Deterioration in Control after years of stability

[John D M]

Good Morning all,

I tend to be pretty self-sufficient in general and with respect understanding and controlling my diabetes but have found recently that my ability to control glucose has changed and a bit of feedback or ideas would be much appreciated. So far this is a long way from being disastrous but is a source of stress as I ask and wait for support from GP practice diabetes nurse.

Diagnosed as T2 nine years ago and prescribed mixed insulin, moved to basal and bolus at my request a few months later. Experimenting with basal made no difference to my control and after a year, I moved to relying on bolus only.

Since then, eight years of solid control with the good fortune not to work as hard as I know many do to maintain or strive for control.

Over that period, bolus needs have changed but without seeing glucose drift upwards between meals or by a great deal over night.
The last three months, average finger prick results drifting up despite diet, activity and weight being consistent and having increased use of bolus by ~20%. Additionally I'm seeing a drift up of 2-4mmol between meals, having bolused and corrected for those meals, and have seen morning readings increased for >= 8 to 9's, 10's and 11's. I've interpreted this as an emerging need to adopt use of basal along with bolus.

So far a GP appointment to request return to use of basal as well as bolus just served as triage and waiting for a diabetes nurse appointment that's about a month away.

Any thoughts or suggestions as to factors in addition to weight / activity / diet that I should think about?

Thanks
John

 

[Inka]

It does sound like you might need a basal insulin. Perhaps your body’s ability to make some insulin of it’s own has deteriorated. That might also help explain the drift between meals.

Do you carb count and adjust your meal time insulin?

 

[John D M]

Thankyou,
Until now I've not had to carb count and tend to go for a more or less fixed bolus followed by a later correction, if needed.
I'm also pretty boring and predictable with respect to diet and moderately low carb

 

[Inka]

You’ll probably find carb counting helps you. You’ll then be able to ensure consistency and also work out your meal time ratios and whether to increase or decrease them once you start the basal and moving forward.