Hello everyone...fairly new to diabetes, tips?

[Tdm]

Hello everyone, just joined up...and whilst i am here, anyone got any tips about getting through the night without your freestyle libre 2 waking you up with bogus lows? I have a arm band thing that is uncomfortable to sleep on to try to stop me sleeping that side. I think i may need to adjust my basal insulin, for get an insulin that lasts less time and have less at night..any tips (i cant adjust basal at the mo as only on 2 units and my pen only goes down to one...one is too low). Also, my blood sugars go down v quicky if i excercise within 3 hrs of a bolus, which is great for controlling it but a pain if one needs to walk anywhere..any ideas?

 

[everydayupsanddowns]

Sorry to hear you are struggling with Libre and compression lows - are you double-checking with a fingerstick meter overnight?

Does the armband go over the top of the libre? might it be adding some extra pressure? Is there a position on the back of the arm that you don’t lean on when lying on your side?

Which basal insulin are you using? Might there be a 0.5u unit pen available?

 

[Lucyr]

Why don’t you try taking1.5 units if 2 is too much and 1 not enough

Hello everyone, just joined up...and whilst i am here, anyone got any tips about getting through the night without your freestyle libre 2 waking you up with bogus lows? I have a arm band thing that is uncomfortable to sleep on to try to stop me sleeping that side. I think i may need to adjust my basal insulin, for get an insulin that lasts less time and have less at night..any tips (i cant adjust basal at the mo as only on 2 units and my pen only goes down to one...one is too low). Also, my blood sugars go down v quicky if i excercise within 3 hrs of a bolus, which is great for controlling it but a pain if one needs to walk anywhere..any ideas?

 

[Tdm]

My pen only has whole units, but hopefully the diabetes centre can give me something that does half units. Will speak to them tomorrow.
Thanks the suggestion of leaving off the uncomfortable band...perhaps its done its job in adjusting how i sleep. I think i left it off accidentally last night and got no phantom lows so that could be it, and will consider repositioning the libre sensor next time i apply. If i can get overnights to stop dipping then i may get confident enough to leave the alarm off overnight.
Looking foward to a good nihhts sleep

 

[Proud to be erratic]

My pen only has whole units, but hopefully the diabetes centre can give me something that does half units. Will speak to them tomorrow.
Thanks the suggestion of leaving off the uncomfortable band...perhaps its done its job in adjusting how i sleep. I think i left it off accidentally last night and got no phantom lows so that could be it, and will consider repositioning the libre sensor next time i apply. If i can get overnights to stop dipping then i may get confident enough to leave the alarm off overnight.
Looking foward to a good nihhts sleep

Hi @Tdm ,
In another thread I offered some thoughts about half-unit pens for use with NovoRapid and Tresiba and I'm copying those remarks for your interest.

"I now have half unit reusable NovoEcho pens, with disposable cartridges, for both my NovoRapid and Tresiba - different colours, huge array of choices [blue or red]! Apart from finer tuning of doses the insulin cartridges take up a lot less fridge space and there is less overall waste to be recycled. Seems to be pretty cost neutral for the NHS, provided the pens last more than 3 yrs."

Then in a later post: "Not all insulin providers do half unit pens. If you decide to switch, make sure you get 2 pens (same colour) for the first insulin that you change. Because the pen lasts 4 yrs or more, it is essential that you have a reserve, from the outset. With disposable pens a single pen failure is of little consequence, just ditch and get another from the box. But you can't do that if you only have one pen; I'm not saying failures are frequent, but one reserve is absolutely vital.

Then if you switch the other insulin get a different colour pen; I deliberately didn't get a 2nd in the other colour reasoning that I have one true reserve and could use the wrong colour reserve pen as a temporary fix while a replacement is provided. I could, of course put tactile markers on one pen to distinguish it from another - but that involves even more thought!! There are moments when life is too short .... However, I have tested my reserve pen, as a precaution. This all makes me sound a bit obsessive !!

A further bonus of these NovoEcho pens is that they store a simple record of the dose and time last used in the end of the pen. So when you have a moment of "did I actually take my bolus (or basal)?" there is the opportunity to check on the pen and reassure oneself."

Apologies if you are already familiar with most of this.

 

[Tdm]

I've 3 novoechos now though i just use for novorapid...not sure if that was delibrate or a mess up between drs and diabetes clinic! Agree re fridge space, those disposable pens take up lots space. I do like that you can check what you dosed...before i got the echos i used to take a photo with my phone before injection but that was one extra thing to remember to do. I only recently got a smart phone but they are so useful for diabetes..for libre, timing preboluses, reminders, timing excercise....my a1c went down to 6.2 today on my libre as the early, horribly spike ridden days fall outside the 90 days window...that made me rather happy! If i can just get a few solid night of sleep thst would be the icing on the cake, and perhaps i can stop thinking of diabetes, like, all the time.

 

[Proud to be erratic]

I've 3 novoechos now though i just use for novorapid...not sure if that was delibrate or a mess up between drs and diabetes clinic! Agree re fridge space, those disposable pens take up lots space. I do like that you can check what you dosed...before i got the echos i used to take a photo with my phone before injection but that was one extra thing to remember to do. I only recently got a smart phone but they are so useful for diabetes..for libre, timing preboluses, reminders, timing excercise....my a1c went down to 6.2 today on my libre as the early, horribly spike ridden days fall outside the 90 days window...that made me rather happy! If i can just get a few solid night of sleep thst would be the icing on the cake, and perhaps i can stop thinking of diabetes, like, all the time.

Great. But I'm mildly confused, since my NovoEcho pens routinely allow me to use half-units, whereas at post#4 I got the impression that you didn't have access to half-units from your pen?

 

[Tdm]

I have 3 echos but only novorapid cartridges for those echos. i dont have abasaglar cartridges that go in the echos, only the disposable pens in whole units, hence my inability to fine tune my basal insulin, and hence my being awake at 2am waiting for blood sugars to raise after therapeutic snack (not gone below 4 but want to see them up a bit before going back to sleep).

 

[Tdm]

When i was put on insulin in dec 21 they started me on 10 units of basal insulin (rather than the 2 I am on now), so they didn't think about my being able to do half units. It was a wild ride in those early days!

 

[Proud to be erratic]

I have 3 echos but only novorapid cartridges for those echos. i dont have abasaglar cartridges that go in the echos, only the disposable pens in whole units, hence my inability to fine tune my basal insulin, and hence my being awake at 2am waiting for blood sugars to raise after therapeutic snack (not gone below 4 but want to see them up a bit before going back to sleep).

Got it, thanks. Yes, I remember those early days of uncertainty.

I'm busy all today, but I need to go back and read the whole thread to properly understand the full picture.

It sounds as though you are trying to regulate using your basal (which some people do) whereas I keep my basal pretty fixed, optimised for ensured stability through the night [in practice nothing is static for very long!!] and use my bolus for food and any corrections as the day unfolds. I have Tresiba as my basal, which lasts for up to 40 hrs, so daily changes take up to 3 days to come into effect; therefore its altered infrequently. Bosul changes generally provide a response in the 4-5 hr window. So if I'm too low I respond with more carbs; if I'm too high I usually just wait until the next meal bolus and then add a correction to the food dose. This avoids stacking insulin. If I'm uncomfortable about being high, I will get active, in some way, to reduce my natural insulin resistance and let whatever insulin is on board "go further". I rarely take a bolus correction within 4-5 hrs.

This means as I go to sleep, I always take a last scan. If I'm low I'll take a reassurance snack, but I trust my ratio sufficiently to feel happy that the snack will work. I only wait to confirm this if I'm taking a hypo, or near hypo, response. Then I want the confirmation that recovery is happening. If I'm above 8 I'll take a very small correction, just enough to nudge me back to 6 and then sleep through until either I need the bathroom or when I wake to get up. Unbroken sleep is very important to one's overall metabolism. Broken sleep causes stress, which is fundamentally the enemy of DM and usually leads to elevated BG.

If your basal dose is in the low 20s, half units are pretty irrelevant. I take 10 basal units and contemplating going down to 9.5, because 9 seemed to be too little when tried over a 7 day period.

 

[Tdm]

Well, the diabetes clinic tell me they don't do my basal insulin in cartridges for the echopen so no chance of going down to 1.5 units that way. I made the mistake of mentioning i have my face to face apointment next month so the whole thing has been kicked into the long grass til then.

 

[Proud to be erratic]

Well, the diabetes clinic tell me they don't do my basal insulin in cartridges for the echopen so no chance of going down to 1.5 units that way. I made the mistake of mentioning i have my face to face apointment next month so the whole thing has been kicked into the long grass til then.

Apologies, I read "the 2 I am .." as 21 ..... Hence my confusion. !!!

So may I suggest, and I am neither a longstanding D expert nor medically qualified, in the interim bring your basal to 1, thus get a feeling of security about not having night time lows and (with your own awareness that you are on a v low basal dose) use your bolus to regulate your day time food and activity needs. This might result in slightly more bolus sometimes.

Also, I presume you are on a single daily basal, so what time of day do you take rhat?

 

[Tdm]

6pm....i've tried moving it about but that doesn't help...ablasaglar doesnt really have peaks. When i went down to one unit my bs just kept going up so thats really just too low. I'm thinking a insulin that lasts about 12 hrs may give me more flexibility, we'll see what the docs says

 

[Proud to be erratic]

6pm....i've tried moving it about but that doesn't help...ablasaglar doesnt really have peaks. When i went down to one unit my bs just kept going up so thats really just too low. I'm thinking a insulin that lasts about 12 hrs may give me more flexibility, we'll see what the docs says

Well, I can see your predicament. When you tried moving it did you try around 8am, or whenever you routinely get up using 2 units? The profile I could quickly find didn't show it totally flat. Could some of its intensity be diminished by the small hours of the morning?

I'm merely thinking how might you get a better night's sleep ....

 

[Tdm]

Well, i managed to sleep better at night- partly because my libre sensor stopped playing up, partly because i decided to just let it progress and realised it didn't tend to go low if left alone. The drs at the diabetes clinic weren't much practical help re alternatives to ablasaglar...suggested none of the basal insulins go into lower than 1 unit. He also said my blood sugar control was v good and you could hardly tell from the graph i had diabetes, then rather spoilt it all by suggesting i was working too hard at it! I mean, i understand some struggle with burnout, but i was so proud to get my a1c to 6, and its up to me how much effort i put in surely? Anyway, i was miffed. Plus i found out i was underweight (I had to ask st the clinic...didn't have scales...i've bought some now and they same my bmi is 16- yikes! Not good). I was sent to see the dietician again. They suggested i eat more carbs. Told them i could do that..i like eating! Anyway, have been stuffing myself with scones and clotted cream (albeit fibreflour scones)
Still, if i put weight on i should become a wee bit less insulin sensitive and that i hope, will stop my basal insulin being so active overnight...it did seem to be less dippy when i weighed more. I do have to rethink my low carb approach though...am trying to double number of carbs, to about 90 a day, hope can do it without spikes.

Anyway, practical question...for breakfast i have muselli. Sugars go up, i excercise, they come down, v predictable, and i get on with my day. In the evening i have similar number carbs in meal, sugars go up, i excercise, they come down, and it continues up and down pretty much til i go to bed....do you think its due to fats? Do you think more carbs, less fats in evening would mean it spikes then settles? Or is it something else? I would try museli in evening by was of experiment but that may have to wait until i am bit chubbier