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Type 1: Problems with high lunchtime BG readings lately...

ptw1953

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Hi to anyone reading this post.

I am a type 1 diabetic. Have been for these last 23 years (since i was 40). I have never tested my BG in all these years, and relied on how I felt to judge how much QA insulin to take - usually 10 units per meal (yeah, I know...) but when I took early retirement from my job, I decided to get a grip, and I completed the DAFNE course in November 2015. One of the bet decisions i have made in my life, I have to say.

6 weeks before the course began I attended a routine pre-arranged appointment at the diabetic clinic, to get my HbA1c. It was 115mmol iirc, the result of being stupid for so many years.

6 weeks after the course ended, I attended another routine appointment at the clinic, and because I had determined to bring down the HbA1c result, I had a reading of 57mmol. I was very happy.

I maintained this level until late October this year when I had another routine appointment (9 months after the last one). The reading was 46 mmol, but doctor told me that I had many low BG readings in the mornings, and that I should reduce my morning BI by one unit, and that if I was still low in another 2 weeks, I should reduce my evening BI to the same level. This I duly did, and felt better in the mornings. I had to increase my morning QA ratio to 1.5:1 to get the lunchtime reading to an average of 8.0. Still too high for my liking, but I determined that i would work to manage my QA levels better. I have, and now read 7.5 on average when i awake, and 6.5 on average at lunchtime.

All good and well so far, but this last week my lunhtime BG readings have been 11.0 on average (I eat the same food amount at breakfast everyday) and this is causing me some disappointment. I am not ill, and am keeping fit and busy.

Pehaps I am being too hard on myself, as I increase my QA at lunchtime, and by 5pm I am usually back in the 5.5 - 6.0 range, although sometimes I am low (3.0 - 4.0) at circa 4pm, so I take a sip of lucozade.

I am very scared to take too much QA in the morning. I suppose what i am asking people is; am I worrying about nothing?

Not controlling my BG at breakfast/lunchtime is making me a tad depressed. My next apointment at the clinic is in January 2017.

I apologise for the length of this War and Peace post. I hope I am maing sense...

ptw1953
 
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Welcome @ptw1953 :)

Are you in the UK? I'm a little confused by your test results above. When you say "97" do you mean 9.7 or are you using the US units @ptw1953 ?
 
Hi azure. Thank you for your post. I have amended my post. I was using HbAc1 readings to make my points, and not normal readings. Silly is as silly does...
 
Ah, thanks for that :)

I wouldn't be happy with a before lunch reading of 11. If I got such a reading, I'd consider things like was I ill or stressed, was my insulin ineffective eg because it had become too warm, had I put on weight, was my basal dose correct, etc, etc

A lot to,consider!

Many people have to up their basal during colder weather/darker days. So you could first do a basal test to make sure that's at the correct level and is working for you.

I test two hours after meals - I don't leave it until the next meal. Have you tried doing that? If so, what are your results?
 
I am very scared to take too much QA in the morning. I suppose what i am asking people is; am I worrying about nothing?

Not controlling my BG at breakfast/lunchtime is making me a tad depressed.

It seems like you migh need to check whether your basal rate is keeping you on check in the morning, if your happy that's ok look at whether your morning I:C ratio is working. What is your bg at bed time, pre breakfast and two hours after breakfast? What are you eating for breakfast? When do you bolus in relation to eating?

What's making you scared of insulin in the morning? In accordance with DAFNE you have noted a pattern (having to correct with lunch every day) so now you make small adjustments to doses to correct that morning rise.
 
I dose for BF and then need another dose about 1.5 hours later to stop the rise and sweep up the cortisol rise. Lately I sometimes even need another small dose 2 hours after the last one. I had to up my basal as well since dark cold weather. I can't up basal more or I'll hypo. Cortisol and DP are beasts
I would rather take extra shots ( as fun as it isn't) and stop the spike.
 
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