Honeymoon vent

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Mumpie_olgran

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Type 1
Hi all. This is nothing more than a slightly childish vent I think but please indulge me as I'm normally pretty even handed about this T1 thing. But today has been a ridiculous fight on the insulin front and so was yesterday. I'm pretty sure it's just my knackered old pancreas giving up more of the ghost but basically nothing could bring BS down yesterday or the day before. I upped the basal (glargine) this morning from 20 to 22 and have literally been carb free for the day (one stray potato in my lunchtime salad notwithstanding). And on the correction doses I've now done 2, 4, 4 and 3 units of Novorapid. To put that in context that's more than I would normally take in a carb containing day (I don't take that many carbs as standard)

And still now I can see the wretched thing rising and rising on the dexcom so I'm pretty sure I'll have to whack in some more at some point overnight tonight

None of this is life threatening and I know a lot of people on this forum and elsewhere have way harder things to endure but just thought I'd throw this quick rant out there in the hope it'll help me feel better!

Thanks all and well done if you're still reading this slightly self indulgent drivel. You have better patience than me

I'm actually in two minds about whether to up the basal again tomorrow morning but think I've read somewhere it's best to give each tweak a couple of days to bed in? Not totally sure about that though. So maybe this had turned from a whine into a question after all. Stick with 22 or try a further couple of units of I have carried on rising overnight??
 
If it is any consolation I have had one of those days today too, although conversely I have eaten a few more carbs than I normally would, but my levels were all night and on waking and I have just battled every hour to bring them down. So far today I have injected Fiasp 12 times to try to keep a lid on it and some injections were stacked half an hour after the previous one and then another an hour later as it continued to go up instead of down. Thankfully I have kept it mostly in range with a couple of minor excursions into low double figures and I managed to get it down to 5 momentarily but it has been a constant battle. No idea why I get days like this but it happens occasionally and usually things settle down, but I have increased my evening basal dose and taken it early to help. I should say that I am not advocating other people stack corrections so closely, but this works for me using Fiasp which is faster and shorter acting and I monitor my BG levels very closely and have a good idea that if my levels continue to go upwards half an hour after a correction then I generally need another one. I would rather give multiple small corrections as let levels get really high and be tempted to rage bolus, but I have to say, I am feeling rather like a pin cushion today after 12 jabs, plus my 2 Levemir and the day isn't over yet!!

They always used to recommend that you waited 3 days between basal adjustments. I can certainly get away with daily adjustments regularly with Levemir and I think @helli used to use Glargine and make daily adjustments with it. I think in the days before CGM they were more cautious about increasing basal and of course the very long acting basals like Tresiba and Toujeo will become unpredictable with daily adjustment, but if it was me, I would experiment with another increase assuming I could keep a close eye on my levels via CGM and have alarms as a safety net in case it does suddenly drop you.

I believe Glargine can get stuck in tissue sometimes and release at a later date but if this has been going on for 2 days or more then I think that is unlikely. Have you tried a different pen/cartridge in case the insulin is compromised or the needle was blocked.... don't know how rigorous you are about doing an air shot....

Anyway, wishing you lots of luck for a better day tomorrow, but can empathize and share with your frustration.
 
Thank you for the thoughts. It is genuinely comforting to hear some shared pain, particularly as I know you've had more practice than me on the whole thing

Yes I'm very diligent on air shots and actually I'm on a nearly new pen (maybe 3 days old), so possibly I've got a duff load in that pen. Seems a bit of a waste to bin it on the off chance that it's a poor batch though?

Thank you for the solace
 
Sometimes no matter what you do type 1 kicks you. It sucks. Sorry, we’ve all. been there

thoughts
1. Dexcom is pretty reliable but have you double checked the stubborn high with finger prick? Just to verify..
2. Are you ill or coud you be about to be? That often shoves glucose stubbornly high. Covid is more common again. If you have a test handy could be worth checking?
3. Drink some more water to help flush out the glucose. Maybe take a short walk if possible or go up and down stairs a few times
4. keep hypo treatment handy overnight just in case the novorapid wakes up unexpectedly. Keep an eye on your levels and make sure you alarms are on.

hopefullly tomorrow’s better
 
rebrascora said:
I think @helli used to use Glargine and make daily adjustments with it.
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You are right, Barbara. I found a change in Lantus (the brand of glargine I used) would take effect pretty much immediately. In fact, I found Lantus only lasted 22 hours rather than the advertised 24 so there were no remnants to leecg into the next day.

@Mumpie_olgran just a quick check - have you done a finger prick test to check your Dexcom is not making up numbers? In my "glargine days", I did not have a CGM so my fingers told the whole story and I still rely on them more than a sensor (not that I would want anyone to take my CGM away from me).
 
Thank you both
Yes I have finger pricked too. Not every time today but definitely three times and they all corroborate the CGM findings

So to your questions overall @Saoirse
1. Yes
2. I don't feel ill at all but that could be in the pipeline. One of our house had a bit of a cold at the moment
3. Thank you!
4. Done, again thank you

The illness question has me thinking... Would be a new leading indicator for me

Appreciate the replies and wisdom, thanks again
 
Mumpie_olgran said:
Thank you for the thoughts. It is genuinely comforting to hear some shared pain, particularly as I know you've had more practice than me on the whole thing

Yes I'm very diligent on air shots and actually I'm on a nearly new pen (maybe 3 days old), so possibly I've got a duff load in that pen. Seems a bit of a waste to bin it on the off chance that it's a poor batch though?

Thank you for the solace
Click to expand...
I wouldn't necessarily bin it, just open a new one and see if things get any better straight away. If not put the new pen back in the fridge and use it when you next need a new one and go back to the current pen for now, which you will likely get through a lot quicker if you have to keep increasing the doses!! 🙄
 
Just to quickly report back. I had my final correction dose last night at 2230 and 6.00 this morning was at 4.5. Since been drifting up to 5.5 but that all feels within the realms of normal, so have left it at 22u for the time being. Time will tell (unless it doesn't....)
 
Glad things worked out with your dose overnight @Mumpie_olgran
A drift up when we get up is quite common.
 
SB2015 said:
A drift up when we get up is quite common.
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Thanks @SB2015 yes I've heard lots about the dawn phenomenon but so far I've not experienced it at all myself. Maybe the start of a new trait for me
 
@Mumpie_olgran glad things are back to normal although I would be a little nervous going down to the 4s overnight.
Do you have a half unit pen?
If not, I would recommend requesting one. You may need 21.5 units.
 
No I don't, I only have a full unit pen. Although if I were to tweak then I suspect I'd look to the bolus dose instead of the basal on last night's form. I'll check on that with the nurses next time though, thanks for the suggestion

Regarding the 4s, I do have the CGM buzzer set to alarm if it goes below 4.2 which somehow I managed to miss yesterday which was helpful!
 
For me, three main things cause elevated blood sugar.
  1. When I am developing a cold or chest infection (prone to those due to pleurisy as an infant).
  2. Dawn phenomenon. Here, I set a CGM high alarm at 8mmol/L and take 1 unit NovoRapid. If I miss the alarm I may need to take 2 units to get back in target.
  3. High protein meals. Here, if I do not stay alert blood sugar can start to rise 3hours or more after eating and can easily drift up to 11 or more. Even after correcting it can take hours to come back down.
Also, for me, not all carbs are created equal. I used to love chilli but had to give it up coz kidney beans drive my blood sugar sky high. Same with thai food unless I cut way back on coconut milk.

T1D just sucks sometimes and there are no answers. such is life…
 
Good to hear things are behaving themselves for you this morning @Mumpie_olgran. Long may it continue!

I needed another 2 corrections before bed last night making a grand total of 14 jabs of Fiasp yesterday which I think is an all time record for me!!. Needed 1 JB overnight but woke up on 7.0 this morning (so maybe I didn't need it afterall) and so far, apart from a couple of units to cover Foot on the Floor which is normal for me, levels are behaving impeccably today, without need for correction. Clearly there was something in the air yesterday (probably the Diabetes Fairy) causing us mayhem but she has hopefully moved on to visit some other poor unsuspecting diabetic today. Little trouble making minx that she is! Good riddance!
 
Don't worry you're not alone! It sounds a bit like my Saturday night into Sunday - ate a normal sort of supper (70g carbs) took split bolus as planned (4 + 3U), went up to 12mmol/l but didn't come down, ended up taking another 2 + 2U during the evening. Had started dropping when I went to bed and IoB looked like it should flatten out somewhere reasonable, took normal basal.

On Sunday morning my libre showed that it had hit 7mmol/l and then gone straight back up to 12mmol/l and sat there for the rest of the night. I took my normal basal, took 6.5U of bolus with the aim of bringing it down. Then sat all morning drinking cups of coffee (I know, milk and caffeine have an effect, but not this much). It dropped to 9mmol/l after a couple of hours and then started back up again almost immediately, so I took another 3U, it then proceeded to rise to 11mmol/l and sit there until lunchtime.

At that point I decided exercise was the only answer, plus it wasn't raining any more. I ate a few Ritz crackers (for some pre-ride salt) for a total of 10g of carbs and headed out for a 3h30 ride. Interestingly I only ate another 18g of carbs during the ride (unusual considering I had standard bolus plus not much pre-ride) and when I got home I went high as soon as I ate stuff (which is also unusual for me.) I did reduce my evening basal a bit (7U vs 9U normally) just in case, though I probably didn't need to bother.

I have remained on an even keel since then (with no/very reduced dawn effect until this morning), but I do wonder if I have/had an underlying infection as I expected to need to eat much more.
 
Thanks all for the replies. Pleased to report I've had a MUCH steadier day today. And that included a rather out of character gnocchi for lunch

I think you're right @rebrascora about the evil fairy. Should feed that one back into the various literature on T1D :D

Also pleased to report that my mood is rather better today. Not sure what's chicken and what's egg when it comes to BS and mood...
 
The DF is a well known phenomenon here on the forum. Numerous people have tried to curb her naughty antics and @Northerner was supposed to have her encased in a concrete tomb at one stage but she still managed to escape to wreak havoc on us. I would be very surprised if Alan hasn't written a poem about her which he might share with us if he sees this link.... his poems are legendary! I know he has numerous photos of her and in fact she did a bit of a tour of the UK via forum members at one point and was snapped in various locations, so there is documentary evidence of her existence! .
 
Got it, I'll keep fly papers, fly swats and flame throwers close to hand
 
Nothing like being prepared!!
 
rebrascora said:
The DF is a well known phenomenon here on the forum. Numerous people have tried to curb her naughty antics and @Northerner was supposed to have her encased in a concrete tomb at one stage but she still managed to escape to wreak havoc on us. I would be very surprised if Alan hasn't written a poem about her which he might share with us if he sees this link.... his poems are legendary! I know he has numerous photos of her and in fact she did a bit of a tour of the UK via forum members at one point and was snapped in various locations, so there is documentary evidence of her existence! .
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Trouble with the DF is that she can project her astral self into the ether, so physical restraint is usually only a temporary restriction on her antics 😱 🙂

You can follow her travels where she offered unwelcome advice to Forum members here, on her blog 'Couchsurfing with the Diabetes Fairy' :D Some people think that she looks like a certain pig, but she can't see the resemblance herself... :D

diabetesfairy.blogspot.com

Couchsurfing with the Diabetes Fairy

Pssst! Over here. I'm in disguise at the moment as quite frankly I'm seriously out of my comfort zone and I'm feeling a little bit exposed....
diabetesfairy.blogspot.com diabetesfairy.blogspot.com

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fairy eggs.jpg
 
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