Basal insulin

[Woodywoodpecker]

Decided to go for it this morning took 6.5 units for breakfast, didn’t spike was so pleased with myself. Wasn’t so pleased 2 hours later, half way round Tesco low alarm went off had a Freddy frog in bag kept me going till got home. It’s always been my nightmare off going low while shopping. Just a few months ago I would have panicked and probably abandoned my trolly, but I kept calm and carried on

 

[rebrascora]

It sounds like your insulin dose was too much and you are perhaps trying to reduce the spike with insulin rather than adjust the prebolus timing to reduce the height of the spike.
Pleased Freddy Frog was able to save you from a hypo and you managed to continue your shopping. This is all good confidence building progress. Well done!

 

[Woodywoodpecker]

It sounds like your insulin dose was too much and you are perhaps trying to reduce the spike with insulin rather than adjust the prebolus timing to reduce the height of the spike.
Pleased Freddy Frog was able to save you from a hypo and you managed to continue your shopping. This is all good confidence building progress.

Yes that’s what I’m doing, been wondering what I am doing wrong in the morning, usually do 25 minutes will try 30 tomorrow thank you

 

[Inka]

Yes that’s what I’m doing, been wondering what I am doing wrong in the morning, usually do 25 minutes will try 30 tomorrow thank you

If you bolus at the right time for you, you might even find you can reduce your bolus amount. I did when I moved my breakfast bolus earlier.

Overall, it sounds like you might be having a little too much insulin. Spikes are ok. Don’t try to squash them so much that you impair your day to day functioning and find yourself feeding hypos.

 

[Woodywoodpecker]

If you bolus at the right time for you, you might even find you can reduce your bolus amount. I did when I moved my breakfast bolus earlier.

Overall, it sounds like you might be having a little too much insulin. Spikes are ok. Don’t try to squash them so much that you impair your day to day functioning and find yourself feeding hypos.

Thank you it’s the breakfast one I struggle with, will try to bolus bit earlier

 

[Inka]

Thank you it’s the breakfast one I struggle with, will try to bolus bit earlier

Breakfast is often the most difficult meal - it’s not just you 🙂 I tolerate a higher spike after breakfast than I do at other times because a) it makes life easier and I can get on with my day; and b) I know that if I have extra bolus, then I’ll have a nuisance persistent low later. The simple answer is to tolerate a higher spike and not keep trying to push it down. It took me a long time to learn this lesson, but things are so much easier now I have.

 

[Woodywoodpecker]

Breakfast is often the most difficult meal - it’s not just you 🙂 I tolerate a higher spike after breakfast than I do at other times because a) it makes life easier and I can get on with my day; and b) I know that if I have extra bolus, then I’ll have a nuisance persistent low later. The simple answer is to tolerate a higher spike and not keep trying to push it down. It took me a long time to learn this lesson, but things are so much easier now I have.

when I wake up in the morning, first thing I think about is what dose am I going to take the day, then I get frustrated when it spikes, but by 9 am having to have a snack to keep it up, rest off day ok. Time to stop stressing myself out, sometimes feel a failure and it gets me down. I’m at hospital for review on Monday, I’m dreading it as not keen on the doctor. She’s determined that my alarm should be 4.2, I’m happy at 5 as at work I work a welding machine with hot bar

 

[Inka]

My consultant gave me advice but never interferes or asks about my alarm settings. Just nod and smile and do what works for you. Accept a breakfast spike - especially if it comes down later, which they almost always do.

 

[Lucyr]

Wasn’t so pleased 2 hours later, half way round Tesco low alarm went off had a Freddy frog in bag kept me going till got home

Do you normally treat hypos with chocolate? It’s not really advised.

 

[everydayupsanddowns]

Good luck with your ongoing experiments @Woodywoodpecker

Were you not told to always carry rapid acting glucose with you (something with high glucose content and low fat). Chocolate isn’t recommended for treating low BGs because the fat slows down the carbs.

Glucose tablets, Jelly Babies, Skittles, Haribo, Fruit Pastilles or something similar are common choices on the forum.

 

[rebrascora]

Do you normally treat hypos with chocolate? It’s not really advised.

I considered a similar response and then I realised that she was not treating a hypo but just responding to her low alarm which is set above 4, so a Freddie Frog is an appropriate snack to push levels back up a bit to prevent a hypo. .

 

[Lucyr]

I considered a similar response and then I realised that she was not treating a hypo but just responding to her low alarm which is set above 4, so a Freddie Frog is an appropriate snack to push levels back up a bit to prevent a hypo. .

Hopefully there was a fingerprick to confirm above 4 too though. In a supermarket your bg can be dropping fast and so there’s a decent chance of being hypo when the alarm goes off and of needing to fix it fast not slowly with chocolate to make sure you can safely complete the shopping and drive home. Chocolate would be more appropriate for preventing a hypo when you’re sedentary not mid supermarket shop

 

[rebrascora]

Hopefully there was a fingerprick to confirm above 4 too though. In a supermarket your bg can be dropping fast and so there’s a decent chance of being hypo when the alarm goes off and of needing to fix it fast not slowly with chocolate to make sure you can safely complete the shopping and drive home. Chocolate would be more appropriate for preventing a hypo when you’re sedentary not mid supermarket shop

I believe the OP's alarm is set at 5 which gives plenty of time to treat with something other than hypo treatment. I would not finger prick to double check a low alarm on my Libre unless it was below 4 and I was going to be driving shortly afterwards. Libre consistently reads lower than BG for me, even when levels are dropping. I appreciate this may not be the case for @Woodywoodpecker but even so, your levels being at 5 should not warrant needing to test with a finger prick, otherwise where do you draw the line.

 

[Lucyr]

I believe the OP's alarm is set at 5 which gives plenty of time to treat with something other than hypo treatment. I would not finger prick to double check a low alarm on my Libre unless it was below 4 and I was going to be driving shortly afterwards. Libre consistently reads lower than BG for me, even when levels are dropping. I appreciate this may not be the case for @Woodywoodpecker but even so, your levels being at 5 should not warrant needing to test with a finger prick, otherwise where do you draw the line.

We are advised to always fingerprick before responding to a high or low alarm. So I’d fingerprick every time I prevent a low or correct a high. Otherwise if the libre is reading low, as it often does for many, then you’ll end up too high. Or if the libre is behind because you’re dropping faster than it’s realised yet, you end up low and unable to drive home from Tesco because you treated with slow chocolate instead of fast carbs.

This is especially important to fingerprick when you’ve done more insulin than you usually would before doing an activity renowned for dropping bgs

 

[SB2015]

when I wake up in the morning, first thing I think about is what dose am I going to take the day, then I get frustrated when it spikes, but by 9 am having to have a snack to keep it up, rest off day ok. Time to stop stressing myself out, sometimes feel a failure and it gets me down. I’m at hospital for review on Monday, I’m dreading it as not keen on the doctor. She’s determined that my alarm should be 4.2, I’m happy at 5 as at work I work a welding machine with hot bar

You are not in any way a failure @Woodywoodpecker . You are already managing so many things and doing the same as the rest of us - gradually getting your head round what works for you and making adjustments as necessary. well done.

If you are spiking then having to have a snack to keep your levels up after breakfast it sounds to me like there is too much much insulin. Could you adjust your carb ratio?
The pre-bolus timing sounds like it is sorting the spike, and you can continue to adjust that as necessary.

It is your appointment on Monday and their focus should be enabling you to manage your diabetes effectively in your life. Your welding work sounds like a very good reason to be safe around lower levels and a target of 5 sounds very sensible. Explain to them why, and how this gives you time to head off any hypos.

You will have your quick acting carbs at the ready at work. In the welding centre a juice could be good as that can be even quicker than jelly babies or the like, especially if you swill it around in your mouth where the glucose can start to be absorbed.

Remember how well you are doing and turn up on Monday with a list of questions for them to sort out, armed with explanations of anything you have already needed to change. (I had to adapt my settings on my pump to suit me and my consultant was happy to listen to my reasoning). Let us know how you get on.

 

[Woodywoodpecker]

My consultant gave me advice but never interferes or asks about my alarm settings. Just nod and smile and do what works for you. Accept a breakfast spike - especially if it comes down later, which they almost

I believe the OP's alarm is set at 5 which gives plenty of time to treat with something other than hypo treatment. I would not finger prick to double check a low alarm on my Libre unless it was below 4 and I was going to be driving shortly afterwards. Libre consistently reads lower than BG for me, even when levels are dropping. I appreciate this may not be the case for @Woodywoodpecker but even so, your levels being at 5 should not warrant needing to test with a finger prick, otherwise where do you draw the line.

We are advised to always fingerprick before responding to a high or low alarm. So I’d fingerprick every time I prevent a low or correct a high. Otherwise if the libre is reading low, as it often does for many, then you’ll end up too high. Or if the libre is behind because you’re dropping faster than it’s realised yet, you end up low and unable to drive home from Tesco because you treated with slow chocolate instead of fast carbs.

This is especially important to fingerprick when you’ve done more insulin than you usually would before doing an activity renowned for dropping bgs

I don’t usually have chocolate for a low, usually have lift glucose tablets, first time shopping and alarm going of just grabbed first thing at hand, didn’t realise chocolate was slow, but thank you will know for next time

 

[Woodywoodpecker]

You are not in any way a failure @Woodywoodpecker . You are already managing so many things and doing the same as the rest of us - gradually getting your head round what works for you and making adjustments as necessary. well done.

If you are spiking then having to have a snack to keep your levels up after breakfast it sounds to me like there is too much much insulin. Could you adjust your carb ratio?
The pre-bolus timing sounds like it is sorting the spike, and you can continue to adjust that as necessary.

It is your appointment on Monday and their focus should be enabling you to manage your diabetes effectively in your life. Your welding work sounds like a very good reason to be safe around lower levels and a target of 5 sounds very sensible. Explain to them why, and how this gives you time to head off any hypos.

You will have your quick acting carbs at the ready at work. In the welding centre a juice could be good as that can be even quicker than jelly babies or the like, especially if you swill it around in your mouth where the glucose can start to be absorbed.

Remember how well you are doing and turn up on Monday with a list of questions for them to sort out, armed with explanations of anything you have already needed to change. (I had to adapt my settings on my pump to suit me and my consultant was happy to listen to my reasoning). Let us know how you get on.

Thank you I have a list written for Monday. But doubt I will get clear answers, I’ve learnt more on here

 

[Proud to be erratic]

...... levels being at 5 should not warrant needing to test with a finger prick, otherwise where do you draw the line.

Higher!

If you think of your low setting as an Alert not an Alarm and use that alert to keep yourself away from hypo territory, then you reduce or remove the problem of going very low and then having to think about whether you are fit to drive. I, personally, don't find being at 5mmol/L necessarily leaves sufficient time to catch a hypo. Yes, if I'm somewhere sedentary then it might be fine for a measured response; but if I've been active and with insulin still on board it's too easy to hit 3.5 while fumbling around for those 10-15 gms of faster carbs. At 5.6 (Libre's upper limit for low Alert) or 6 heading off even a rapid fall is viable.

There is a reason why TIR guides us that 25% higher than 10mol/L is acceptable, yet only the much reduced 4 or 5% for time spent lower.

 

[Woodywoodpecker]

Last 2 mornings have been better, just a small spike. Walking to work this week so will have to adjust for that. A seagull kindly done it’s business on my car, so needs a respray