# BS disastorous results - looking for some comments / help please



## mum2westiesGill (Oct 22, 2012)

Friday 13/10/2012
00:19 Bed - *16.5* (28u)

Saturday 14/10/2012
11:32 Bfast - *8.9* (4CP = 4u)
19:53 Dinnr - *14.8* (estimated CPs as went out for indian = 8u+2u corr)
00:31 Bed - *23.1* (28)

Sunday 14/10/2012
15:30 Lunch - *5.6* (5CP - 6u)
19:23 Dinnr - *20.7* (4CP - 4u +6u corr)

Monday 15/10/2012
11:23 Bfast - *9.5* (4CP = 4u)
16:14 Lunch - *12.8* (5CP = 6u +2u corr)
20:20 Dinnr - *4.8* (3CP - 4u)
22:44 Bed -* 5.6* (28)

Tuesday 16/10/2012
10:42 Bfast - *13.6* (4CP = 4u)
16:34 Lunch - *8.7 * (4CP = 4u)
20:41 Dinnr - *8.3* (4CP = 4u)
23:08 Bed - *8.3* (28)

Wednesday 17/10/2012
11:24 Bfast - *8.8* (3CP = 4u)
13:53 Lunch - *12.4* (4CP = 4u +2u corr)
19:02 Dinnr - *8.7* (5CP - 4u)
23:56 Bed - no test (30)

Thursday 18/10/2012
11:06 Bfast - *8.3* (2CP = 4u) (should've done 2u)
20:30 Dinnr - *10.5* (4CP = 4u)
23:56 Bed - *18.0* (30)

Friday 19/10/2012
11:16 Bfast - *14.8* (2CP - 4u +2u corr) (should've done 2u+2u corr)
15:59 Lunch - *11.9* (4CP = 6u)
20:32 Dinnr - *12.2* (4CP = 4u +2u corr)
23:46 Bed - *11.4* (30)

Saturday 20/10/2012
14:43 Lunch - *16.7* (4CP = 4u +4u corr)
01:00 Bed - no test (30)

Sunday 21/10/2012
14:50 Lunch - *20.4* (4CP = 4u +6u corr)
19:12 Dinnr - *16.5* (4CP = 4u +4u corr)
22:49 Bed - *16.5* (30)

Monday 22/10/2012
11:31 Bfast - *22.4* (4CP = 4u +6u corr)


As you can see my results are disastrous! My HB1AC was 9.6% in August 2011 then it went to 6.8% in December 2011. I've got an app on my smartphone called 'On Track' which is near enough with HB1AC results and it's currently showing my HB1AC as 8.2%!! Not as high as the 9.6% but still high enough. I'm not doing anything or eating anything different. Does anyone have any ideas as to what I can do to try to put this right? I currently don't need jelly babies but my poor OH (who's not diabetic) does!


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## Northerner (Oct 22, 2012)

I'd say that all those high numbers and corrections mean that your meal/insulin ratios are way out, so you need to reestablish how much insulin you need per CP for different meals during the day. I think you also need to look at increasing your basal insulin. In fact, I would look at the basal first because you can't really establish your meal ratios if your basal is not right. Lots of basal testing required I think, either skipping meals or having no-carb meals (although some people find even protein will affect their blood sugar levels in the absence of any carbs).

I don't think there is a quick fix for this, it will have to be a careful and methodical testing regime as you establish each change in requirement - only change one thing at a time.


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## Urbansoulpie (Oct 22, 2012)

I would have to agree with Northerner, looks like both your basal and bolus ratios need increasing, I would also start with your basal and test, test, test.

Lots of testing will help establish patterns and gives your DSN lots to work on when you next see them.

Keep going, you'll get there and soon be feeling lots better.


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## randomange (Oct 22, 2012)

Hello! Sorry, this turned into a bit of a long one...

I think the short answer is that you need to test more!  I know DAFNE only suggests testing at particular times, but sometimes the only way to see where you need to change things is to gather information, and to get that you need to test. Then it's just a case of going through things piece by piece.

If it were me, I would start by testing to see if my basal is correct.  If you are high at bedtime, do you correct? From your logs, it looks like you don't, but there are several occasions where you drop quite a lot overnight. If you are not correcting, then that would suggest to me that your basal is way too high. Start by testing before bed (and naughty you - there are several times where you don't test before bed!), then see what you are in the morning.  If it's quite different, then repeat, but test at 3 am to see what is going on during the night.  I would then tweak my basal until I was remaining as steady as possible overnight.

When you know your basal is ok, then you should start looking at your ratios.

I'm curious as to what your ratios and correction factors are?  It looks like you're on a blanket 1:1, but then there are times when you do something different (14/10 lunch - BG ok, 5CP but 6u?) Is there a reason for this?  And your corrections - sometimes you correct at breakfast and sometimes not - again, is there a reason? Not trying to criticise , just aware that I sometimes change things for reasons that aren't always obvious!

There are also quite large gaps between testing on some days.  I know that DAFNE tells you only to test and correct with meals, but I think if your BGs are misbehaving, I would be testing in between meals to see what is going on - e.g. are you coming down in between meals and then rising, or are you still high after a meal and then staying the same? Also, if you have many hours in between meals, then a correction after one meal may have you in range for the next one.

Again, sorry, this became a bit of a long ramble!  This is just what I would do, and you can always get in touch with your DSN.  I think when your BGs start going out of whack it can be a bit hard to see the wood for the trees, and I've found that the best way to deal with it is to take a deep breath, and then essentially start from scratch and be quite systematic about testing things.

I hope some of this helps!


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## mum2westiesGill (Oct 22, 2012)

Thank you all so far for all your comments / help.

I'm going to start by doing a few 3am basal tests for the next 2/3 nights and let you all know results etc. I'll have to maybe set a reminder on my meter when i do my bedtime test tonight.


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## everydayupsanddowns (Oct 22, 2012)

+1 for suggestions about basal test.

Detaile here if you've not done it before: http://www.diabetes-support.org.uk/info/?page_id=120

My meal ratios and corrections rarely play nicely if my basal is even slightly out - and while I can firefight for a while long term it's just way too stressful.

As soon as you have your basal tested and holding you steady-ish then you can tweak meal ratios knowing that you are doing so from a firm footing rather than trying to hit one moving target from another.

On the plus side though... it looks like you aren't yoyoing right down into hypos so pat yourself on the back for that. 

How 'boring' have your meals been? I wonder if at least some of the difficulty might be carb estimation - it often is with me.


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## lauraw1983 (Oct 22, 2012)

First thing that jumped out at me is you are not testing enough - do you drive?

I know until I got my basal right, which involved switching to Levemir from Lantus too, and even then it was a horrid switchover at first (I posted on here!) - but finally now it is giving me MUCH better coverage and actually does cover my basal needs and holds me steady overnight! Amazing for me, the only time I wake up high is if I have maybe had a high carb/fat meal as I just cannot get the timing right for splitting boluses. 

Before I did the above I thought I was on a 1:7 carb ratio for all meals (or on DAFNE terms 1:1.5)  I definitely am not, in the mornings I am less active (at work, at a desk!) I am 1:1.5 but then always 1:1 for other meals! On days I am more active (days off work, weekends etc) then I am 1:1 for all meals! Oh and on non work days/weekends I also drop my daytime basal by just 1 unit from 17u to 16u as I was having some hypos when at 17u!

Basal testing is a total PITA but so worth it, it gets things on a much steadier footing for you to know what to do for mealtimes. The 3am tests are very useful too, and a must in order to know what is going on overnight.

If you have done DAFNE, do you have their login and phone app to keep a note of BG results? I have found it one of the best things ever, shows patterns etc and you can share it on the DAFNE forum too for others who have done the course to see and help spot what is going on too.


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## paul.johnson (Oct 22, 2012)

What time do you have your injections ? as you seem to be running out of Basal (long acting) or incorrect dosages as others have indicated..good luck


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## mum2westiesGill (Oct 22, 2012)

paul.johnson said:


> What time do you have your injections ? as you seem to be running out of Basal (long acting) or incorrect dosages as others have indicated..good luck




I have my basal (BI) usually around 22:00 - 23:00.....

Thank you for wishing me good luck in getting BS levels back on track again.


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## mum2westiesGill (Oct 23, 2012)

Monday 22/10/2012 (cont)
16:14 Lunch - *19.6* (7CP = 8u +4u corr)
19:59 Dinnr - *14.8* (5CP = 6u +2u corr)
23:53 Bed - *12.6* (30u)

Tuesday 23/10/2012
04:05 Night (basal test) - *14.2* ( I know this should be done at 3am but alarm didn't wake me up)
11:27 Bfast - *30.0* (4CP = 4u +6u corr)


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## Northerner (Oct 23, 2012)

whiskysmum said:


> Monday 22/10/2012 (cont)
> 16:14 Lunch - *19.6* (7CP = 8u +4u corr)
> 19:59 Dinnr - *14.8* (5CP = 6u +2u corr)
> 23:53 Bed - *12.6* (30u)
> ...



Looks like some significant Dawn Phenomenon going on there Gill - do you test as soon as you wake or after you've been up, had a coffee etc. ?


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## mum2westiesGill (Oct 23, 2012)

Northerner said:


> Looks like some significant Dawn Phenomenon going on there Gill - do you test as soon as you wake or after you've been up, had a coffee etc. ?




After I've been up, when I've had a brew. Basically I do my fasting test when I have my breakfast.


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## lauraw1983 (Oct 23, 2012)

whiskysmum said:


> Monday 22/10/2012 (cont)
> 16:14 Lunch - *19.6* (7CP = 8u +4u corr)
> 19:59 Dinnr - *14.8* (5CP = 6u +2u corr)
> 23:53 Bed - *12.6* (30u)
> ...





What is your ratio? Why are you having 8u for 7CP's? And 6u for 5CP's? How much does 1u drop you down by for a correction too?

Would you normally correct any high reading at bedtime - your 12.6?

What was your evening meal last night? 

You might have dropped low before 4am, and that was it rising back up if you are? My DSN told me anytime between 2 and 3am is best.

If you are not eating breakfast until 11.30 or so too, I would be testing as soon as you wake for the day before you get up and moving around. Anything could be happening between getting up and eating too. Have you ever tried splitting your dose of lantus?


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## lauraw1983 (Oct 23, 2012)

also - what is BG now at, 2 hours after eating breakfast?


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## mum2westiesGill (Oct 23, 2012)

Tuesday 23/10/2012 (cont)
13:41 2 hrs after bfast - *24.6*


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## lauraw1983 (Oct 23, 2012)

If you answer the other bits up there ^^^ then maybe together we can try to help further too....

Are you planning to eat again before 4 hours is up? (ie before your QA will have fully run out from breakfast?)


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## Northerner (Oct 23, 2012)

whiskysmum said:


> After I've been up, when I've had a brew. Basically I do my fasting test when I have my breakfast.



It would be worth testing as soon as you can when you open your eyes. A lot of people find their levels shoot up after waking if they don't inject/eat asap, so testing as soon as you wake will give you a better picture of what happens with your levels through the night. For example, if your numbers are actually quite reasonable overnight, but you react to a big DP rise by increasing your basal, you may end up having night hypos. The DP needs to be considered separately.


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## mum2westiesGill (Oct 23, 2012)

lauraw1983 said:


> What is your ratio? Why are you having 8u for 7CP's? And 6u for 5CP's? How much does 1u drop you down by for a correction too?
> 
> Would you normally correct any high reading at bedtime - your 12.6?
> 
> ...




My ratio is 1:10. So I should really be doing 7u for 7CP's & 5u for 5CPs. My pen goes up in 1u.

I've never corrected at bedtime for fear of going hypo.

My evening meal last night was Asda Lasagne meal deal !/4 of the pack & 2 of those small garlic bread rounds.

I'm usually awake about 7am - 8am ish then go down to do a brew. Also I've never tried splitting my dose of lantus - too scared to do that.


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## mum2westiesGill (Oct 23, 2012)

lauraw1983 said:


> If you answer the other bits up there ^^^ then maybe together we can try to help further too....
> 
> Are you planning to eat again before 4 hours is up? (ie before your QA will have fully run out from breakfast?)




Thank you so much to you and to Northerner also  and anybody else  

The next time I will probably be eating will be about 3pm ish then 7.30pm ish.

Breakfast is usually about 10am - 11am ish, that's because I just can't eat early, I'm just not an early bird


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## lauraw1983 (Oct 23, 2012)

whiskysmum said:


> My ratio is 1:10. So I should really be doing 7u for 7CP's & 5u for 5CPs. My pen goes up in 1u.
> 
> I've never corrected at bedtime for fear of going hypo.
> 
> ...




My first thought would be that certainly for breakfast you need to try 1.5:1 ratio.

But honestly, before ratios are looked at you need to sort the basal out, seems like something is WAY out with it. Don't be afraid of splitting your lantus, at first you could try a 15u/15u split 12 hours apart, as it's well known in many people it does not last 24 hours! however before doing it I think you should seek advice and support from your DSN about it. 

Lasagne & garlic bread is quite high carb and fat too, so some of that could be a delayed spike from that too.


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## lauraw1983 (Oct 23, 2012)

whiskysmum said:


> Thank you so much to you and to Northerner also  and anybody else
> 
> The next time I will probably be eating will be about 3pm ish then 7.30pm ish.
> 
> Breakfast is usually about 10am - 11am ish, that's because I just can't eat early, I'm just not an early bird



I'm the same re; morning eating.

I do get a rise between getting up and eating though, and although being on Levemir has reduced that rise a bit it still happens! Sometimes, depending what kind of day I am going to be having, I will inject 1 or 2u to stop that rise happening if I know I won't be eating for a while....was trial and error for that though.

I do the same if I wake up higher than my target range though (6-8mmol), I will correct that then see it come down a bit before I would then eat & inject again.


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## mum2westiesGill (Oct 23, 2012)

Tuesday 23/10/2012 (cont)
15:29 Lunch - *16.4* (5CP = 5u +4u corr)

My DSN (also the practice nurse at the surgery) rang me this afternoon. I explained what's going on atm re my BS levels & also about the help I'm recieving on here  .
Without me waffling on too much basically my HBA1c wasn't due until next month (November) so she's brought it foward to this Thursday 25/10/2012  . She said I'll get all my bloods done and maybe see if there's any lingering infection anywhere. worried.com.
I've also got to take a sample in   nervous.com.
I'll book to see my DSN a week later for results etc.
She asked me how I feel in myself because she noticed I'd seen one of the GPs re depression - I feel great in myself again now, very very calm etc - a few weeks back one of the GPs put my dose of citalopram up from 10mg to 20mg.
Lastly I've got to put my BI / lantus up by 6u so It'll go from 30u to 36u. When doing it myself I only ever change my BI / lantus by 2u but she explained that upping it or downing by 4u, 6u shuoldn't cause too many problems.
She very kindly said during the phone call "I'm just eating a toffee!" "Oops I shouldn't be saying that cause your diabetic lol"


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## Northerner (Oct 23, 2012)

It will be interesting to see what the increase in lantus does for you Gill, hope all goes well with the tests


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## mum2westiesGill (Oct 23, 2012)

lauraw1983 said:


> My first thought would be that certainly for breakfast you need to try 1.5:1 ratio.
> 
> But honestly, before ratios are looked at you need to sort the basal out, seems like something is WAY out with it. Don't be afraid of splitting your lantus, at first you could try a 15u/15u split 12 hours apart, as it's well known in many people it does not last 24 hours! however before doing it I think you should seek advice and support from your DSN about it.




Yes once I get this very annoying basal sorted I'll maybe up my breakfast ratio but like you say the basal needs to be sorted out first - a bit like babysteps or one thing at a time.

I mentioned to my DSN about the splitting of lantus but she said to try upping it first, who knows even though I've been diabetic for 20 years maybe my pancreas has been still producing a very slight amount of insulin and now it's not and I now need more insulin. Then apart from upping the BI / lantus is to have my HBA1c done.


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## mum2westiesGill (Oct 23, 2012)

Northerner said:


> It will be interesting to see what the increase in lantus does for you Gill, hope all goes well with the tests




Hmmm yes it is worrying me although I won't see anything probably for a few days. Thanks for wishing me well with the tests. I don't think I dare post them on here, I'll feel so shown up. I do have an andriod app on my phone called On Track and when I compare the results on there to other results they seem to be fairly spot on and atm the HBA1c is showing 8.2%  !!!! It was 9.6% in August 2011 then 6.8% in December 2011  .


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## Northerner (Oct 23, 2012)

whiskysmum said:


> Hmmm yes it is worrying me although I won't see anything probably for a few days. Thanks for wishing me well with the tests. I don't think I dare post them on here, I'll feel so shown up. I do have an andriod app on my phone called On Track and when I compare the results on there to other results they seem to be fairly spot on and atm the HBA1c is showing 8.2%  !!!! It was 9.6% in August 2011 then 6.8% in December 2011  .



Gill, never be afraid to share your numbers here, no-one will judge you. Everyone here knows what a struggle this can be at times, and just when you think things are going well someone (The Diabetes Fairy) will shift the goalposts and things have gone to pot again. The main thing is that you are doing your best to overcome your current difficulties, and we are all here to help you succeed


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## mum2westiesGill (Oct 23, 2012)

Northerner said:


> Gill, never be afraid to share your numbers here, no-one will judge you. Everyone here knows what a struggle this can be at times, and just when you think things are going well someone (The Diabetes Fairy) will shift the goalposts and things have gone to pot again. The main thing is that you are doing your best to overcome your current difficulties, and we are all here to help you succeed




Thank you so so much for this. And yes I will share when I get those numbers which someone (The very bad Diabetes Fairy) is making me have. I have my HBA1c on 25/10/2012 (Thursday) then while I'm at the surgery I have to make my appointment to see my DSN for about a week later so I'll post then. I'll keep you posted as to the date I'm seeing the DSN for my results.


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## Pumper_Sue (Oct 24, 2012)

Hi Gail after reading through this lot   a couple of things spring to mind.
1 your basal appears to be well out and not covering 24/7
2 What level are you eating at? The normal is wo wait until blood sugar is below 8 before you eat. If you are bolusing and correcting at those high numbers and then eating before your insulin has worked, you have no chance of getting a normal number.
3 If it were me I would stick to very simple meals and lower the carb content as well until you have sorted your self out. Also stick to the same carb content for each day.

First priority is to sort your basal. Fix that before you start messing around with anything else. Also even your meals out so you have at least 5 hours between them and don't snack at all until you have sorted yourself out.
Then you can see exactly what is going on.

Another thing just to make sure you have done so........... have you checked to see if your pen is delivering your insulin? IE no cracked vial or faulty pen. Is the insulin def ok?


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## mum2westiesGill (Oct 24, 2012)

Tuesday 23/10/2012 (cont)
20:20 Dinnr -* 8.6* (4CP = 4u)
00:21 Bed - *7.6* (36) (put BI - lantus up from 30u to 36u as per instructions from DSN)

Wednesday 24/10/2012
02:30 Night (basal test) - *8.7*
08:29 Fasting - *9.0* (test done before getting out of bed to go downstairs)


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## Northerner (Oct 24, 2012)

whiskysmum said:


> Tuesday 23/10/2012 (cont)
> 20:20 Dinnr -* 8.6* (4CP = 4u)
> 00:21 Bed - *7.6* (36) (put BI - lantus up from 30u to 36u as per instructions from DSN)
> 
> ...



Those are looking much better Gill  It would be worth it, if you don't intend having breakfast for a while after getting up, to test just before you inject/eat to see if/how much your levels have risen. In the past I have tested as soon as I woke, then tested again when I was ready for some breakfast about an hour later and my levels had risen from 5.5 to 11.00! So you can see how big a climb this can be. I now test as soon as I get up, and also inject, even though I may not eat for 30-45 minutes and this helps lower the rise and also any spike from when I eat. Even so, I tested out of curiosity this morning and despite a waking level of 6.0 and injecting immediately, 45 minutes later I tested again just before eating and my level had gone up to 7.3 - so it just goes to show how powerful this dawn effect can be. Basically, most of my morning injection goes towards combating the rise caused by my liver rather than the food I consume, so this is something I need to factor in over and above the carbs I have counted for my breakfast. Not saying it is the same for you, but something to bear in mind.


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## Pumper_Sue (Oct 24, 2012)

whiskysmum said:


> Tuesday 23/10/2012 (cont)
> 20:20 Dinnr -* 8.6* (4CP = 4u)
> 00:21 Bed - *7.6* (36) (put BI - lantus up from 30u to 36u as per instructions from DSN)
> 
> ...



That's a great improvement 
Make sure you don't make any changes for at least 3 day's, then see what else can be done.


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## everydayupsanddowns (Oct 24, 2012)

That's a GREAT improvement Jill! Well done and long may it continue


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## mum2westiesGill (Oct 24, 2012)

Pumper_Sue said:


> Hi Gail after reading through this lot   a couple of things spring to mind.
> 1 your basal appears to be well out and not covering 24/7
> 2 What level are you eating at? The normal is wo wait until blood sugar is below 8 before you eat. If you are bolusing and correcting at those high numbers and then eating before your insulin has worked, you have no chance of getting a normal number.
> 3 If it were me I would stick to very simple meals and lower the carb content as well until you have sorted your self out. Also stick to the same carb content for each day.
> ...




Hi Sue, 
The levels I'm eating at are the ones I've on posted this thread. I do bolus and correct at the same time but I think if I had to wait for my level to come down to below 8 before I started to eat I'd be waiting forever  .

What sort of simple meals with maybe a few less carbs would you suggest to try? 
Breakfast I usually have toast 
Lunch is usually a sandwich and maybe soup normal tinned or cup soup. 
Dinner is usually a cooked meal: homemade fish pie topped with mash potato, cottage pie, spag bol, ready meal sometimes for quickness. Tonight we're having (homemade by OH) chicken in gorgonzola sauce (chicken fillets, cheese sauce granuels with gorgonzola cheese added) & rice.

Yes I'm going to try to sort out the basal first.

All insulin vials QA & BI seem to be ok ie not cracked or anything. 
My QA pen when I do an air shot shoots out. 
My BI pen when I do an air shot sometimes shoots out and sometimes a dribble comes out. Haha just tried it now doing a few air shots and it's shooting out perfectly each time! I am wondering whether to start using my spare BI pen because when I compare it to my current BI pen some of the numbers on the dial are starting to wear off. Then I'll request another spare one.


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## mum2westiesGill (Oct 24, 2012)

Northerner said:


> It would be worth it, if you don't intend having breakfast for a while after getting up, to test just before you inject/eat to see if/how much your levels have risen.




Wednesday 24/10/2012 (cont)
10:55 Bfast - *18.7* (2CP = 2u +4u corr) (tested & injected then waited 30 mins or so before eating bfast to let BS level drop a bit)
11:32 Bfast - *17.3* (ate bfast, starving, couldn't wait any longer)

so it's gone from *9.0* at 08:29 to *18.7*!!!!!! arghhhhh


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## Northerner (Oct 24, 2012)

whiskysmum said:


> Wednesday 24/10/2012 (cont)
> 10:55 Bfast - *18.7* (2CP = 2u +4u corr) (tested & injected then waited 30 mins or so before eating bfast to let BS level drop a bit)
> 11:32 Bfast - *17.3* (ate bfast, starving, couldn't wait any longer)



So your levels more than doubled between waking and testing before breakfast?  I think you should try having a little of something soon after you get up with your cuppa  and see if this stops your liver from raising your levels so much. You could try something non-carb or just a small amount of carbs (I find Belvita biscuits quite good, about 8.5g carbs).


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## mum2westiesGill (Oct 24, 2012)

Northerner said:


> I think you should try having a little of something soon after you get up with your cuppa  and see if this stops your liver from raising your levels so much. You could try something non-carb or just a small amount of carbs (I find Belvita biscuits quite good, about 8.5g carbs).




I'll try this tomorrow. Maybe a plain rich tea? Plus injecting?


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## mum2westiesGill (Oct 24, 2012)

whiskysmum said:


> I'll try this tomorrow. Maybe a plain rich tea? Plus injecting?




A thought has come into my mind. I'll be able to do my fasting test before getting out of bed but I won't be able to have a biscuit or insulin because I'm having my HBA1c done tomorrow @ 09:30am which has to be fasting.


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## Northerner (Oct 24, 2012)

whiskysmum said:


> A thought has come into my mind. I'll be able to do my fasting test before getting out of bed but I won't be able to have a biscuit or insulin because I'm having my HBA1c done tomorrow @ 09:30am which has to be fasting.



I didn't think the HbA1c had to be fasting as what your levels are like on the day is insignificant - presumably they are testing for other things (cholesterol maybe?) which may require fasting.


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## mum2westiesGill (Oct 24, 2012)

I think she (DSN) said she wanted to check all my bloods worried.com.


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## mum2westiesGill (Oct 24, 2012)

So onto Friday after I've done my fasting test on waking would it then be maybe a plain biscuit and an injection when I go downstairs to do the brew?


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## Northerner (Oct 24, 2012)

whiskysmum said:


> So onto Friday after I've done my fasting test on waking would it then be maybe a plain biscuit and an injection when I go downstairs to do the brew?



I would try the biscuit without the injection first, to see what the outcome is. It will obviously raise your levels a bit, but the rise from the biscuit may hold back the big rise from the liver. Alternatively, it might add to it, in which case you would know that injecting a unit or two might be required. Good luck!


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## mum2westiesGill (Oct 25, 2012)

Wednesday 24/10/2012 (cont)
15:41 Lunch - *17.6* (5CP = 5u +4u corr)
20:37 Dinnr - *10.0* (5CP = 5u)
23:13 Bed - *5.8 * (had 1 x plain buiscuit, maybe wrong & perhaps panicking but didn't want to go lower due to having HBA1c on Thursday am)

Thursday 25/10/2012
08:21 Fasting - *24.8 * (1. test done before getting out of bed to go downstairs 2. had 1u QA to see what would happen)
10:50 Bfast - *20.4* (4CP = 4u +6u corr)
15:45 Lunch - *16.5* (5CP = 5u +4u corr)


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## Urbansoulpie (Oct 25, 2012)

Hi

Again, I would really recommend that you test loads more, it will give you much more of an idea of what's going on.

Even if you only test every 2 hours and note them all down, it'll show you loads more and maybe you could even spot some patterns, especially if you note down what your eating, how much insulin your taking and and activity you are doing at the same time.


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## everydayupsanddowns (Oct 25, 2012)

whiskysmum said:


> Wednesday 24/10/2012 (cont)
> 15:41 Lunch - *17.6* (5CP = 5u +4u corr)
> 20:37 Dinnr - *10.0* (5CP = 5u)
> 23:13 Bed - *5.8 * (had 1 x plain buiscuit, maybe wrong & perhaps panicking but didn't want to go lower due to having HBA1c on Thursday am)
> ...



My big question is WHAT on earth is happening overnight to get you from 5.8 to 25  Patti who posts here sometimes did say she got a bit of a 'kick' late on with Humalog causing more drop than you might expect after around 3 hours, which might have meant that despite the biscuit you dipped low and the liver 'helped out'. 

Alternatively - it might have been the biscuit and just a general rise 

Have you done any more overnight tests recently?

The drop between waking and breakfast on Thursday is encouraging. Would be worth playing with that a bit more IMO.


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## mum2westiesGill (Oct 25, 2012)

Urbansoulpie said:


> Hi
> 
> Again, I would really recommend that you test loads more, it will give you much more of an idea of what's going on.
> 
> Even if you only test every 2 hours and note them all down, it'll show you loads more and maybe you could even spot some patterns, especially if you note down what your eating, how much insulin your taking and and activity you are doing at the same time.




Thanks for this I'll try to get more tests in


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## mum2westiesGill (Oct 25, 2012)

everydayupsanddowns said:


> My big question is WHAT on earth is happening overnight to get you from 5.8 to 25  Patti who posts here sometimes did say she got a bit of a 'kick' late on with Humalog causing more drop than you might expect after around 3 hours, which might have meant that despite the biscuit you dipped low and the liver 'helped out'.
> 
> Alternatively - it might have been the biscuit and just a general rise
> 
> ...




Re your big question WHAT is going on overnight - I really don't know but I'd love this not to happen

The last overnight test I did was 02:30am on Wednesday, it was *8.7*


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## mum2westiesGill (Oct 25, 2012)

whiskysmum said:


> HBA1c wasn't due until next month (November) so she's brought it foward to this Thursday 25/10/2012  . She said I'll get all my bloods done and maybe see if there's any lingering infection anywhere. worried.com.
> I've also got to take a sample in   nervous.com.
> I'll book to see my DSN a week later for results etc.




So I've had my HBA1c done this morning plus all other bloods. My appointment for my diabetic review isn't until 08/11/2012   and if there's anything wrong before then my DSN will phone me. So until then I'll just spend the next 2 weeks worrying myself sick.


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## Northerner (Oct 25, 2012)

whiskysmum said:


> So I've had my HBA1c done this morning plus all other bloods. My appointment for my diabetic review isn't until 08/11/2012   and if there's anything wrong before then my DSN will phone me. So until then I'll just spend the next 2 weeks worrying myself sick.



Try not to worry Gill, just use the time to gather as much information as you can so your DSN will have lots of information to work on to help you sort things out


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## mum2westiesGill (Oct 25, 2012)

Northerner said:


> Try not to worry Gill, just use the time to gather as much information as you can so your DSN will have lots of information to work on to help you sort things out




Awww thank you. I usually take a print out in with me when I see her so I'll maybe printout the previous 10 days before the date I see her.

In the meantime I'll continue to post my results on here whatever they maybe and look forward to some helpful comments  .


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## Pigeon (Oct 25, 2012)

Have you ever had a continuous glucose monitor? Might help you to sort out what's going on overnight. Ask your team for one at your review!


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## mum2westiesGill (Oct 26, 2012)

Northerner said:


> I would try the biscuit without the injection first, to see what the outcome is. It will obviously raise your levels a bit, but the rise from the biscuit may hold back the big rise from the liver. Alternatively, it might add to it, in which case you would know that injecting a unit or two might be required. Good luck!




Thursday 25/10/2012 (cont)
20:24 Dinnr - *6.2* (4CP = 4u)
23:27 Bed - *10.9* (36u)

Friday 26/10/2012
03:52 Night - *18.0*
08:32 Fasting - *23.8* (plain digestive (1 x), (trying the biscuit without injection)
10:19 Bfast - *33.3* (2CP = 2u +6u corr) (1. obviously the biscuit without the injection hasn't worked in holding back the big rise from the liver and has just added to the already big rise so must make a note of having just 1 x plain buscuit plus injecting a unit or two when i do my fasting level before getting out of bed 2. this is the highest level my meter goes to also waited 45 mins before having 1 x round toast for bfast then forgot to test again before having toast  )

Will be eating linch at about 3pm - 4rpm ish.


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## everydayupsanddowns (Oct 26, 2012)

whiskysmum said:


> Thursday 25/10/2012 (cont)
> 20:24 Dinnr - *6.2* (4CP = 4u)
> 23:27 Bed - *10.9* (36u)
> 
> ...



Interesting to see your overnight result being *very* different to the previous one. I think you may need to take a bit of a closer look at what is going on there, because it looks like either your mealtime dose is falling way to short, or your Lantus is not holding your steady... or possibly both!

One slightly tricky thing is the relative lateness of your evening meal. By eating at 8.30 you are going to bed with some insulin (and food) still active which can make it hard to spot meal dose errors.

I would do at least one more set of overnioght tests (preferably more than that) where you test at midnight, 2am, 4am and 6am to watch the pattern. A few nights of that would give you very valuable info as to what is happening when you sleep.

Last night you rose substantially - textbooks suggest an accurate basal dose would have kept you within +/-2mmol/L of your starting point.


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## Pattidevans (Oct 26, 2012)

Gill
As Mike said, I was on Humalog and it gave me a huge kick in the tail... so in order to level out any post prandial high I would be hypo at 5 hours but that doesn't seem to be your problem.

What I want to say to you is that I do have a HUGE dawn phenomenon problem.  I can go to bed in the 5s or 6s, I can test throughout the night with no rise, but the minute I put my foot on the floor my BG will rise and rise and rise.  So I have got into the habit now of testing the minute I wake, if under 6 I will inject 1u, if over 6 I will inject 2u.  This will keep me steady until I eat brekkie mostly.  Today I got up at 10 am at 6.1 and I took 2u and I actually ate at 2pm and I was then 6.4.

I hope this may help.
Sorry forgot to say I changed to Apidra which is a bit quicker.


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## mum2westiesGill (Oct 27, 2012)

Pattidevans said:


> the minute I put my foot on the floor my BG will rise and rise and rise.  So I have got into the habit now of testing the minute I wake, if under 6 I will inject 1u, if over 6 I will inject 2u.  This will keep me steady until I eat brekkie mostly.  Today I got up at 10 am at 6.1 and I took 2u and I actually ate at 2pm and I was then 6.4.




Friday 26/10/2012 (cont)
16:00 Lunch -*19.3* (5CP = 5u +4u corr)
20:18 Dinnr - *11.7* (4CP = 4u)
22:46 Bed - *6.7* (36u)

Saturday 27/10/2012
03:21 Night - *13.3* (slept through the 03:00 alarm  )
05:55 Night - *21.8*
09:06 Fasting - *27.5* (2u)
11:03 Bfast - *22.6* (4CP = 4u +6u corr)


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## everydayupsanddowns (Oct 27, 2012)

whiskysmum said:


> Friday 26/10/2012 (cont)
> 16:00 Lunch -*19.3* (5CP = 5u +4u corr)
> 20:18 Dinnr - *11.7* (4CP = 4u)
> 22:46 Bed - *6.7* (36u)
> ...



That's another significant rise overnight WhiskeysMum - your BG virtually doubles between bedtime and 3am, and then continues to rise through 6am until 9am and possibly beyond.

In your shoes I would have corrected at 6am, and if not then certainly at 9am. The 2u you gave was not finished by 11am, but on the basis that you dropped 5mmol/L between 9am and 11am it seems likely that you could operate on 1u for a 3mmol/L drop. So a correction at 6am and near enough 22mmol/L might involve 5u even without trying to counteract any DP rise.

First off though I suggest you speak to your nurse about Lantus as the rise between 11pm and 3am doesn't look right at all. What did you eat for your eve meal?


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## Northerner (Oct 27, 2012)

whiskysmum said:


> Friday 26/10/2012 (cont)
> 16:00 Lunch -*19.3* (5CP = 5u +4u corr)
> 20:18 Dinnr - *11.7* (4CP = 4u)
> 22:46 Bed - *6.7* (36u)
> ...



I would be concerned that you might be having a night hypo and then rebounding. You went to bed around 2.5 hours after eating and you were already down to 6.7. For me, my mealtime insulin lasts for 5 hours or more, so if I was at 6.7 after a couple of hours I'd expect go much lower by 4-5 hours.


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## everydayupsanddowns (Oct 27, 2012)

Northerner said:


> I would be concerned that you might be having a night hypo and then rebounding. You went to bed around 2.5 hours after eating and you were already down to 6.7. For me, my mealtime insulin lasts for 5 hours or more, so if I was at 6.7 after a couple of hours I'd expect go much lower by 4-5 hours.



Good point Northerner. A midnight, 2am, 4am, 6am test pattern might really help to give some extra clues.


----------



## mum2westiesGill (Oct 27, 2012)

everydayupsanddowns said:


> That's another significant rise overnight WhiskeysMum - your BG virtually doubles between bedtime and 3am, and then continues to rise through 6am until 9am and possibly beyond.
> 
> In your shoes I would have corrected at 6am, and if not then certainly at 9am. The 2u you gave was not finished by 11am, but on the basis that you dropped 5mmol/L between 9am and 11am it seems likely that you could operate on 1u for a 3mmol/L drop. So a correction at 6am and near enough 22mmol/L might involve 5u even without trying to counteract any DP rise.
> 
> First off though I suggest you speak to your nurse about Lantus as the rise between 11pm and 3am doesn't look right at all. What did you eat for your eve meal?




Hi Mike,
I've taken all this on board, thank you.
I'll deffinately be speaking to my DSN about Lantus, when I see her I've to take in a printout of the last 10 days previous to my diabetic review so will be doing lots of basal tests before I see her.
My evening meal last night was mince & a small amount of pasta bows / penne about 4CP when I look at the carbs/cals book.





Northerner said:


> I would be concerned that you might be having a night hypo and then rebounding. You went to bed around 2.5 hours after eating and you were already down to 6.7. For me, my mealtime insulin lasts for 5 hours or more, so if I was at 6.7 after a couple of hours I'd expect go much lower by 4-5 hours.




Again taken on board, thank you Northerner.





everydayupsanddowns said:


> Good point Northerner. A midnight, 2am, 4am, 6am test pattern might really help to give some extra clues.




I will carry on doing these tests but I'm going to hit a problem in the early hours of tonight / tomorrow. I'm going out tonight around 7pm ish and won't probably be home until 01:30 - 02:00 ish ish...we're going to a Phoenix (local rock covers band) gig, lots of friends going too.  Also with the clocks going back an hour - HELP!!


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## everydayupsanddowns (Oct 27, 2012)

Have a great night Gill

Real life comes first - basal tests can wait. 

You might want to test tonight anyway, but it won't really count towards your a 'basal test' understanding because it's such an unusual evening


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## mum2westiesGill (Oct 27, 2012)

everydayupsanddowns said:


> Have a great night Gill
> 
> Real life comes first - basal tests can wait.
> 
> You might want to test tonight anyway, but it won't really count towards your a 'basal test' understanding because it's such an unusual evening




Thank you Mike!

Thank you for assuring me that real life does come first. Sometimes I forget and get so paniky about trying to get my diabetes right first.

I'll take my BI out with me & will be doing that injection then at the same time I'll do what would be my bedtime test then after that we'll see.


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## mum2westiesGill (Oct 28, 2012)

Saturday 27/10/2012 (cont)
19:07 Dinnr - *18.6* (4CP = 4u +4u corr) (no lunch, no QA, night out)
22:53 Bed - *17.5* (36u) (did test and injection whilst out)

Sunday 28/10/2012
08:42 Fasting - *5.9* (1u) (no overnight basal testing done)
11:14 Bfast - *11.2* (4CP = 4u)


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## Pattidevans (Oct 28, 2012)

One thing does stand out for me a bit and that's the fact that you're on such low doses of rapid acting compared to your basal of 36u.  Usually the balance between rapid acting and basal would be about 50/50 or 60/40.  I don't know if anyone else has noticed that and has any comment on it? It doesn't really explain the rise in the night, though I suppose if your ratios really are that low you must be quite sensitive to insulin and therefore perhaps you're taking too much basal and your liver is kicking in to fight it all the time.  Only a thought....


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## mum2westiesGill (Oct 29, 2012)

Sunday 28/10/2012 (cont)
13:39 Aftbf - *17.6*
15:07 Lunch - *18.0* (5CP = 5u +4u corr)
17:44 Aflun - *16.0*
23:50 Bed - *26.8* (36u)

Monday 29/10/2012
07:55 Fasting - *20.5* (5CP = 3u) plain rich tea (1 x) 1. no overnight basal testing done, really tired 2. bit of a kick start, maybe could have done 5u)
10:51 Bfast - *16.6* (4CP = 4u +4u corr)
13:22 Afbf - *20.3*
16:12 Lunch - *17.4* (5CP = 5u +4u corr)


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## Northerner (Oct 29, 2012)

Oh dear Gill, all those numbers are about 10 mmol/l higher than they should be  It would seem that your corrections don't actually bring your levels down.  It's beginning to look like both your insulins need increasing significantly.


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## mum2westiesGill (Oct 29, 2012)

Northerner said:


> Oh dear Gill, all those numbers are about 10 mmol/l higher than they should be  It would seem that your corrections don't actually bring your levels down.  It's beginning to look like both your insulins need increasing significantly.




Hi Alan,

Last Tuesday when I spoke to my DSN on the phone she said to alter (upp) the basal from 30u to 36u which I obviously have done.
Atm all of my bolus insulin to carb ratios ie before bfast, bef lunch & bef dinner are 1:10.

Thanks for your quick reply


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## bev (Oct 29, 2012)

Hi Whiskysmum,

I am wondering whether your LA is running out? Lots of LA doesnt work for the full 24 hours. It is good that you have increased to 36 units but have you tried splitting this? If you are going to split it you need to ask your DSN what split to do - I seem to remember we did a 70/30 split for Alex when on MDI - but cant remember which way round the split was as it was a few years back now and he is on a pump so its a bit hazy.

The ratio's might also need changing as most people find they are more insulin resistant for breakfast ratio - but dont change any of this until you have tried changing the LA as it will get really complicated for you to work out what is and what isnt working!

Alex's split of bolus/basal is around 70/30 - but he is 14 so not sure if this makes a different to an adult split.Bev


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## mum2westiesGill (Oct 30, 2012)

Monday 29/10/2012 (cont)
18:49 Aflun - *14.7*
20:25 Dinnr - *13.8* (5CP = 5u +2u corr)
22:46 Bed - *6.8* (36u)

Tuesday 30/10/2012
02:02 Night - *13.9* (missed 4am & 6am alarms)
06:59 Fasting - *19.8* (5CP / 5u corr) (1 x rich tea)
10:31 Bfast - *15.9* (4CP = 4u +4u corr)


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## DeusXM (Oct 30, 2012)

Looks like your basal is still way off or that you're having massive DP - you're spiking from 6.8 to 13.9 in four hours and it just keeps going up. Your new basal will still take a couple of days to bed in.

Your evening dinner ratio, however, looks about right - you brought it down from high to relatively normal.

I think part of the problem though is that you're still just fighting fires at the moment. If I were in your position I'd be inclined to do a no-carb couple of days to basically wrestle my BG back down to normal levels consistently, and then start re-introducing carbs.


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## mum2westiesGill (Oct 31, 2012)

Tuesday 30/10/2012 (cont)
16:08 Lunch - *17.0* - (5CP = 5u +4u corr)
18:26 Aflun - *12.9*
20:13 Dinnr - *9.0* - (4CP = 4u)
23:16 Bed - *5.7* (36u)

Wednesday 31/10/2012
02:02 Night - *14.4*
07:49 Fasting - *19.6* (5u) (did 5u QA as kick start, forgot biscuit  )
10:19 Bfast - *13.4* (4CP = 4u +2u corr)
12:34 Afbf - *18.6*
13:23 Lunch - *14.0* (4CP = 4u +3u corr) (had to have lunch earlier then normal  )


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## bev (Oct 31, 2012)

Hi Gill,

What changes are you making to your basals if any? There have been many replies suggesting you either increase your lantus or split the dose - but it doesnt appear you have done? Until you make a change you will keep getting the same high levels which must be making you feel upset and ill too. I would speak to your DSN asap and ask about either splitting the Lantus or increasing it as this isnt getting you anywhere.Bev


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## Northerner (Oct 31, 2012)

bev said:


> Hi Gill,
> 
> What changes are you making to your basals if any? There have been many replies suggesting you either increase your lantus or split the dose - but it doesnt appear you have done? Until you make a change you will keep getting the same high levels which must be making you feel upset and ill too. I would speak to your DSN asap and ask about either splitting the Lantus or increasing it as this isnt getting you anywhere.Bev



Gill has increased her lantus from 30 to 36 units bev.



whiskysmum said:


> Tuesday 30/10/2012 (cont)
> 16:08 Lunch - *17.0* - (5CP = 5u +4u corr)
> 18:26 Aflun - *12.9*
> 20:13 Dinnr - *9.0* - (4CP = 4u)
> ...



Tuesday's numbers do look better Gill, although I would still wonder about that 5.7 at bedtime, only 3 hours after your dinner. My levels would definitely drop much lower by 5 hours, especially with the assistance from the fresh lantus dose and the little spike I used to get from it an hour or two after injecting. So, I think you may still be going hypo and then rebounding, which is why you had the 14.4 and 19.6. I would suggest trying to stay up and monitor your levels at 3, 4 and 5 hours after dinner to see if you are indeed falling too low.


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## bev (Oct 31, 2012)

Hi Northerner,

I just found that - the thread is so long!Gill - have you ever used a CGM? I am inclined to agree with Northerner that you may be dropping during the night and perhaps a rebound and a combination of DP is sending your levels high on waking. I would either do two hourly testing for a few nights or ask for a CGM - something strange is going on at night and once you wake high you are more resistant for the rest of the day.Bev


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## mum2westiesGill (Nov 6, 2012)

Wednesday 31/10/2012 (cont)
19:46 Dinnr - *17.8* (6CP = 6u +4u corr) (had 1 x toffee as a halloween treat but felt so guilty about this in my situation)
23:32 Bed -* 12.3* (36u)

Thursday 1/11/2012
07:47 Fasting - *20.7 *(5CP / 5u) (did 5u QA & had rich tea as a kick start)
11:31 Bfast - *14.9 * (4CP = 4u +2u corr)
16:28 Lunch - *13.3* (5CP = 5u +2u corr)
20:44 Dinnr - *10.0 * (4CP = 4u)
23:10 Bed - *8.9* (40u) (on advice from DSN upped basal / lantus from 36u to should be 42u but to be on safe side a little am doing 40u for a couple of days then will do 42u)

Friday 2/11/2012
02:19 Night - *14.9*
03:50 Night - *17.0*
07:29 Fasting - *18.9* (5CP / 5u) (did 5u QA & had rich tea as a kick start)
10:20 Bfast - *14.5* (4CP = 4u +2u corr)
12:49 Afbf - *16.8*
16:05 Lunch - *13.4* (5CP = 5u +2u corr)
20:20 Dinnr - *13.0* (4CP = 4u +2u corr)
23:22 Bed - *12.5* (40u) (STARTED USING NEW BI PEN - AUTOPEN 24, BLUE ONE, NUMBERS STARTING TO WEAR OFF OTHER ONE)

Saturday 3/11/2012
02:32 Night - *5.2*
03:58 Night - *3.0* (didn't feel hypo, ignored this & went back to sleep! tired)
06:13 Night - *3.2* (felt very hypo, had 4 x chewy toffees, 1/2 rnd bread 10g CHO)
06:42 Hypo check - *5.8*
08:46 Fasting - *4.6* (bs under 6 so had 1u QA & 1 x buscuit)
10:28 Hypo - *2.9* 4 x fruit pastilles (was going to have bfast but was hypo so treated)
10:45 Hypo check -* 3.7* 2 x fruit pastilles
11:01 Bfast - *5.1* (4CP = 4u)
13:15 Afbf - *6.7*
15:40 Lunch - *5.4 * (4CP = 4u)
18:01 Aflun - *7.9*
19:37 Dinnr - *5.2* (5CP = 5u)
23:02 Bed - *13.9* (40u)

Sunday 04/11/2012
07:28 Hypo - *2.4* fruit pastilles (4 x) (no overnight basal testing done)
07:45 Hypo check - *4.1* fruit pastilles (1 x)
08:01 Hypo check - *4.4* went back to sleep
10:04 Hypo -* 2.8 *fruit pastilles (4 x)
10:44 Bfast - *5.3* (4CP = 4u)
13:38 Afbf - *9.4*
15:32 Lunch - *8.1* (5CP = 5u)
18:44 Dinnr - *11.3* (5CP = 5u)
23:12 Bed - *9.5* (40u)

Monday 05/11/2012
08:56 Fasting -* 8.0* (2u) (1. no overnight basal testing done, tired 2. 2u QA but no biscuit - kick start)
11:08 Bfast - *10.6* (4CP = 4u)
13:38 Afbf - *13.5*
15:37 Lunch - *15.9* (5CP = 5u +4u corr)
18:32 Aflun - *14.9*
19:47 Dinnr - *14.2* (5CP = 5u +2u corr)
23:40 Bed - *8.9* (42u) (as per instruction from DSN)

Tuesday 06/11/2012
02:26 Night - *6.2*
04:00 Night - *3.1* (missed treating! fell asleep!)
09:56 Hypo - *2.6* 4 x fruit pastilles (also Fasting)
10:15 Bfast - *4.3* (4CP = 4u) (also  Hypo check)
12:52 Afbf - *14.9*
16:01 Lunch - *12.4* (5CP = 5u +2u corr)


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## Julia (Nov 6, 2012)

whiskysmum said:


> [ (STARTED USING NEW BI PEN - AUTOPEN 24, BLUE ONE, NUMBERS STARTING TO WEAR OFF OTHER ONE)



And then (mainly) single figures...Have you found the (or at least part of the) problem?!


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## bev (Nov 6, 2012)

Hi Gill,

Much better levels - but a little low now. Why are you having sweets for a hypo? They dont work as quick as a fizzy drink like coke or lucozade. Its not the best thing to do to go back to sleep and not treat a hypo. Maybe you could go back to 40 units instead to see if this stops the hypo's?Bev


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## Pumper_Sue (Nov 6, 2012)

Looks to me as if splitting the basal would be a good option.


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## mum2westiesGill (Nov 11, 2012)

Tuesday 06/11/2012 (cont)
20:12 Dinnr - *9.3* (5CP = 5u) (had 5u extra for cheese cake)
23:29 Bed - *4.1* (42u)

Wednesday 07/11/2012
03:04 Hypo - *2.8* fruit pastilles then fell asleep & missed hypo check)
08:17 Hypo - *3.2* 4 x fruit pastilles
08:34 Hypo check - *3.7* 2 x fruit pastilles
08:51 Hypo check - *5.9* 2 x plain rich tea 5g CHO ech and had 1u as a kick start
11:24 Bfast - *6.4* (4CP = 4u)
13:36 Afbf - *12.9*
15:24 Lunch - *11.7* (5CP = 5u)
19:26 Dinnr - *8.5*
23:14 Bed - *4.9* (42u)

Thursday 08/11/2012
03:10 Night - *2.6*
03:27 Hypo check - *2.2*
07:59 Hypo - *2.7*
08:16 Hypo check - *4.2*
15:48 Hypo - *2.9*
16:00 Hypo check - *2.8*
16:17 Lunch - *4.1* (5CP = 5u)
20:20 Dinnr - *3.2*
00:02 Hypo - *2.2* (42u)
00:20 Hypo check - *4.6*

Friday 09/11/2012
09:25 Hypo - *2.4*
09:43 Hypo check - *3.2*
10:38 Hypo check - *3.9*
10:55 Bfast - *4.9* (4CP = 4u)
13:17 Afbf - *9.4*
16:11 Hypo - *2.5*
16:29 Hypo check - *4.1* (5CP = 5u)
20:21 Hypo - *2.7*
20:34 Hypo check / Dinnr - *3.4* (4CP = 6u) (DSN wants me to add on an extra 2u to this dose and to decrease bedtime BI dose to try and get rid of night time hypos)
23:05 Hypo - *3.8*
23:35 Hypo check - *6.1* (new Clickstar pen) (42u)

Saturday 10/11/2012
08:02 Hypo - *2.8*
08:21 Hypo check - *4.1*
11:44 Bfast - *5.4* (4CP = 4u)
15:44 Lunch - *5.9* (5CP = 5u)
19:33 Dinnr - *5.3*
23:17 Hypo - *2.8* (42u)
23:31 Hypo check - *3.4*
00:05 Hypo check - *5.2* 

Sunday 11/11/2012
08:14 Hypo - *2.3*
08:47 Hypo check - *4.4* (did 1u QA & had 1 rnd bread 20.8g CHO as kick start)
10:57 Bfast - *7.5* (4CP = 4u)
14:25 Lunch - *7.9 *(5CP = 5u)


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## sofaraway (Nov 11, 2012)

Whats the reason you haven't followed your DSN's advice re the BI?


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## Pumper_Sue (Nov 11, 2012)

Right Gill over to you,
you have done all these blood tests and results and logged everything.
So it's time for *You* to tell us what you deduce from the results and what exactly you are going to do about them. Looking at them it doesn't appear that you have done anything at all so far


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## Northerner (Nov 11, 2012)

There's quite a contrast in those numbers to what you were posting before Gill - so many hypos  As Sue says, what do you think you might need to do to get some stability in the 'middle ground'? Where do you think the problem might be, basal or meal ratios?


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## bev (Nov 11, 2012)

Hi Gill,

23 hypos in 5 days!Like 'Sofaraway' said I am wondering why you havent dropped your BI as advised by your DSN? I think everyone is hoping that you can get your levels sorted but without your input its a little difficult. There have been quite a few questions that have gone unanswered. Do you have any ideas of what to do to get your levels sorted out?Bev


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## mum2westiesGill (Nov 11, 2012)

sofaraway said:


> Whats the reason you haven't followed your DSN's advice re the BI?




It was Thursday 08/11/2012 when I saw my DSN & last Monday 05/11/2012 when I upped my BI dose so I was waiting until Monday 12/11/2012 tomorrow before I alter it again this time being reduced from 42u to 36u. I was waiting because I thought it was 3 or 4 days or even a week before you can make any changes with Lantus.


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## Northerner (Nov 11, 2012)

whiskysmum said:


> It was Thursday 08/11/2012 when I saw my DSN & last Monday 05/11/2012 when I upped my BI dose so I was waiting until Monday 12/11/2012 tomorrow before I alter it again this time being reduced from 42u to 36u. I was waiting because I thought it was 3 or 4 days or even a week before you can make any changes with Lantus.



You're correct Gill, it's usually best to wait two to three days between making changes to lantus


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## mum2westiesGill (Nov 11, 2012)

Northerner said:


> You're correct Gill, it's usually best to wait two to three days between making changes to lantus




Thank you. Tonight I've done 42u then tomorrow night I'm going to do 36u. Then we will see!!!




Northerner said:


> There's quite a contrast in those numbers to what you were posting before Gill - so many hypos  As Sue says, what do you think you might need to do to get some stability in the 'middle ground'? Where do you think the problem might be, basal or meal ratios?




As you say there's a contrast there & I'm just totally baffled! What to do???

Don't know if it's right or wrong but I've had a beef paste sandwich tonight for supper eek!!


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## trophywench (Nov 12, 2012)

Gill

I wish you would do your own thing with your insulin rather than just keep waiting for your DSN to OK it.

YOU treat your diabetes.  Not any doctor or any DSN.  YOU.

Now, (and this is a Q for you to answer in your head, I don't need to know the actual answer!) why are you taking Citalopram?  If it's for depression or anxiety (which I had and was why I took it, I also had panic attacks) it was a bastard when it stopped or wasn't so bad for a day or two, because I was suddenly hypo.  It was utterly amazing how much all that mental crap affected my blood sugar.  And that actually wound me up even more esp bearing in mind it was just PEOPLE (ie specific ones not the human race generally) who were doing this to my head.  But on the days when I didn't need to worry about those people (LOL ie Saturday and Sunday and any Bank Holiday) I had instant improvements to my BG.

So are you getting a bit less carp thrown at you at the mo or something?

Or could it have been your old pen just wasn't functioning?

Or did you have your period and you suddenly need to take extra insulin for that even though you never have before, or is it the 'change' starting, or have you had eg a pee infection that you didn't know about?

Or was it the cold weather starting and now your body has got used to it again?

LOL - but they are all possibilities and you do need to have a bloody good think and see 'What is different/ What WAS different?' - and we can't do that for you.


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## mum2westiesGill (Nov 12, 2012)

trophywench said:


> Gill
> 
> I wish you would do your own thing with your insulin rather than just keep waiting for your DSN to OK it.
> 
> YOU treat your diabetes.  Not any doctor or any DSN.  YOU.




Hi trophywench,

Thank you very much for your post on my thread.

I wish I would do this a bit more often & I have done this sometimes in the past in between 6 monthly appointments then when I go for my appointment I just tell my DSN what I'm taking at the time & she advises / looks at my print off of results and gives her opinion, then......like you say it should be back over to ME!!

At the end of the day it's MY body not the doctor or DSN's body.


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## mum2westiesGill (Nov 12, 2012)

trophywench said:


> Now, (and this is a Q for you to answer in your head, I don't need to know the actual answer!) why are you taking Citalopram?  If it's for depression or anxiety (which I had and was why I took it, I also had panic attacks) it was a bastard when it stopped or wasn't so bad for a day or two, because I was suddenly hypo.  It was utterly amazing how much all that mental crap affected my blood sugar.  And that actually wound me up even more esp bearing in mind it was just PEOPLE (ie specific ones not the human race generally) who were doing this to my head.  But on the days when I didn't need to worry about those people (LOL ie Saturday and Sunday and any Bank Holiday) I had instant improvements to my BG.
> 
> So are you getting a bit less carp thrown at you at the mo or something?
> 
> ...




I really don't mind saying on the forum, I'm open to most things lol. I take Citalopram for depression. Started on them in ? (probably 4/5 yrs ago) and have been great until another mini bout which started in August / September just. My friend took me off to the drs and the dr put my dosage up from 10mg to 20mg.

So maybe it could my BG has been affected by the higher dosage of Citalopram & the fact I'm extremely calm, relaxed & not stressed atm.

Or maybe it's my old pen

Or........like you say there's a never ending list of possibilities.


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## scotstigress (Nov 16, 2012)

wow whiskey, those readings look really really familiar lol  mines are the same as u can see from my 'bloody sugars' post....i think from what ive read on here and what others are replying, splitting the basal is defo the way to go, im going to start splitting mine tomorrow, probably a 15/5 split. i have the DSN on 26th so im hoping it will settle before i see her. ive split before but kept forgetting to take the second injection  but, with my HbA1c now above 10, and the effect its having on my moods, its time to give it another try. good luck in sorting them out.


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