Day One disaster!

[pippaandben]

So yesterday all happy and raring to go on my new basal/bolus regime.
Before breakfast 6.5. 2 slkices burgen and 2 slices thin bacon 24g, medium banana 20g So on 1u:10g injected 4.5 units. No way was I going to inject the "standard" 6u for that amount of carbs
One hour later 6.0 - why did it go down? Change ratio for next meal?

2 hours later Injected first basal at 8u (evening nurse has said 6u)
Also did 2 our BG test. 3.1 PANIC 2 glucose tablets
+ 15 minutes 4.9 phew thank goodness
+15 minutes 4.2 Oh No! I glucose tablet and medium sweet banana.
Went to surgery - only 100yds away. Diabetes practice nurse not in but got appt within half an hour to see another.
Reading at +30 in waiting room 4.4
Nurse greeted me with - I hope you don't have any questions about insulin!!
Explained what had happened - she looked bemused. Said to see receptionist to get other nurse to ring me the next day!

Hubby in a state and won't let go of my arm as he thinks I am about to collapse any time despite reassurances. Went to local pharmacy where he calmed me down and advised to just have some carbs now and test at one hour as testing too much increases anxiety and might give false higher reading.
So half hour later 5.7 and one panini with cheese and ham. One hour later 8.0.
Thank goodness I thought and carried on for the day.
Dinner 49.2 gms - decided to use 1:12 so 4 u but added half as pre dinner reading 7.4.

One hour later PANIC big time. Had injected basal and not bolus now what.
Tx local support group secretary suggested thank goodness not other way round and not to do bolus now as could hypo later. Leave off basal at 10pm don't add the remainder of the dose and then start again next day. Agreed highering ratio good idea and depending on am reading do a really minor correction.
+2hour 11.8. +3 hours 13.1. Bedtime 9.6. This morning 7.1!!
Tx from surgery the nurse can see me at 11.40.
Had told her all along I wanted to carb count - just thankful I did. Also in post have got appt for dietician for next week - but literature does not mention carb counting but perhaps that is cos it's a standard leaflet. Will do total food diary with carbs, injections etc.

Hope today is under better control - have already labelled my pens now! Don't know why I made that silly mistake as a) they are 2 different colours and types and b) for my Humalog I use the Humapen which I have used all the time before meals for the Mix.

 

[caroleann]

Hi sorry to hear about your bad day,is your dietion app at the hospital if so and your lucky enough to get the same one i had you will be ok she fully supports carb counting and helped me a lot.

 

[pippaandben]

Hi sorry to hear about your bad day,is your dietion app at the hospital if so and your lucky enough to get the same one i had you will be ok she fully supports carb counting and helped me a lot.

No -its at Coxheath Clinic - AB.

 

[everydayupsanddowns]

Well done for coping so well Pippaandben

And don't worry about mixing up basal and bolus insulins. You aren't the forst and you won't be the last! At least you now have them labelled 🙂

It can be difficult moving between insulin regimen and some sort of 'wobbles' are likely in the early days one way or another. You are coping very well, just keep testing lots and write everything down!

It won't be long before you have built up a picture of what is likely to heppen. It may well help to eat relatively 'consistent' meals for the first few weeks (in terms of the amount of carbs involved). Once you have found your feet you will be able to spread your wings a little 🙂

M

 

[Lizzzie]

Bless you! - don't worry they are teething troubles. You're doing well recording everything, Keeping in touch with your nurse and making a huge effort with matching carb counting. It'll get there and it'll get easier so that it no longer feels like your main preoccupation.

The idea of regulising your meals for a week or three is a good one: write down Bg, Grams of Carb eaten, insulin had and time for every time you eat / test then look back to see how you're doing. It sounds like you already are.

Then If you have changed your bolus ratio, collect 2 days worth of data before you look at the big picture and make any decisions about your new levels : one or two results could be a coincidence / down to basal / exercise / anything else. Different rules might apply to breakfast and lunch.

Anyway, good luck, keep it up and today will be better!

 

[pippaandben]

Bless you! - don't worry they are teething troubles. You're doing well recording everything, Keeping in touch with your nurse and making a huge effort with matching carb counting. It'll get there and it'll get easier so that it no longer feels like your main preoccupation.

The idea of regulising your meals for a week or three is a good one: write down Bg, Grams of Carb eaten, insulin had and time for every time you eat / test then look back to see how you're doing. It sounds like you already are.

Then If you have changed your bolus ratio, collect 2 days worth of data before you look at the big picture and make any decisions about your new levels : one or two results could be a coincidence / down to basal / exercise / anything else. Different rules might apply to breakfast and lunch.

Anyway, good luck, keep it up and today will be better!

Thanks Lizzie. As I am seeing dietician Thursday of next week I am keeping all details. Why don't they make log books bigger?

Just back from nurse. She says reduce humalog from standard 6u am/10u pm to 3u/5u. What a surprise that this just about equates to what carb counting would produce but she won't admit it. So I will do 1u:12gm as I did for breakfast as 2hours after my levels were same as before and do corrections on 0.5u:3mml. if necessary.

She also says to reduce Levemir to 5u am and pm from 8/6. As I have already taken my 8u am she says just do 4u tonight. Thoughts anyone?

Does seem a big change all at once - but then it is easier to add later I suppose. Hope to get 2-3 days of useful results now to her on Friday.

 

[everydayupsanddowns]

Just back from nurse. She says reduce humalog from standard 6u am/10u pm to 3u/5u. What a surprise that this just about equates to what carb counting would produce but she won't admit it. So I will do 1u:12gm as I did for breakfast as 2hours after my levels were same as before and do corrections on 0.5u:3mml. if necessary.

I'm sorry pb, but just randomly halving someone's meal doses without any advice/information about the carbs that are expected to be eaten seems like less than well thought out to me. It's like teaching someone to drive, but only telling them to worry about braking and accelerating, not bothering to mention anything about steering! 😱

I think you have a far more practical approach to your insulin management than your nurse does!

After these first few weeks once things have settled a little, I wonder if it might be worth you running some overnight tests to see how steadily your basal is holding your BG levels, and then skipping some meals to test what happens during the day (your BG should remain within 1-2mmol/L of where you start if you miss a meal).

 

[trophywench]

Well ....... just as well you query stuff, isn't it?

And by the way the very first thing that struck me was your panicking your BG changed from 6.5 to 6.0. That could be down to meter tolerance or anthing - it doesn't really even qualify as a change. If you go from 6.5 to 3.5, then it would!

Pens - try keeping your long acting pen somewhere different. I had a thing to keep 2 pens in, in my bag. The Lev pen only got taken out of the thing when I needed it and it was put straight back. The Novorapid pen sat on the corner of the dining table with my meter all day till I went out of the house. My meter still lives there now.

If you were jabbing Lev at breakfast time and bedtime, you could keep that one in a cupboard.

I don't think you can tell anything really useful (apart from disasters obviously! LOL) for the first few days of any changed insulin. First you have to get the residue of the old one out of your system (couple of days) then get the new one(s) in (couple of days) and only another couple of days after that can you truly say, this is what my body appears to do on the new regime. So that's a week gone before you can start really getting down to the rest of your life.