hello to all.

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stargatefan

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Type 1
Hi,
i'm new to this forum but i am certainly no stranger to forums.

i was diagnosed Type 1 fourteen years ago and have battled highs and lows ever since. i am soon to be speaking with a diabetes nurse and showing my blood glucose levels over the last month. this is purely to try to figure out why i do not get low alarm signals!
so i signed up to see if there are others with the same problem and what solutions they found... plus any other information i can gain. 🙂
 
hi and welcome to the forum have a good look around and remember no question is regarded silly here x🙂
 
Hi, welcome to the forum 🙂 We do have some members who suffer from hypo unawareness, so I am sure you will be able to swap notes with them. Has your nurse suggested possibly using a CGMS (Continuous Glucose Monitoring System) to try and spot any patterns in your levels? What insulin regime are you on? I find that (like most people) if I have been on the low side for a while then my symptoms only appear at very low levels - I had a 2.4 the other day and was only just starting to experience symptoms and feeling a bit 'odd'. The general advice in such circumstances is to run your levels higher than normal for a while so you react more readily when you fall below what your body and brain are used to. Some people have found that a pump helps.

Have you investigated what might be causing your highs? Please ask any questions you may have, there is a wealth of experience here and often it is the most recently diagnosed who can help most as they are more up to date with current thinking, treatments and techniques 🙂
 
Hi there stargate and a warm welcome to the forum
 
Hi stargatefan. Welcome 🙂

Hopefully, if you can get to grips with your BGs, with our help of course, then your hypo recognition will return. 🙂

Rob
 
thanks for the welcome.

yeah im currently investigating why i am unaware. (please no jokes here)
im generally unaware of most things let alone my glucose levels.

my lowest test yet was while i was cooking my dinner, i was a bit sweaty.
it was 0.7 i was fine, coherent and finished cooking my dinner then ate it.
i thought it best to jab after.

my nurse suggested that it could be that i am having hypos while asleep so this could be a reason for the unawareness!

the highest i have tested myself was 28.0 but i don't get much of a hyper awareness apart from anywhere above 9.0 i get a metallic smell in my nose i believe that is from the sense of smell reacting to a slightly higher blood pressure.

prepare yourselves for silly questions. 😉
 
What regime are you on ? eg. MDI, pumping, etc

And what sorts of doses/ratios work for you ?

Rob
 
i am on Novorapid injections from a cartridge pen 3 a day before meals.
then Lantus at night.

breakfast i jab around 12-14 units depending on the glucose result.
Lunchtime i jab around 12-14 ------------ditto-----------
dinnertime i jab around 14-18 ------------ditto-----------

night jab is between 18-24 units depending on my night test.

i don't think i am very active during the day but i am in the process of decorating my bathroom. i am currently unemployed.
 
stargatefan said:
i am on Novorapid injections from a cartridge pen 3 a day before meals.
then Lantus at night.

breakfast i jab around 12-14 units depending on the glucose result.
Lunchtime i jab around 12-14 ------------ditto-----------
dinnertime i jab around 14-18 ------------ditto-----------

night jab is between 18-24 units depending on my night test.

i don't think i am very active during the day but i am in the process of decorating my bathroom. i am currently unemployed.
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What you say here suggests that you don't inject according to the carb content of your food but your levels before eating. Have you ever been on a 'carb-counting' course, such as DAFNE (Dose Adjustment For Normal Eating)? If not, then you should definitely raise this with your nurse. I'd also suggest starting a food diary, detailing everything you are eating and including the amount (in grams) of carbohydrate. Do you ever test after eating to see what effect the food has had on you?
 
Welcome to the forum stargatefan 🙂

Further to Alan's post about Carb Counting, if you don't already have it the Visual Carbs & Cals book is a big help and they now do a pocket version too 🙂
 
i try to inject units to encompass the glucose level just tested and the content of food. i will definitely mention carb counting to the nurse to see what she has to offer. im sure many diabetics can relate to me with this. when i go through these meetings its more they are reading from a script rather than actually looking at the person in the chair. so any words i can mention that breaks them out of the rigmarole and see that i could do with some help will be appreciated.

my levels seem to bounce from low to high like the blade of a saw rather than curve like a wave. that may be because i havent figured out how to draw graphs correctly in M$ excel...
 
stargatefan said:
i try to inject units to encompass the glucose level just tested and the content of food. i will definitely mention carb counting to the nurse to see what she has to offer. im sure many diabetics can relate to me with this. when i go through these meetings its more they are reading from a script rather than actually looking at the person in the chair. so any words i can mention that breaks them out of the rigmarole and see that i could do with some help will be appreciated.

my levels seem to bounce from low to high like the blade of a saw rather than curve like a wave. that may be because i havent figured out how to draw graphs correctly in M$ excel...
Click to expand...

There are a lot of refinements you can make to improve your post-meal glucose levels. Courses like DAFNE teach you about ratios i.e. the amount of insulin you inject according to the carb content of food, and also that these ratios can change throughout the day - for example, I need four times as much insulin per 10g carbs for breakfast than I do for my evening meal, so it is far from constant through the day. I also inject 15-30 minutes prior to eating to give my insulin a chance to get working as the food starts to digest and this has improved my post meal levels a great deal.

You might also want to consider your lantus doses and perhaps doing some 'basal testing', which determines if the amount of lantus you are talking is set correctly - another good question to test the knowledge of your nurse! If he/she hasn't heard of it then you might question the level of knowledge...😉

Do you have software for your meter that can do the graphs and statistics for you? What meter do you usually use, and how many times a day do you test?
 
just about to sit down and eat my dinner now... just pasta and a sauce.
pre meal test is 2.1 so i tend to jab after eating as im afraid to fit and jab the fork in my head. 🙄

i really should fill in some history about myself further. let me eat first and swear at the news for a bit and then i'll post a little more.

bon appetit.
 
stargatefan said:
just about to sit down and eat my dinner now... just pasta and a sauce.
pre meal test is 2.1 so i tend to jab after eating as im afraid to fit and jab the fork in my head. 🙄

i really should fill in some history about myself further. let me eat first and swear at the news for a bit and then i'll post a little more.

bon appetit.
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If I was 2.1 before eating I would have some fast sugar like jelly babies or full-sugar coke first and wait until levels started to rise. There's a danger that your meal will be too slow at bringing you levels up and they may fall further first. From what you have said, I'm guessing a 2.1 has little in the way of symptoms? How long since your previous meal? If over 4 hours, this would suggest your lantus dose might be too high.
 
Thanks for your time on this by the way. (humbled)

yeah 2.1 has no signs with me what so ever. it could continue to fall and i would be none the wiser.
i think you are right about lantus. i know very little of how it works apart from in 2007 a nurse gave me the new pen and said "this is your new night jab".

so in 2007 i was diagnosed with mouth cancer and spent 2 years in and out of hospital having operations and radiotherapy.
im fine now, i think, let me look up 'fine' in the dictionary... 😉
so having mouth cancer makes it difficult to eat. when in hospital they put you straight on a sliding scale for insulin then right after that they hook up a liquid feed tube for nasogastric intubation. sounds great until you have a look at the liquid food, being pumped into you, which is basically sugar. so my levels went to hell in hospital. since i have been 'better' i still use a liquid supplement food as i only have 1 parotid(saliva) gland and i cant open my mouth very far.
So want to know what is in the liquid food supplement? its lactose based right?
so when i eat lunch it is supplemented with an high fiber liquid feed. that is why my lunch jab unit is quite big.

How long since your previous meal?
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it was about 4 hours. so if you say that is possibly something to do with the lantus jab i shall take that information to the appointment with me too.
i prefer to go with questions.

the other problem i have is with fast sugars. perhaps it is something to with my metabolism but fast sugars can take me from low to double figures in minutes.

so personal info :
Sex = male
Age = 40
Height = 5'7" / 172cm
Weight = 11 stone / 70kg

can you give me any more information on this carb counting diet?

Do you have software for your meter that can do the graphs and statistics for you? What meter do you usually use, and how many times a day do you test?
Click to expand...
i use an Ascensia Contour glucose tester its awesome, 5 seconds, tiny amount of blood required etc etc.
i test about 4 times a day varying before and after meals.
it didnt come with any software or any cables to attach it to a pc to download it.
i am quite proficient with spreadsheets and have a template to generate a decent graph to show me where the problems are (n't).
just doing a test now for the after dinner result = 6.8 (and climbing fast)

thanks for any info or loaded questions you can give me to take to my appointment.
 
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Very sorry to hear about the mouth cancer, I can see that that can present extra problems for you. My Dad had mouth cancer too, but has been thankfully 'clear' now for over 20 years. It would certainly be worth finding out what the carb/sugar content of the liquid supplement food is. It may be possible to reduce any post-meal spikes by changing the timing of your insulin - this can take a lot of trial and error, but is worth it in the long run. I usually inject 15-30 minutes prior to eating, but obviously wouldn't do this if I was low like you were.

We sound very similar in a lot of ways! I am a little older than you (52) but it sounds like we are a similar build/height/weight. This is interesting because the doses you give are very similar to what I started on when first diagnosed 3+ years ago. I found that the lantus had been set way too high for me (20 units originally, causing me to wake with night hypos or very low in the morning). Eventually, I reduced it to around 8 units, although it has been as low as 3! My novorapid has also reduced, although not as significantly as the lantus.

Carb counting isn't a diet, just a way of calculating insulin doses according to what you want to eat. There is an online version of the course here if you want to learn more about it: http://www.bdec-e-learning.com/ and you should definitely ask your nurse about what might be available in your area.

Regarding your meter - most companies allow you to register the meter which then gives you access to free batteries, logbooks and control solution, and usually free software and cables, although some companies may charge around ?20 for this.
 
Hiya

Couple more questions ! Are you under stress? Are you now or have you been, taking steroids for anything? - both of those are a pig.

When my BG was doing the Hi/LO shuffle (caused by stress, over-correcting hypos, the ups and downs causing recative ups and downs (where a hypo is followed by reactive hyper-glycaemima and a high is followed by reactive hypoglycaemia) we worked out a strategy which involved the number 7.0 LOL

Never correct more than to bring my BG back down to 7.0.
Never correct unless my BG was over 7.0. As 1 unit of Novorapid brings me down by 3.0, that meant I had to be - well at least - 9.5 before I corrected.

I only learned the last bit, by actually participating on a Carb Counting course. Essential piece of info, together with '10g of Carb increases my BG by 3.0' for anyone on insulin, IMHO

Yes it's counter to everything we are told, must keep your BG under this that or the other, must have an A1c under this blah blah - but it worked actually - and worked pretty quick. I stabilised at a much higher level than I was currently striving to achieve. My hypo symptoms returned. Then we started gradually knocking mumbers off the levels to correct down to, etc. All in all took 6 months. That's nothing out of your whole life!

And since then I have never had AWOL hypo symptoms.

There could be other things at work - eg Thyroid? Addisons? ........
 
trophywench said:
Couple more questions ! Are you under stress? Are you now or have you been, taking steroids for anything?
Click to expand...

i dont really suffer from stress. thankfully, i can shrug off anything and deal with it.
i am treating a skin condition on my hand and the cream says (steroid potency: mild) so that may be something.
its strange with diabetes how something slight for one person can affect another considerably. it's a case of finding what triggers ones hi/lo Pogo.

trophywench said:
When my BG was doing the Hi/LO shuffle (caused by stress, over-correcting hypos, the ups and downs causing recative ups and downs (where a hypo is followed by reactive hyper-glycaemima and a high is followed by reactive hypoglycaemia) we worked out a strategy which involved the number 7.0 LOL
Click to expand...

sounds like great advice as if i start getting high or low readings i react by changing my dose or eating fast sugars which is, in fact, counter productive.
7 seems a decent number, a nice safe zone above and below it.

Northerner said:
I usually inject 15-30 minutes prior to eating, but obviously wouldn't do this if I was low like you were.
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This '15-30 minute' window is that roughly how long Novorapid takes to kick in to gear?
or is insulin reaction times subject to each individual too?
i use an 8mm needle on my pen and my nurse asked if i wanted 4mm needles. i declined as 8mm is fine for me, i think she saw that i dont have a lot 'spare' for injections.
i use injection sites in my belly (for all 3 day/meal jabs) and at night i inject into the gluteus maximus 😱 i dislike using arms and legs as it smarts there.

another diabetic told me, the other day, that your day jabs should be done in the gluteus maximus. im just guessing that we all have our own injection areas.
unsure exactly why but im trying to find more and more diplomatic ways of saying 'bum'. 😱
perhaps after the diabetes nurse i can visit a psychologist.

im still reading through posts and picking up loads of information which is great news for me.
 
Soemthing to watch for, when resitricting injection sites, is fatty lumps or areas which are slightly more padded. If you inject in the same sort of area too often, over time you will develop fatty lumps under the skin, which feels comfortable to inject into, so you keep doing it there, ad infinitum. Trouble is, the insulin then comes in fits and starts instead of a nice, steady trickle.

If you could introduce your arms or legs, it would possibly help with absorption.

I was told at a recent visit to the DSN (which tallies with advice I had years ago) that the major muscles in the thighs and buttocks can also delay absorption. I now do bolus (humalog) in abdomen and arms and basal (lantus) in thighs and buttocks.
🙂
And just to get you on road to recovery. BUM. 😱

Rob
 
ok,

back from seeing the diabetic goddess. 😉
i never asked her if she was married... 🙂
she has booked me on a carb counting course but they are really busy and full.
there must be loads of diabetics given this course. so i am guessing it is really beneficial.
i think she wanted to keep my graph of blood test results so she can make a poster like "this is how NOT to handle your glucose levels".
i need to be more strict on my diet and have been told to bring my lantus injection to a much earlier time. just after dinner! so about 6-7pm.
this is because it sits in the background giving a slow release of insulin over 20-22 hours. so when my lantus starts dropping off it will be in the afternoon rather than the evening after my evening meal (which is the largest meal of my day).
she dropped a little warning that if i turn up to my next meeting showing low blood sugars that she will have to phone the DVLA and get my drivers license taken away. that would be ... Catastrophic for me. its possible that she said that to scare me into a much tighter controlling regime.

all i can say is bring on this carbohydrate counting course. as looking at my food it is fairly heavy in carbs. pasta, potatoes and bread as well as these lactose based food supplements.

still... all scary stuff for me personally so i thought it might be best to get some telephone numbers in the waiting room for any of these volunteer type support people. now all i have to do is pluck up the courage and call them.

she did give me a new glucose meter to try out called "Freestyle Insulinx" and has a nice usb cable to download the results. there are 2 modes to the device "simple" and "advanced" or "Geek!" as i like to call it. 🙂
freestyle-insulinx
it helps to calculate insulin doses depending on the test result and the meal you are about to eat.
the jury is out on this device.
ill let you know how i get on with it. i'll probably be using my old Bayer Contour at the same time to settle my nerves... lol.

last of all... my HbA1c was 7.5% so it has risen by 0.2 in a month.

Goodbye favourite foods and alcohol. sniff.

(hello diabetes support---Recipes )
:D
 
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