changing insulin and trial on Libre

[Flo15]

Hi, I am type two on insulin. Tonight I am changing from Levemir to Toujeo, which i am terrified about as I have been on Levemir for years, control is awful so seeing if a different insulin is better for me. I suffer from terrible fear of hypos so I know i wont sleep well for a few nights. Also as my control is so dreadful I am being referred for a months trial on the libre, so maybe we can see what is going on whilst asleep. I had put in my own private order of the starter pack last Tuesday but my order is still on hold, so may cancel it now. Dreading tonight, am I the only one who has such a fear of hypos, surely it cant just be me?

 

[stephknits]

I think fear of hypos is quite natural. No one likes the idea of loosing control. Do you have many hypos? Do you have good hypo awareness? I think I got over my fear by knowing that I usually catch them at an early stage and they are easily managed. Still not ok with night time ones, but luckily have very few of those these days

 

[Flo15]

No I don't have many hypos but that's mainly because I test so much, too much but when I do I have a low I become extremely anxious and test every minute and drink too much lucozade and end up high. I know it is totally irrational and hinders my blood control. I have started to panic when I see a 6mmol now and eat to get it higher, I know it sounds crazy

 

[everydayupsanddowns]

Have you been offered any training or education Flo? Might sound a drag, but I wonder, from what you’ve said if it might help to have a bit of a brush up on the basics and to be able to share that with others for group discussions. Something like DAFNE or BERTIE?

Alternatively a book like ‘Think like a pancreas’ or Ragnar Hanas’ ‘Type 1 Diabetes’ might really help?

Sometimes the Drs don’t know how to advise, but books/courses that give a general framework would allow you to pick the nuggets that you need from the stuff you already know.

 

[grovesy]

Have you been offered any training or education Flo? Might sound a drag, but I wonder, from what you’ve said if it might help to have a bit of a brush up on the basics and to be able to share that with others for group discussions. Something like DAFNE or BERTIE?

Alternatively a book like ‘Think like a pancreas’ or Ragnar Hanas’ ‘Type 1 Diabetes’ might really help?

Sometimes the Drs don’t know how to advise, but books/courses that give a general framework would allow you to pick the nuggets that you need from the stuff you already know.

It says in Avatar that Flo15 is Type 2, most even on Insulin are not offered any training.

 

[Flo15]

Thanks for replies. The only thing I have been offered is a carb counting course, I did that last February and it lasted less than one hour. I haven't been offered Bertie and can't have the other one as I am not type 1, well no one seems to know what I am tbh but most doctors etc say type 2. I originally had gestational diabetes 14 years ago with my second child, which i had to go on insulin for. Three years lateri did a blood test and my blood sugar was 15mmol so I went on metformin for a year and then it stopped working and i had to go on insulin , this was 9 years ago now.

My basal insulin is I think completely out. I take 44 levemir at night and 27 units 12 hours later in the morning. When I wake at 7.00am my bloods can be anywhere from 7mmol to 16mmol. If I have carb free breakfast or skip breakfast then my blood sugars rise rapidly, they increase say from 10mmol to 16mmol within an hour and keep rising up to 22mmol by lunchtime.

I am so lost with it all. I thought by changing to different basal which is once a day that maybe I can suss it all out better.

 

[mikeyB]

Your basal seems rather odd. I take twice as much Levemir in the morning as I do at bedtime. I got better control with that than a single dose basal ( Lantus).

Quite high doses too. Sounds like you might have a touch of insulin resistance, so rather than fiddle with types of insulin, adding in Metformin might steady things down. Just a thought, you’d have to discuss that with your diabetes team.

A trial on the Libre should give you an idea where things are going wrong.

 

[Flo15]

Forgot I am on 4 tablets of metformin too.

 

[mikeyB]

Oops🙂 So much for that plan!

 

[Flo15]

I suffer from DP so maybe that is why i have a higher dose at night. The trouble was from the start is that the diabetes team knew i went on insulin with my pregnancy ( that was a mixed insulin though) and thought i knew how to do basal etc but i dont, and have just I have just injected roughly what i think it should be! I have struggled since i have been on fast acting and basal.

 

[mikeyB]

Sorry, don’t know what DP is, or why it should mean you take a higher basal dose at night. I still think you need a discussion with your diabetes team.

 

[Flo15]

Sorry It means Dawn Phenomenon, my blood sugars starting rising at about 4am, so think the higher basal may help with that possibly or maybe not?

 

[Robin]

Sorry It means Dawn Phenomenon, my blood sugars starting rising at about 4am, so think the higher basal may help with that possibly or maybe not?

Dawn phenomenon is notoriously hard to manage. The problem with upping basal to deal with it, is that it can make you hypo during the middle of the night. (Some people find a protein snack which converts slowly to glucose over a number of hours helps you not to drop too far during the first part of the night,)
Some people carry on upping their basal because they are high in the morning, not realising that eventually this becomes a rebound high after they've dropped low in the small hours. If you know that you rise from 4am, though, it sounds like you are on the case and checking overnight numbers.

 

[Flo15]

I am usually steady till 3 -4 ish and then can go up 1or 2 mmol every hour until 7am when I get up, it only stops rising when I take my rapid and eat breakfast.