At last Im being listened too!

[gillrogers]

Yay! My dbn nurse who started me on this journey as a LADA type one is back! I wrote a polite complaint to her and I said i need to be listened to about my situation and variables not just my graph looked at. She agreed and we worked out a plan of action which i had been asking for. She agrees with what ive been saying about my basal rate ! Im so glad shes back as weve always been on the same wave length!

 

[Josh DUK]

Yay! My dbn nurse who started me on this journey as a LADA type one is back! I wrote a polite complaint to her and I said i need to be listened to about my situation and variables not just my graph looked at. She agreed and we worked out a plan of action which i had been asking for. She agrees with what ive been saying about my basal rate ! Im so glad shes back as weve always been on the same wave length!

Happy for you! Hope it goes well!

 

[gillrogers]

Thanks @Josh DUK

 

[SB2015]

Yay! My dbn nurse who started me on this journey as a LADA type one is back! I wrote a polite complaint to her and I said i need to be listened to about my situation and variables not just my graph looked at. She agreed and we worked out a plan of action which i had been asking for. She agrees with what ive been saying about my basal rate ! Im so glad shes back as weve always been on the same wave length!

That sounds promising Gill.
I hope that this will make things easier for you.

 

[gillrogers]

That sounds promising Gill.
I hope that this will make things easier for you.

Well so far nothings working. Changing my bolus up is not making a jot of diffetance. My glucose levels seem to move up with it. Yet a basal test shows my basal level is ok. I dont get it. My injecton sites feel fine.

I had the same meal.last night as i did wednesday yet i had to do a unit and a half correction at bed time . This keeps happening. So i adjust my bolus up and it happens again. Im on a new vial of lyumjev so its not that.

 

[Inka]

Sorry to hear that @gillrogers To some extent that’s the nature of Type 1/LADA - you work hard to find something that works, and then it suddenly doesn’t work anymore. That’s the most stressful and frustrating aspect of it.

Could you give a little more detail about what you ate on Wednesday and Thursday and your blood sugars? If there’s nothing obvious as a culprit, then there are a number of possibilities that you could explore, so try to keep positive, frustrating as it is xx

 

[rebrascora]

It is likely that you are going through a period of change in your honeymoon period. They are very frustrating. I found that I would fire fight with bolus insulin corrections for a week and then increase my basal and then start fire fighting with corrections again a week or so later and have to increase the basal again. Over 3 months my basal dose almost doubled the last time I went through such a spell and it was an incredibly frustrating time. Thankfully they then stabilized and have been pretty stable ever since, give or take a few units.
Corrections are an everyday part of my diabetes management though and I just accept that and don't worry about it. It is the only way I can achieve good TIR, so I regularly inject 5 or 6 bolus injections a day plus 2 basal (sometimes just 1 basal, depending on exercise.) I don't worry about it. I just inject as much insulin as I need when I need it.

 

[gillrogers]

Hi @Inka it was a homemade chilli (no heat) and basmati rice. Same weights and carb count. That was give or take 5 mins around 6pm. I have my evening basal around then , that went though to 6.15 after my dinner. I started on 9.8mmol rose to 13 over 2 hours and stayed there until I corrected at bed time at 10.30. My bolus was including a correction of half a unit as I had already adjusted the bolus ratio to add another half unit from the day before which i was expected to do.

 

[gillrogers]

It is likely that you are going through a period of change in your honeymoon period. They are very frustrating. I found that I would fire fight with bolus insulin corrections for a week and then increase my basal and then start fire fighting with corrections again a week or so later and have to increase the basal again. Over 3 months my basal dose almost doubled the last time I went through such a spell and it was an incredibly frustrating time. Thankfully they then stabilized and have been pretty stable ever since, give or take a few units.
Corrections are an everyday part of my diabetes management though and I just accept that and don't worry about it. It is the only way I can achieve good TIR, so I regularly inject 5 or 6 bolus injections a day plus 2 basal (sometimes just 1 basal, depending on exercise.) I don't worry about it. I just inject as much insulin as I need when I need it.

Thanks @rebrascora Barbera, yes seems that way for me I reckon. I don’t mind if I’ve got to do corrections . I can cope with the trend per sey just want that trend to start of lower. I’m not kidding you but every time I can get to start the day nice a low. I won’t come back to range enough for it to carry on through out the day so that I can start low enough the following day. I wonder if I can use my night time basal to do that? I keep being told it’s perfect and not to change it and it is good once the correction has got it down. I agree but perhaps I need to tweak that to bring me down. I can afford a slightly higher nighttime basal of half a unit I reckon.

 

[Inka]

Hi @Inka it was a homemade chilli (no heat) and basmati rice. Same weights and carb count. That was give or take 5 mins around 6pm. I have my evening basal around then , that went though to 6.15 after my dinner. I started on 9.8mmol rose to 13 over 2 hours and stayed there until I corrected at bed time at 10.30. My bolus was including a correction of half a unit as I had already adjusted the bolus ratio to add another half unit from the day before which i was expected to do.

Rice can be tricky. In theory basmati is low GI but I find that sometimes it’s absorbed slowly and sometimes faster. I use potatoes to work out my evening meal ratio - boring but more predictable.

If it’s not the variable speed rice, it could be the honeymoon and it’s erratic insulin production; it could be something you thought was insignificant eg you did very moderate housework one evening but not the other; your hormones (pretty much all stages of female hormones can cause havoc with your blood sugar, perimenopause and menopause in a far more unpredictable way); your stress levels, etc etc.

 

[rebrascora]

Thanks @rebrascora Barbera, yes seems that way for me I reckon. I don’t mind if I’ve got to do corrections . I can cope with the trend per sey just want that trend to start of lower. I’m not kidding you but every time I can get to start the day nice a low. I won’t come back to range enough for it to carry on through out the day so that I can start low enough the following day. I wonder if I can use my night time basal to do that? I keep being told it’s perfect and not to change it and it is good once the correction has got it down. I agree but perhaps I need to tweak that to bring me down. I can afford a slightly higher nighttime basal of half a unit I reckon.

I personally think that experimenting is key to good diabetes management, so if it was me I would play with my evening basal dose to see if that helped. In fact I adjust my evening dose often because I need to because my overnight levels are very responsive to exercise the previous day. That is the beauty of Levemir, that it allows you to make easy adjustments and if you have a half unit pen then you can make nice small adjustments. If you are going to adjust it, always weight up all the risks and err on the side of caution. So for instance.... don't do a correction at bedtime with Lyumjev and a basal increase at the same time.

 

[gillrogers]

I personally think that experimenting is key to good diabetes management, so if it was me I would play with my evening basal dose to see if that helped. In fact I adjust my evening dose often because I need to because my overnight levels are very responsive to exercise the previous day. That is the beauty of Levemir, that it allows you to make easy adjustments and if you have a half unit pen then you can make nice small adjustments. If you are going to adjust it, always weight up all the risks and err on the side of caution. So for instance.... don't do a correction at bedtime with Lyumjev and a basal increase at the same time.

Thanks @rebrascora Barbera, thats just how i had planned it. Then breakfast worked, lunch worked and i just had this feeling that dinner would do as well without the change to my evening dose of levemir. And it did. All i did was push back my morning levemire does time by 30 mins, and had a lot of going up and down my stairs more than usual during the morning which i had planned to do becausr of sorting stuff out in my "office”. I used that instead of a correction half and it worked much better. The weather was milder too.

So I’m thinking that if I’ll start using my stairs as an excercise tool especially if I’m doing paperwork for the day - as long as my knees hold up to it lol then that could be the key!

 

[gillrogers]

Rice can be tricky. In theory basmati is low GI but I find that sometimes it’s absorbed slowly and sometimes faster. I use potatoes to work out my evening meal ratio - boring but more predictable.

If it’s not the variable speed rice, it could be the honeymoon and it’s erratic insulin production; it could be something you thought was insignificant eg you did very moderate housework one evening but not the other; your hormones (pretty much all stages of female hormones can cause havoc with your blood sugar, perimenopause and menopause in a far more unpredictable way); your stress levels, etc etc.

That’s very true @Inka , it all worked yesterday as I explained to Barbera just. Oh basmati can be wired some days it works, some days it doesn’t. I did homemade air fries yesterday and added a big handful of baby leaf salad leaves to my chilli instead of the rice.

 

[rebrascora]

Intuition is a big part of diabetes management so it is great that you followed that gut instinct that it was going to resolve without extra Levemir on this occasion.
Yes, your stairs can be a really useful tool and I often do 10-20 ascents and descents to get my heart rate and breathing elevated to help lower levels a bit although you have to be careful because if you go at it too hard, it can actually inflate your levels in the short term, so if you are already high it can push you higher. CGM is so helpful for being able to assess the pace which is most useful to you. We really are so lucky to have the modern tech we have to track our levels.

 

[gillrogers]

Intuition is a big part of diabetes management so it is great that you followed that gut instinct that it was going to resolve without extra Levemir on this occasion.
Yes, your stairs can be a really useful tool and I often do 10-20 ascents and descents to get my heart rate and breathing elevated to help lower levels a bit although you have to be careful because if you go at it too hard, it can actually inflate your levels in the short term, so if you are already high it can push you higher. CGM is so helpful for being able to assess the pace which is most useful to you. We really are so lucky to have the modern tech we have to track our levels.

Sure is! I like the Xdrip/Shuggah app , it’s really helped me understand more on what’s happening and when and a bit of why. What I don’t get is if the libre app is capable of being a full cgm then why don’t Abbotts own LibreLink app work like one.?

 

[rebrascora]

What I don’t get is if the libre app is capable of being a full cgm then why don’t Abbotts own LibreLink app work like one.?

No idea, except that perhaps there was a rush to get the product to the market and keep the cost competitive. I know there was a time when demand for Libre far outstripped their production and they would not sell to new customers and existing customers were restricted to how many they could buy. Holding the product back to get that extra feature and get it passed through all the regulatory systems was probably not considered worthwhile at that time, but obviously they are trying to rectify that with the Libre 3.
Personally, I am not sure I trust the Abbott's software team to get it right because they have had some quite shocking issues with updates recently which have taken a ridiculously long time to resolve and that rather knocks your confidence in their abilities. I am happy enough scanning with the reader and don't feel the need for full CGM or unofficial apps although I entirely understand why people use them.

 

[Tdm]

I use excercise to reduce my sugars when i have bolus insulin in my system. Thats when i do most of my 'diabetic' hosework. I find my bolus can change quite a lot - earlier in the year my ratio was 1 to 3, now 1 to 20! Keeps you on your toes. I find basmati rice tends to a steady, level rise in blood sugars.

 

[Tdm]

No idea, except that perhaps there was a rush to get the product to the market and keep the cost competitive. I know there was a time when demand for Libre far outstripped their production and they would not sell to new customers and existing customers were restricted to how many they could buy. Holding the product back to get that extra feature and get it passed through all the regulatory systems was probably not considered worthwhile at that time, but obviously they are trying to rectify that with the Libre 3.
Personally, I am not sure I trust the Abbott's software team to get it right because they have had some quite shocking issues with updates recently which have taken a ridiculously long time to resolve and that rather knocks your confidence in their abilities. I am happy enough scanning with the reader and don't feel the need for full CGM or unofficial apps although I entirely understand why people use them.

At least libre app officially runs on many phones - with dexcom they only officially allow the app on a handful of phones. I still love my dexcom though

 

[helli]

Back to the question why the same food has a different effect on your blood sugars.
I would say it is likely to be because food is not the only thing that affect our blood sugars. There is a big difference for me if I have been exercising in the last 24 hours or not or if I am stressed or if I picked up an injury or what time I eat or ...
The only way of really expecting the same effect every time is to live in a sealed bubble and do nothing.
It can be frustrating but, as @rebrascora says, correction is often necessary.

 

[Tdm]

Back to the question why the same food has a different effect on your blood sugars.
I would say it is likely to be because food is not the only thing that affect our blood sugars. There is a big difference for me if I have been exercising in the last 24 hours or not or if I am stressed or if I picked up an injury or what time I eat or ...
The only way of really expecting the same effect every time is to live in a sealed bubble and do nothing.
It can be frustrating but, as @rebrascora says, correction is often necessary.

I use different ratios for depending on if is breakfast or not, and whether its a workday or not.