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Type 1: Blood Sugar All Over the Place Really Need Help Adjusting Levels

Just reading through this thread and my first instinct was the basal is running out over night causing the morning highs, was going to suggest split dosing the levemir too. I'm surprised your HCPs haven't suggested anything to help with your increasing hba1c results.

Anyway, you've decided you want to get on top of this and now taking appropriate action, good for you and keep on it! Keep asking and posting - we're all in this together.
 
@akaust I am often thwarted in attempts to do basal testing. Deep breath & try again when you feel like giving it another go.

There is the option to try a super simplified basal test by just seeing how you do overnight - might help to bring your meal forward a little bit if possible with your commute. Test before bed, test on waking - have you changed loads or are you stable? You want the basal to achieve that stability. It's not as good as a proper basal test, but its not as frustrating if nothing is achieved and you probably really should be testing before bed and on waking as a matter of routine anyway - it's a good place to start with keeping an eye out for patterns and changes with basal requirements on a continuing basis.
 
What about Exercise ! a gentle walk which you could increase in distance after a while, will certainly help your body burn the sugars and assist with the control.
 
Hey, I have had this problem all year this year, doctor was less than useless but finally got referred and turns out I stupidly hadn't moved my injection sites around enough and my insulin wasn't being absorbed properly. Moving injection sites all over my legs instead of just top of things and belly has sorted it out totally. I eat a lot of carbs, have been diagnosed for 4 years and am type 1. Good luck and hopefully you'll be able to figure it out but I would definitely get help from your diabetic nurse. I got a half unit pen to use while I figured it out!
 
You seem to rise during the night or when getting up??

1) do you test during the night at all, if no, then I would suggest a couple of nights when yountest 4 hours after you went to sleep.

2) do you test as soon as you wake whilst still in bed or after you have got up and about to eat?

Reason I ask this- some people can have dawn phenomenon or waking or both....
Ie I can be 5.0 when waking and testing in bed but I currently need 4.5 units of bolus in me immediately. Hubbie then gets me2 drinks before my feet hit the floor... But I need this to just get up. I then have a brunch of melon and yogurt about 11am and proding I have had those 4.5!units I will be under 6.0. If I didn't I'd be in then20's..

Have you tried basal testing at all? I would suggest you try..
 
Hi akaust. Well I think you've got more than enough information from everyone so far. The solution is there it just takes a bit of trial and error and figuring out. One bit of advice I would offer is, don't let this little glitch get you down and depressed, you're at the start of a lifelong journey, you've had the honeymoon period now it gets a bit more challenging. Take all the advice given and I'm sure you'll find the solution to your problem. Just remember that it's you that has control and not your diabetes. Good luck.
 
Lots of helpful comments to try to assist. I will add some if I may. Your fasting blood sugar levels should be around 6 approx before breakfast. If not you will have high blood sugars throughout the morning. Try this: get up early - 4 or 5 and test. If high and yours will be then inject some insulin. Don't test again for at least an hour( that is how long you need to give the insulin to start working.) Your aim is to get your sugar levels between 5 and 8 pre breakfast. Now if your levels are up around ten or more you really don't need food for breakfast. It's simple you need to lower your blood sugars and adding more fuel means you will need yet more insulin. In drug users terminology you are chasing the rat! So cut down on fuel and aim to get your levels down by using enough insulin. People will tell you you are using too much or not enough. My first consultant told me to ignore them. His motto was you need as much insulin as necessary!!!!
 
If you keep a record of your carbs and insulin (novorapid) try dividing your daily carb by units of insulin you need, you may find your ratio is nearer 1 in 7 or 8 rather than 1 in 10.
273g carb
39 units novorapid
is nearly 1 in 7, perhaps you should try this ratio for a few days.
 
I didn't read through all the comments here, so some of this may be a repeat. I'd like to give my two cents worth, but first a little about me. I've been a T1 for 48 years. I still have my toes, my kidneys work (mostly!), and I don't have heart disease. I take Levemir morning and night, and Humalog for increases in carbs or unexplained highs.
My opinion is to look at this more holistically. You will have a very weak and tiring schedule if you try living by insulin and testing alone. Diabetes affects everything. Stress, exercise, and sleep can all affect your sugar levels.
It doesn't mean you can NEVER have sugar (fortunately), but you must plan for it and compensate with insulin. For me, it's not worth it. I try to use sugar-free Torani syrup in my coffee - and very little at that - along with brewing it with cinnamon. Some say cinnamon helps with absorption of insulin; it has helped me.
I recently got my sugars under control by giving up carbs for the most part and eating on protein and fat. Some days it's tough, but for the majority I feel so much better that I don't miss it. I make all the meals for my family, so I substitute mushrooms for my carbs at dinner - like making Baked Spaghetti for my family with noodles with chopped mushrooms instead of pasta - and I've even won one of my family over to my side.
All this to say it doesn't stand alone. It's a way of life, not just a shot. I know that sucks for sure. I hope this is helpful (at least a little). Coming here is your best support, so you've taken the best first step.
 
RAPS_od said:
but seriously, diabetes is a sugar allergy. If you were allergic to, say, peanuts, eating one or having peanut butter could kill you.
Click to expand...

Hello @RAPS_od - this is incorrect, stating that diabetes is a sugar allergy is misleading to the OP, in the context however that consuming sugar means administering insulin to regulate the blood glucose levels then it is a justifiable argument to suggest reducing or omitting sugar from your diet as being beneficial to the OP.

Sugar is a carbohydrate and so we must view any carbohydrate as having the potential to raise blood glucose levels for which insulin is a necessary requirement.
 
Diabetes is an auto immune disease not a sugar allergy. Although that might have been meant figuratively it can still mislead people.

I'd also add that a young relative has a peanut allergy and I don't think the comparison is accurate at all.
 
Hi all- Finally had my sugar level at a normal level this morning although had a hypo during the night and had to get up and have a glass of juice to sort it out (didn't finish dinner). Any way, my sugar level was 7.8 at 8am this morning and have taken 10 units of levemir last night at 8pm and 10 units again this morning at 8am

Sugar Levels So Far:
8:00 -7.8
9:30 - 9.4
10:30 - 10.4
(will update again later)
Its pretty clear so far that the levemir is not doing enough to keep my levels stable and this is with a much increased split dose (i was only taking 15 units once a day before which explains a bit of the problem)

@Magic172 - I am going to start back at the gym again in the next month so hopefully that will help a little
@adrian12 - I was using the same spot for a while but in the last few days have been using my legs as i have been wearing shorts and that still did not make much of a difference
@donnellysdogs - I test as soon as I wake up and have set an alarm recently during the night to test when i have eaten late and taken novorapid
@therower - thanks for your kind words - I really am taking control of this now I am more determined than ever to get on top of it
@davej1950 - Is this how i figure out how many units i need per 10 grams of carbs?
@RAPS_od - I have already stopped the sugar in my tea and coffee - Got sucralose yesterday and it is a really good substitute

Will update the basal test a bit later on today and hopefully someone can help me adjust the levemir dose.
 
@akaust Well done on getting your basal test done

In regards to increasing your amounts the rule of thumb as taught to me by my nurse and DAFNE is that to only increase by 10% at a time, then leave for 3 days, check and change again if necessary, the idea being that 10% is a small enough adjustment to not throw you too much if you do err on the side of being too low.

Once your basal is right everything else will fall into place.

BTW what caused your hypo last night ?
 
You may find your 'during the day' results are slightly higher now you're only having 10u of basal in the morning instead of the 15u you were having before (but which was then running out over the night), and judging by last nights result you may be having a touch too much basal before bed - may I suggest moving 1 or 2 units from the night time to the morning basal - but give it a few more days before changing basals again.
 
Hello again,

@Juicyj - Will move to 11 in the morning and 11 at night and retest in a few days thanks for your help with that. Last nights hypo was caused by taking novo and not finishing dinner then going to bed luckily woke up and corrected it.

@slip I think last night was more to do with the not finishing my meal and also not knowing exactly how much novo to take per 10g of carbs at the minute because I was overdoing it before to compensate for the lack of levemir which is now doing more. I revcieved the think like a pancreas book yesterday and am going to look at that to find out how to test how many mmol a unit of novo lowers sugar by and how many units of novo to take per x grams of carbs

UPDATE ON THE BASAL TEST
8:00 -7.8
9:30 - 9.4
10:30 - 10.4
12:00 - 10.2

When can i stop taking readings is this enough now?
 
Hi @akaust Yes I would stop now - go and have something to eat
 
Hi akaust, you mentioned starting back at the gym. Be aware this can have an impact on your blood sugar NOT only during and shortly afterwards. From personal experience a good workout can effect blood sugar up to 6hrs later. Do plenty of checks and see how you respond to exercise and make sure you hydrate before you exercise and keep a good stash of emergency carbs with you. Happy training.
 
Yes, Think Like a Pancreas talks a bit about the effects of exercise on later blood sugars, so that should help.

But well done. You made a lot of progress in a few days so clearly a systematic approach helps and your control was not as disastrous as you appeared to think at first.

And a very good exercise habit you've got there!


Sent from my iPhone using DCUK Forum mobile app
 
Just a question.. Do you have breakfast?

I have to have about 4 or 4.5 units of bolus because my levels rise so sharply when my legs hit the ground and I start getting up.. It maybe that just a 0.5 bolus would stop that rise that is shown in todays readings...

lowering my evening basal injection and raising my morning one worked well for me but it still did not sort out the immediate rise in my levels when I got up.

Have you got a 1/2 unit pen for levemir. Now you've got your levels lowerish I would personally only change by 1/2 a unit on your levemir doses if you need to adjust.
 
What you are doing is adding extra novorapid to the next meal to try to bring high levels down it is better to have the right amount for each meal, not play catch up.. If you keep records, go back and divide total daily carbs by novorapid. My wife started off on 1:10, eventually after less than 12 months she was on a 1:5 ratio then she tried a gluten free diet aiming at 150 g carb a day. The ratio went back to 1:8 and her daily requirement went from 45 units a day to 20. it is now about 7 - 7.5 ratio and relatively stable.
 
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