Hyper advise please

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I would echo what @rebrascors has said about pre bolusing.
I only learnt about that from others on here. I was amazed at the positive impact it had on my levels, and really helped me to reduce the size of the spikes. It did take a bit of trial and improvement to work out how long a delay to do At each mealtime. Let us know how you get on.
 
Hi Trev. How are you this morning. Hope I was wrong and you didn't hypo last night or you managed to head it off if my calculations were about right..... there were a lot of guesses and assumptions involved. 🙄
 
@CoventryTrev yes I hope your okay today.

Can’t really add to what you have already been told.

I only noticed the impact or pre injecting once I was on the libre.

And with corrective does I was told smaller amounts so for me 2 units and wait 2 hours, if not levelling after that then take more.
Hope your okay
 
Hello @CoventryTrev,
I also can't add much to what has already been said, but particularly endorse Barbara's comments about prebolusing. It is as much an art as it is a science! I use my Libre trend arrows along with the Libre numerical reading (which I habitually have to mentally adjust to reconcile the consistent differential between sensor and actual BG) to determine exactly when the first mouthful of food is taken. I make my best guess at how much pre- bosul time, then always wait to be bow 8, preferably 7, before actually eating. It is a real pain in the .... sometimes and my wife is understandably irritated by my saying, just as the meal reaches its optimum cooking or ready for the table moment - I can't eat yet! With time, we've both found strategies for managing that.

I don't take smaller correction doses and wait 2 hrs to then further correct. I'm not saying that is wrong, but I was told to stay very alert to how much insulin is already on board and be wary of subsequently stacking insulin, to then become hypo. So I take my full calculated correction dose, wait more than 4 hrs, then further correct. The profile for NovoRapid is approximate, it could still have some residual effect after 4 hrs; that varies from individual to individual.

Another consideration is what might the glycaemic effect be for you (we all respond differently) for the food that you have eaten and that your body is digesting. If, for example, your last meal was a high fat cheesy pizza, then its digestion may not be underway for +2hrs, even +4hrs. So any correction may be starting but the glucose from eating may not yet be in your blood; thus you can get a false perspective of the overall picture.

But my biggest overall observation for you is that control is impossible, but good D management is achievable - with time and experience. Perfection is impossible; there are too many other factors affecting your BG that unexpectedly come along and surprise you, but (again with time) can be dealt with as they occur - providing acceptable D management.

I'm sorry I haven't been along earlier. We've just marketed and successfully agreed a sale of our house as well as its successor and we've been extraordinarily busy with all of that. Of course we're now subject to whatever the economy will be throwing our way in the next weeks and months - but this is out of our control. We're in the relative lull, after agreeing prices and starting to plan packing and actual moving; everyone in both chains want this done by Xmas but whether the solicitors will play ball is another matter - even if various mortgage offers remain in place!
 
Hi everyone.
Thanks for your help last night.
I kept my phone next to me all night and the Libre alarm didn't go off. I woke just before 7am and I tested straight away and was sitting on 9.2.
Postman has just delivered the Carb and Calorie counter book and I'm hoping this is going to help with carb counting. I looked at the app and not keen on paying £35 for the full version.
 
That's a good outcome @CoventryTrev - I didn't want to butt in last night, you were in good hands with @rebrascora. 🙂 Glad to hear your book has arrived today. Roll on your carb counting appointment. Have you had a look at www.bertieonline.org.uk to get you started? (I'm sure someone'll have mentioned it already).

£35?!!! They must think diabetic people are loaded! 😱
 
Bloden said:
That's a good outcome @CoventryTrev - I didn't want to butt in last night, you were in good hands with @rebrascora. 🙂 Glad to hear your book has arrived today. Roll on your carb counting appointment. Have you had a look at www.bertieonline.org.uk to get you started? (I'm sure someone'll have mentioned it already).

£35?!!! They must think diabetic people are loaded! 😱
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Thank you. Everyone I've spoken to on here have been great! It certainly helps as I don't know anyone with diabetes away from this forum.
I did the first module on Bertie a couple of days ago. I haven't done the 2nd one yet as it's about carbs and they confuse me at the moment.
I received a letter from the hospital today to advise me my first appointment with the diabetes team will now be a phone call. I called them to say a phone appointment is not suitable for a new diabetes patient and I insist on a face to face. I'm waiting for a call back.
I don't understand how a phone appointment is going to beneficial to me.
 
So pleased you are OK and I was worrying needlessly. You clearly managed the situation really well last night, so give yourself a gold star!.
As regards carb counting, the first and by far easiest way is to check the box or packet if you are eating something preprepared, like last night. Learning how to locate and interpret that data in the nutritional info box is the first step, so do start looking at the carb content on the packaging.
 
rebrascora said:
So pleased you are OK and I was worrying needlessly. You clearly managed the situation really well last night, so give yourself a gold star!.
As regards carb counting, the first and by far easiest way is to check the box or packet if you are eating something preprepared, like last night. Learning how to locate and interpret that data in the nutritional info box is the first step, so do start looking at the carb content on the packaging.
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Thank you so much for last night. You have a heart of gold and deserve a gold star!
 
Totally agree that you need a face to face appointment. Hope that doesn't mean there is a further delay.
 
CoventryTrev said:
Thank you. Everyone I've spoken to on here have been great! It certainly helps as I don't know anyone with diabetes away from this forum.
I did the first module on Bertie a couple of days ago. I haven't done the 2nd one yet as it's about carbs and they confuse me at the moment.
I received a letter from the hospital today to advise me my first appointment with the diabetes team will now be a phone call. I called them to say a phone appointment is not suitable for a new diabetes patient and I insist on a face to face. I'm waiting for a call back.
I don't understand how a phone appointment is going to beneficial to me.
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Good idea taking it easy on the learning front, baby steps worked for me.

I wouldn't be happy with a phone appointment either...good for you for inisisting.
 
Glad you managed to make it through those tricky BGs @CoventryTrev

It can be so tempting to ‘rage bolus’ when levels are rising and the insulin you’ve injected seems to be about as effective as water - but it’s important to remember (especially in the evenings) that insulin acts over 4-5 hours, and that corrections can take up to an hour to get going. So while it worked out reasonably this time, sloshing in big corrections once levels are already skyrocketing can cause a later plummet and the gluco-coaster is no fun at all.

If you are sticking with your fixed doses until your appointment, I suggest you cap the carb intake of your evening meals to 50g total carbs - try that for a few days and see how it goes. You may end up with 40g, 60g or something else entirely, but if your meal doses are fixed it makes sense to have a fixed carb count to work to.
 
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