Yo Yo blood sugars after new insulin regime

[Elliejane]

Hi
Type 1, only diagnosed a month ago.
I've just started on Novorapid and Levemir from Humulin M3, and have struggled to control my glucose levels. I'm carb counting using a accuchek expert had 3 occasions where my glucose levels have dropped sharply about 1h 15mins after eating. I think either my ratio is wrong, or wondering if my food is being absorbed more slowly than the insulin is working. Seems to happen on higher doses (6-8 units) and lunch / evening. The problem is I then have to eat more to prevent a hypo - then my levels shoot right up from 4s to 15-20 3-4 hours later. Any advice? Or any similar experiences? Maybe I just need time to work out what suits me.

 

[Kristin251]

I had the exact same thing. I would plummet, need to eat and then go hyper.
For me it was the timing of each macronutrient coming in at different times
I solved the problem by going very low carb ( less than 20 a day) and reducing my insulin by A LOT. In my experience carb counting didn't work at all. In theory it sounded good but I always rode th roller coaster. Now I eat the same macronutrients at each meal during the day and know my exact dose that keeps me steady

Perhaps someone who figured it out can help. I sure couldn't get it right. Maybe if I split doses I could but not interested in that. I think pump users have better luck. Also, besides low carb I need to watch my protein as that will raise me well. I think it's more common in type 1's.

 

[Elliejane]

I had the exact same thing. I would plummet, need to eat and then go hyper.
For me it was the timing of each macronutrient coming in at different times
I solved the problem by going very low carb ( less than 20 a day) and reducing my insulin by A LOT. In my experience carb counting didn't work at all. In theory it sounded good but I always rode th roller coaster. Now I eat the same macronutrients at each meal during the day and know my exact dose that keeps me steady

Perhaps someone who figured it out can help. I sure couldn't get it right. Maybe if I split doses I could but not interested in that. I think pump users have better luck. Also, besides low carb I need to watch my protein as that will raise me well. I think it's more common in type 1's.

Thank you Kristin! I am going to try reducing both my carb intake and my insulin dose tomorrow and see how that helps...

 

[azure]

Thank you Kristin! I am going to try reducing both my carb intake and my insulin dose tomorrow and see how that helps...

You could try reducing your ratio @Elliejane

A basal test would also be sensible. But don't panic. It's early days on your new regime and it'll take you a while to get used to it.

I also suggest you speak to your DSN for advice as when I swapped from mixed insulin to MDI, my doses needed a number of tweaks..

Reducing carbs wouldn't be my first choice unless you're eating an excessive amount.

Can you give us an idea of what you're eating?

 

[paulliljeros]

hi @Elliejane , the other alternative is to continue with the carbs and foods that you are eating, but look at both the Glucose Index and the fat content of the foods. Low GI foods are absorbed much slower, and higher fat foods slow down the absorption of carbs. If you are eating meals with slow absorption, you can consider splitting your bolus dose, and taking perhaps 50% before the meal, and then the other 50% a short time after starting to eat. There are no hard and fast rules here, so trial and error with blood tests to confirm what is happening is the best way forward.
On a pump, I will often take 30% or 40% up front, and then spread the remainder over 4 hours, but this is obviously not possible with injections. Hope that helps

 

[slip]

Could be all manner of things involved here, honeymoon, carb ratios, carb counting errors, hypo over treatment, food types, wind direction..........

Give us a run down of everything and we can advise but your DSN is there to help too.

 

[Daibell]

Hi. Getting the Basal right is always the first priority. Yours may be right already. There are different approaches to doing the balancing depending on whether you split or not. A rough check is that your morning fasting blood sugar is between 5 and 7. May be you are taking too many carbs when you're going too low and overshooting. When I go low I just have one or two glucose tablets which is a controlled amount.

 

[himtoo]

Hi there @Elliejane
welcome to the forum
as you are only diagnosed a month ago and have had a change in insulin regime as well , you should be on the phone a couple of times a week to your DSN to discuss blood sugar results , doses , any exercise and events in your life.
all of these can affect blood sugars.
Right now it is also really important to remember it is very early days , you can only gain experience in real time , so it is important to be kind to yourself.

trying to establish some routine can help a lot too in these early months.
so for example sticking to a few meals that you know the carb value , eating at the same times , and regular testing are all things
that can help you to get your bloods in range more of the time.

reducing carbs would not be a priority in these early months.

do keep posting too !!
all the best !