BS disastorous results - looking for some comments / help please

[Northerner]

So onto Friday after I've done my fasting test on waking would it then be maybe a plain biscuit and an injection when I go downstairs to do the brew?

I would try the biscuit without the injection first, to see what the outcome is. It will obviously raise your levels a bit, but the rise from the biscuit may hold back the big rise from the liver. Alternatively, it might add to it, in which case you would know that injecting a unit or two might be required. Good luck! 🙂

 

[mum2westiesGill]

Wednesday 24/10/2012 (cont)
15:41 Lunch - 17.6 (5CP = 5u +4u corr)
20:37 Dinnr - 10.0 (5CP = 5u)
23:13 Bed - 5.8 (had 1 x plain buiscuit, maybe wrong & perhaps panicking but didn't want to go lower due to having HBA1c on Thursday am)

Thursday 25/10/2012
08:21 Fasting - 24.8 (1. test done before getting out of bed to go downstairs 2. had 1u QA to see what would happen)
10:50 Bfast - 20.4 (4CP = 4u +6u corr)
15:45 Lunch - 16.5 (5CP = 5u +4u corr)

 

[Urbansoulpie]

Hi

Again, I would really recommend that you test loads more, it will give you much more of an idea of what's going on.

Even if you only test every 2 hours and note them all down, it'll show you loads more and maybe you could even spot some patterns, especially if you note down what your eating, how much insulin your taking and and activity you are doing at the same time.

 

[everydayupsanddowns]

Wednesday 24/10/2012 (cont)
15:41 Lunch - 17.6 (5CP = 5u +4u corr)
20:37 Dinnr - 10.0 (5CP = 5u)
23:13 Bed - 5.8 (had 1 x plain buiscuit, maybe wrong & perhaps panicking but didn't want to go lower due to having HBA1c on Thursday am)

Thursday 25/10/2012
08:21 Fasting - 24.8 (1. test done before getting out of bed to go downstairs 2. had 1u QA to see what would happen)
10:50 Bfast - 20.4 (4CP = 4u +6u corr)
15:45 Lunch - 16.5 (5CP = 5u +4u corr)

My big question is WHAT on earth is happening overnight to get you from 5.8 to 25 😱 Patti who posts here sometimes did say she got a bit of a 'kick' late on with Humalog causing more drop than you might expect after around 3 hours, which might have meant that despite the biscuit you dipped low and the liver 'helped out'.

Alternatively - it might have been the biscuit and just a general rise 🙄

Have you done any more overnight tests recently?

The drop between waking and breakfast on Thursday is encouraging. Would be worth playing with that a bit more IMO.

 

[mum2westiesGill]

Hi

Again, I would really recommend that you test loads more, it will give you much more of an idea of what's going on.

Even if you only test every 2 hours and note them all down, it'll show you loads more and maybe you could even spot some patterns, especially if you note down what your eating, how much insulin your taking and and activity you are doing at the same time.

Thanks for this I'll try to get more tests in

 

[mum2westiesGill]

My big question is WHAT on earth is happening overnight to get you from 5.8 to 25 😱 Patti who posts here sometimes did say she got a bit of a 'kick' late on with Humalog causing more drop than you might expect after around 3 hours, which might have meant that despite the biscuit you dipped low and the liver 'helped out'.

Alternatively - it might have been the biscuit and just a general rise 🙄

Have you done any more overnight tests recently?

The drop between waking and breakfast on Thursday is encouraging. Would be worth playing with that a bit more IMO.

Re your big question WHAT is going on overnight - I really don't know but I'd love this not to happen

The last overnight test I did was 02:30am on Wednesday, it was 8.7

 

[mum2westiesGill]

HBA1c wasn't due until next month (November) so she's brought it foward to this Thursday 25/10/2012 😱. She said I'll get all my bloods done and maybe see if there's any lingering infection anywhere. worried.com.
I've also got to take a sample in 😱 nervous.com.
I'll book to see my DSN a week later for results etc.

So I've had my HBA1c done this morning plus all other bloods. My appointment for my diabetic review isn't until 08/11/2012 😱 and if there's anything wrong before then my DSN will phone me. So until then I'll just spend the next 2 weeks worrying myself sick.

 

[Northerner]

So I've had my HBA1c done this morning plus all other bloods. My appointment for my diabetic review isn't until 08/11/2012 😱 and if there's anything wrong before then my DSN will phone me. So until then I'll just spend the next 2 weeks worrying myself sick.

Try not to worry Gill, just use the time to gather as much information as you can so your DSN will have lots of information to work on to help you sort things out 🙂

 

[mum2westiesGill]

Try not to worry Gill, just use the time to gather as much information as you can so your DSN will have lots of information to work on to help you sort things out 🙂

Awww thank you. I usually take a print out in with me when I see her so I'll maybe printout the previous 10 days before the date I see her.

In the meantime I'll continue to post my results on here whatever they maybe and look forward to some helpful comments 🙂.

 

[Pigeon]

Have you ever had a continuous glucose monitor? Might help you to sort out what's going on overnight. Ask your team for one at your review!

 

[mum2westiesGill]

I would try the biscuit without the injection first, to see what the outcome is. It will obviously raise your levels a bit, but the rise from the biscuit may hold back the big rise from the liver. Alternatively, it might add to it, in which case you would know that injecting a unit or two might be required. Good luck! 🙂

Thursday 25/10/2012 (cont)
20:24 Dinnr - 6.2 (4CP = 4u)
23:27 Bed - 10.9 (36u)

Friday 26/10/2012
03:52 Night - 18.0
08:32 Fasting - 23.8 (plain digestive (1 x), (trying the biscuit without injection)
10:19 Bfast - 33.3 (2CP = 2u +6u corr) (1. obviously the biscuit without the injection hasn't worked in holding back the big rise from the liver and has just added to the already big rise so must make a note of having just 1 x plain buscuit plus injecting a unit or two when i do my fasting level before getting out of bed 2. this is the highest level my meter goes to also waited 45 mins before having 1 x round toast for bfast then forgot to test again before having toast 😱)

Will be eating linch at about 3pm - 4rpm ish.

 

[everydayupsanddowns]

Thursday 25/10/2012 (cont)
20:24 Dinnr - 6.2 (4CP = 4u)
23:27 Bed - 10.9 (36u)

Friday 26/10/2012
03:52 Night - 18.0
08:32 Fasting - 23.8 (plain digestive (1 x), (trying the biscuit without injection)
10:19 Bfast - 33.3 (2CP = 2u +6u corr) (1. obviously the biscuit without the injection hasn't worked in holding back the big rise from the liver and has just added to the already big rise so must make a note of having just 1 x plain buscuit plus injecting a unit or two when i do my fasting level before getting out of bed 2. this is the highest level my meter goes to also waited 45 mins before having 1 x round toast for bfast then forgot to test again before having toast 😱)

Will be eating linch at about 3pm - 4rpm ish.

Interesting to see your overnight result being *very* different to the previous one. I think you may need to take a bit of a closer look at what is going on there, because it looks like either your mealtime dose is falling way to short, or your Lantus is not holding your steady... or possibly both!

One slightly tricky thing is the relative lateness of your evening meal. By eating at 8.30 you are going to bed with some insulin (and food) still active which can make it hard to spot meal dose errors.

I would do at least one more set of overnioght tests (preferably more than that) where you test at midnight, 2am, 4am and 6am to watch the pattern. A few nights of that would give you very valuable info as to what is happening when you sleep.

Last night you rose substantially - textbooks suggest an accurate basal dose would have kept you within +/-2mmol/L of your starting point.

 

[PattiEvans]

Gill
As Mike said, I was on Humalog and it gave me a huge kick in the tail... so in order to level out any post prandial high I would be hypo at 5 hours but that doesn't seem to be your problem.

What I want to say to you is that I do have a HUGE dawn phenomenon problem. I can go to bed in the 5s or 6s, I can test throughout the night with no rise, but the minute I put my foot on the floor my BG will rise and rise and rise. So I have got into the habit now of testing the minute I wake, if under 6 I will inject 1u, if over 6 I will inject 2u. This will keep me steady until I eat brekkie mostly. Today I got up at 10 am at 6.1 and I took 2u and I actually ate at 2pm and I was then 6.4.

I hope this may help.
Sorry forgot to say I changed to Apidra which is a bit quicker.

 

[mum2westiesGill]

the minute I put my foot on the floor my BG will rise and rise and rise. So I have got into the habit now of testing the minute I wake, if under 6 I will inject 1u, if over 6 I will inject 2u. This will keep me steady until I eat brekkie mostly. Today I got up at 10 am at 6.1 and I took 2u and I actually ate at 2pm and I was then 6.4.

Friday 26/10/2012 (cont)
16:00 Lunch -19.3 (5CP = 5u +4u corr)
20:18 Dinnr - 11.7 (4CP = 4u)
22:46 Bed - 6.7 (36u)

Saturday 27/10/2012
03:21 Night - 13.3 (slept through the 03:00 alarm 😡)
05:55 Night - 21.8
09:06 Fasting - 27.5 (2u)
11:03 Bfast - 22.6 (4CP = 4u +6u corr)

 

[everydayupsanddowns]

Friday 26/10/2012 (cont)
16:00 Lunch -19.3 (5CP = 5u +4u corr)
20:18 Dinnr - 11.7 (4CP = 4u)
22:46 Bed - 6.7 (36u)

Saturday 27/10/2012
03:21 Night - 13.3 (slept through the 03:00 alarm 😡)
05:55 Night - 21.8
09:06 Fasting - 27.5 (2u)
11:03 Bfast - 22.6 (4CP = 4u +6u corr)

That's another significant rise overnight WhiskeysMum - your BG virtually doubles between bedtime and 3am, and then continues to rise through 6am until 9am and possibly beyond.

In your shoes I would have corrected at 6am, and if not then certainly at 9am. The 2u you gave was not finished by 11am, but on the basis that you dropped 5mmol/L between 9am and 11am it seems likely that you could operate on 1u for a 3mmol/L drop. So a correction at 6am and near enough 22mmol/L might involve 5u even without trying to counteract any DP rise.

First off though I suggest you speak to your nurse about Lantus as the rise between 11pm and 3am doesn't look right at all. What did you eat for your eve meal?

 

[Northerner]

Friday 26/10/2012 (cont)
16:00 Lunch -19.3 (5CP = 5u +4u corr)
20:18 Dinnr - 11.7 (4CP = 4u)
22:46 Bed - 6.7 (36u)

Saturday 27/10/2012
03:21 Night - 13.3 (slept through the 03:00 alarm 😡)
05:55 Night - 21.8
09:06 Fasting - 27.5 (2u)
11:03 Bfast - 22.6 (4CP = 4u +6u corr)

I would be concerned that you might be having a night hypo and then rebounding. You went to bed around 2.5 hours after eating and you were already down to 6.7. For me, my mealtime insulin lasts for 5 hours or more, so if I was at 6.7 after a couple of hours I'd expect go much lower by 4-5 hours.

 

[everydayupsanddowns]

I would be concerned that you might be having a night hypo and then rebounding. You went to bed around 2.5 hours after eating and you were already down to 6.7. For me, my mealtime insulin lasts for 5 hours or more, so if I was at 6.7 after a couple of hours I'd expect go much lower by 4-5 hours.

Good point Northerner. A midnight, 2am, 4am, 6am test pattern might really help to give some extra clues.

 

[mum2westiesGill]

That's another significant rise overnight WhiskeysMum - your BG virtually doubles between bedtime and 3am, and then continues to rise through 6am until 9am and possibly beyond.

In your shoes I would have corrected at 6am, and if not then certainly at 9am. The 2u you gave was not finished by 11am, but on the basis that you dropped 5mmol/L between 9am and 11am it seems likely that you could operate on 1u for a 3mmol/L drop. So a correction at 6am and near enough 22mmol/L might involve 5u even without trying to counteract any DP rise.

First off though I suggest you speak to your nurse about Lantus as the rise between 11pm and 3am doesn't look right at all. What did you eat for your eve meal?

Hi Mike,
I've taken all this on board, thank you.
I'll deffinately be speaking to my DSN about Lantus, when I see her I've to take in a printout of the last 10 days previous to my diabetic review so will be doing lots of basal tests before I see her.
My evening meal last night was mince & a small amount of pasta bows / penne about 4CP when I look at the carbs/cals book.

I would be concerned that you might be having a night hypo and then rebounding. You went to bed around 2.5 hours after eating and you were already down to 6.7. For me, my mealtime insulin lasts for 5 hours or more, so if I was at 6.7 after a couple of hours I'd expect go much lower by 4-5 hours.

Again taken on board, thank you Northerner.

Good point Northerner. A midnight, 2am, 4am, 6am test pattern might really help to give some extra clues.

I will carry on doing these tests but I'm going to hit a problem in the early hours of tonight / tomorrow. I'm going out tonight around 7pm ish and won't probably be home until 01:30 - 02:00 ish ish...we're going to a Phoenix (local rock covers band) gig, lots of friends going too. Also with the clocks going back an hour - HELP!!

 

[everydayupsanddowns]

Have a great night Gill

Real life comes first - basal tests can wait.

You might want to test tonight anyway, but it won't really count towards your a 'basal test' understanding because it's such an unusual evening 🙂

 

[mum2westiesGill]

Have a great night Gill

Real life comes first - basal tests can wait.

You might want to test tonight anyway, but it won't really count towards your a 'basal test' understanding because it's such an unusual evening 🙂

Thank you Mike!

Thank you for assuring me that real life does come first. Sometimes I forget and get so paniky about trying to get my diabetes right first.

I'll take my BI out with me & will be doing that injection then at the same time I'll do what would be my bedtime test then after that we'll see.