Been diagnosed about 7 months ago now and Nurse has told me i need to try and get my levels down below 10 if possible.
I am finding this difficult.
As an example everyday I have a bagel about 11am at work, prior to my meal I am reading at 9.5 so I take 2 units and eat my roll and an hour later read to be at 10. Perfect!
The next day I think “right let’s get my average down” so I take 3 units for my bagel. Half hour later it falls to 3.5?!?
how can I lower my average. Does anyone recommend a half pen? So I can inject 2.5 units instead?
I can tell you how I managed this. I use Humalog as bolus and Abasaglar as basal.
On the advice of my Diabetes Nurse and Dietitian, I routinely upped my basal injection by about 2 units every 3 days from a start of 8 to 22. I stopped when I realised my morning readings were about the same as my bedtime readings. Looking at my records, this took about 3 weeks.
At the same time, I implemented a strict timing regime for eating. Breakfast at 9am latest. Lunch no less than 4 hours (preferably 5) hours later at maybe 1-2pm and dinner at 6pm. I wanted to make absolutely sure that the previous meal bolus had left the building before piling in more insulin. You can't make sense of your readings if you start overlapping meals and injections. I also try to eat broadly the same amount of carbs at each meal.
Again, at the same time, I started upping my bolus to food ratios from 1:10 to about 1:7 over a period of 3 weeks.
Finally, I try to stick to the same amount of exercise each day at roughly the same times.
By eating roughly the same amount of carbs (healthy ones to prevent immediate spikes) at the same time each day, and exercising in a consistent way, I try to remove as much variation (outside my insulin amounts) as possible because I believed that this would help to get my levels under control ASAP.
At the start, I was averaging readings of about 14.0 per day. One week after diagnosis I was down to averaging about 10.0 per day with some wild swings in individual results. After Two weeks, those wild swings in pre-meal readings had largely tightened and I was averaging about 9.0. After 3 weeks, that came down gradually to 9.0 then 8.0 and finally I am averaging pre-meal readings of about 6.0 to 7.5, 8 weeks after diagnosis.
I now know my ratios and basal for the moment.
Next job was to start making sure I tested 2 hours after eating to eliminate spikes and to inform my actions if I did have a spike. I can mostly get rid of any spikes by immediately walking a few miles or taking a correction bolus (I rarely do this because I want to avoid hypo-hyper-hypo-hyper cycles) or whatever.
For me, the key was consistency in as many things as possible. From there I can start experimenting with treats or changes in carbs per meal. For now, other than the odd panicky situation I seem to be doing OK. That was quite a rapid drop in blood sugars though (3 weeks from a diagnosis of about 35.0) and apparently that's probably causing me some of my nerve pain although that's starting to become more manageable.
Your process will be different but I hope this helps you in some way and gives you some ideas to try out.
