hungry

[rosie1]

l have looked at other peoples daley diet but if l just had a banana & yogert for breakfast l would be starving .l just cant seem to get this diabetes right and lm feeling worred

 

[Northerner]

What would you normally have Rosie? Bear in mind that if you eat food without carbs then you don't need to restrict the quantities as much (unless you are looking to lose weight as well). Having protein/fat should also help make you feel less hungry for longer, so perhaps scrambled eggs, mushrooms, tomatoes, bacon etc. might be better for you 🙂

 

[LeeLee]

When I was trying to lower my levels initially, I found it to be frustratingly perverse. By that I mean that when I was hungry at higher levels, I craved carbs (rice/pasta/potato based meals, cereals and bread, crisps and biscuits).

Once I got used to eating yogurt or eggs for breakfast and only tiny quantities of the other carby stuff, the cravings and hunger pangs reduced significantly. It really is worth the effort. 🙂

 

[Northerner]

What happens is that your brain doesn't know you have diabetes. Because you are not using the glucose in your blood efficiently (as indicated by high blood glucose levels) your brain assumes you are not getting enough glucose, so it prompts you to eat more carbs to 'top up'. Things should improve if you are able to get more normal levels, and as LeeLee says, just a tiny amount of carbs can help alleviate the brain's craving 🙂

 

[Jamieizz]

What happens is that your brain doesn't know you have diabetes. Because you are not using the glucose in your blood efficiently (as indicated by high blood glucose levels) your brain assumes you are not getting enough glucose, so it prompts you to eat more carbs to 'top up'. Things should improve if you are able to get more normal levels, and as LeeLee says, just a tiny amount of carbs can help alleviate the brain's craving 🙂

I never realised that! Might explain why often feel so hungry in the evenings soon after a meal, when I try to run my levels a bit higher to avoid night-time hypos...

 

[DeusXM]

I try to run my levels a bit higher to avoid night-time hypos...

If you need to do this, I'd suggest instead altering your insulin dose. Running your levels a little bit higher just to avoid hypos is likely to increase your risk of problems further down the line.

 

[Jamieizz]

If you need to do this, I'd suggest instead altering your insulin dose. Running your levels a little bit higher just to avoid hypos is likely to increase your risk of problems further down the line.

I know, its not ideal, I'm going to try and do some basal testing again, but it has always come out okay before. I'm also on a very low dose of basal (6u of Levimir once a day before bed) so it would seem odd to take it even lower.

Last night was a good example of my problem - when I went to bed at 11pm my levels were 11.5 and by 2:20pm I woke up with a hypo (3.6). This was 4 1/2 hours after I had last eaten. I had 15g quick acting carbs, waited 10 minutes and I was 4.1 so had 15g slow acting carbs and went back to sleep. When I woke up I was 9.7.

It just seems next to impossible to get a decent bed-time and morning reading without risking hypos - many of which I sleep through. I know it doesn't help that I eat quite late but because of work/parental duties it is difficult to eat more than 2hrs before bed.

Any suggestions greatly appreciated!

 

[Northerner]

I know, its not ideal, I'm going to try and do some basal testing again, but it has always come out okay before. I'm also on a very low dose of basal (6u of Levimir once a day before bed) so it would seem odd to take it even lower.
...

Jamie, when I was diagnosed I was put on 20 units of lantus, but gradually had to decrease it until last year I was down to 2 units and I decided to try without it as I was still waking in the low 4s. I've managed fine for over a year now, just needing the occasional 2 units when ill and my waking levels have crept up. I was diagnosed 5 years ago.

I'm not suggesting you stop the levemir of course, just pointing out that there is no such things as a low dose or a high dose - there is just the dose that is right for you, so if you need to drop the levemir to 3 or 4 units so you can go to bed at a lower level and nit hypo, then so be it! 🙂

 

[PattiEvans]

Last night was a good example of my problem - when I went to bed at 11pm my levels were 11.5 and by 2:20pm I woke up with a hypo (3.6). This was 4 1/2 hours after I had last eaten.

Jamie

That could easily have been caused by your bolus. You don't mention which one you are on, but I would say that without doubt when I was on Humalog it had a sharp kick in the tail at between 4.5 and 5 hours which would bring my BGs down quite fast. Novorapid also lasted 5 hours. I'm on Apidra now and although they say 4 hours duration I think it's nearer 4.5 hours.

 

[DeusXM]

It could be either your basal or your bolus but unless you've noticed the same activity pattern as pattidevans, I'd be inclined to look at reducing your basal.

I'm not sure how long you've been diagnosed and I would say you are on what would appear to be a small dose of Levemir, but it might be you're one of those very lucky people who isn't insulin resistant at all or even has some residual beta function. As Northerner says, don't be afraid to to trim your basal down if you need to.

It's hard to tell what's going on overnight as there could be a variety of things going on - you may have significant dawn phenomenon, you might be suffering a rebound from hypos (although there is debate over whether this happens). I know it sucks but some interval testing overnight is probably a good idea. You may find that you actually have to split your Levemir dose if you have a significant amount of variability between your day needs and your night needs. Information is power!

 

[Jamieizz]

I'm on Novorapid and yes, I do find that even after 5hrs it can still be working. So could well be the reason, but as my levels were over 11 when I went to bed I thought I was safe.

V.interesting to hear that your basal need is so low Northerner - I'll try the basal test tonight and try and do as many readings as possible through the night (I have a 6 wk old baby in the room so waking up regularly won't be too much of a problem!).

The other thing is that my levels do tend to start to rise again in the early hours. The other night I tested at 3:20am and was 5.1. Then when I woke I had gone up to 9.1. I'm guessing a bit of 'dawn phenomenon'...

 

[PattiEvans]

It could be either your basal or your bolus but unless you've noticed the same activity pattern as pattidevans, I'd be inclined to look at reducing your basal.

Of course it's always best to test basal before suspecting anything else.

I'm on Novorapid and yes, I do find that even after 5hrs it can still be working. So could well be the reason, but as my levels were over 11 when I went to bed I thought I was safe.

I can't seem to stop the spikes, but I can easily come down from over 11 to 4 in the last hour of the bolus.

The other night I tested at 3:20am and was 5.1. Then when I woke I had gone up to 9.1. I'm guessing a bit of 'dawn phenomenon'...

Unless your Levemir is actually running out I'd agree with the DP. This morning I was 5.1 at 4am and 7.2 on waking at 8.31. By the time I had breakfast at 9.15 I had risen to 8.6 and if I hadn't injected and eaten it would be in double figures by now. I think the only way to tackle DP of this magnitude is the pump.

 

[Northerner]

Unless your Levemir is actually running out I'd agree with the DP. This morning I was 5.1 at 4am and 7.2 on waking at 8.31. By the time I had breakfast at 9.15 I had risen to 8.6 and if I hadn't injected and eaten it would be in double figures by now. I think the only way to tackle DP of this magnitude is the pump.

Yesterday I was 5.7 on waking. I injected, but didn't eat anything for an hour. I tested just before eating, and I was...5.6! 😱 If I hadn't injected I would have probably been in double figures - most of my morning injection is to counter the DP rise rather than the food I eat. Novorapid lasts at least 5 hours for me and takes between 45 mins and an hour to start working, depending on time of day (quicker as the day progresses) And to think that I always used to inject just before eating!

 

[Jamieizz]

Thank you Patti and Northerner, it is very reassuring to hear that you both have encountered very similar problems.

Novorapid lasts at least 5 hours for me and takes between 45 mins and an hour to start working, depending on time of day (quicker as the day progresses) And to think that I always used to inject just before eating!

I only ever take my Novorapid just before I eat or sometimes during courses or after the meal. Looks like I should start taking my bolus a bit earlier to help avoid spikes!

Anyway, I did the basal test last night, which was interesting:

19:00 - 4.1 (took 5g of carbs to raise my levels slightly)
20:30 - Carb free meal of salmon and salad (no dressing although there were some cherry tomatoes in there)
22:45 - 10.6 (and took my usual daily 6u of basal, no bolus correction)
01:45 - 10.6
02:45 - 11.2
05:45 - 9.4
07:30 - 11.9

So I think that suggests my Levemir during the night is about right and that there is defintiley a bit dawn pheneomon (I know that if I hadn’t eaten and had a bolus that my levels would have continued to rise from 11.9).

Re the evening, I couldn't understand why my levels had jumped up from 4.1 to 10.6 – I can only put it down to the cherry tomatoes or possibly the Levemir running out…

 

[Northerner]

...Re the evening, I couldn't understand why my levels had jumped up from 4.1 to 10.6 ? I can only put it down to the cherry tomatoes or possibly the Levemir running out?

I would say that is more than likely. It only lasts about 12 hours in some people, plus small doses don't seem to last as long as larger ones.

 

[trophywench]

I was about to suggest having your Levemir after your evening meal. I used to have my evening jab of it about 9.30 or 10pm ish, 4u - with 14u when I got up.

Cos there is no way Pedro that 6u Levemir injected at bedtime will last you till bedtime tomorrow - unless you weigh the same as eg a 3 year old LOL

 

[DeusXM]

Re the evening, I couldn't understand why my levels had jumped up from 4.1 to 10.6 ? I can only put it down to the cherry tomatoes or possibly the Levemir running out?

Protein will also raise your blood sugar as well. I find if I have a protein shake for breakfast (with 10g of carbs in it), I have to bolus as if I've eaten 45g of carbs to stay level.

 

[trophywench]

Not always Deus, it doesn't require insulin in my case.

I have been observing this possibility for 41 years now and have never discerned that it happens, though of course it could sometime in the future LOL

Furthermore, I haven't found that it affects this or that type of person - like I wondered at one time if it was only extra-low-carbers (I mean less than c.80g daily) who got this - since I don't low carb, just have what I always have had, around 100 to 120g a day. So, No it isn't, by what I've observed.

 

[PattiEvans]

19:00 - 4.1 (took 5g of carbs to raise my levels slightly)
20:30 - Carb free meal of salmon and salad (no dressing although there were some cherry tomatoes in there)
22:45 - 10.6 (and took my usual daily 6u of basal, no bolus correction)
01:45 - 10.6

I know Trophywench gets away with it but I deffo don't. Any protein and fat will raise my BG in the absence of carbs.

 

[Jamieizz]

I was about to suggest having your Levemir after your evening meal. I used to have my evening jab of it about 9.30 or 10pm ish, 4u - with 14u when I got up.

Cos there is no way Pedro that 6u Levemir injected at bedtime will last you till bedtime tomorrow - unless you weigh the same as e.g. a 3 year old LOL

Haha, there isn't that much of me these days actually, but I think you're right - I'll have a go at splitting the Levemir to 8pm and 8am and see how it goes.

Re the impact of protein and fat on sugar levels, I?m even more confused now! Looks like fasting is the only way to truly see how your basal is working.