# Hello and a brief introduction



## Eternal422 (Aug 2, 2022)

Hello everyone!  Initially diagnosed as Type 2 at age 42, but very quickly progressed to insulin and current diabetes healthcare team consider me a late onset Type 1 (GAD antibody tests were inconclusive having been done quite some time after my diabetic symptoms appeared).  

After initial care under my local hospital to get me started on a basal-bolus insulin regime I was discharged back to my GP for many years to continue under my own steam and achieved fairly good BG control.  

After a house move and a new GP, they referred me to the hospital (now having virtual appointments!) who have got me on the Freestyle Libre 2 as well as getting me to make changes to my insulin dosing to improve my HbA1C which had just crept up outside the “normal” range.

Looking forward to learning more from everyone here and maybe being able to help some people with my experiences!


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## rebrascora (Aug 2, 2022)

Hi and welcome. 

Great to hear that you have Freestyle Libre now you finding that? Did you get any training or do the Libre Academy modules on the Abbott website? Understanding the differences between Libre readings and BG readings and the Libre system's limitations and foibles can be useful, particularly if you have been reliant on finger pricking for quite a while. The extra information Libre gives you is amazing though.

Which insulins are you using? You must be doing something right if you have managed to maintain your HbA1c in the normal range until fairly recently. That is good going! 

Is there anything particular which brings you to the forum at this time ie. any specific problems or questions or are you just wanting to compare notes with others in a similar situation? Whatever caused you to join the forum I hope you will make yourself at home and that you find it as beneficial as I have over the past 3 years since I joined. Look forward to getting to know a little more about you....


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## Eternal422 (Aug 2, 2022)

rebrascora said:


> Hi and welcome.
> 
> Great to hear that you have Freestyle Libre now you finding that? Did you get any training or do the Libre Academy modules on the Abbott website? Understanding the differences between Libre readings and BG readings and the Libre system's limitations and foibles can be useful, particularly if you have been reliant on finger pricking for quite a while. The extra information Libre gives you is amazing though.
> 
> ...


Hi there and thank you for the welcome!

My last HbA1C was about 56 if I remember correctly, so just creeping up a bit.  I am using Levemir at night, currently 28U and on the hospital’s advice have changed my Novorapid from 1U : 10g CHO to 1U : 8g CHO.

I had the initial webinar from Abbott to start me off and have done the Academy modules.  Only on my first sensor which was great for 4 days and then suddenly started reading around 2.5 lower than BG even when BG has been stable for a period.  I understand the differences between BG and ISF testing and pleased with the first 4 days being “close enough” to make insulin dosing decisions.  However now I’m wondering whether I can trust the system to that extent.

That really is the reason I joined now, to try and learn more about the system and improve my overall control.  I’m so grateful that my local health centre have referred me to the hospital and their care has been brilliant, including getting me on the Libre straight away!  

I now feel that I want to learn from others to help me as well as possibly being able to help others with my experiences.  There are times when I “fall out” with diabetes and testing, carb counting and taking insulin every time I eat become very wearing.  So hopefully I can take some comfort here, getting and giving care and support.

Your HbA1C figures look really good - a massive improvement from your diagnosis!  Especially given a chunk of that time was during lockdown!  Interesting you went onto insulin almost straight away rather than the usual route of diet then Metformin ( which did absolutely nothing for me ).  But it must be working well for you given your figures and a good call from your doctor/diabetic team.

Take care and looking forward to chatting more!

Tony


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## rebrascora (Aug 2, 2022)

Hi again.

Interesting that you just take Levemir just once a day and on an evening! Not sure if you are aware but it it usually split into a morning and evening dose as it doesn't really last a full 24 hours.... usually about 16-20hrs depending upon the dose. I am on a similar number of units to yourself but I need much more in the morning and a lot less in the evening. I find that my needs vary quite a bit, particularly the night time dose. Today I injected 22u in the morning and 5 yesterday evening, but tonight I will probably just take 3.... maybe 3.5u as I have been quite active. I love my Levemir for the flexibility it provides to enable me to adjust my doses to fit my needs and the Libre for enabling me to see whether my current dose is holding me steady or if I need an increase or decrease.

Actually I was originally started on Metformin and Gliclazide and a low carb diet but the medication did nothing and whilst the diet was effective to some extent I had to whittle it down to very low carb ( it felt like eating cardboard as I was following NHS advice, so low fat and low salt etc as well, to get BG into single figures and after 6 weeks they started me on insulin as my HbA1c had gone up instead of down. Had the GAD and C-peptide about a month later and was confirmed Type 1 2 months after that when results came back. I remained on the Metformin for another few months but the Glic was stopped as soon as I was started on insulin. I think there is a broad spectrum of how Type 1 exhibits and is treated in more mature adults. I am just very thankful that I didn't experience DKA .... and hope I never do.  

Sorry to hear you are having problems with Libre 2 already. I have been using the original Libre (1)  which doesn't have the alarms and whilst I knocked a couple off reaching into animal feed bins or in the shower and had a couple that started reading low as you describe..... which can sometimes be because it has been dislodged slightly if it got knocked or caught on bra straps etc, they have mostly been really reliable and I often go days without finger pricking at all. 
I have just applied my first Libre 2 sensor today and I am monitoring with trepidation as some people have found they have had lots of problems with Libre 2 when they had no problems with Libre 1 and others find Libre 2 more accurate than Libre 1 and very reliable. It is hard to know if there have been bad batches which some people have been supplied from or if they have changed something with the Libre 2 and it is not suiting some people's body chemistry so well or if it is to do with the phone/software people are using. We have the odd member of the forum who has had 50% failure rate with Libre 2 which is really shocking and of course totally knocks their confidence, as it has obviously done with you already, having your first one fail. Fingers crossed your new one is better.... and that my first Libre 2 behaves itself. So far I have had a couple of incidents when it hasn't behaved quite as I would expect my normal sensor to work.... Normally Libre 1 reads lower than BG and will show me hypo when I am usually mid 4s. Tonight I felt a bit hypo but the Libre 2 was persistently showing me 4.8. I had some carbs anyway, but my heart continued to pound and when I did a finger prick, which I should have done earlier of course, I was 3.9 despite the carbs I had had and Libre was eventually showing me as 3.8 so pretty accurate but I had probably been hypo for about half an hour then, so it seems to be a bit further behind the curve than Libre 1 is for me.... I am just using the Libre 1 reader with the Libre 2 sensor because I don't have a smart phone so I don't have the alarm functions and not really interested in alarms to be honest as I have pretty good hypo awareness. It is only day one though so we will see how it goes from here. 

Anyway, great to have your experience added to the forum resources and look forward to learning from you as well as perhaps sharing tips with you that I have learned from others here.

Have you ever been offered a DAFNE course? Just thinking that that was instrumental in my Levemir dose being split and learning how to adjust it with more confidence.


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## Eternal422 (Aug 3, 2022)

Hi again, interesting you should mention about splitting the Levemir, I had been wondering whether that was needed, especially as before the Libre sensor started reading low and playing up, it was showing a gradual rise in BG during the day so that was always battling high BG in the evenings.  On my last consultation with the hospital I did ask if taking it just at night in one dose was still correct and they said yes.  But maybe they didn’t want me to make too many changes in one go, already suggesting increasing it 2U at a time for a couple of days as well as changing my carb ratio from 1:10 to 1:8.  But I will ask next week when I have another virtual consultation with the , so thank you for bringing this suggestion up!

Interesting that your path was similar to mine, although sadly for me the GP had just automatically assumed I was T2 and didn’t do the GAD/ C-Peptide test until it was too late to get a conclusive result, but I did get onto insulin fairly quickly.  Really glad they managed to get yours diagnosed and under control so quickly!

I wasn’t offered the DAFNE course, but when I switched to basal-bolus insulin (after asking for it from the GP), the hospital I was referred to did a great job in educating me and getting me sorted!

Really pleased to hear that Libre does work well for the majority of people and I hope your experience of the Libre 2 is positive.  I’m just hoping that this sensor is a glitch and going forwards that my experiences will be much better.  It’s such a useful tool and I was starting to learn more about what foods do what to me and how to better adjust my insulin to keep under tighter control.  Fingers crossed the next sensor will be good and I’ll start having some useful data to help!


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## Bruce Stephens (Aug 3, 2022)

Eternal422 said:


> But maybe they didn’t want me to make too many changes in one go,


Probably, but Levemir really doesn't last 24 hours so you can expect it to be an explanation for some problems.


Eternal422 said:


> I wasn’t offered the DAFNE course


There's online sources covering the same material (an in-person course has other benefits), https://www.bertieonline.org.uk and https://www.mytype1diabetes.nhs.uk


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## Eternal422 (Aug 3, 2022)

Thanks Bruce for the info.  Seems like I really need to split the Levemir dose and I’ll definitely bring this up next week on my hospital appointment.  I’ll take a look at the links too - after so many years I’m feeling that it would be well worth refreshing my knowledge and bringing it up to date too!


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## Eternal422 (Aug 9, 2022)

Well, had my phone appointment yesterday with the hospital and talked a lot over with my DSN.  I asked about splitting the Levemir dose but my DSN said that for the time being it would be best to continue as I am without making too many changes in one go.  I’m changing from my old 8mm needles down to 4mm (apparently 8mm is now considered to be too much and the shorter needles should ensure the insulin is injected in a more useable position) and continuing with 1:8 carb ratio, titrating the Levemir up further if needed to achieve better results at fasting and then throughout the day.  I’ve also got a dietician appointment, but not until October.  I also have a new range of 4.5 to 8.9 (previously I was using 3.9 to 10), something which should help me to get tighter control and improve my HbA1C.

But, you know what has affected me more than anything?  They have confirmed that I am Type 1.  Initial diagnosis was Type 2 at age 42 but very quickly it became apparent that first diet, then metformin wasn’t working so I was onto insulin within a short space of time (probably as much as 2 to 3 years, but that was more down to the GP at the time going through the diet then metformin pathway).  My nurse said that how my BG was reacting to the injected insulin (and the amount needed) also proves that my pancreas is not generating any at all.  Apparently the consultant would call it “presumed type 1”.

I guess I suspected / knew this all along, but having it actually verified has somehow hit me emotionally.  Nothing changes of course to how I’m managing it and I now have some super support from the hospital team so all positive.  Maybe after 20 years it is starting to sink in a bit and leaving me feeling a little knocked out about it!


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## Bruce Stephens (Aug 9, 2022)

Another advantage of the shorter needles is that they can be thinner, so they're a bit nicer to use (the shorter length is also nicer of course).


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## Eternal422 (Aug 9, 2022)

Bruce Stephens said:


> Another advantage of the shorter needles is that they can be thinner, so they're a bit nicer to use (the shorter length is also nicer of course).


Hopefully I won’t get as many bruises either!


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## rebrascora (Aug 9, 2022)

Sorry to hear the confirmation of Type 1 has knocked you sideways a bit. I think there is always an element of hope with the Type 2 diagnosis that somehow you might be able to push it into remission whereas the Type 1 diagnosis is a confirmation of a lifetime of injecting insulin. I know you have already been on insulin a long time but I guess it is the finality of it. 
I do wonder at them adjusting your bolus ratios instead of getting your basal right first because when you come to sort your basal out, those ratios will likely need changing again. Basal doses are the foundation of good management. If your basal dose(s) are correct or as close a fit as possible then everything else makes sense. If basal isn't holding you level in the absence of food then you are starting on uneven foundations and that will mean you have to keep correcting as you go along, but no doubt they will have their reasons. Just seems odd to me. Hope the smaller needles are more comfortable and that your new Libre sensors behave impeccably to make up for the failure of your first one.


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## Eternal422 (Aug 9, 2022)

Thank you Barbara, you are spot on : I guess I was thinking that I might go into remission or something, even though deep down I knew I wouldn’t.  I feel somehow a bit more vulnerable in a way, even though nothing has changed in my health or treatment.  Having health anxieties doesn’t help which I think is why I focus on the technical aspect of things to avoid going down the path of worrying about diabetic complication, etc. even though I am getting all my regular screening and there are thankfully no issues.

My DSN did say about increasing the Levemir which I’ve done but not sure whether that’s quite correct yet.  I’m hoping the Libre will be a big help in showing me how that’s working.  What you say about a stable foundation makes perfect sense, so I’ll see how it goes.  My DSN did say that she would look at reviewing everything with regard to basal, bolus, carb rations and correction factors on my next appointment in November by then hopefully I’ll have loads more data, fingers crossed for some good Libre sensors!


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## Eternal422 (Aug 11, 2022)

Just a quick update : sensors now on my repeat prescription and first couple now received.  Also now using the 4mm needles (down from 8mm) and I must say they are brilliant!  I was doing the, apparently out-dated “pinch an inch and inject into that” with the 8mm, now with the 4mm no more pinching and I can painlessly inject across a much larger area of my tummy - great for varying injection sites and avoiding the dreaded lumps with unpredictable release of insulin!  Maybe no more bruises as well!

Oh, and the replacement sensor is running well.  I’ve decided to use the Libre for making bolus decisions and trust in it rather than doing finger pricks and worrying about whether the sensor is accurate or not.  I guess it is like comparing apples and pears and ultimately not worthwhile.  My DSN did say to trust the sensor and bolus based on its readings, so here goes!


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## everydayupsanddowns (Aug 12, 2022)

Thanks for the update Tony, and glad you’ve found us 

I guess it’s not unexpected for the confirmation of your diabetes type to have knocked you sideways a bit - I guess it’s a bit like getting diagnosed all over again!

But it’s great that you have access to Libre2, and as a T1 (should you become interested in it) you could always explore pump therapy or ‘hybrid closed loop’ (where pump and sensor work together with a degree of automation) if you end up with some frustrations of insulin dosing that you just can’t seem to fix with injections. 

Once you’ve got used to your new meal ratios if I were in your shoes I’d probably not spend that much time tinkering with single dose Levemir, if I was planning to try a split dose. As @rebrascora says, I see basal as my foundation, and getting / tweaking that ‘right’ on an ongoing basis seems to fix most of the problems I am having with meal doses/corrections.

When I was on injections I came across the concept of basal testing, and it made a *huge* difference, suddenly removing much of my diabetes randomness (that ended up being related to wonky basal). 

There’s a write-up here if you think it would help you









						How To Successfully Test Your Basal Rate
					

Are you looking for basal rate information and testing instructions? Perfect! You're in the right place!




					www.mysugr.com


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## Eternal422 (Aug 12, 2022)

Hi Mike and thank you so much for the link to basal testing. I’ve had a quick read and keen to give it a go, so will be reading it thoroughly before making a start. It makes perfect sense to get the basal right first and rather than wait until my next appointment at the end of November it seems sensible to start now. 

Had some high spikes today up to around 15 which is not normal for me, but we are away this weekend and eating different things where I’ve had to guess at carbs. Also a few drinks which despite carrying carbs do always seem to bring my BG down a fair bit. My sensor is showing around 4 now which feels a bit low to how I feel, but I’m resisting doing a finger prick test and just going with the Libre as I really want to trust it and go with what it is saying, otherwise it sort of defeats the purpose if I’m constantly checking it!

So glad I’ve found this forum, even though been a member of DUK for years I’ve never ventured into here and wish I had years ago as there is such a great wealth of practical experience from everyone here.


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## Bruce Stephens (Aug 12, 2022)

Eternal422 said:


> My sensor is showing around 4 now which feels a bit low to how I feel,


When my Libre says 4 I tend to assume I'm fine. (They usually read a bit lower than test strips and even if it's accurate 4 is in the normal range so I expect to feel normal, no different to 5 or 6 or 7.)


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## Eternal422 (Aug 12, 2022)

Thanks Bruce, it’s great to get confidence from you on this. I would start to feel a hypo at 4, but as you say, the Libre reads a bit lower than BG so treat 4 as normal. In fact another scan tells me it is now 5.5 so was starting to rise a bit anyway.

It’s all a bit of trial and error anyway I suppose, it’s just that the Libre is giving me so much more information than I’ve ever had before. But really loving it!


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## everydayupsanddowns (Aug 14, 2022)

Conversely, in an effort to reduce my exposure to 3.x’s to protect my battered warning signs i’ve been treating readings in the 4s with a little something for a few years. 

Partly because sensors are showing me what me levels were 5-10 minutes ago, and it doesn't take much of a drift for 4.x to become 3.x in 10 minutes. 

The trick is to treat cautiously and keep an eye on things, so as not to end up bouncing up too high. I’m happier in the 5s and 6s generally.


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## Eternal422 (Aug 18, 2022)

everydayupsanddowns said:


> Once you’ve got used to your new meal ratios if I were in your shoes I’d probably not spend that much time tinkering with single dose Levemir, if I was planning to try a split dose. As @rebrascora says, I see basal as my foundation, and getting / tweaking that ‘right’ on an ongoing basis seems to fix most of the problems I am having with meal doses/corrections.


Just a quick follow on question about this if I may?  New Libre sensor is behaving beautifully, now I can see clear patterns but do not know how to treat them!

Typically my overnight drops from around 8 to 5, than after breakfast it picks up to about 8 again despite covering the carbs with Novorapid.  It remains there until lunch, again covering the carbs, peaks at about 10 and drops back to 8 where it stubbornly sticks for the rest of the day.  Same thing for my evening meal.  From this I’m guessing that my carb counting and ratio stop the peaks, but although BG is level, it is a bit higher than I wanted.  I am presuming this is down to the basal, keeping things nice and steady, so I have just increased from 28 to 30 (still doing one shot at bedtime for now).

I’m probably answering myself here and need to look at splitting the Levemir dose?  I think maybe I need to speak to my DSN now rather than waiting until the end of November for my next appointment, but I’d be really interested to hear any other opinions on what has worked?


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## berryr99 (Aug 18, 2022)

Eternal422 said:


> Hello everyone!  Initially diagnosed as Type 2 at age 42, but very quickly progressed to insulin and current diabetes healthcare team consider me a late onset Type 1 (GAD antibody tests were inconclusive having been done quite some time after my diabetic symptoms appeared).
> 
> After initial care under my local hospital to get me started on a basal-bolus insulin regime I was discharged back to my GP for many years to continue under my own steam and achieved fairly good BG control.
> 
> ...


Hello and welcome,

My position is the same - type 2 on insulin for many years but my GP practice seem very uninterested in my care. I think they don't have the correct resources in place as my last visit earlier this month ended up with me explaining about dosage and carb counting. This visit didn't end well as I got quite annoyed - I have significant peripheral neuropathy in my feet which they hadn't even logged - seemed to want to bat it back to podiatry. This is a very useful forum and answers many questions.


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## Eternal422 (Aug 18, 2022)

berryr99 said:


> Hello and welcome,
> 
> My position is the same - type 2 on insulin for many years but my GP practice seem very uninterested in my care. I think they don't have the correct resources in place as my last visit earlier this month ended up with me explaining about dosage and carb counting. This visit didn't end well as I got quite annoyed - I have significant peripheral neuropathy in my feet which they hadn't even logged - seemed to want to bat it back to podiatry. This is a very useful forum and answers many questions.


Hi Robert, sorry to hear what happened with you at your GP.  When I started on basal bolus as a (then) diagnosed T2, they did refer me to the hospital where I got a brilliant grounding in how to self manage.  Having moved house 4 years ago, my new GP just kept things ticking over until this year when they told me that they didn’t really look after insulin treated patients, having them under the care of the local hospital instead.  However, that was a great step for me as I now have access to a great DSN, diagnosis changed to T1 (admittedly not something I particularly welcomed, but best to know where I stand) and been started on the Freestyle Libre.

Maybe, like me, you could ask your GP to refer you to the local hospital diabetic team to help you?

Like you, I’m so glad that I’ve found this forum and can hear other’s experiences and thoughts.  Let us know how you get on.


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## everydayupsanddowns (Aug 18, 2022)

Eternal422 said:


> Just a quick follow on question about this if I may?  New Libre sensor is behaving beautifully, now I can see clear patterns but do not know how to treat them!
> 
> Typically my overnight drops from around 8 to 5, than after breakfast it picks up to about 8 again despite covering the carbs with Novorapid.  It remains there until lunch, again covering the carbs, peaks at about 10 and drops back to 8 where it stubbornly sticks for the rest of the day.  Same thing for my evening meal.  From this I’m guessing that my carb counting and ratio stop the peaks, but although BG is level, it is a bit higher than I wanted.  I am presuming this is down to the basal, keeping things nice and steady, so I have just increased from 28 to 30 (still doing one shot at bedtime for now).
> 
> I’m probably answering myself here and need to look at splitting the Levemir dose?  I think maybe I need to speak to my DSN now rather than waiting until the end of November for my next appointment, but I’d be really interested to hear any other opinions on what has worked?



I can’t give you advice, as I have absolutely no medical qualifications, so all I can do is reflect what some of my thinking would be if those were my numbers…

Firstly - the role of my basal is to keep my levels chugging along steadily when I’m between meals (or miss or delay a meal) and when I’m only averagely active. ‘Steadily’ for me would mean staying within +/-1.5 to 2 of my previous reading overnight, or if no meal/dose is happening. So if my BG was dropping 8-5 overnight I’d be thinking my basal is too high.

In the morning, as soon as I get out of bed, my BG begins to rise (because my caveman hormones kick in to fire up the burners). Some people get this in the early hours, often called Dawn Phenomenon. So some of the rise might be related to other factors than food/insulin?

Have you been advised to take ‘correction doses’? This is where you add a little extra insulin when your BG is above range with the intention of getting you back to mid-range by your next meal. If you’ve not been advised about this it might be worth a conversation with your DSN?

Steady readings are my preference, even if they are a little above range to a rollercoaster of highs and lows… but even better if I can gently nudge the steady high level into range 

And I’d be really interested to hear how you got on with a split basal - spreading the coverage out more evenly over the 24 hours.


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## Pattidevans (Aug 18, 2022)

Hi from me

I too was diagnosed as T2 in 2003.  I was on insulin very quickly as levels were so high (in the 30+ range consistently) but it took me 8 years to get a final diagnosis of T1 (rather than my previous diagnosis of T2 on insulin - a subtle difference, but huge in terms of treatment and attitudes).  In my experience the new diagnosis was amazing in that it opened so many doors regarding modern treatment.  I am now on a pump with Libre 2 on prescription and I am one of those who finds it exceedingly accurate.  So that's more or less my background.

The link Mike gave you mentions the book "Think like a Pancreas" by Gary Scheiner and I would highly recommend it.  As I highly recommend basal testing... with the caveat that from time to  time our basal needs change, even if only a little,  with the weather and numerous other factors, so you  will need to do the basal testing all over  again if things start to go a little wonky.

You mention that drinking alcohol lowers your numbers, despite the carbs in it.  Yes, it does, because it keeps Mr Liver busy processing the alcohol so poor Mr Liver is far too busy to emit his normal output of  glycogen into the blood stream.

For your information I attach a chart of the action of Levemir.  Across the bottom you can see how long Levemir will last according to the amount per kilo of body weight you are injecting.  So say you weighed 65 kilos and you use 25u levemir then  divide 25 by 65 and you come to .38 - call it 0.4u and follow the horizontal line across... you will see that the Levemir will most likely last 22 - 24 hours for you.  However, I suspect you are currently not taking .4u per kilo.  I can however, see why your DSN is upping the Levemir.  If she goes by that chart then perhaps she is hoping that the increased amount of levemir  per kilo of body weight may make it last the full 24 hours.


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## Eternal422 (Aug 18, 2022)

Thanks for the comments Mike, much appreciated.  I did wonder if the morning rise was the dawn phenomenon albeit occurring only when I have breakfast, but maybe that is just timing and a coincidence.  I do take correction doses when needed before meals, but somehow this isn’t helping now.  I love the BG being pretty stable rather than bouncing all over the place, just want to bring the level down a bit.

Funny how you can be ok for ages, confident you know what you’re doing and then suddenly you get a curve ball!  I guess that’s D all over!  Of course, a lot of this was previously hidden to me before the Libre, so some of this may have been happening all along and only now exposed thanks to all the graphs and constant readings!

The overnight drop would suggest actually reducing the basal as you say, but then I don’t know what effect that would have on the rest of the day.  Definitely one for the DSN to help me with, I’ve left a message tonight to get a call back to chat it over.  The advantage being that she can see the Libre data which will be a big help.


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## Eternal422 (Aug 18, 2022)

Pattidevans said:


> I too was diagnosed as T2 in 2003. I was on insulin very quickly as levels were so high (in the 30+ range consistently) but it took me 8 years to get a final diagnosis of T1 (rather than my previous diagnosis of T2 on insulin - a subtle difference, but huge in terms of treatment and attitudes). In my experience the new diagnosis was amazing in that it opened so many doors regarding modern treatment.


Hi Patti, very true!  The difference now is amazing!  Although, to be fair, when originally classed as T2, my GP put me on a twice a day mixed insulin which didn’t work with my irregular eating patterns at the time, so when I suggested trying basal-bolus, he referred me to the hospital team who were great.  But then after being discharged back into primary care I was pretty much left to my own devices.  I must admit I didn’t do too badly, very few hypos and a good HbA1C for years.  But now with a new GP health centre and a referral to hospital to help arrest the slowly increasing HbA1C, they diagnosed me as T1, got me onto the Libre and are being great.  Really though this classification between T1 and T2 shouldn’t affect the level of care, only subtle differences in treatments.

It’s great you find the Libre accurate too - my first sensor started failing after just 4 days, read low and then expired altogether.  This second one is doing great and seems pretty accurate too.

I had heard of Think Like A Pancreas years ago, maybe I should have a read now to get myself more up to speed with things.  I think after all this time I have fallen into the trap of taking things for granted and not paying as much attention as I did initially.


Pattidevans said:


> You mention that drinking alcohol lowers your numbers, despite the carbs in it.


Thank you for the explanation - that makes perfect sense now!  I always knew that it affected my BG but not the reason why!  Not that I’m anything more than an occasional drinker, but even one or two drinks has the effect of lowering my BG.



Pattidevans said:


> For your information I attach a chart of the action of Levemir.


Thank you so much for this bit of information!  I am 86.4kg and injecting 30U Levemir, so 0.35.  Looking at your chart that may only be lasting around 18 hours.  So, typically taking it at around 10pm means it would be out by around 4pm on the following day.  Interesting.

Lots to ponder about.  I should be getting a call back from my DSN in the next day or two, so I’ll discuss a bit more with her as to how to tackle this.

Thank you so much for your comments and info.  It’s great to chat over stuff with others going through the same sort of things.


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## Pattidevans (Aug 19, 2022)

Good luck with your chat with the DSN.  Let us know what transpires.


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## Eternal422 (Aug 20, 2022)

Pattidevans said:


> Good luck with your chat with the DSN.  Let us know what transpires.


Really impressed as I had a call back yesterday from a DSN from the hospital team in response to the previous night’s voicemail I left with them!

He said that the Libre charts were among the best he had seen and nothing to worry about.  However, to lower the steady line a bit more into the middle of my range he suggested taking the Novorapid about 30 mins before eating, that way the insulin peak would better match the BG peak from eating.  Taking it at the same time as eating means it is playing catch-up and May be the reason that although I don’t peak much above range, my levels remain at the top end of the range.

He also said that the Levemir dose seemed reasonable and the steady lines means it is working well.  

He also talked through correction doses of Novorapid, starting with 1U to bring down BG by 3 (apparently it’s average effect), but only to take a correction 3 hours after the last Novorapid as that dose would be starting to wane by then, I.e. to avoid insulin stacking.

Last night was my first go at taking Novorapid 30 mins before my meal and that worked well with no big peak and levels returning to mid-range.  However I’ll need a few days of doing this to see if it works for me ok.  Last night was a bit different as it was a 40 minute walk over fields to a local pub for a drink and meal, then the same walk back afterwards.  The walk there dropped my BG by about 3, amazing what a difference it makes!  Mind you, even a bit of light gardening has the effect of dropping my BG, so it just goes to show how important exercise is for me!


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## trophywench (Aug 20, 2022)

I too successfully used a split dose of Levemir for years.  18u TDD split 14u when I rose at approx 7 to 7.30 ish, 4u at night.  The pm dose started at bedtime - 11-ish - but hypo by the early hours - so changed the evening dose to 9.30 to 10 ish and that made a huge difference, no more overnight hypos.  (Remembering to do it at that time was the main prob!)  Every single one of our bodies has it's own little idiosyncracies - but basal testing is an ongoing feature of most of our lives if we want to achieve decent ongoing BG results!


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## Eternal422 (Aug 22, 2022)

@Pattidevans - just received my copy of “think like a pancreas”, looks full of really useful information, looking forward to reading through it and putting it into practice!


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## Eternal422 (Sep 15, 2022)

Just got my latest HbA1C result : 58 . However, that would cover June to August and i was only using Libre in August, so I can well believe prior to that things were not good.  Hopefully my next test will show an improvement now that I can actually see what is going on and maybe, just maybe, get an HbA1C closer to the current LibreView figure of 47


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