Bother this bloomin' bolus - the cure, part 2

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Northerner

Northerner

Admin (Retired)
Relationship to Diabetes
Type 1
Well, after last April's rapid decline in my lantus/basal requirements, eventually dropping from 20 units to 6, it appears that my bolus requirements are now falling. Just lately (since this cold snap began) I've been reducing my novorapid with my meals, but I'm just not reducing it enough. Meals that I have been pretty confident about dosing for are now sending me hypo 2.5 hours later. I'm writing this recovering from a completely surprising 2.8, even though I had reduced my bolus, and then taken an extra 20% off just to make sure!😱

I've only had two readings above 5.8 this week - most are in the 2s, 3s, or 4s. I'm fairly happy with my lantus because I wake between 4.5 and 5.1. So...I must be nearly cured! There's no other explanation😱

Things have been pretty good all month - only one reading in double figures and that was after lots of booze just befre New Year, but lately - too many hypos!

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Hi Northe,

Your not alone in this! Alex has had approx 10 hypo's over the past 6 days - but this is made easier with the sensors - so we 'catch' him at about 3.5! Although he did wake at 1am on a level 2 - which scared me. I was very happy that he woke though - he said he felt really sweaty and thirsty. He just treated himself and was waiting to do the 10 minute check when i had gone into his room - so i felt very proud,relieved and a bit guilty that he was able to sort it out on his own.

I also have him on 70% basal during the night and varying between 70% and 80% during the day.

I havent altered his bolus's - but he has been between 5 and 8 at the 2 hour check - which is lower than normal.

So, my guess is that its the cold weather! As your normally on the lower side anyway - i suspect its weather related for you too. Isnt it amazing how much the weather can alter things?🙂Bev
 
Thats a pretty impressive graph, looks like only one day with a reading above 10 if I can read it right.
You know that you need to keep reducing your boluses until you end up back in range, wonder if you'll get such a significant drop in bolus requirements, I wouldn't of thought so, because meeting bolus requirements is harder for you pancreas to do on it's own.
Would be very interesting to see your c-peptide result, maybe you can pursuade them next time you go to the hospital.
 
Thanks Nikki, yes only one over 10 (10.7) and one at 10 bang on. Had another hypo this lunchtime, although not a bad one (3.3). Woke at 4.6 which seems to have been every day this week now. The thing is, I have not been very active at all over the past few days because I can't go out running in the ice (although I say a couple of guys today when I walked to the shops!). I would have expected my bolus requirements to increase, not decrease! I thought I was shivering the other day from the cold, but tested and I was hypo!

My bolus requirements came down by around 30% last Spring/Summer, and I've probably dropped them by about 10-15% this week, but still going low. Thank goodness the basal seems stable and I don't have to worry about night hypos. It would be good to know the C-peptide, but I'm not due at the hospital again until October. Might be seeing GP soon though, so I could ask her!
 
Be careful once you are able to start running again, you wouldn't want to have a severe hypo because you suddenly up your insulin sensitivity again. Also be careful that you don't start to lose your awareness, running so tight and now with lots of hypos you could risk losing this short term.
 
sofaraway said:
Be careful once you are able to start running again, you wouldn't want to have a severe hypo because you suddenly up your insulin sensitivity again. Also be careful that you don't start to lose your awareness, running so tight and now with lots of hypos you could risk losing this short term.
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Looking at the weather forecasts I don't think I'll be doing that soon! Thanks for the advice though, I often forget just how sensitive I can become after a run - for up to 40 hours!😱

Funny thing with the hypos, I've really felt some at 3.8 and not with others until 2.8. I get different symptoms too, at different times of day - in the evening my eyesight goes funny, earlier I get the shakes and sweats!
 
Crumbs Northerner. Incredible set of figures. But kind of odd to see the drop... And Alex too.

We have done precisely the opposite. A 10% increase virtually across the board in the last week, all in one day! After three days of running high, the excuses ran out, and we upped everything, to very good effect. I think this is growth. But certainly the cold is not pulling E down, alas...
 
Well, despite dropping my lunchtime novorapid by 20% I still managed a 2.4 about 3 hours later - that's after a 3.3 just before lunch. I've eaten a huge plate of rice and chilli tonight and FORCED three jaffa cakes down, so will see if that keeps me above 5 before bed! (Reduced teatime insulin by 4 units)😱
 
Northerner said:
Well, despite dropping my lunchtime novorapid by 20% I still managed a 2.4 about 3 hours later - that's after a 3.3 just before lunch. I've eaten a huge plate of rice and chilli tonight and FORCED three jaffa cakes down, so will see if that keeps me above 5 before bed! (Reduced teatime insulin by 4 units)😱
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forced the jaffa cakes....? remember the poor robin...ahhhh
 
am64 said:
forced the jaffa cakes....? remember the poor robin...ahhhh
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The robin's got cheesy lard balls (if you see what I mean!):D I had to buy more jaffa cakes when out on my bread and milk sortie...
 
Northerner said:
The robin's got cheesy lard balls (if you see what I mean!):D I had to buy more jaffa cakes when out on my bread and milk sortie...
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Cheesy lard balls sound tasty, have you posted the recipe on the recipe board?

As weather has got colder my requirement has gone up nearly at 1unit for 10grams carbs at the mo, unless I've been on my feet for a few days! My Basal hasn't changed ever tho (except for 2 week when I dropped it by 2 units)! It's a game ain't it🙄
 
FFFFFFFFFFFFFFFFFFFFFFFFFFF I HATE BOLUS! My daily amounts are off the scale with 30plus units and I'M STILL GOING HYPER!!!!!!!!!!!!!!!!!!!!!!!!!!
 
salmonpuff said:
FFFFFFFFFFFFFFFFFFFFFFFFFFF I HATE BOLUS! My daily amounts are off the scale with 30plus units and I'M STILL GOING HYPER!!!!!!!!!!!!!!!!!!!!!!!!!!
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30 isn't particularly high Sam - I have about 25-30 most days. It used to be about 40-45. Although some people have about 5!
 
salmonpuff said:
FFFFFFFFFFFFFFFFFFFFFFFFFFF I HATE BOLUS! My daily amounts are off the scale with 30plus units and I'M STILL GOING HYPER!!!!!!!!!!!!!!!!!!!!!!!!!!
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My friend Dave is on 50 units of Basal twice a day....

What does your DSN say Sam? Are you keeping an accurate diary? Food, exercise, insulin taken and BG readings? Have you got a temperature/infection somewhere?
 
Northerner said:
Well, despite dropping my lunchtime novorapid by 20% I still managed a 2.4 about 3 hours later - that's after a 3.3 just before lunch. I've eaten a huge plate of rice and chilli tonight and FORCED three jaffa cakes down, so will see if that keeps me above 5 before bed! (Reduced teatime insulin by 4 units)😱
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Just three jaffa cakes? Hmmm... I had a whole packet the other day. And I walked about 13 miles to burn them off listening to Level 42 and KB on the ipod.
 
brightontez said:
Just three jaffa cakes? Hmmm... I had a whole packet the other day. And I walked about 13 miles to burn them off listening to Level 42 and KB on the ipod.
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13 miles? Crikey, there's dedication to the cause Tez😉 ~They're 8.5g carbs each apparently...I'm going to have another one now!
 
Well, I have managed better today with the insulin. Woke to 4.7, was 3.9 before lunch and 4.4 before tea. 🙂
 
Agree with Northerner, 30 units doesn't seem a load really? Granted we have a teenager, but his ratios are 1:5 breakfast, 1:10 lunch, 1:9 dinner. He weighs about 8 stone and is 5'7" ish. For basal he's on an average of 16 units (this is pump though so is much more finely calibrated, would be higher on MDI). TDD about 45-50 units, basal and bolus together (bolus only, maybe 30?)...

Last visit to consultant thought it slightly low for age and stage. Whole thing varies hugely of course, but we've always been told 1unit/kg average (though adults can get to .7/kg). Teenagers tend to be much higher, sometimes as much as 1.5units/kg. This is type 1 of course...

Anyway, my rambling is just trying to point out that there is no general 'too much/too little' of insulin as far as I know, but docs do look at guidelines to get an idea of how things are balancing...

Amazing numbers Northerner. We are still trying to beat down the night readings a little. Looks like a 20% increase on the way...Again, this is within days, all of a sudden. Sigh.
 
Patricia said:
...Amazing numbers Northerner. We are still trying to beat down the night read ings a little. Looks like a 20% increase on the way...Again, this is within days, all of a sudden. Sigh.
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You have a lot more to contend with than a 51 year old! I'm still quite amazed at my waking levels - they have been between 4.4 and 4.8 for the past 8 days - I consider myself very lucky. In fact, I've just finished my latest BG diary and looking back my highest reading was 13.9 at the London Meet, when I was subjected to the scarily high levels of Katie and Sugarbum and this increased my levels by some sort of osmosis...😱😉 In three months I've had three readings in double figures - 13.9, 10.0 and 10.7.

As for the bolus. I seemed to get it right yesterday, was 5.8 before bed, so hopefully I can repeat that today.
 
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