• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

Hi there.. I am writing this on behalf of my sister.

Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
H

Harvestmoon

New Member
My sister.. age 55..was newly diagnosed with type 1 brought on by her cancer treatment.. Got the libre 4 weeks ago but sugar levels have been crazy high.. Works out her carbs perfectly but her novorapid (ratio 1 unit to 8 carbs) does not seem to be doing the trick.. Levels have been in the high teens.. Also bread and cereal put her of the scale.. And that's low carb versions!!.. Also takes lantus at night.. Need help please..
 
Hi, and welcome to the forum. Has she spoken to her diabetes team to see what they suggest?
 
Welcome to the forum @Harvestmoon

It sounds like there might be a few things going on in combination

The first thing to do, as @MrDaibetes suggests is to try to book a phone or video call appointment with her diabetes team or DSN. they will certainly want to know that her levels are running so high.

What happens 4-5 hours after the doses? Have levels returned to roughly the pre-meal level? If so it may be dose timing rather than amount. Insulin for meals works over a surprisingly long time so it’s important to take a fairly long view of the dose action as a whole. It can help to take the dose, then wait 10-20 minutes before eating to allow the insulin time to get going.

It’s not possible (or wise!) for anyone here to suggest dose adjustments because of the added complications of the cancer for your sister - perhaps her doses were set cautiously to begin with?

Certainly, as your sister begins to learn how to adjust doses and ratios under the instruction of her clinic she will soon find that nothing is ever set in stone and doses, ratios and correction factors tend to wander about over the weeks and months of the year.

Perhaps it would be wise to avoid cereals (I know I do!) if they are particularly ‘spiky’.
 
Last edited:
Welcome to the forum @Harvestmoon from another late starter (53)

Imam sorry to hear that your sister is dealing with so many things at present. In the early stages of diagnosis her DSN will want to work with her on getting doses correct. So it would be good for them to know that her levels are running so high at present. They can then work with her on making necessary changes.

There are certain foods that will raise the glucose levels very quickly. It is different for all of us, but cereal is a common problem, and I avoid those. Someone described them to me as a bowl of sugar in disguise. The Libre can be very helpful in finding out which foods your sister can manage, and adjusting the timing of the pre meal insulin dose (Bolus) can help to lower the post meal spikes, by giving the insulin time to get working to match the development of the glucose from the carbohydrates eaten.

Keep in touch and ask any questions that you have.
 
Hi @Harvestmoon Sorry your sister is having problems. I’d hope they can be gradually sorted. It’s normal to start Type 1s on less insulin than they probably need. This is to avoid hypos. Then the doses are gradually increased until the blood sugar results are in a more normal range. Note too that it can be inadvisable to bring the blood sugar right down too fast, so there’s sometimes a stepped approach with target ranges rather than being strict straightaway.

Your sister should speak to her team, give them the results of her blood tests, what she ate, when, etc. They can then adjust her insulin. This won’t be one magic adjustment. It will probably be a series of adjustments over a period of weeks.

So - it’s not her fault (or the bread, cereal, pasta’s fault - she should be able to eat those ok once her insulin is sorted). But she does need to keep in frequent c tact with her team to get her insulin doses adjusted.

Wishing her good health.
 
Hi there everyone.. Thanks for the replies.. My sister self adjusts her own insulin (as instructed by her team)... However, sometimes a single correction dose does not even register and she needs more.. Is this normal? Also, should she avoid all bread and cereal?.. or maybe up her dosage when eating those items?.. Is it OK to do that..
 
How long is she leaving the correction dose to work? Has she been given a correction ratio - ie how much 1 unit of insulin will put her blood sugar down?

No, she doesn’t have to avoid cereal and bread! Not if she’s a Type 1. However, she’d need to adjust her mealtime insulin to cover the amount of carbs she’s about to eat.

Has she been taught how to do that?
 
Welcome Harvestmoon.
How long has your sister been diagnosed? My understanding is, when first on insulin, people are usually told to use a fixed does. Since your sister is self adjusting, has she been using insuling for some time?
If it's more recently, our blood glucose (BG) does tend to be hight when first diagnosed.
Also, I belive, initial doeses are a touch conservative. They are then adjusted by the diabetes tearm. Once the based level is established, BG levels should be better. The D person also gets to do a course called Dafne, which covers how to manage insuling doeses I'm told.
 
When we say 'self adjusting insulin' - we do not mean someone else telling us what dose to take, and then doing the jabs of the new amount ourselves - we mean being sufficiently expert to enable us to recognise the possible reasons our BG is not where we need it to be, and taking the appropriate course of action to avoid that same thing happening again in the foreseeable future.

That sort of knowledge is only gained over TIME - certainly not quickly acquired.
 
trophywench said:
When we say 'self adjusting insulin' - we do not mean someone else telling us what dose to take, and then doing the jabs of the new amount ourselves - we mean being sufficiently expert to enable us to recognise the possible reasons our BG is not where we need it to be, and taking the appropriate course of action to avoid that same thing happening again in the foreseeable future.

That sort of knowledge is only gained over TIME - certainly not quickly acquired.
Click to expand...
Hi there.. My sister was diagnosed 2019...Upon leaving hospital she had fixed doses.. However after her first appointment with diabetic team(she has only had 2)they told her that she was fine to self adjust as she was more than capable.. She keeps records and notes every day so I got the impression they were happy for her to do that.. I am always present at any appointments she has whether that is diabetes or cancer related... So.. This has been quickly acquired...
 
Thank you everyone.. My sister was diagnosed in November 2019..Upon leaving hospital she was on fixed doses... After her first appointment with diabetes team they told her it was fine to alter and work with her doses as she was more than capable.. I was also there.. She had one more appointment after that and said she was managing great. She keeps meticulous record of doses and corrections... She got the libre almost 4 weeks ago.. Prior to that it was the fingerpricking and monitor so after 4-5 hours when she redid it, it was reasonably within her set range... She was also eating breads and cereal then.. However, since the libre you can test it constant, if you so wish, and she can see crazy readings.. I'm wondering if maybe this was happening the whole time before the libre except she was unaware?!!
 
She’s obviously going through an awful lot right now with the cancer and the diabetes. Have either of you spoken with the nurse team at Cancer Research UK?
Although not expert in diabetes they are experts in cancer and may be aware of any complications or considerations regarding the diabetes that arise from the cancer treatment.
 
ColinUK said:
She’s obviously going through an awful lot right now with the cancer and the diabetes. Have either of you spoken with the nurse team at Cancer Research UK?
Although not expert in diabetes they are experts in cancer and may be aware of any complications or considerations regarding the diabetes that arise from the cancer treatment.
Click to expand...
Hi there
ColinUK said:
She’s obviously going through an awful lot right now with the cancer and the diabetes. Have either of you spoken with the nurse team at Cancer Research UK?
Although not expert in diabetes they are experts in cancer and may be aware of any complications or considerations regarding the diabetes that arise from the cancer treatment.
Click to expand...
Hi there... This was a rare side effect because of immunotherapy.. It completely destroyed her pancreas.. Her cancer is under control at present.. waiting for next scans... so not affecting the diabetes supposedly..
 
She was also eating breads and cereal then.. However, since the libre you can test it constant, if you so wish, and she can see crazy readings.. I'm wondering if maybe this was happening the whole time before the libre except she was unaware?!!

Just a thought - is she injecting her meal-time insulin enough in advance of her meal? She might have been told she can inject and eat immediately. That’s rarely true. Most people inject 10-20 mins in advance of eating. It will vary for each meal eg for me at breakfast, I need to inject 30 minutes in advance of eating. Lunch and evening meal are less. If she isn’t already doing this, she can do it by cautiously moving her injection 5 mins earlier at a time.

Bread and cereal are fine for Type 1s. The diet for Type 1 is not the same as the diet for a Type 2. Is she on a special diet unrelated to her diabetes that doesn’t allow them?

I find it’s actually easier to control my blood sugar with moderate amounts of carbs because otherwise you need to count protein and sometimes deal with a kind of resistance to the insulin if you eat very low carb.

Sometimes the Libre can be really helpful but sometimes it can cause unnecessary stress and too much focus on ‘perfection’. Use it as a tool not a judgement-giver.
 
I would also ask when she is taking her bolus insulin (the insulin for her food). For me, at breakfast time I need to inject an hour or sometimes more before my food in order to avoid my BG levels going into orbit and then coming back down a couple of hours later. Lunchtime and evening meal only need 20 mins before food.

I believe you are correct in assuming this has been happening all along and it is just that the Libre enables your sister to see it now. It is a fantastic bit of kit for helping you iron out these blood glucose spikes. Slowly experimenting with bringing those meal time injections forward, a little at a time, and seeing what the Libre graph shows should enable her to sort it out.
 
No I meant is NOT easily acquired - has she been on a DAFNE course?

She'll be able to basal test now much more easily with the Libre, so that's good!
 
Hi there.. I passed on all messages regarding the timing of doses.. Yesterday she injected 10 mins prior to eating her sandwich(chicken and bread)and fruit but said she felt like she was about to pass out just before eating as it seemed like the insulin had hit her system too quickly.. I suggested taking a lesser dose but she reckons that once the insulin is in your system, regardless of dose, its going to start working.. To me a 50mg tablet will be faster acting than a 10mg tablet, for instance, but she says insulin does not work that way.. She started of with a reading of 6.8, injected 6 units of novorapid, but it still climbed up to 14 plus, so ended up taking correction doses a couple of hours later.. Any thoughts please... I'm sorry if this sounds boring but we are trying to get sorted and all help and suggestions are much appreciated.. Many thanks..
 
The time in advance will vary for each meal. She needs to check her blood sugar if she thinks she’s going low as that feeling can sometimes be deceptive.

It doesn’t sound boring at all. It takes time to go through all possibilities 🙂
 
Harvestmoon said:
seemed like the insulin had hit her system too quickly.. I suggested taking a lesser dose but she reckons that once the insulin is in your system, regardless of dose, its going to start working.. To me a 50mg tablet will be faster acting than a 10mg tablet, for instance, but she says insulin does not work that way.
Click to expand...
I never thought the doesage (in any medication) affected how quickly it affects the system. The medication would affect the system as the same rate. The doesage will change how much the system is affected.

With insulin, it's to be timed to hit to take affect the same time (or a little after) as your food does. Taking into account you BG levels.
 
Well I'm the same as your sister - I mean I actually am because I have tested my BG when I felt hypo before eating and I have been hypo - for me Novorapid gets going after approx. 10 minutes though a lot of people say it takes up to an hour for them. I know that for me too, there's no Novorapid left after approx. 4.5 hours. For others it's longer or shorter.

My own body didn't get on too well with Lantus, but there you go.

Each one of us is different !
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Back
Top