Hallo and help

[Aybrice (Blueduck)]

Any advice will be good
Suddenly my bs levels have gone crazy in the mornings
Today got up at 6.30am bs 6.8.
9 units background Levimi
Breakfast 2.5 humalog

Now what happens is my bs just keeps going up. Now at nearly 10.00 o’clock and am 9.9

up to a about a month ago all was well, would level out after breakfast and may dip or up by 1 or 2 by lunch. Now everything has gone a bit crazy

tried upping my over night background, had hypos in the middle of the night. Tried upping my breakfast humalog, hypo mid morning

tried changing levimir also resulted in hypo

there is something I’m not seeing here and hope that someone can just give me some insight. I eat exactly the same for breakfast every day, no appointments with the dn at the moment and hba1c and usual diabetic test cancelled until who knows when, under the current situation

awaiting some expertise thank u

 

[Inka]

Hi @Aybrice 🙂

If it’s a sudden change, the first thing I’d do is change to a new cartridge for your insulins in case they’ve degraded.

Then I’d do a basal test.
You could also try moving the time of your breakfast Humalog slightly earlier so it can get acting on your breakfast quicker.

Can you identify any change in your routine that might be causing this?

 

[Aybrice (Blueduck)]

Hi Inka
Changed cartridge right away, basal tested lunch, but not breakfast, I really cannot do without food first thing in the morning. Was injecting 20 mins before breakfast, today tried 25mins,which seems crazy, and still up by 10. Do you think 30 mins before would be the next step.

Have been eating at varied times for dinner, because of work, but again, this is not that unusual for me, and am usualy able to correct at breakfast and be ok by lunch

 

[Inka]

When I took Humalog I had to inject 30 mins ahead for breakfast, and when pregnant (ie more insulin resistant) I had to inject 45mins+ ahead. So yes, I’d try 30 mins.

I get what you’re saying about needing food in the morning. I’m the same. So, if it was me I’d try the 30mins. I would then consider having a fraction more insulin for breakfast if that had no effect. If I did that, I’d probably move back to 20mins ahead for my injection just to be safe, then move up gradually to 30 mins ahead if necessary.

 

[Aybrice (Blueduck)]

Thank you
Will try 30 tomorrow
I appreciate your help
Actually, I have been having issues with fish and chips, so maybe it’s all part of things changing
I used to have to inject 45 mins after we had fish and chips, but now that’s not working and I have to inject half my insulin 15 mins before and then the rest 30 mins after starting to eat, this way I stay at about 7, which is good for fish and chips
That’s interesting about you having to change when pregnant, I came late to this diabetic lark, at 49, had lots of menopausal issues, maybe it’s my hormones playing up again, thought they had settled after a few months of good bs results, but maybe I’m wrong

 

[trophywench]

Err, are you only having Levemir once a day? because it was originally always intended to be taken twice a day and most T1s find we need it twice. Only thing is though - not a 50/50 split nor 12 hrs apart.

Is your body clock really that precisely fussy that you can neither delay nor bring forward breakfast for a while? - nobody's asking you to miss it! Just stagger the timing over the period of a few days spread over a week, ish.

 

[Aybrice (Blueduck)]

Err, are you only having Levemir once a day? because it was originally always intended to be taken twice a day and most T1s find we need it twice. Only thing is though - not a 50/50 split nor 12 hrs apart.

Is your body clock really that precisely fussy that you can neither delay nor bring forward breakfast for a while? - nobody's asking you to miss it! Just stagger the timing over the period of a few days spread over a week, ish.

 

[Aybrice (Blueduck)]

Have 3 units before bed
9 units when I wake up
I was meaning I did not want to cut breakfast out for basal testing
But yes also, body is very fussy and any food time change through the day is a trauma! Can sort irratic evening meals but, have difficulty with times and excercise, for example
A 1 hour morning walk, means the next day my body thinks I will have another walk, so i now have to anticipate this and I need extra insulin with breakfast, at least 1 unit or more, but it’s a bit of a guess to how much to stop bs going very high, my sdn recommended this and it works fairly well, mostly!

 

[rebrascora]

I need to take my Fiasp 45mins before eating at breakfast time and Fiasp is supposed to be the fastest acting insulin and NovoRapid needs an hour at least in the morning for me, so don't be frightened to experiment with increasing the prebolus period further in 5min slots and see how that works but with you being LADA it may be that you have reached the end of a honeymoon period and your basal needs are changing. I had 2 distinct phases last summer where my insulin needs notably stepped up as my beta cells died off.

 

[Aybrice (Blueduck)]

I need to take my Fiasp 45mins before eating at breakfast time and Fiasp is supposed to be the fastest acting insulin and NovoRapid needs an hour at least in the morning for me, so don't be frightened to experiment with increasing the prebolus period further in 5min slots and see how that works but with you being LADA it may be that you have reached the end of a honeymoon period and your basal needs are changing. I had 2 distinct phases last summer where my insulin needs notably stepped up as my beta cells died off.

Thank you for that
Sometime I feel so bogged down with worry about what’s going on that I can’t always see the options

 

[rebrascora]

I think it is important to feel confident to experiment with your Diabetes by using your test strips more frequently sometimes than just the prescribed times or if you have a Libre, making use if the data it gives you. What works for one person, doesn't necessarily work for another, so figuring out how your system works is really important rather than just accepting the guidelines which we are told like inject 10 mins before eating etc.
My consultant was quite shocked when I told him that I was pre bolussing my NovoRapid an hour before breakfast but I was able to show him the results of my testing and he could see it was what I needed. There are other members here on the forum who have to prebolus that far in advance of breakfast time too and others that would hypo after 15 mins... we are all different. I also need to give myself 2 extra units for Dawn Phenomenon, so even if I am not having any breakfast (or a carb free breakfast) and I am in range, I usually need 2 units of Quick Acting insulin as well as my Levemir first thing when I get up.

 

[Aybrice (Blueduck)]

Reading your reply, I think I’ve become a little lazy, with bs being stable and need to get back to basics.

I have Libre so can monitor quite closely. You sound fresh and enthusiastic, I think I’ve lost that in the last year. I would not have thought on dawn phenomenon to inject without eating, so thank you, I need to engage my brain and get a grip

 

[rebrascora]

Well I have only been diagnosed just over a year and still struggling to get stable results and longing for Libre to help with that, so yes I am still enthusiastic about figuring it out most days, but I know that longer term I will have spells when I get bored with it and already have days like that. Also I am sure it helps that I have the time to read up about it and learn from others here on the forum because I am retired with no dependents.
I would certainly not consider it laziness on your part but just that perhaps you have not needed to look at it more closely or had the luxury of time to spend on it until things have started going a bit haywire now. Be kinder to yourself.

 

[brisr949]

Worrying too much will also cause a BS rise, so try not to be too hard on yourself and just try some of the things suggested and im sure you'll get all back under control.
Adam

 

[trophywench]

Basal needs move any number of times throughout a normal life, Aycliffe - so the need for proper basal testing (and my God that's exactly WHY I was so keen to trial a Libre but unfortunately at the time it bore no ruddy resemblance to whatever my BG was actually doing at the same(ish) times so GRRR, back to doing it the old fashioned (LOL) way.) Grit your teeth and just get on with it!

(music from the cartoon version of the Jungle Book running through my head ……. )