Wrong Direction

[tommyj]

Hi guys,

I am a newly dx'd Type 1.5 - had been dx as Type 2 6 months ago but metformin & gliclazide where having zero impact - I started insulin yesterday and my levels have went the wrong way!

I just started using Apidra (6 units around each major meal) & Lantus (6 units @ bedtime) yesterday - my levels have been around 12-13 for weeks now but this morning pre-breakfast I got an 18.1??? Is insulin not meant to make my bg go down - or does it take a few days to kick in? I havent had an 18 pre-breakfast reading in months.

Yours confused

/TJ

 

[noblehead]

tommyj,

You'll have to give lantus a couple of days before you can be sure that the dose is right for you, if after this time your morning readings are still high try increasing the dose by a unit at a time and wait 2 days before adjusting again. What was your before bed bg reading?


Nigel

 

[tommyj]

Unfortunately I didnt do a pre-bedtime reading - I must do that this evening. Cheers.

 

[sugar2]

HI,
The one thing I know for sure os that they will have started you on a "too low" dose, on purpose. The idea being that they start you low, and build you up slowly...rather than giving what they think you may actually need, and risk over estimateing, and having you crash with low blood sugars. Test as regularly as possible...and also take note of the amount of carbohydrate that you eat. For a few days, while you [lay with your levels, it may be worth sticking to the same amounts of the same foods...so the only variation is your insulin levels. That high reading could have been caused by eating lots of carbs? There are various approaches to mainting the best blood sugar, but we would all agree, that the more carbs you east, the more insulin you need....so keeping this consistent for a few days while you start to sort things out might be an idea? Then, when you getthe lantus levels stabalised, you can look at a ratio for food insulin, that works for you. This can take a while, so please don't get disheartened!

 

[totsy]

hya tommy,
it can take a while to get the dose right, your diabetic team will be starting a low dose and building up slowly, try not to worry

 

[the_anticarb]

my dsn told me that it's more common for people to be given too high basal doses to start with, as apparantly we don't need as much basal as some doctors think, so if they have started you off low and let you build up, that's really good better than starting off with too much and going hypo. The base insulin dose is definitely trickier to work out than the bolus, as it lasts so long. just build up gradually and if you are in target before meals, then you will be at the right dose

 

[tommyj]

Well thats 6 days over me and as predicted my levels have evened out somewhat - I'm still on 6 units across the board (4 times daily) but today's readings have been 7.2, 7.5 and 6.2 - massive improvement thanks to the insulin.

Gym starts tomorrow evening - I think the general guidelines are to check before and after - if anyone has any other tips let me know - I'll probably mistake being fe***d as being a hypo as I have no idea what a hypo feels like!

 

[totsy]

hya tommy,
let us know how u get on with the gym

 

[sugar2]

Check before and after...if you are below about 5, I owuld have a light snack.

To me, early hypo feels a bit like he feeling you get when you have a few drinks? Not drunk...but you know you shouldn't drive/phone your boss etc,as you aren't quite right. I am a lightweight..and get this feeling after 1/2 a glass of wine (cheap date!) and other fet it after 1/2 a bottle...but it is a distinct stage, beyong which I have a hangover.