Advice on spikes

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Tom1982

Tom1982

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Hello all.

We got a Libre finally on Thursday so we are starting to see patterns in our daughters BG levels. We carb her food and give her the Novorapid then wait the 15 minutes. In this time we’ve found out she’s actually going low! And it seems to be every time! Should we try ten minutes instead or even eat straight after insulin?

Regards
Tom
 
Hi l would eat straight after the injection lve always done that with no problems
Gary
 
Tom1982 said:
Should we try ten minutes instead or even eat straight after insulin?
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Yes, those are reasonable things to try.

(Probably not for all kinds of foods, but sometimes it might work better to inject after eating (or during, between courses say). If you start with something very low carb like salad that might make sense, for example.)
 
Bruce Stephens said:
Yes, those are reasonable things to try.

(Probably not for all kinds of foods, but sometimes it might work better to inject after eating (or during, between courses say). If you start with something very low carb like salad that might make sense, for example.)
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Genuinely had no idea you could do this. Will go easy but all good info cheers.
 
Tom1982 said:
Genuinely had no idea you could do this. Will go easy but all good info cheers.
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Injecting after eating isn't common. (When I do it it's usually because I started eating when I was a bit low to begin with, or because I forgot to inject before (which, even after decades, still happens now and again).)

Injecting just before eating is much more common: it's what most of us do when eating out (we wait until we've actually got the food before injecting).
 
Injecting after eating might be handy if you're not sure how much your daughter will eat, e.g. if trying something new, there's nothing worse than injecting for the full amount then they decide they're full when they've only eaten half and then you're trying to find apple juice or glucose tabs or anything that they can stomach to make up the difference!
I've also had my daughter going hypo in the middle of a meal because she was faffing around taking too long to eat, so then we gave her some glucose to bring her up again, then she went high because if only she'd eaten her meal a bit quicker she wouldn't have needed the glucose!
 
Finding out all kinds of weird stuff with this Libre. Why would her levels go up at night? Dinner was at about 7. She was at 6.8 by 9 o’clock and as soon as she falls asleep it starts to climb. Currently 15!
 
My daughter’s does that. She is on a pump so we can adjust the basal by the hour, and it has to do a massive increase from about 9pm until midnight just to keep her anywhere near level, then it gradually drops again. Don’t really know why, except that your basal requirements are not the same over 24 hours, so if your daughter’s basal needs don’t quite match when the insulin is working at its most efficient then she will go up and down even if she doesn’t eat anything. Not to mention the 42 other things that can affect blood sugar levels!
 
Tom1982 said:
Genuinely had no idea you could do this. Will go easy but all good info cheers.
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I used to mid-bolus my evening meal - ie bolus between main course and pud. (I don't need to now that I'm using a pump, for some reason). I found it really handy cos I'm never sure if I want a pud or not. Good luck with the tweaking!
 
“the 15 minutes” is a suggestion, not a rule. It’s to give a rough idea of what might work for the average person with an average meal eating at an average speed. As you might guess, in real life that 15 mins often needs adjusting. Some people need less time, some more. Some people need 30 minutes before breakfast, 10 mins before lunch and straight before the evening meal. It also depends where you inject as some sites are quicker than others.

So, yes, move her injection forward and give that a try.
 
Sally71 said:
My daughter’s does that. She is on a pump so we can adjust the basal by the hour, and it has to do a massive increase from about 9pm until midnight just to keep her anywhere near level, then it gradually drops again. Don’t really know why, except that your basal requirements are not the same over 24 hours, so if your daughter’s basal needs don’t quite match when the insulin is working at its most efficient then she will go up and down even if she doesn’t eat anything. Not to mention the 42 other things that can affect blood sugar levels!
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Is your daughter on a closed loop system?
 
Tom1982 said:
Is your daughter on a closed loop system?
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No we have the T-Slim with Basal-IQ, which cuts the basal off if blood sugars are dropping too low and then restarts it once they are rising again. But it doesn’t do anything about highs. We can upgrade to Control-IQ which is hybrid closed loop (it does all the basal by itself and you just have to input carbs at meal times), but after 2 years still haven’t done this! Partly because daughter didn’t want to at first, then because too much else was going on, then we finally got the training done at the beginning of this year and got the code to do the upgrade but still haven’t done it. I think my daughter is a bit afraid to, she sort of wants the upgrade but if we do it and then she decides she prefers it how it is now you can’t change it back again. I’d like her to do the swap but she’s the one with the diabetes and she’s 16 now so I’m trying to step back and let her make her own decisions.
 
Sally71 said:
I think my daughter is a bit afraid to, she sort of wants the upgrade but if we do it and then she decides she prefers it how it is now you can’t change it back again.
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That seems odd. I wonder why on earth they made it irreversible like that?
 
Sally71 said:
. I think my daughter is a bit afraid to, she sort of wants the upgrade but if we do it and then she decides she prefers it how it is now you can’t change it back again. I’d like her to do the swap but she’s the one with the diabetes and she’s 16 now so I’m trying to step back and let her make her own decisions
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That does seem strange. I will flag @everydayupsanddowns who will know more about the t-slim.

I am using the Medtronic version with the 780. I have to have it set up for the other mode in case my sensor fails. I am also able to switch out of the automated mode if the system needs a bit more help.
I know that having switched over to the closed loop I would not want to go back as it takes over a lot of the thinking for me and keeps me in range a lot more.

I hope that Mike can clarify this.
 
I think you can turn the Control-IQ off, but then it will just function like a basic pump and won’t have any sensor input at all. You can’t go back from Control-IQ to Basal-IQ, that would be like trying to change your PC back to a previous version of Windows without wiping the whole disk and starting again. That's how I understand it anyway
 
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