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Working late so eating late.. Extremely high fasting blood glucose levels.

Discussion in 'Type 1 Diabetes' started by Haeloo, Oct 19, 2018.

  1. Haeloo

    Haeloo · Member

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    Hi guys,

    I am becoming extremely worried I have been working in a new job (personal trainer and fitness instructor) foe the last few months. I don't get home until 10 ish so am eating my dinner around 10.30pm. I take tresiba 16 u at 8 am km the morning do fasted cardio and don't have breakfast as Nd my fasting bs have been ridiculously high ie. 15+ mmol every morning. I eat a high fat moderate protein lie carb dinner going to bed as Nd take roughly 4-5 units of novorapid with it but it seems like no matter how much insulin I take they still come in high in the morning. They tend to swing quite low come the evening time so when I come in after work they are quite tight . 4.2 ish mmol. As I eat most of my food at night can anyone give me any tips or tricks if they gave found a way to manage blood sugars around such a lifestyle. (ps I start work late afternoon... 4 pm and I also do some form of resistance training around 1pm everyday.) also I am roughly taking 14 u novorapid everyday to account for high blood sugars and any food consumed.

    Kind regards,
    Leah
     
  2. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    I would experiment with the timing of your basal [tresiba], you could maybe move it to before bed instead......

    I would definitely do a basal test over night also.....your evening meal hasn't got any carbs so that makes it ideal to test the basal.....you may need to adjust it upwards.....

    I am certainly not an active person like you are but the best basal regime for an active person like yourself in my opinion is a split dose using Levemir.....

    Other basals can be split, but I believe Levemir responds best to it...

    There could be some dawn phenomenon taking place as well.....do you know what this is?
     
  3. Haeloo

    Haeloo · Member

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    Thank you so much for your reply.. I do indeed. I think I'll do a few basal tests over the next few nights. You are probably right moving the tresiba might help. I just really want to be careful I don't get low blood sugars during work, and that my mot. ING readings are lower.

    Do you mind me asking what asplut levemir is? Is that a bolus half in the morning half at night?

    Leah
     
  4. LooperCat

    LooperCat Type 1 · Expert

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    That sounds awfully like dawn phenomenon to me, do you have a Libre so you can see how your levels trend overnight?
     
  5. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    Levemir is a long acting background insulin like Tresiba, last about 12-18 hours, obviously everyone is different and larger dose will last longer....

    So you can split it evenly over a 24 hour period, but it can be split unevenly too, so a dose before bed, so 8 or 9 hours, then a dose at breakfast to last till the before bed dose again....

    the split allows you to adjust each dose independently, so ideal if you are a lot more active in the day....

    its all about experimenting and adjusting to get it right for your own body.....

    as mentioned, dawn phenomenon could be at work, so the liver spitting out glucose in the hours before waking...unfortunately you really need to break your fast to stop that process...

    food for thought....
     
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  6. Haeloo

    Haeloo · Member

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    I don't unfortunately Mel... Is it hard to get approved for one?
     
    • Agree Agree x 1
  7. Haeloo

    Haeloo · Member

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    Really really helpful info. Thank you. I might chat with my consultant about levemir so. Thank you so so much!!!
     
  8. Deleted Account

    Deleted Account · Guest

    Libre may be available from the NHS (assuming you are in the UK). Some areas have very strict criteria. Others are more likely to provide them. You will have to ask your diabetes team to find out what your local criteria is.
    However, you can purchase one yourself to try it out. I believe the cheapest place to get them at the moment is Asda Pharmacy at £44 each. One Libre lasts for 2 weeks.
    If you want to know more about Libre, there are many many many threads about it on the forum.
     
    • Agree Agree x 1
  9. bmtest

    bmtest · Well-Known Member

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    It's a new job so things do run high till your confident, understand the profile of insulin you are using and test more while experimenting. Think of you body like an steam train fire engine its slow to start on a morning and bring boil once your ticking over it will stay static with mimimal top up of food or insulin.

    For example run 3 mile on a week night for 1st time you will be hypo next day its shock to body and you may struggle on run depending on diabetes experience, what i am saying is once you have mastered a routine your body is used to it.

    Test more often while you adjust your routine is not that out of the ordinary, also carb count and inject accodingley to your ratio.

    I eat late and down 3 pints around 1 am but thats my routine, I like to inject long lasting at night for me it gains the easy marks while I am asleep the only problem for me is the 3 pints can make me inject fast acting instead of 24hr insulin and its a big shocker when you wake from sleep with this scenario as no one in my house ever helps me get down stairs for anti venom with tiled floor in pool of sweat.
     
  10. Haeloo

    Haeloo · Member

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    Thank you

    Thank you! Im living in Ireland so I must contact the team to see what the situation is like here.. I do know its more difficult for adults here. I wonder is there anywhere online you can purchase them or does asda pharmacy ship?thank you for this info regardless.
     
  11. Haeloo

    Haeloo · Member

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    You're so right.. I'd just love to feel some way on top of things after 4 months. I'm sorry to hear about your episodes.
     
  12. Haeloo

    Haeloo · Member

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    Hi guys,
    Thank you for all your help and support.. I've been splitting my dose of basal and it has been working really well.. Only the last two mornings I've been coming in at 18 and 16 mmol.. I went to bed last night at 13 mmol took 2 u of bolus to correct and woke up at 5am to test and was 19 mmol at 5 am. I corrected this again with 3 units of bolus and woke up this morning, did 30 minutes of hill sprints and skipping and tested 40 mins post exercise and was 16 mmol. Anyone know what might be going on? I'm following a very low carb keto style diet of max 20-30g carbs a day.. Last night for dinner (at 10.30 pm) I had butter fried brocolli leeks and chicken. I was 7 mmol before dinner..i took 2 bolus units with dinner and was 4.2 mmol 40 mins post dinner and then like I said 13 mmol 2 hours post dinner right before bed.
     
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