DOES THIS SOUND RIGHT?

[mum2westiesGill]

Waking this morning was 13.9 at 7:46am so I did a mysugr advised correction of 4 units of humalog - was hypo 3.8 at 10:07am so had 3 jelly babies then did 15 minute test and also had breakfast at 10:26am and bg at breakfast was 4.6 - had 36g of carbs but my sugr advised just 1 unit of insulin for my breakfast - is this because I still had Insulin working from my correction dose?

 

[pm133]

You are highlighting the very danger posed by relying on technology to tell you what to do with your diabetes.

I'd have thought that taking 4 units of bolus for a reading of 13.9 is almost certainly going to cause a hypo under any circumstances unless you have some insulin resistance.

I think you need to talk to your DSN again and take her through what you've experienced.
The key question you need to ask her is why your readings are so high on waking. It sounds to me like your basal isn't right.

 

[mum2westiesGill]

You are highlighting the very danger posed by relying on technology to tell you what to do with your diabetes.

I'd have thought that taking 4 units of bolus for a reading of 13.9 is almost certainly going to cause a hypo under any circumstances unless you have some insulin resistance.

I think you need to talk to your DSN again and take her through what you've experienced.
The key question you need to ask her is why your readings are so high on waking. It sounds to me like your basal isn't right.

Thank you for your reply.

My correction factor is 2mmol.

Should I just talk her through what happened this morning re the 4 unit correction?

The high reading this morning was probably due to all the carbs last night - I don't seem to be getting high readings every morning - apart from this morning the last few mornings I thought haven't been too bad

 

[rebrascora]

@pm133 The OP has a correction factor of 2mmols so the 4 units should have reduced levels by 8mmols which should have put her at 5.9. Higher BG levels often need slightly bigger corrections so I don't think the technology was out of order in suggesting that but it may be that something else is at play. Perhaps a rogue finger prick reading in the first place or basal insulin dropping levels for some reason.

 

[pm133]

Thank you for your reply.

My correction factor is 2mmol.

Should I just talk her through what happened this morning re the 4 unit correction?

The high reading this morning was probably due to all the carbs last night - I don't seem to be getting high readings every morning - apart from this morning the last few mornings I thought haven't been too bad

You should talk to her about anything which troubles you.
Show her your overnight meter readings and she'll be able to tell you if you properly bolussed for those carbs last night.

 

[mum2westiesGill]

@pm133

Waking levels the last few mornings
4/6/2021 - 13.3 - reason - had a chinese takeaway the night before and injected after eating
3/6/2021 - 13.9 - reason - might have eaten too many carbs the night before when bedtime bg was below 8mmol
2/6/2021 - 7.2 🙂
1/6/2021 - 4.3 🙂
31/5/2021 - 6.9 🙂
30/5/2021 - 5.3 🙂
29/5/2021 - 13.4 - reason - was away and eating out

 

[pm133]

@pm133 The OP has a correction factor of 2mmols so the 4 units should have reduced levels by 8mmols which should have put her at 5.9. Higher BG levels often need slightly bigger corrections so I don't think the technology was out of order in suggesting that but it may be that something else is at play. Perhaps a rogue finger prick reading in the first place or basal insulin dropping levels for some reason.

You're right that other factors might be at play.
It could be that her correction factor isn't exactly 2 mmol and it could change depending on what time of day it is.

The technology doesn't take any of that into account and that's was what I was getting at (maybe not particularly articulately though 🙂 ).

 

[pm133]

@pm133

Waking levels the last few mornings
3/6/2021 - 13.9
2/6/2021 - 7.2
1/6/2021 - 4.3
31/5/2021 - 6.9
30/5/2021 - 5.3
29/5/2021 - 13.4

I guess on the two occasions where you woke up high, you'd had a lot of carbs the night before?

 

[mum2westiesGill]

You should talk to her about anything which troubles you.
Show her your overnight meter readings and she'll be able to tell you if you properly bolussed for those carbs last night.

Recently I have spoken to her on several occasions - she's probably sick of me by now lol.

When you say overnight meter readings do you mean on the freestyle libre?

 

[pm133]

Recently I have spoken to her on several occasions - she's probably sick of me by now lol.

When you say overnight meter readings do you mean on the freestyle libre?

Yes.
She might well be sick of you but you clearly need help on those occasions where you wake up high. That needs fixing as soon as possible because it's very likely you are spending extended periods of time at that level.
That's what your Libre will tell you, providing you scan at bedtime and as soon as you wake up and any time in between that you get up to the toilet or whatever.

 

[mum2westiesGill]

I guess on the two occasions where you woke up high, you'd had a lot of carbs the night before?

You're correct re the 13.9 this morning - it was probably too many carbs before going to bed.
Re the 13.4 on 29/5/2021 - we went for a meal the night before - I tested after the meal and did a correction - which my DSN has said is ok for me to do if that's what I feel comfortable with.

 

[mum2westiesGill]

Yes.
She might well be sick of you but you clearly need help on those occasions where you wake up high. That needs fixing as soon as possible because it's very likely you are spending extended periods of time at that level.
That's what your Libre will tell you, providing you scan at bedtime and as soon as you wake up and any time in between that you get up to the toilet or whatever.

Do you think it's worth asking her about just 2 mornings in the last 6 or 7 when I've been high? The rest of the mornings have been ok.

I'm not using the libre at the moment.

 

[pm133]

Do you think it's worth asking her about just 2 mornings in the last 6 or 7 when I've been high? The rest of the mornings have been ok.

I'm not using the libre at the moment.

Like I said above, you should talk to her about anything that you are worried about.
They may be sick of hearing from you but this is their job and they are paid to do it.

As a matter of interest, why did you stop using your Libre?

 

[mum2westiesGill]

Like I said above, you should talk to her about anything that you are worried about.
They may be sick of hearing from you but this is their job and they are paid to do it.

As a matter of interest, why did you stop using your Libre?

I'm with you on that re that they may be sick of hearing from me - at the moment I'm on the phone to her several times a day about this that and the other.

I stopped using the libre because sadly I didn't feel comfortable with it

 

[pm133]

I stopped using the libre because sadly I didn't feel comfortable with it

Ah OK. Unfortunately, in that case I can't really advise on what's causing the morning highs.
The only thing you can do to check if you've failed to bolus for high carbs the previous night is to do finger prick tests 2 and 4 hours after your last meal at night.

 

[mum2westiesGill]

Ah OK. Unfortunately, in that case I can't really advise on what's causing the morning highs.
The only thing you can do to check if you've failed to bolus for high carbs the previous night is to do finger prick tests 2 and 4 hours after your last meal at night.

I'm thinking it's because
- I had 2 many carbs on one of the readings and
- I tested and corrected after the meal out on the other high reading.

 

[Lisa66]

Hi. As others have said its worth having a good chat through everything with your DSN..I doubt she will be sick of hearing from you, she will just want to do her job and help you.

Did I see on another thread that you had some crackers and cheese and then a digestive biscuit before bed? Sorry if I’ve misunderstood. It could well be that the cheese may have slowed the crackers down a bit maybe. 10g of carbs in general and with all things being equal etc etc tends to raise our levels by about 3...so the crackers and biscuit would put you up by about 9. Possibly this took a little time and is why you ended up at 13 this morning. Tricky to tell without the Libre, but I appreciate that you don’t like it.

May be worth setting an alarm for perhaps 3am for a few nights and doing a test to see what’s going on. Just a thought or two 🙂

 

[everydayupsanddowns]

My correction factor is 2mmol.

If you went hypo after taking the recommended correction, it could well be that your correction factor needs a tweak Gill?

 

[Jenny101]

Hi mum2westiesGill, I'm also on humalog and discovered that that particular insulin can work and peak at different times than I'd orignally been told by the doctors. My body will also react differently during the day! In the morning and at lunch I have insulin 20 minutes before eating, in the evening I'll have insulin just before eating. A couple of years ago I also found that I didn't need a correction dose of 1 unit of insulin to 1 mmol blood sugar, instead I've had to reduce it to 0.3 units to 1 mmol blood sugar. If I have problems I generally alter something slightly, wait 3 days, see what happens, if something's still wrong then I'll adjust a little again. Such fun!!!

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