Sorry having a really frustrating time and feeling sorry for myself!

[gillrogers]

So my recent crack of my figures went tits up when the weather changed. Ive had to drop my breakfast bolus by half a unit and DB nurse wanted me to drop my lunchtime bolus by half a unit 2 too. Well that didnt work by a long shot. Breakfast is ok but lunchtime is off and throwing my evening off too even with a correction factored in. Perhaps my evening ratio has changed but in the other direction. I cant seem to win. I dont know how to tackle my lunch time bolus as its a half unit change. My lunchtime one was too much which I agree with as I ended up snacking like no tomorrow before dinner. So perhaps Im at the wrong end of the ratio and need to up the carbs amount to get to that end of the ratio.

And im getting frustrated by not being able to have a coffee with a bit of milk in it because it will take me up a couple of numbers! It was so much easier when I was type 2!

 

[rebrascora]

If you are having to make changes to more than one of your meal ratios and you are finding things frustrating then it is almost always because your basal insulin (Semglee) dose is wrong. I find that my basal doses need tweaking much more frequently than my meal ratios and in fact I have never altered my meal ratios so far in 2.5 years, but basal needs change a lot with activity levels, the weather, hormones etc. Sometimes I go weeks and weeks with the same basal dose and other times I have to tweak it every few days to balance things.
I can tell you that it is bliss when you get your basal dose correct and then everything works as it should, particularly after a frustrating period like you are currently experiencing. Do some research on basal testing or ask your nurse. Is your DB nurse at the GP surgery or a specialist trained nurse at a hospital clinic? Having Libre makes basal testing so much easier.
Basically it involves missing meals and seeing what your levels are doing in the absence of food and bolus insulin. Obviously you don't miss all 3 meals in a day but miss breakfast one day and then skip lunch the next and evening meal the next and that will show you if your basal is holding you steady or too much and dropping you low or too little and you are going high. Sometimes it will impact more at certain times of the day and changing the time that you take your basal insulin will improve things depending upon the basal insulin you are using... ie taking it in the morning instead of at night or vice versa. Sometimes just a 1 unit increase or decrease in basal makes the world of difference or sometimes a change of insulin will help if the profile of your basal insulin no longer matches your body's needs. I can need several corrections involving 4-6 units of quick acting insulin during the day when just a single unit increase in my basal will sort the problem, so getting your basal dose right can have a much more significant impact that you would imagine.

 

[gillrogers]

Hi Barbara, that test sounds so complicated. I'm hungry all the time so lord knows how I'd manage going without a meal. My dB nurse is at the hospital at a clinic.

 

[Ditto]

I really admire you guys. I can't even imagine. Can't even manage type 2.

 

[gillrogers]

If you are having to make changes to more than one of your meal ratios and you are finding things frustrating then it is almost always because your basal insulin (Semglee) dose is wrong. I find that my basal doses need tweaking much more frequently than my meal ratios and in fact I have never altered my meal ratios so far in 2.5 years, but basal needs change a lot with activity levels, the weather, hormones etc. Sometimes I go weeks and weeks with the same basal dose and other times I have to tweak it every few days to balance things.
I can tell you that it is bliss when you get your basal dose correct and then everything works as it should, particularly after a frustrating period like you are currently experiencing. Do some research on basal testing or ask your nurse. Is your DB nurse at the GP surgery or a specialist trained nurse at a hospital clinic? Having Libre makes basal testing so much easier.
Basically it involves missing meals and seeing what your levels are doing in the absence of food and bolus insulin. Obviously you don't miss all 3 meals in a day but miss breakfast one day and then skip lunch the next and evening meal the next and that will show you if your basal is holding you steady or too much and dropping you low or too little and you are going high. Sometimes it will impact more at certain times of the day and changing the time that you take your basal insulin will improve things depending upon the basal insulin you are using... ie taking it in the morning instead of at night or vice versa. Sometimes just a 1 unit increase or decrease in basal makes the world of difference or sometimes a change of insulin will help if the profile of your basal insulin no longer matches your body's needs. I can need several corrections involving 4-6 units of quick acting insulin during the day when just a single unit increase in my basal will sort the problem, so getting your basal dose right can have a much more significant impact that you would imagine.

Hi rebrascora, so I've spoken to my dB nurse and Dietitian. They both say my basal is fine as it's keeping me steady at night. They both say my problem is that Im not starting the day low enough, which makes sense. I need to start having substantial snacks enough to need half a unit of insulin and a supper with a half unit. They don't want me prebolusing over 30 minutes. My activities during the day just don't allow me that time anyway. I'm hoping the snack with the half unit will mean I will only have to prebolus my breakfast and possibly dinner as in theory I'll still have insulin on board at snack time and subsequent meal times

 

[everydayupsanddowns]

Sorry to hear your diabetes is giving you such a runaround @gillrogers

I need to start having substantial snacks enough to need half a unit of insulin and a supper with a half unit. They don't want me prebolusing over 30 minutes.

I’m a little confused by this… Are you wanting to snack because you are hungry? Who is declaring the ‘need’?

I have always found snacking adds quite a lot of extra complexity into my diabetes number juggling, because its a whole extra speed-of-dose-plus-speed-of-food balancing act, coupled with the fact that you will already have some insulin already active.

In general, keeping snacks at 5g of carbs (like a handful of nuts) has been my go-to for years, and I can have that without insulin. Though if I do fancy something more substantial I will go for it - but it’s always a higher risk strategy I find.

 

[gillrogers]

Sorry to hear your diabetes is giving you such a runaround @gillrogers


I’m a little confused by this… Are you wanting to snack because you are hungry? Who is declaring the ‘need’?

I have always found snacking adds quite a lot of extra complexity into my diabetes number juggling, because its a whole extra speed-of-dose-plus-speed-of-food balancing act, coupled with the fact that you will already have some insulin already active.

In general, keeping snacks at 5g of carbs (like a handful of nuts) has been my go-to for years, and I can have that without insulin. Though if I do fancy something more substantial I will go for it - but it’s always a higher risk strategy I find.

Hi everydayupsanddowns,. It's me, I'm always hungry, I've always been a hungry person, even before LADA appeared nuts works for all of half an hour, as does anything else like cheese or veg sticks. for example, 1 teaspoon of coffeemate in decaf coffee 3 hours after my breakfast will send me up 2 whole units.

I did as my dietitian suggested yesterday and it worked. As long as I match the carbs to my insulin dose ratio I'm not piling unneeded insulin in which I was initially worried about. She said to me the problem with excess insulin hanging around is if you are doing a correction in between meals. Instead of leaving it until a meal time. Which made sense to me. Plus I'm on relatively small doses anyway.

 

[Robin]

1 teaspoon of coffeemate in decaf coffee 3 hours after my breakfast will send me up 2 whole units.

Have you looked at the nutritional info for Coffee Mate? the biggest ingredient is glucose syrup! Do you use it for the convenience or because you like it? If just for the convenience, those little UHT pots of milk you find in hotels might spike your Blood Sugars less.

 

[rebrascora]

Yes, I found CoffeeMate spiked my levels really badly, but it probably also qualifies as an UPF (Ultra Processed Food) so I won't use it anymore. I have real double cream in my coffee on a morning because the fat helps to keep me feeling full, provides slow release energy and it tastes good. If I run out of fresh cream, I have butter in my coffee until I can buy more. I stopped using Elmlea as I think it is also UPF.... but that is a whole other topic/thread.

If you are eating quite a lot of UPF, that may be why you are constantly hungry. I used to be like that but since going low carb and cutting out the heavily processed foods, I don't need to eat lots of food anymore.

 

[gillrogers]

Yes, I found CoffeeMate spiked my levels really badly, but it probably also qualifies as an UPF (Ultra Processed Food) so I won't use it anymore. I have real double cream in my coffee on a morning because the fat helps to keep me feeling full, provides slow release energy and it tastes good. If I run out of fresh cream, I have butter in my coffee until I can buy more. I stopped using Elmlea as I think it is also UPF.... but that is a whole other topic/thread.

If you are eating quite a lot of UPF, that may be why you are constantly hungry. I used to be like that but since going low carb and cutting out the heavily processed foods, I don't need to eat lots of food anymore.

Ohh now that's an idea, no I don't eat much ultra processed food. I tend to make from scratch. I'll try cream then instead of coffee mate. I only went that road cos I tried it at mother in law's and liked it lol. Cheese doesn't touch me so double cream probably won't . Thanks Barbara