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Advice please

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This mornings reading was 5.1 and this evenings was 5.3.

I had reduced my morning insulun down 2 units to 6 and removed my midday metformin. I also reduced my carb intake in the day time.

So far things seem better but the one thing I seem to have gleaned on this forum is that everything is forever changing and nigh on imposdible to pin down.

I had a good meal of mince, carrots and mashed potato this evening. Carefully weighed. Two more small meals to go before bed.

It will be interesting to see the reading tomorrow morning.

As far as I can I have very carefully controlled my carbs intake. Might actually be helping. It is certainly better than the chaos at the beginning.
 
Your readings are great so what you’re doing seems to be working well!
 
I decided to just lower my carb intake by a small amount yesterday evening and as I thought would happen my fasting blood glucose level this morning had dropped to 4.7. So it looks like I have to keep my evening carbs up a little, or get up in the middle of the night and snack. I prfer to eat a little more in the evening.

Today I have lowered my morning insulin by 2 units again and reduced my morning carbs too. However, since my fasting blood glucose level was lower than I want I have increased my morning carbs accordingly. This should take care of the evening blood glucose test resut.

And just to add to things. I noticed that I was feeling a bit hungry following my snacks recently. Looking at the data it became obvious that my main meals were significantly stronger in cals and carbs than the snacks. Today I have tried to balance all meals and snacks carbs whilst keeping to what I feel are the right morning and evening carb amounts.

What makes it all even harder is ensuring that the calories don't go above a certain level or I will start to gain weight.

Its a lot of juggling and balancing, but its worth it if the outcome is good.

Besides I have nothing much else to do at the moment.
 
Is there any reason you don’t want your morning glucose to be 4.7? I don’t follow why you’d need to eat more at night because of a perfect morning reading?
 
Lucyr said:
Is there any reason you don’t want your morning glucose to be 4.7? I don’t follow why you’d need to eat more at night because of a perfect morning reading?
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I think it’s because @Gwynn ‘s readings have been consistently dropping, and 4.x gives not much wiggle room.

As I understand it, NICE guidance for T1s is to aim for 5-7 as a waking level, because readings lower than that are associated with potentially long periods of undetected overnight hypoglycaemia, particularly with longer diabetes duration.
 
everydayupsanddowns said:
I think it’s because @Gwynn ‘s readings have been consistently dropping, and 4.x gives not much wiggle room.

As I understand it, NICE guidance for T1s is to aim for 5-7 as a waking level, because readings lower than that are associated with potentially long periods of undetected overnight hypoglycaemia, particularly with longer diabetes duration.
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Ah I see that makes sense. Was thinking more that a T1 taking no evening insulin at all surely doesn’t have to worry much about severe hypos in the morning, but I guess the honeymoon could be why the blood sugars are normal in the morning.
 
Lucyr said:
Ah I see that makes sense. Was thinking more that a T1 taking no evening insulin at all surely doesn’t have to worry much about severe hypos in the morning, but I guess the honeymoon could be why the blood sugars are normal in the morning.
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I have a pump and can have the exact basal I need, but even then I’m nervous about waking up in the 4s. It always pays to be cautious with overnight numbers when you’re on any insulin at all. As @Gwynn has been drifting low, it makes sense to be very careful, as he’s meticulously doing 🙂
 
Hi @Gwynn
Congratulations on your great diabetes management.
I notice you are, understandably, concerned about waking to a low blood sugar reading.
Unfortunately, as you are on fixed insulin doses, you are likely to be "feeding your insulin" - eating carbs to use your insulin. If you were on the basal bolus regime mentioned earlier, you would be able to eat the carbs you want and dose accordingly.
If you are happy with your current approach then there is no point in changing but, as mentioned, it is more restrictive.
 
Yup spot on. I am very nervous of morning readings below 5. Tomorrow morning will be better!!!

To be honest I am learning as I go. It is all new.

I was really alarmed when I first came home from hospital and the readings were all over the place, high and low. The morning readings were very low and getting lower every day. I am amazed that I didn't become ill again. So I redoubled my efforts to get my head around it all as best I could. Talk about confused, at first.

Things seem ok now and controlable. So, no relaxing, I am awaiting something to upset things that I hadn't thought of. I hope there isn't anything but....

And I wonder why they put me on such a higher (?) dose of insulin at the hospital especially as I wasn't eating properly there, nor were they monitoring dietary things at all. Mind you I have no idea what a high dose is, so it could have been a normal default level.
 
This 'split' approach to taking your insulin - does that involve twice as many injections? Or is part of it by tablet.

How does the metformin fit into the picture. I remember someone mentioning that they were surpised that I was taking both the metformin and insulin.
 
Gwynn said:
This 'split' approach to taking your insulin - does that involve twice as many injections? Or is part of it by tablet.

How does the metformin fit into the picture. I remember someone mentioning that they were surpised that I was taking both the metformin and insulin.
Click to expand...
The "split" means injecting insulin every time you eat carbs (bolus) and once per day (basal) for background. I have been doing this for more than 15 years. It quickly became second nature and fitted my varied life and diet much better than the fixed dose regime as it allows me to eat what and when I want (or can if I am stuck in meetings).
I cannot comment on Metformin as I have never taken it.
 
How did they/you work out how much basal/bolus? Or did 'you' work it out and tell them so that you can order the right prescriptions for you. Is the type of insulin that you take for the background daily dosage a different type. Ie is it a slow acting type (or are they all slow acting)

Considering my experience at the hospital I am not sure that I feel able to trust them to get it right, just now. I feel that I am dealing with a lot whilst I am getting used to this new way of life.

Later on I will consider the split approach as it sounds a good way forwards, but not until I know what I am doing, better than I do now.

But thanks for the info.
 
Gwynn said:
How did they/you work out how much basal/bolus? Or did 'you' work it out and tell them so that you can order the right prescriptions for you. Is the type of insulin that you take for the background daily dosage a different type. Ie is it a slow acting type (or are they all slow acting)
Click to expand...
There are two types of insulin for basal bolus - the slow acting which is the background and fast acting which is the bolus.
There are some guidelines around dosing but it does require some tweaking as we are all different.
I was suggested a dose for basal and then adjusted it if my blood sugars did not stay stable when fasting (overnight).
Once we were confident with the basal, we could work on the bolus dose. It is common to start with a ratio of 1 unit for every 10g carbs and then adjust this if it is too much or not enough.
Bolus can also be used for corrections - over time I learnt how much 1 unit of fast acting insulin would reduce my blood sugars by if I didn't eat anything.

The important thing is that diabetes is something we need to self manage. It is not a case of being prescribed a fixed dose of 2 tablets a day because there is so much that affects our blood sugars and we shouldn't have to live each day exactly the same.
 
Each of us needs as much insulin as we need - and that won't be anything like anyone else's need! Every single one of us is different. However brilliant a hospital is, it is always a guesstimate!

Eventually there will actually be one expert in the world for Gwynn's diabetes. None of us know him - but you do. His name is Gwynn!
 
I don't think I am expert yet by a long way. But I am so grateful for your helpful suggestions and comments.

Just had a very nice tea, a bit late as we had an electrical problem as all the lights and everything went off. Ho hum, its been a challenging year so far
Electrician to visit this week sometime.
 
Interested to know what you had for tea??? You can't tempt us like that and then not give details! Always interested in new ideas for meals.
 
It was beef mince, potato, & carrots. One of my favourites. A bit heavy on calories though so I have to have a smaller portion.

Later on I have some strawberries and raspberries to look forward to.

Balancing my carbs during the day seems to have curbed the hungry feel I was getting between main meals. Quite tricky to work out though whilst balancing everything else.
 
Thanks for elaborating. Sounds nice but unfortunately it is a bit carb heavy for me.
 
Yes at 43g carbs it was the only thing on the menu for tea.

And oh, calamity, the strawberries and raspberries I had saved for later on were mouldy!!! I had to substitute some nectarines instead. All good.

I should have checked them before. Whoops.

So, that is carb heavy. How do you divide your carbs across the day. And, how many carbs do you consume in a normal day
 
Gwynn said:
How do you divide your carbs across the day. And, how many carbs do you consume in a normal day
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I think you will get as many answers are there are members of the forum, and huge varieties among the T1s too, as well as between the various diabetes types.

I tend to eat around 150-170g of carbs most days, but with the marvel of insulin I’ll occasionally have single evening meals which are more than 100g by themselves (sorry T2s!).

Personally I’ve ended up mostly having pretty consistent breakfasts and lunches with only moderate carbs (20g and 50g) and more variety in the evenings which are 60-70g of carbs and upwards.

What matters more though, is what will suit you better, fit in with your lifestyle, and give you BG levels and fluctuations you are happy with 🙂
 
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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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