Another bad evening after dinner

[gillrogers]

3 days running now I have gone very low or hypo just before dinner or just after dinner. Each taking 2 bottles of glucojuice to recover. Last night I may just as well gave not had my lispro. It was rice. In theory with 50gms carbs with rice = 5 units of lispro but I knew I needed only 4 but have been trying to drop it to 1:20. I'm terrible with math ratios. Pershp I should go 1:30. Anyway, ended up going to bed at 10pm on 13mmol and ended being woken by my sensor alarm at 2.30 on 5.2. I know it will drop so downed a glucojuice bottle and it's taking forever to come back up, 40 mins later and it 5.8! I'm 9n 10 units of semglee long lasting. If I lower it I get too high in the morning and during the day. I just can't get it right anymore. It takes a week to get a response from my dB team.

 

[Pumper_Sue]

Hello @gillrogers it sounds to me as if your basal is the problem.
Perhaps ask to try Levemir as that can be split into two doses and easier to adjust. Another option to consider would be to change the time of the basal. Obviously you need to talk to your team about this. So keep on at them even ringing the sectary of your team to get them to ring you.

 

[gillrogers]

Hello @Pamper_Sue,

Thanks, yes I was literally just wondering if I'm on the right basal. I'll suggest that to them.

Thanks.

 

[Inka]

I completely agree with Sue. That sounds like a basal issue. If it was me, I’d ask for a twice daily basal as they give more flexibility and can be really helpful for situations like you describe.

 

[gillrogers]

Thank you @Inka

 

[everydayupsanddowns]

In the meantime it sounds like it might be safer to reduce your basal dose, and add insulin to your breakfast - even if that is a fixed ‘pre correction’ rather than a ratio change.

Some forum member find they need to allow extra insulin at breakfast time to account for extra glucose released from their liver as part of Dawn Phenomenon / Feet Hit The Floor, where your liver’s caveman brain dumps glucose to help you go out and hunt a mammoth for breakfast(!)

Fighting BGs that drop sharply overnight is exhausting and risks long overnight hypos that may not wake you up, which is a quick way to put a big dent in your hypo warning signs

 

[gillrogers]

Yes that's what I've done. I've a feeling that phenomenon does start around 6.30 for me.

 

[gillrogers]

Hi Ladies and Gents,

So yesterday I was on the phone to my DB nurse for about 45 mins! We went through everything and she suggested I drop another unit of basal, bite the bullet and pre-bolus 15-20 mins before meals, carb/insulin ration 1:10 (deduct the fibre) and drop a unit of insulin if I have work as its active. Only part time and at the most an hour am, and pm. So im burning off the sugar instead.

She worked out, which i and you suspected that my basal was too high, hence me running down too low before meals, during and after. If my low alarm goes off at night, remember to double check with finger prick as the sensor will give a false alarm if I've slept on it. Ive done that twice now, Ive also got to remember not to extra dose if im running to high after the meal as it runs into my next meal. Duh - i knew that so why do I panic! lol.

So im doing this for a week and we will chat again next week and look together at my libreview stats to see how ive done. One day in and done pretty well if i may say so and that was ontop of a sensor false alarm at breakfast time when I panicked and downed a glucojuice before prick testing to confirm.

And there we have it!

Thats all folks!

Speak soon 🙂

 

[Pumper_Sue]

So yesterday I was on the phone to my DB nurse for about 45 mins! We went through everything and she suggested I drop another unit of basal, bite the bullet and pre-bolus 15-20 mins before meals, carb/insulin ration 1:10 (deduct the fibre) and drop a unit of insulin if I have work as its active. Only part time and at the most an hour am, and pm. So im burning off the sugar instead.

In the UK the fibre is already deducted from the carbs 🙂 I'm assuming you are in the uk or have I got that wrong?
Glad you have a plan of action re your basal though.

 

[gillrogers]

In the UK the fibre is already deducted from the carbs 🙂 I'm assuming you are in the uk or have I got that wrong?
Glad you have a plan of action re your basal though.

Hi @Pamper_Sue, yes I'm in the UK, how do you mean that in the UK fibre is already deducted from the carbs? I don't understand as it's listed separately on food labels here with a Total Carb number. I'm sure when I did the Bertie course they said to deduct it. Could be me that's misunderstood it though lol.

 

[Lucyr]

Hi @Pamper_Sue, yes I'm in the UK, how do you mean that in the UK fibre is already deducted from the carbs? I don't understand as it's listed separately on food labels here with a Total Carb number. I'm sure when I did the Bertie course they said to deduct it. Could be me that's misunderstood it though lol.

For example attached, UK packaging, a slice of this bread contains 16.8g carbs and 1.9g of fibre. You would count it as 16.8g carbs because the fibre is a seperate part, that’s 1.9g on top of the 16.8. We don’t bolus for the 1.9g fibre usually in the uk.

The sugars is an example of something that is included within the carb count, the “of which” sugars tells you that the 1.2g sugars are included within the 16.8g carbs.

So for this label I would count as 16.8g carbs. In other countries they do it differently, in America the fibre is shown included in the carbs and they have to take it off.

 

[gillrogers]

Hi @Lucyr and @Pamper_sue , sorry I read @PamperSues message incorrectly duh! Still half a sleep with wonky eyes. I'm a tit! Sorry ladies.