Changes in sugar levels help

[ILikeSugar :|]

Hi I've been diabetic for about 4 or 5 months now and have been managing it relatively well although I've had my ups and downs but I was just wondering if this happens to everyone with diabetes or if it's just me, my sugar levels seem to change quite a lot like one week I'll take 1 unit of insulin for every 10 grams of crabs but then other weeks I'll have to take more or less then the amount I usually take, I recently just went into what i thought was the honey moon period so i was taking a lot less insulin then normal but now my sugar levels seem to be going high after every meal even though I'm taking the normal amount of insulin for it, if anyone knows what to do or has any advise it would be much appreciated. Note they was going low a lot the past couple of weeks even though i was taking so little insulin so I cant seem to find the fine balance where I'd be safe and not have to worry whether they're high or low all the time.

 

[Inka]

It does sound like the honeymoon @ILikeSugar :| Its a time of erratic insulin production so often hard to predict what’s going to happen. Also, the recent hot weather probably messed things up too. I went low more than usual and had to change my insulin ratios.

That’s the thing about Type 1. It’s not a case of finding ‘the right doses’ and sticking to them and getting great blood sugars - things change and lots of things can affect your blood sugar. All you can do is err on the side of caution to avoid hypos as much as possible, and accept that nobody gets perfect blood sugars all the time.

Welcome to the forum 🙂

 

[Ljc]

Hello @ILikeSugar :| . Welcome to the forum . It’s nit something I have experienced myself but I know from reading on here that the honeymoon period can be difficult.
I like most folks in here thought honeymoons were supposed to be enjoyed , but hey ho.

Other with more experience will be along soon but a little more info will help us give you more appropriate advise.
What insulin’s are you on.

It’s likely you haven’t been told about this but just in case you have, have you done a Basal test recently, don’t worry if you don’t know how, just say and we will explain.

I

 

[ILikeSugar :|]

Hi @Ljc thanks for getting back to me at the moment I'm on a novorapid pen and a lantus pen, and no I havent ever heard of a bolus test?

 

[ILikeSugar :|]

It does sound like the honeymoon @ILikeSugar :| Its a time of erratic insulin production so often hard to predict what’s going to happen. Also, the recent hot weather probably messed things up too. I went low more than usual and had to change my insulin ratios.

That’s the thing about Type 1. It’s not a case of finding ‘the right doses’ and sticking to them and getting great blood sugars - things change and lots of things can affect your blood sugar. All you can do is err on the side of caution to avoid hypos as much as possible, and accept that nobody gets perfect blood sugars all the time.

Welcome to the forum 🙂

Alright thank you for the info I will keep that in mind

 

[Inka]

Another thought @ILikeSugar :| How far in advance of your meals are you injecting your Novorapid? It could be that you simply need to inject a little further in advance. As an example, with Humalog (similar to Novorapid) I have to inject 30 mins in advance of breakfast and 20+ mins for lunch and 15 mins or so for my evening meal.

Correct timing of your bolus (meal) injection can mean the difference between a high sugar and a normal sugar.

 

[ILikeSugar :|]

@Inka normally I take my insulin about 10 minutes before every meal and usually that seems to work well but like my post says my sugar levels seem to change a lot so a lot of the time I'm changing the time to about 15 or 20 minutes before my meal and sometime that still leaves them going high but the I've had times where I've taken it 10 minutes before a meal and I just end up going on a low it's quite confusing

 

[Inka]

Ah, that’s hard @ILikeSugar :| Again, this sounds like the honeymoon. Your body is probably still producing some insulin in response to high sugar but producing it too late to stop the high and possibly also producing too much, which can send you low.

Sadly, there’s no magic solution. I remember well how difficult it was. My targets then were slightly higher and that helped. I also tested lots and kept hypo treatments near. It gradually eases off as your remaining islets fail. That sounds sad (and it is) but it does make control a little easier.

 

[ILikeSugar :|]

@Inka Yeah I'm sure it will be fine soon enough it's always changing it's just a bit annoying as I spent 100% of my time in target the past few days on my freestyle libre app but now theyve shot right down to 18% but thank you for the information I just thought the honeymoon period kept you at lower sugar levels.

 

[Inka]

It can cause hypos, yes, but it can also cause spikes because, for example, unknown to you, say your own insulin was kicking in to help with your lunch. You were therefore basing your lunch ratio on this without knowing. Now perhaps that help from your pancreas has become erratic or reduced so your ratio no longer covers your carbs - or worse, only covers it sometimes.

 

[ILikeSugar :|]

@Inka yes that makes sense now thank you so have you got any advice on if I should lower or up my insulin dose or should I just keep it the same as normal and just wait for my sugar levels to go back to normal?

 

[Inka]

Because you’re so recently diagnosed and things are still settling, I’d speak to your team @ILikeSugar :| Your Type 1 will be quite unsettled still.

 

[helli]

@Inka normally I take my insulin about 10 minutes before every meal and usually that seems to work well but like my post says my sugar levels seem to change a lot so a lot of the time I'm changing the time to about 15 or 20 minutes before my meal and sometime that still leaves them going high but the I've had times where I've taken it 10 minutes before a meal and I just end up going on a low it's quite confusing

@ILikeSugar :| there are many things which can affect our blood sugars. Aiming to control your levels and be perfect all the time will be fighting a losing battle.
You have only been doing this for 4 or 5 months but, believe me, in 10, 15, 20 years time you could still be learning and tweaking your insulin management.

In a healthy body with a fully acting pancreas, extremely fast acting insulin is released when it detects that the body's blood sugar levels rise. Injected insulin does not work as fast so we have to approximate/guess when our levels will rise and time the injection appropriately. Unfortunately, different foods affect blood sugars at different rates. As we know from hypo treatments, pure sugar can raise our levels very fast. On the other hand, something like pizza will be slow in raising levels due to the high fat content.

So, the 10, 15, 20, 30 minutes pre-bolus works great for some meals but may be too early or too late for others.

Before the arrival or Libre and CGMs becoming more common, we never knew about the peaks because we injected too early or too late. Despite that, and despite only having much slower insulin, people with Type 1 diabetes have received their 40, 50 and 60 year medals.

What I am taking along time to write is that it is incredibly hard to do the job of a major bodily organ whilst living a full life. But you don't have to be perfect at it. You will have some highs and lows. But if you know how to manage them and they are not all the time, there are far more important things in your life to worry about.

 

[ILikeSugar :|]

Thank you @helli for the information I do like to keep them in range but your not wrong I'm not going to get them in range 100% of the time all the time and yes im using a freestyle libre so I'm seeing the spikes an hour after my meal which gets annoying but I guess it happens a lot of the time with everyone my sugar levels are normally not too bad after a couple hours it's just recently where theyve been a bit erratic, like I've said in my post they do seem to change a lot once I've just got the hang of getting my insulin right itll change and I'm pretty much starting over again

 

[ILikeSugar :|]

Because you’re so recently diagnosed and things are still settling, I’d speak to your team @ILikeSugar :| Your Type 1 will be quite unsettled

Because you’re so recently diagnosed and things are still settling, I’d speak to your team @ILikeSugar :| Your Type 1 will be quite unsettled still.

Okay then thanks again @Inka I will speak to them when I can I've recently booked a specialist nursing appointment but they can only talk on the 20th of September so I havent really got a team until then but no doubt it will change by then as well

 

[rebrascora]

Thank you @helli for the information I do like to keep them in range but your not wrong I'm not going to get them in range 100% of the time all the time and yes im using a freestyle libre so I'm seeing the spikes an hour after my meal which gets annoying but I guess it happens a lot of the time with everyone my sugar levels are normally not too bad after a couple hours it's just recently where theyve been a bit erratic, like I've said in my post they do seem to change a lot once I've just got the hang of getting my insulin right itll change and I'm pretty much starting over again

I'm afraid this is a long term problem with managing Type 1 diabetes.... Just when you think you have it cracked and things are ticking along nicely, the goal posts move and you have to rejig things and find new strategies to cope with the way the game is now playing out. I sometimes go weeks or months with the same basal doses and then suddenly they need almost daily adjustment for several weeks and then things might settle down again for a few weeks.

Some people do seem to have much more stable levels than other people and you just have to do your best with the situations that present themselves. I remember there was a newly diagnosed girl on my DAFNE course who was maybe about 3 months in and every single one of her readings every day, was spot on in range. She ate whatever she wanted, injected insulin with a ratio of 1:8g carbs and her body worked like clockwork even when she was injecting 10+ units of insulin. She had never had a hypo either. Then there was another lady who had had diabetes for 52 years and was only using tiny amounts of insulin (just 3 or 4 total units per day) and having horrendous hypos almost every night and going mid teens hyper almost every morning. It really seems to be a lottery and some people seem to have a much rougher ride than others, so try not to be tempted to compare how you are doing against how other people manage, especially if you are struggling. Just manage it as best you can.
I found that being prepared to experiment and see what worked for me was an important part of learning to become the expert in my personal diabetes rather than doggedly following advice. For instance, after a lot of experimentation I found that 1hr-1hr15mins was the optimum time to prebolus NovoRapid for me at breakfast time and I needed an extra 1.5-2 units to cover Foot on the Floor syndrome. My consultant was totally shocked but he couldn't argue because I could show him my readings. That has changed now because I am on a slightly faster acting insulin and my body has changed and 35mins is about right now and I no longer need the extra 1.5-2 units for DP/FOTF as either my liver has settled down and doesn't release so much glucose on a morning or my basal insulin is covering it. I am now experimenting with the timing of my basal insulin to try to deal with a rise in my levels on an evening. The Libre is an incredibly valuable tool in enabling you to see what happens during these "experiments" in order to figure out what works best for you.
Obviously if you do experiment with changing the timing of your insulin or your basal dose etc, do it conservatively, with a careful eye on keeping yourself safe.

 

[ILikeSugar :|]

Thank you @rebrascora for the info your not wrong about it being a lottery ticket I'm sure I'll figure it out again and manage to get it stable again but like you said it's like a game of tit for tat no doubt I'll have to change again soon once I've figured things out and also I'm sure I'll fond more out how to manage my own diabetes in the months and years to come, I tried injecting my insulin about 20 minutes before eating lunch today and I ended up going low so maybe I will try 15 minutes tomorrow and see how that works as when I've been doing it 10 minutes before I seem to go high.