Before tea and after tea/during the evening

[mum2westiesGill]

18:26pm before tea - when tea was ready - 3.9 - treated with 4x dextrose tablets then checked after 15 minutes

18:47pm 15 minute hypo check 5.0

19:42pm used test result from before tea - 102g carbs but told bolus advisor 87g of carbs - 8.0 units of humalog food

After tea and during the evening
20:53pm 1hr 11mins after tea 8.0 within target
22:02pm 2hrs 20mins after tea 4.6
22:48pm 3hrs 5mins after tea 3.7 so treated with 4x dextrose tablets
23:23pm 15 minute hypo check and also bedtime 5.8 back within range - had 4x rich tea biscuits

 

[rebrascora]

What do you make of these results Gill? Are you seeing any patterns which suggests you need to change something?

 

[rebrascora]

I should say that you also need to look at some of your other readings over the past few days and perhaps jot down the dates and times you have had hypos in the last couple of weeks.

 

[mum2westiesGill]

18:26pm before tea - when tea was ready - 3.9 - treated with 4x dextrose tablets then checked after 15 minutes

18:47pm 15 minute hypo check 5.0

19:42pm used test result from before tea - 102g carbs but told bolus advisor 87g of carbs - 8.0 units of humalog food

After tea and during the evening
20:53pm 1hr 11mins after tea 8.0 within target
22:02pm 2hrs 20mins after tea 4.6
22:48pm 3hrs 5mins after tea 3.7 so treated with 4x dextrose tablets
23:23pm 15 minute hypo check and also bedtime 5.8 back within range - had 4x rich tea biscuits

What do you make of these results Gill? Are you seeing any patterns which suggests you need to change something?

I don't know what to make of my results. The things which stand out to me (I don't know if this can be called patterns)
which would suggest I need to change something would be the 2 hypos. Maybe too much tresiba. Am I right?

 

[mum2westiesGill]

I should say that you also need to look at some of your other readings over the past few days and perhaps jot down the dates and times you have had hypos in the last couple of weeks.

Do you think it's worth looking at some of my other readings over the past few days because it was only 1 night where I suddenly decided to test more or less every hour after a meal or should I try and do a few more days and evenings like this?

 

[mum2westiesGill]

Highs/above target

Tuesday 26/10/21
23:06pm 14.5 bedtime
had 1 whisky & diet coke and 1 baileys during the evening


Wednesday 27/10/21
8:03am 13.2 - waking
13:38pm 12.4 before lunch


Thursday 28/10/21
9:59am 11.2 before breakfast


Friday 29/10/21
13:20pm 11.3 before lunch
22:17pm 10.3 bedtime
night out - had 2x whisky and diet cokes during the evening


Wednesday 3/11/21
7:13am 10.5 waking


Saturday 6/11/21
13:26pm 10.8 before lunch


Monday 8/11/21
9:41 11.3 before breakfast
13:56pm 10.1 before lunch


Hypos


Friday 29/10/21
18:05pm 3.8 before tea


Monday 1/11/21
19:11pm 3.3 before tea


Monday 8/11/21
7:31am 3.8 waking
18:26pm 3.9 before tea

 

[rebrascora]

It seemed like you had had more hypos than that in the last 2 weeks but it may be that I have read about them twice in different posts.

Your high readings Monday morning and afternoon were because you over treated the hypo that you woke up to so I would discount those because there is a valid reason for them. I don't think there is enough of a pattern to adjust the Tresiba dose yet but I would keep an eye on the situation.

I think some of your high evening readings might be to do with slow release carbs from things like Chinese takeaway. Also you do sometimes have a tendency to have a biscuit or snacks either when you are out or at bedtime which you don't bolus for. I appreciate some are to bring your levels up and some may be to "counteract alcohol" but some people don't need anything and others do. Also, Baileys is quite sweet so that may be spiking your levels. Can you be sure the cola with your spirits is diet? Does it come out of a bottle that you can see the label or from a drinks dispenser. It is very easy for serving staff to get it wrong and it has certainly happened to me when I have asked for diet cola... So those are all things to consider but at the moment with your levels being occasionally high and occasionally low, I would say that there isn't enough of a pattern to do anything about it just yet.

 

[mum2westiesGill]

Thanks @rebrascora for your help I appreciate it so much.

It seemed like you had had more hypos than that in the last 2 weeks but it may be that I have read about them twice in different posts.

Your high readings Monday morning and afternoon were because you over treated the hypo that you woke up to so I would discount those because there is a valid reason for them. I don't think there is enough of a pattern to adjust the Tresiba dose yet but I would keep an eye on the situation.

How long would you give it before adjusting anything?
Should I try and do some more testing after meals like I did last night? If yes please can you refresh my mind about the after meal testing - should it start from the first mouthful of food or should it start from when the insulin in my case humalog is taken?

I think some of your high evening readings might be to do with slow release carbs from things like Chinese takeaway. Also you do sometimes have a tendency to have a biscuit or snacks either when you are out or at bedtime which you don't bolus for. I appreciate some are to bring your levels up and some may be to "counteract alcohol" but some people don't need anything and others do. Also, Baileys is quite sweet so that may be spiking your levels.

Can you be sure the cola with your spirits is diet? Does it come out of a bottle that you can see the label or from a drinks dispenser. It is very easy for serving staff to get it wrong and it has certainly happened to me when I have asked for diet cola...

The cola is definitely diet because most of the drinks are when I'm at home in the evening. When I go out if I go to the bar myself I make sure I watch the serving staff like a hawk lol and if son or hubby go I always stress to them 100 times over lol that it has to be diet coke.

So those are all things to consider but at the moment with your levels being occasionally high and occasionally low, I would say that there isn't enough of a pattern to do anything about it just yet.

 

[rebrascora]

How long would you give it before adjusting anything?

As long as necessary. ie if a pattern emerges where you are getting regular highs or lows at set times of the day. So if you woke up hypo 3 days out of 4 that would suggest you need to do something. If you were regularly having 2 hypos a day. If you were mostly in target before tea and then going high at bedtime most nights and remaining high all night.

You could try doing a basal test as other have suggested in another thread by skipping a meal each day in rotation and seeing what your levels do in the absence of food and bolus insulin.

As regards testing more intensively I think you will end up getting confused and being tempted to intervene when you see levels go high. Personally I don't think it will help you, unless you are doing a basal check and skipping a meal, so that you get a better picture of what your basal insulin is doing. I get the impression you are reluctant to do basal testing though. Not sure if it is the idea of skipping a meal each day or just that you are not confident about how to go about it.

 

[mum2westiesGill]

As long as necessary. ie if a pattern emerges where you are getting regular highs or lows at set times of the day. So if you woke up hypo 3 days out of 4 that would suggest you need to do something. If you were regularly having 2 hypos a day. If you were mostly in target before tea and then going high at bedtime most nights and remaining high all night.

You could try doing a basal test as other have suggested in another thread by skipping a meal each day in rotation and seeing what your levels do in the absence of food and bolus insulin.

As regards testing more intensively I think you will end up getting confused and being tempted to intervene when you see levels go high. Personally I don't think it will help you, unless you are doing a basal check and skipping a meal, so that you get a better picture of what your basal insulin is doing.

I get the impression you are reluctant to do basal testing though. Not sure if it is the idea of skipping a meal each day or just that you are not confident about how to go about it.

You've hit the nail on the head here! I'm very reluctant because it's something I've never done since being diabetic in 1992. It's the idea of skipping a meal every day - I would be absolutely starving and probably thirsty. Also how to go about it easily. The best days, times etc to do it because I go to work Monday to Friday from 11:30am to 1pm........

 

[Lucyr]

Are you planning on doing the basal testing that has been suggested on your previous threads where you've asked if the tresiba dose is correct? Basal testing is the only way to work that out.