken with a start at some point between 3am and 8am (I usually get up at 8, that’s when I take my Tresiba, the joys of being self employed and running my business from home means I can run my hours to suit!). It’s not like when you wake with a hypo, there’s no sweating, shakes or any of the usual symptoms of that. I just wake up. From fast asleep to wide awake in an instant. So I scan the Libre, and can see that (usually) the trace is even, steady and constant in my range - after basal testing I’m happy I’ve got the dose right for overnight stability - with a slight tip up that seems to have happened in the last half hour or so, usually an increase of 0.5-1mmol above my bedtime reading. The pic of my scanner shows a typical example. The arrow marks where I was awoken just after it had started to rise. So I took however many units I’ve calculated is right (quite a bit of trial, error and dextrose went into working it all out), and it bottomed out at around 4.5mmol, which I’m happy with before climbing slightly to the 5.4 on the screen. It’ll climb slowly through to about mid morning, so I sometimes have to take a unit correction to keep it under control. </p><p></p><p>So I don’t know how it deals with it, but it certainly seems to - I can bore you rigid with all the scanner shots I’ve collected showing that it really does <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite2" alt=";)" title="Wink ;)" loading="lazy" data-shortname=";)" /> After I’ve done the jab, I just read my kindle until I fall back to sleep. </p><p></p><p>[ATTACH=full]26888[/ATTACH] </p><p></p><p>On the rare occasion I manage to sleep through the hepatic alarm clock, I’ll end up with something like this one, and it’ll take me all morning to get it back into range, because I’m quite insulin resistant in the morning. </p><p></p><p>[ATTACH=full]26889[/ATTACH]</p><p></p><p>I do inject into muscle when I want faster corrections in the daytime, usually a deltoid, and then work it to make it speed up. But if/when I can nip that dawn rise in the bud before it really gets going, I have a nice, steady BG day. If I can’t, I tend to be a bit all over the place. So as inconvenient as all this is, if I were to try a midnight jab, I’d still have to set an alarm and wake up, because I’m asleep well before then! I suspect I’d hypo if I tried that, to be honest. Especially if it all kicked off later rather than earlier - for the same reason, I don’t think a pump would be the answer, as the timing is really variable and unpredictable. I even recorded and charted the time it happens agains sunrise, outside and room temperature, my basal waking temperature and bedtime BG, but there was no correlation. </p><p></p><p>Today has been lovely so far. Woke at 5 with a 6.1 that was just showing signs of rising (went to bed on a 6.5), so I took 1.5u Novorapid, and it’s been running in the mid fives and low sixes all day so far. I’ve just had a protein shake, so I’m hoping that’ll stop the slump later. I’ll let you know! But thank you for putting so much though into it all, I really appreciate it x</p></blockquote><p></p>
[QUOTE="LooperCat, post: 1802284, member: 468055"] Thank you for such an informative and well thought through suggestion, [USER=468714]@kitedoc[/USER] - it’s all so complicated, isn’t it? I think my body is very uncooperative, because it doesn’t seem to follow the rules on DP. If I am a little higher than I want to be at bedtime (around 2200), I’ll take a small correction dose. This works at my usual evening ratio of 1u:3mmol - a correction would be around half a unit, never more than 1u. I’ll then sleep solidly until I get woken with a start at some point between 3am and 8am (I usually get up at 8, that’s when I take my Tresiba, the joys of being self employed and running my business from home means I can run my hours to suit!). It’s not like when you wake with a hypo, there’s no sweating, shakes or any of the usual symptoms of that. I just wake up. From fast asleep to wide awake in an instant. So I scan the Libre, and can see that (usually) the trace is even, steady and constant in my range - after basal testing I’m happy I’ve got the dose right for overnight stability - with a slight tip up that seems to have happened in the last half hour or so, usually an increase of 0.5-1mmol above my bedtime reading. The pic of my scanner shows a typical example. The arrow marks where I was awoken just after it had started to rise. So I took however many units I’ve calculated is right (quite a bit of trial, error and dextrose went into working it all out), and it bottomed out at around 4.5mmol, which I’m happy with before climbing slightly to the 5.4 on the screen. It’ll climb slowly through to about mid morning, so I sometimes have to take a unit correction to keep it under control. So I don’t know how it deals with it, but it certainly seems to - I can bore you rigid with all the scanner shots I’ve collected showing that it really does ;) After I’ve done the jab, I just read my kindle until I fall back to sleep. [ATTACH=full]26888[/ATTACH] On the rare occasion I manage to sleep through the hepatic alarm clock, I’ll end up with something like this one, and it’ll take me all morning to get it back into range, because I’m quite insulin resistant in the morning. [ATTACH=full]26889[/ATTACH] I do inject into muscle when I want faster corrections in the daytime, usually a deltoid, and then work it to make it speed up. But if/when I can nip that dawn rise in the bud before it really gets going, I have a nice, steady BG day. If I can’t, I tend to be a bit all over the place. So as inconvenient as all this is, if I were to try a midnight jab, I’d still have to set an alarm and wake up, because I’m asleep well before then! I suspect I’d hypo if I tried that, to be honest. Especially if it all kicked off later rather than earlier - for the same reason, I don’t think a pump would be the answer, as the timing is really variable and unpredictable. I even recorded and charted the time it happens agains sunrise, outside and room temperature, my basal waking temperature and bedtime BG, but there was no correlation. Today has been lovely so far. Woke at 5 with a 6.1 that was just showing signs of rising (went to bed on a 6.5), so I took 1.5u Novorapid, and it’s been running in the mid fives and low sixes all day so far. I’ve just had a protein shake, so I’m hoping that’ll stop the slump later. I’ll let you know! But thank you for putting so much though into it all, I really appreciate it x [/QUOTE]
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