How do you get good control without hypos?

[Pigeon]

I've been working so hard to get my HbA1c down since my last apppointment in February, keeping diaries and looking for trends etc.

BUT I find that just as I start to get into the good BG range, I start having at least one hypo a day, at random times and I can't spot a trend. And just as I think I have my ratios sorted for each meal then the amount of insulin I need decreases! The last 4 days my breakfast, lunch and dinner readings have all been good, but I've had 4 hypos:One before lunch, one 2 hours after lunch, one 2 hrs after breakfast, and the last one 2hrs after dinner.

I find that the more hypos I have the longer it takes me to detect it ( e.g. today I got down to 2.7) and so I end up keeping my BG higher to stay safe... but then my HBA1C increases.

I'm getting quite frustrated with it all now, does anyone have any pearls of wisdom to share? I think my carb counting is good, so I will reduce my ratios again tomorrow and try again.

 

[DanW81]

im in the same boat as you pigeon. theres so much talk about getting your hba1c down, so you end up thinking you should take a bit more to get them down, which does the trick initially, but then this sometimes causes a hypo later, so u end up eating random stuff to deal with this & then putting on unecessary weight, etc, etc. So at the end of it all you think maybe its easier just to stay at the slightly above average to be safe. all very annoying sometimes!

 

[Adrienne]

Hiya

This is the problem with tight control on injections and why it is easier to get tighter control on a pump.

If you are too low on and off most of the time, are you sure it is your ratios that are wrong and not too much background insulin (levemir or Lantus). Just a thought.

🙂

 

[Pigeon]

Hmm, good thought Adrienne. The trouble is that I don't take much levemir as it is (approx 1/3 of my daily dose is levemir), 3.5 units in the morning at 6.5 at dinner. Today I took 3U levemir this morning, as I planned to go for a run at lunch. My levels were pretty stable all morning, after using my usual breakfast NR ratio, so maybe I should take 3U levemir on normal days, and 2.5 on days when I'm exercising?

Currently I'm at 6.7 post-run, so I've got something right today 🙂