Evening lows

[everydayupsanddowns]

I'm trying to only get her to finger prick if she's in the fives with a down arrow.

A very good consultant (and worldwide hypo specialist) once mentioned to me the importance of remembering context with CGM readings, especially the lag where hypo dodging is concerned.

5 and a down arrow, means that 5-10 minutes ago you were 5 and heading down. And any hypo treatment will take 10-15 minutes to kick in, so if you want to dodge the low you need to be remembering that 20-25 minute ‘gap’

 

[Thebearcametoo]

The Libre will help to give you data which can help you as to whether it’s the basal that is too high or the evening meal bolus ratio of a combination of both. Lantus will take a couple of days to stabilise so you won’t see the results of a dose change immediately and if she’s exercising today that can affect results for 24 hours or more too. I would be sending her to bed at around 6-7 on a finger prick for tonight and see how all the changes manifest in a few days. Once you’re confident of her overnight levels you can be a bit tighter on bedtime levels.

 

[trophywench]

Yep - agree entirely with far too much Lantus circulating, it's a right PITA even for a stable adult trying to get Lantus dosing adjusted with having to wait 3 days to see if any adjustment really worked or not.

Although it means an extra jab a day lots of us have found Levemir shedloads more 'biddable' cos with Lev (once Lantus is fully eliminated from the body, so not for the first 3 days after changing) usually you can tell within 12 hours whether the change (up or down) is effective.

Dunno whether it's advised for children though; not an expert in NICE paediatric guidelines.

 

[Inka]

I agree about the Lantus. Levemir is better IMO for most people. As far as I know @trophywench its approved for children.

 

[rebrascora]

I'm another big fan of split dose Levemir. For me, I need more than double during the day compared to at night. My current dose is 16 units in the morning and just 3.5 at night and if I have had a very active day, I drop 1-2 units from that night time dose and if I am less active the next day, I add it back on the next night to keep things level and the change is effective during that 12 hour period, so I can chop and change from day to day as required..

I also find my Libre sensors consistently read about 1mmol lower than my finger prick when my levels are low, so 3.5 will actually be about 4.5 or maybe even higher and 2.5 on the Libre will be about 3.6. I don't get too concerned about these low readings although obviously take action to prevent them happening regularly. In range readings are usually pretty close and I haven't had too many high readings that I have double checked since starting using Libre, so I am not sure how they compare. I tend to know when I am too high and needing a correction.

You sound like you are at your wits end and worn to a frazzle trying to do the right thing but worried all the time that you are not getting it right. I know it is frightening in the beginning as an adult patient and it must be 10x worse as a parent of a child, but you really are doing incredibly well and these early months are by far the most difficult both in terms of not having enough knowledge and experience, worry itself and then the pancreas unhelpfully throwing out some insulin when you least expect it just to put a big spanner in the works of all your carefully calculated doses.
Hang in there, it really will get easier.

 

[stephknits]

They changed Alice from Levemir to tresiba because this is what they recommend for young people as it is much more forgiving if you don't do the jab at the same time.

 

[Deleted member 27171]

I agree about the Lantus. Levemir is better IMO for most people. As far as I know @trophywench its approved for children.

Yes is definitely ok for children. My son switched from 1 Lantus to 2 Levemir when he was about 6 I think, he used to find the Lantus injections would sting but Levemir didn’t.

 

[Lilmssquirrel]

Thanks everyone. We made it through last night without incident. I gave her crumble (wholemeal flour, oats, sweetener - no joy at all!) after tea and played a bit fast and loose with the carbs. Glass of milk on top and we made it through the night at a steady 5.3-5.6.

I did forget to drop the Lantus last night but we have both netball and hockey today so was told to dial it down by 2u anyway. Let's seewhat tomorrow brings!