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Confused / Burnout?

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Greyhound Gal

Greyhound Gal

Well-Known Member
Relationship to Diabetes
Type 1
Apologies in advance for the long post but I think it is all connected so needed to include it all.

I'm not sure if I am suffering from a bit of burnout or I just don't know enough (or both), but I just can't get me head around some aspects of my D at the moment.

My confusion began when I got my latest HbA1c result of 36 and I felt this was as low as I wanted to go (risk of hypos) and the GP D nurse said the same. However (!), my daily averages are between 6.0 - 6.5 and my waking levels are normally between 5.5 - 6.3. These are within recommended guidelines. I know I go reasonably low overnight but this is also part of my confusion as my libre always gives a lower reading then my meter.

Libre will often show me just in the red overnight (low range set at 4.2). This can be from about an hour to 5 hours. When I have done night-time meter tests I have been low to mid 5's.

I don't often get hypos but in the week before I saw the nurse I had 2 - one overnight (did not wake) when my libre showed a definite dip to about 2.5ish at about 3am, and another mid afternoon when I was mid 3's on meter.

I found I also dropped early to mid afternoon, but this is after the dog walk and my lunch bolus is at its peak when I'm out so this was understandable. I have countered this by either reducing my lunchtime bolus or eating just before I go out.

In the past few days I also seem to be going low after dinner (checked carbs etc and amount of bolus taken is correct).

I thought I'd do some basal testing. I've tried twice in the past 10 days. Overnight and morning readings have been fine (mid to high 5's), but I cannot go from breakfast to dinner without having a hypo in the afternoon, even when I have breakfast later and dinner much earlier. Just for info, I do normally also have a mid afternoon snack of an apple or such like. I'm sure the same would happen if I tried to go from a late lunch to breakfast the next day.

My brain feels totally fuddled and I'm not sure what is best to do.
1) carry on trying to do basal testing, but I'm pretty sure I will just keep hypoing?
2) amend lunch and evening ratios - currently 1:8g, maybe try 1:9g?
3) reduce basal and see what happens - currently 10u at bedtime, reduce to 9 or 9.5u?

Any advice, thought, guidance, help would be very much appreciated :confused:🙂
 
Can you remind me, how much Lantus do you take, and what time?
 
I'm going through burnout at the moment as well so I know how frustrating all this can be.

Sending you lots of love.
 
Greyhound Gal said:
It's 10u at bedtime which is about 10pm.
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Thankyou. It doesn't sound like mid afternoon or evening is coinciding with Lantus's notorious 5hr peak then. I seem to remember Kookycat had problems in the afternoon with Lantus, I think she was very sensitive to it generally. I don't think she's around at the moment, but if you put something into the search box it might dredge up discussion about it. I think she changed basal in the end.
I'm having problems with Lantus not keeping me steady all the time, I'm working on the principle that if it's right overnight, don't fiddle with it, because during the day you can tweak Bolus, but if it's wrong at night, it stays wrong all night.
 
Thanks Robin, I'll take a look.
 
Just read them thanks. You've a great memory as they are form 2015!
Doesn't look like an all-round solution was found :confused:. I may just have to tweak ratios to start and see what happens.
 
Greyhound Gal said:
Just read them thanks. You've a great memory as they are form 2015!
Doesn't look like an all-round solution was found :confused:. I may just have to tweak ratios to start and see what happens.
Click to expand...
Ah, I can remember all sorts of odd things like that, though I was new to the forum at the time, and having problems with Lantus myself, ( still am!) . I just wish I could remember stuff like, what time my hair appointment is, and what's the name of that person I just met!
 
I'd take the fact that you cannot complete a basal test because you keep going hypo as enough evidence for me to knock a unit or two off Lantus to stop those dips.

I've always found my meal ratios to be fairly stable/predictable if I keep tweaking my basal.

Frustrating in that you know other times of the day 10u seems to be working for you, but that general downward drift during the daytime *and* low levels overnight suggest taking Lantus down a notch would be worth doing.
 
everydayupsanddowns said:
I'd take the fact that you cannot complete a basal test because you keep going hypo as enough evidence for me to knock a unit or two off Lantus to stop those dips..
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Thanks Mike. I think that is what has been in the back of my mind but I've just been concerned my waking readings will go up, so have been hoping to just tweak ratios 🙄. However, in for a pound and all that, I'll try it for the next few nights (as Lantus changes take 2-3 days to take effect) and see what happens.
 
As mike says perhaps knock some basal off.
Have you thought about your lunch time bolus, do you think perhaps you need a different carb ratio?
 
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