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BS disastorous results - looking for some comments / help please

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Saturday 27/10/2012 (cont)
19:07 Dinnr - 18.6 (4CP = 4u +4u corr) (no lunch, no QA, night out)
22:53 Bed - 17.5 (36u) (did test and injection whilst out)

Sunday 28/10/2012
08:42 Fasting - 5.9 (1u) (no overnight basal testing done)
11:14 Bfast - 11.2 (4CP = 4u)
 
One thing does stand out for me a bit and that's the fact that you're on such low doses of rapid acting compared to your basal of 36u. Usually the balance between rapid acting and basal would be about 50/50 or 60/40. I don't know if anyone else has noticed that and has any comment on it? It doesn't really explain the rise in the night, though I suppose if your ratios really are that low you must be quite sensitive to insulin and therefore perhaps you're taking too much basal and your liver is kicking in to fight it all the time. Only a thought....
 
Sunday 28/10/2012 (cont)
13:39 Aftbf - 17.6
15:07 Lunch - 18.0 (5CP = 5u +4u corr)
17:44 Aflun - 16.0
23:50 Bed - 26.8 (36u)

Monday 29/10/2012
07:55 Fasting - 20.5 (5CP = 3u) plain rich tea (1 x) 1. no overnight basal testing done, really tired 2. bit of a kick start, maybe could have done 5u)
10:51 Bfast - 16.6 (4CP = 4u +4u corr)
13:22 Afbf - 20.3
16:12 Lunch - 17.4 (5CP = 5u +4u corr)
 
Oh dear Gill, all those numbers are about 10 mmol/l higher than they should be :( It would seem that your corrections don't actually bring your levels down. :( It's beginning to look like both your insulins need increasing significantly.
 
Northerner said:
Oh dear Gill, all those numbers are about 10 mmol/l higher than they should be :( It would seem that your corrections don't actually bring your levels down. :( It's beginning to look like both your insulins need increasing significantly.
Click to expand...


Hi Alan,

Last Tuesday when I spoke to my DSN on the phone she said to alter (upp) the basal from 30u to 36u which I obviously have done.
Atm all of my bolus insulin to carb ratios ie before bfast, bef lunch & bef dinner are 1:10.

Thanks for your quick reply 🙂
 
Hi Whiskysmum,

I am wondering whether your LA is running out? Lots of LA doesnt work for the full 24 hours. It is good that you have increased to 36 units but have you tried splitting this? If you are going to split it you need to ask your DSN what split to do - I seem to remember we did a 70/30 split for Alex when on MDI - but cant remember which way round the split was as it was a few years back now and he is on a pump so its a bit hazy.

The ratio's might also need changing as most people find they are more insulin resistant for breakfast ratio - but dont change any of this until you have tried changing the LA as it will get really complicated for you to work out what is and what isnt working!

Alex's split of bolus/basal is around 70/30 - but he is 14 so not sure if this makes a different to an adult split.🙂Bev
 
Monday 29/10/2012 (cont)
18:49 Aflun - 14.7
20:25 Dinnr - 13.8 (5CP = 5u +2u corr)
22:46 Bed - 6.8 (36u)

Tuesday 30/10/2012
02:02 Night - 13.9 (missed 4am & 6am alarms)
06:59 Fasting - 19.8 (5CP / 5u corr) (1 x rich tea)
10:31 Bfast - 15.9 (4CP = 4u +4u corr)
 
Looks like your basal is still way off or that you're having massive DP - you're spiking from 6.8 to 13.9 in four hours and it just keeps going up. Your new basal will still take a couple of days to bed in.

Your evening dinner ratio, however, looks about right - you brought it down from high to relatively normal.

I think part of the problem though is that you're still just fighting fires at the moment. If I were in your position I'd be inclined to do a no-carb couple of days to basically wrestle my BG back down to normal levels consistently, and then start re-introducing carbs.
 
Tuesday 30/10/2012 (cont)
16:08 Lunch - 17.0 - (5CP = 5u +4u corr)
18:26 Aflun - 12.9
20:13 Dinnr - 9.0 - (4CP = 4u)
23:16 Bed - 5.7 (36u)

Wednesday 31/10/2012
02:02 Night - 14.4
07:49 Fasting - 19.6 (5u) (did 5u QA as kick start, forgot biscuit 😱)
10:19 Bfast - 13.4 (4CP = 4u +2u corr)
12:34 Afbf - 18.6
13:23 Lunch - 14.0 (4CP = 4u +3u corr) (had to have lunch earlier then normal 😱)
 
Hi Gill,

What changes are you making to your basals if any? There have been many replies suggesting you either increase your lantus or split the dose - but it doesnt appear you have done? Until you make a change you will keep getting the same high levels which must be making you feel upset and ill too. I would speak to your DSN asap and ask about either splitting the Lantus or increasing it as this isnt getting you anywhere.🙂Bev
 
bev said:
Hi Gill,

What changes are you making to your basals if any? There have been many replies suggesting you either increase your lantus or split the dose - but it doesnt appear you have done? Until you make a change you will keep getting the same high levels which must be making you feel upset and ill too. I would speak to your DSN asap and ask about either splitting the Lantus or increasing it as this isnt getting you anywhere.🙂Bev
Click to expand...

Gill has increased her lantus from 30 to 36 units bev.

whiskysmum said:
Tuesday 30/10/2012 (cont)
16:08 Lunch - 17.0 - (5CP = 5u +4u corr)
18:26 Aflun - 12.9
20:13 Dinnr - 9.0 - (4CP = 4u)
23:16 Bed - 5.7 (36u)

Wednesday 31/10/2012
02:02 Night - 14.4
07:49 Fasting - 19.6 (5u) (did 5u QA as kick start, forgot biscuit 😱)
10:19 Bfast - 13.4 (4CP = 4u +2u corr)
12:34 Afbf - 18.6
13:23 Lunch - 14.0 (4CP = 4u +3u corr) (had to have lunch earlier then normal 😱)
Click to expand...

Tuesday's numbers do look better Gill, although I would still wonder about that 5.7 at bedtime, only 3 hours after your dinner. My levels would definitely drop much lower by 5 hours, especially with the assistance from the fresh lantus dose and the little spike I used to get from it an hour or two after injecting. So, I think you may still be going hypo and then rebounding, which is why you had the 14.4 and 19.6. I would suggest trying to stay up and monitor your levels at 3, 4 and 5 hours after dinner to see if you are indeed falling too low.
 
Hi Northerner,

I just found that - the thread is so long!🙂Gill - have you ever used a CGM? I am inclined to agree with Northerner that you may be dropping during the night and perhaps a rebound and a combination of DP is sending your levels high on waking. I would either do two hourly testing for a few nights or ask for a CGM - something strange is going on at night and once you wake high you are more resistant for the rest of the day.🙂Bev
 
Wednesday 31/10/2012 (cont)
19:46 Dinnr - 17.8 (6CP = 6u +4u corr) (had 1 x toffee as a halloween treat but felt so guilty about this in my situation)
23:32 Bed - 12.3 (36u)

Thursday 1/11/2012
07:47 Fasting - 20.7 (5CP / 5u) (did 5u QA & had rich tea as a kick start)
11:31 Bfast - 14.9 (4CP = 4u +2u corr)
16:28 Lunch - 13.3 (5CP = 5u +2u corr)
20:44 Dinnr - 10.0 (4CP = 4u)
23:10 Bed - 8.9 (40u) (on advice from DSN upped basal / lantus from 36u to should be 42u but to be on safe side a little am doing 40u for a couple of days then will do 42u)

Friday 2/11/2012
02:19 Night - 14.9
03:50 Night - 17.0
07:29 Fasting - 18.9 (5CP / 5u) (did 5u QA & had rich tea as a kick start)
10:20 Bfast - 14.5 (4CP = 4u +2u corr)
12:49 Afbf - 16.8
16:05 Lunch - 13.4 (5CP = 5u +2u corr)
20:20 Dinnr - 13.0 (4CP = 4u +2u corr)
23:22 Bed - 12.5 (40u) (STARTED USING NEW BI PEN - AUTOPEN 24, BLUE ONE, NUMBERS STARTING TO WEAR OFF OTHER ONE)

Saturday 3/11/2012
02:32 Night - 5.2
03:58 Night - 3.0 (didn't feel hypo, ignored this & went back to sleep! tired)
06:13 Night - 3.2 (felt very hypo, had 4 x chewy toffees, 1/2 rnd bread 10g CHO)
06:42 Hypo check - 5.8
08:46 Fasting - 4.6 (bs under 6 so had 1u QA & 1 x buscuit)
10:28 Hypo - 2.9 4 x fruit pastilles (was going to have bfast but was hypo so treated)
10:45 Hypo check - 3.7 2 x fruit pastilles
11:01 Bfast - 5.1 (4CP = 4u)
13:15 Afbf - 6.7
15:40 Lunch - 5.4 (4CP = 4u)
18:01 Aflun - 7.9
19:37 Dinnr - 5.2 (5CP = 5u)
23:02 Bed - 13.9 (40u)

Sunday 04/11/2012
07:28 Hypo - 2.4 fruit pastilles (4 x) (no overnight basal testing done)
07:45 Hypo check - 4.1 fruit pastilles (1 x)
08:01 Hypo check - 4.4 went back to sleep
10:04 Hypo - 2.8 fruit pastilles (4 x)
10:44 Bfast - 5.3 (4CP = 4u)
13:38 Afbf - 9.4
15:32 Lunch - 8.1 (5CP = 5u)
18:44 Dinnr - 11.3 (5CP = 5u)
23:12 Bed - 9.5 (40u)

Monday 05/11/2012
08:56 Fasting - 8.0 (2u) (1. no overnight basal testing done, tired 2. 2u QA but no biscuit - kick start)
11:08 Bfast - 10.6 (4CP = 4u)
13:38 Afbf - 13.5
15:37 Lunch - 15.9 (5CP = 5u +4u corr)
18:32 Aflun - 14.9
19:47 Dinnr - 14.2 (5CP = 5u +2u corr)
23:40 Bed - 8.9 (42u) (as per instruction from DSN)

Tuesday 06/11/2012
02:26 Night - 6.2
04:00 Night - 3.1 (missed treating! fell asleep!)
09:56 Hypo - 2.6 4 x fruit pastilles (also Fasting)
10:15 Bfast - 4.3 (4CP = 4u) (also Hypo check)
12:52 Afbf - 14.9
16:01 Lunch - 12.4 (5CP = 5u +2u corr)
 
whiskysmum said:
[ (STARTED USING NEW BI PEN - AUTOPEN 24, BLUE ONE, NUMBERS STARTING TO WEAR OFF OTHER ONE)
Click to expand...

And then (mainly) single figures...Have you found the (or at least part of the) problem?!
 
Hi Gill,

Much better levels - but a little low now.:( Why are you having sweets for a hypo? They dont work as quick as a fizzy drink like coke or lucozade. Its not the best thing to do to go back to sleep and not treat a hypo.😱 Maybe you could go back to 40 units instead to see if this stops the hypo's?🙂Bev
 
Looks to me as if splitting the basal would be a good option.
 
Tuesday 06/11/2012 (cont)
20:12 Dinnr - 9.3 (5CP = 5u) (had 5u extra for cheese cake)
23:29 Bed - 4.1 (42u)

Wednesday 07/11/2012
03:04 Hypo - 2.8 fruit pastilles then fell asleep & missed hypo check)
08:17 Hypo - 3.2 4 x fruit pastilles
08:34 Hypo check - 3.7 2 x fruit pastilles
08:51 Hypo check - 5.9 2 x plain rich tea 5g CHO ech and had 1u as a kick start
11:24 Bfast - 6.4 (4CP = 4u)
13:36 Afbf - 12.9
15:24 Lunch - 11.7 (5CP = 5u)
19:26 Dinnr - 8.5
23:14 Bed - 4.9 (42u)

Thursday 08/11/2012
03:10 Night - 2.6
03:27 Hypo check - 2.2
07:59 Hypo - 2.7
08:16 Hypo check - 4.2
15:48 Hypo - 2.9
16:00 Hypo check - 2.8
16:17 Lunch - 4.1 (5CP = 5u)
20:20 Dinnr - 3.2
00:02 Hypo - 2.2 (42u)
00:20 Hypo check - 4.6

Friday 09/11/2012
09:25 Hypo - 2.4
09:43 Hypo check - 3.2
10:38 Hypo check - 3.9
10:55 Bfast - 4.9 (4CP = 4u)
13:17 Afbf - 9.4
16:11 Hypo - 2.5
16:29 Hypo check - 4.1 (5CP = 5u)
20:21 Hypo - 2.7
20:34 Hypo check / Dinnr - 3.4 (4CP = 6u) (DSN wants me to add on an extra 2u to this dose and to decrease bedtime BI dose to try and get rid of night time hypos)
23:05 Hypo - 3.8
23:35 Hypo check - 6.1 (new Clickstar pen) (42u)

Saturday 10/11/2012
08:02 Hypo - 2.8
08:21 Hypo check - 4.1
11:44 Bfast - 5.4 (4CP = 4u)
15:44 Lunch - 5.9 (5CP = 5u)
19:33 Dinnr - 5.3
23:17 Hypo - 2.8 (42u)
23:31 Hypo check - 3.4
00:05 Hypo check - 5.2

Sunday 11/11/2012
08:14 Hypo - 2.3
08:47 Hypo check - 4.4 (did 1u QA & had 1 rnd bread 20.8g CHO as kick start)
10:57 Bfast - 7.5 (4CP = 4u)
14:25 Lunch - 7.9 (5CP = 5u)
 
Right Gill over to you,
you have done all these blood tests and results and logged everything.
So it's time for You🙂 to tell us what you deduce from the results and what exactly you are going to do about them. Looking at them it doesn't appear that you have done anything at all so far :(
 
There's quite a contrast in those numbers to what you were posting before Gill - so many hypos 😱 As Sue says, what do you think you might need to do to get some stability in the 'middle ground'? Where do you think the problem might be, basal or meal ratios?
 
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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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