Door to floor

E

ellevee

Member
Relationship to Diabetes
Type 1
Hi I wonder if anyone can help .
I posted recently about my levemir and foot to floor And got some great advice . I have another problem that I’m not sure how to deal
With . I get foot to floor most mornings and have started taking on unit of novo rapid to help. However through further testing I have found that my levels come down on their own lunch till about three pm . I cut back my morning levemir or one then half and it still happens . Is this usual or does it mean my basal is too high ? Or could it be my pancreas still works ? I’m not yet a year into my diagnosis and finding it hard to get my basal right for now so my control feels a bit random as I don’t understand what’s happening You can see the one unit holds it for a bit but once that wears off it come down on its own . I’ve attached yesterday’s test for reference . I’ve repeated it and always had same results . I asked my dsn and was told
Im overthinking ‍ . Thanks in advance to anyone who might be able to offer some advice
 

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Hi. Can you confirm that this graph is without any food at all from waking up and just 1unit of NR to cover FOTF when you wake up? It looks like that NR dose brings you down to about 9mmols just before midday and then holds you steady for about an hour before you slowly decrease to about 6.
Do you take your Levemir as a split dose and when do you take it? Are you saying you are only taking half a unit of Levemir as your basal and if so, then yes in my non medical opinion, this is almost certainly your own insulin production and nothing to worry about. At the end of the day, it is not dropping you fast and not dropping you too low.
If you are genuinely only taking half a unit of Levemir a day, then you could certainly experiment with stopping it altogether and see how that goes for a while. You will soon notice when you need to start taking it again. Presumably you do use NR for meals?

I would also like to say that I don't see anything on this graph as a problem as such but if you were/are taking more basal than the half unit your post suggests then you might want to reduce it a bit to reduce that afternoon drop.
 
Hi thanks Barbara I took the novorapid at 10
To 8 when I got up
It held me down with a slight rise and then levelled off about 8/ 9 as you rightly pointed . I didn’t eat anything at all till
around five . It eventually went down to 5.9 at which point I had my meal
. I’ve been taking levemir 2 units at night and 2 in morning . Then cut the morning down after seeing these results . I usually take my
Nighttime around 9 and I know it does drop
Me eg I can go to bed at twelve at 8 mmol and wake up in morning at 5.5 /6 then the minute I’m up it’s up at nine . Any more than 2 units is too much . I take morning dose around 7 or 8 when I get up
I was wondering if the 2 units at night could be responsible for this drop as well even if it can’t cope with foot to floor . It’s hard to work out ratios with a moving target like this my . If I take enough to stay in range at lunchtime I tend to hypo after evening bolus while eating . Which make me think the levemir Is too much or my own insulin works away during the day to get me down again . The foot to floor is the real spanner in the works
 
I wish my chart looked as good as that!

Are you being physically active in the afternoon? I've found that if I don't eat general day to day activities will see the numbers coming down slowly.
 
Ha ha no standup I wish I had been but I was sitting working from home .
Moving like a slug and hardly left my kitchen table all day . Was also
Raining hard which made it unattractive to
Go outside !
 
ellevee said:
The foot to floor is the real spanner in the works
Click to expand...
I just "accept" the "foot on the floor" and use my bolus insulin to deal with it, rather than see it as "a problem". That strategy works well for me. I think "acceptance" is an important part of diabetes management rather than feeling like you have to fix every issue, when finding a strategy to deal with it is all you need.

I wonder if perhaps you are trying a little too hard to keep things very level or find a perfect balance, when all you need is something that is reasonably workable most of the time, especially during the honeymoon period as it can be quite erratic, but even when you are out of it, diabetes rarely plays by the rules and gives you good results all the time. What is your TIR like, when you are eating normally? Are you trying to be too perfect? If you can achieve 70% then that is excellent and you don't need to achieve more than that. Yes, it is nice to get better results still and I am aware that here on the forum you can see other people's good results and feel like you want to achieve those and it can become, sort of competitive, but it is not necessary of helpful if it is causing you concern.

If you go low on an evening but the rest of the day is OK, then adjust your evening bolus back a bit.
I find I need to adjust my Levemir doses to account for exercise, but for me it is the doses of Levemir after exercise rather than the dose during it, but that is just me and my body, which seems to be particularly sensitive to overnight insulin after exercise. Perhaps your body is more sensitive in the evening as that is very common.
 
I think you’re right Barbara im
Probably trying to hard . I’m still a bit scared of the novorapid to be honest . It sound like you like experimenting. I hope
My confidence will Grow to be like yours . It’s very overwhelming . To be honest im
Still A bit wary of the insulin .you might remember from a previous post I thought it took
Six hours to work but I understand it a lot better now I know my basal was playing a huge part of this and now it seems my pancreas is too . My time in range is 75 percent but my meals are small . and im
Not confident to snack outside of meals yet but working on building meals up and getting more confident with the insulin . I admire your approach to diabetes . Think im
Still very emotional about the whole thing !
 
I don’t see any problem with that graph @ellevee 🙂 Remember that blood sugar naturally moves up and down through the day in response to hormones, times, etc etc. I can’t see anything to worry about there.
 
It takes time to build up confidence. Some people worry more about high levels and some are really terrified of lows.
I am lucky I think in that I am not particularly worried about either most of the time. I was at first, but once I got used to dealing with hypos, my confidence grew a lot. I don't worry about highs perhaps because I have never had DKA but I find them really frustrating because once my levels go high they are really stubborn to get down again, so that frustration has taught me to be less afraid of my insulin and to be prepared to use however much it takes to bring me down and if it is too much I can always eat a jelly baby or two to level things out. I see it a bit like driving a car. If I put my foot down to hard on the accelerator (insulin), I can always brake if I end up going too fast ie slow the drop with some fast acting carbs. Once you can see how well those fast acting carbs work, you become less frightened of the insulin and less cautious about using it. Of course we should always treat our insulin with respect because it is potentially very dangerous, but so is the accelerator on a car, but we still use it because it is necessary to get where we want to go. Finding the right amount of insulin for the right occasion is just the same as achieving the right speed for any given road, but if you give it too much you can slow it down again. The helpful thing is that with CGM we now have a speedo that we can keep a close eye on whenever we like/need to, to help us keep to the right speed most of the time.
 
Thank you @Inka I guess I’m still worried about any kind of unexplained drop off . But now I understand a bit better I shakily be able to work round things . And thanks Barbara you driving analogy is great . You sound like a very practical person . You are right of course . I’m very wary of corrections but I think it was you who suggested. Half unit pen . Since I got one it’s helped so much to see where half unit goes to to then build the confidence to do full units . I feel better for running this by you guys . This is a great forum . Thank you ❤️
 
I was also very wary of corrections and they didn't even mention them in hospital after my surgery but now I couldn't manage without them. To continue with the car driving....remember there can be a lag before you hit the accelerator so you need to give them time to work. My little Smart car did 0-60 in about 17 seconds so there would always be a bit of a delay before the speedo reflected my actions.
 
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