Background Insulin re Bedtime Testing

[Northerner]

It's a good point Ellie - I wonder how many people who have difficulty with control are simply 'blessed' with such disparate daily basal needs that they simply can't be met with one or two injections, so need to be given the facility and knowledge to get a much tighter control of those fluctuations and that can only be achieved with a pump at the moment (or a proper pancreas, that would do it all for you! 🙄). My own experience is that I must certainly be supporting my morning basal requirements with extra bolus, but probably not so much later in the day. My basal does keep me rock-steady overnight, happily! 🙂

 

[Robster65]

@northener

I agree it's not the case that all fall into a 'can't be bothered' there is a lot out there that just don't know as nobody tells them!

That was my gripe..

Whiskmum was being done a disfavour because other people were making an assumption that either they couldn't do the calculating or perhaps that the individual might by chance be in the 'can't be bothered to' group..

Or, from what whiskysmum was asking, she had been given virtually no information from the outset and had been left to 'get on with things'. From that standpoint, to ask her to work out the information that has taken you a long time and hard work to find out would have been taking things too far. From my own experience, I know it is potentially dangerous time to be guessing and I clearly none of us are in the 'can't be bothered' group because we're on this forum trying to find out as much as we can to help ourselves. We do our best to give members the best advice we can to suit their circumstances. Caution is always the best way forward since we won't be there if she hypos in the night. 🙂

@Robert

No my diabetes wasn't always predictable and I wouldn't know why one day I would have a hypo less than 2 hours after having breakfast but the next day be as high as a kite😱 Nothing made sense.. But I now know that this was purely down to ignorance I actually fundamentally didn't have a clue what I was doing... Once I starting learning then it started to become clearer where my problems lay and I could work out insulin adjustments to compensate for the excess peaks and trough's of an unstable basal profile, to a certain degree.. And it highlighted my need for an insulin pump, to make life a lot easier for me as I the ability to flatten my roller coaster of a basal profile in a decent working line to work from.. And deliver a dose of insulin to suit my needs and not up carbs to match the minimum dose of an insulin pen!

And on forums I do find that a lot of people who say I've got 'unpredictable' or 'Brittle diabetes' fundamentally their control problems lay in that they don't have the knowledge to work out what's what..

I know that I can't even now or when I was on MDI tag insulin on to tea for a supper I intended to eat a couple hours later as my BG would land in my boots very quickly.. By doing this mixing one lot of insulin from one meal and/or snack with another meal/snack ends up with my control becoming unpredictable..

I agree. When someone says they are brittle or can't get stabilised, my first thought is that they haven't had the right information/training to approach the problems systematically. It's something I've learnt only in the last couple of years.

I know what I can get away with for me but wouldn't want to tell someone else it's easy to do. I'd rather tell them how MDI is intended to work simply so they can stabilise and then they can work out how to incorporate snacks and do the little tweaks.

As you say, a pump is the only way you can properly iron out those dips and bumps in your basal profile, dynamically if needed, but not being on a pump that isn't a possibility for me or for whiskysmum. So, I appreciate your comments but there was no way WM could apply those calcs to her own situation in the scope of the thread. We have to also consider that we're not abel to give specific advice on doses or calcs and can only convey methods.🙂

Rob

 

[everydayupsanddowns]

I've not been pumping long enough yet to know how 'stable' things will get once I have got a good working basal profile, but I'm another whose Diabetes rarely seems to stand completely still.

On MDI small changes in routine, weather, the simple ebb and flow of life required me to make ongoing adjustments to basal dose in order for things to 'work the pretty much same'. As a consequence I needed to work with an understanding of how things were generally working 'this week' rather than relying on one static set of principles. I've always seen basal:bolus doses as partners in crime (a little downward inaccuracy in one can be made up by a little upward inaccuracy in the other without you really noticing). When the goalposts move it's a case of making an adjustment so that things meet in the middle again (most of the time). Even if I got my MDI basal rock solid for a week, there was no guarantee that it would not be 0.5u out a week or two later.

I have a basic expectation of what will happen when, but usually base the smaller timing/dose tweaking decisions, at least in part, with a feel for whether this week things are a little 'over' or 'under'.

Sorry - this thread may now be going a little OT 😱

 

[mum2westiesGill]

http://www.diabetessupport.co.uk/boards/showthread.php?t=22474

If i've done the above link thing right then have a look at my "diabetes story" in the newbies forum, there was firstly a great deal of negligence from either drs or hospital, i don't know which, both in my pregnancy when it was found i had gd then secondly in 1992 when i became seriously ill with a "virus" & from then on apart from the usual diabetic care & reviews etc i've really just been left to it 😡

 

[Northerner]

http://www.diabetessupport.co.uk/boards/showthread.php?t=22474

If i've done the above link thing right then have a look at my "diabetes story" in the newbies forum, there was firstly a great deal of negligence from either drs or hospital, i don't know which, both in my pregnancy when it was found i had gd then secondly in 1992 when i became seriously ill with a "virus" & from then on apart from the usual diabetic care & reviews etc i've really just been left to it 😡

Yes, I remember reading it Gill, a really horrible introduction and I'm still amazed that doctors don't test for high blood sugars when you have all those symptoms. I used to think that it might be because they didn't think adults could get Type 1, but then I have read far too many stories about similar problems diagnosing children

Keep asking your questions 🙂 I've learned a huge amount from the experiences of people here, and I think we will all continue to learn because of the subtleties and complexities it throws at us.

 

[mum2westiesGill]

Yes, I remember reading it Gill, a really horrible introduction and I'm still amazed that doctors don't test for high blood sugars when you have all those symptoms. I used to think that it might be because they didn't think adults could get Type 1, but then I have read far too many stories about similar problems diagnosing children

Keep asking your questions 🙂 I've learned a huge amount from the experiences of people here, and I think we will all continue to learn because of the subtleties and complexities it throws at us.

Thanks Northerner. Yes i'll keep asking my questions, there's loads to ask. Re "I've learned a huge amount from the experiences of people here" what would we all do without such a fantastic website & all the great ppl on here .

 

[Robster65]

Thanks Northerner. Yes i'll keep asking my questions, there's loads to ask. Re "I've learned a huge amount from the experiences of people here" what would we all do without such a fantastic website & all the great ppl on here .

The questions you ask Gill, highlight the way many of us have been left over the years, btu especially in your case.

There's a lot of assumption in the diabetic care system about what we do or don't know. So many times Ive been nagged about re-using needles or checking my feet, but no one thought to check if I could carb count or if I knew about pumping options.

Some more old-time diabetics may read your questions and realise that they don't know either. So they can go back to their clinics and ask for the information.🙂

Rob