hypo aggressive behaviour

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Pumper_Sue said:
As you seem to be prone to night time hypos have you thought about Levemir as a basal insulin? This can be split into 2 doses which would allow you to reduce your evening dose and hopefully cut down your lows.
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I do split my Tresiba. I heard Dr Bernstein say that Tresiba was a basal insulin that suited this well.
 
bujanin said:
I do split my Tresiba. I heard Dr Bernstein say that Tresiba was a basal insulin that suited this well.
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I would be interested to hear or read that, in context. Do you have a link to Dr Bernstein saying that or a reference to a credible written article by Dr Bernstein?

In principle, with a typical 40 hr profile for Tresiba it is hard to justify splitting Tresiba into nominal 2 x 12 hr doses. It also sits in contradiction of why that particular profile was developed, to reduce the number of total daily injections. It is also marketed as an insulin that is particularly useful for frequent long distance flyers, because of that longevity allowing them to more comfortably manage straddling time zones.
 
Proud to be erratic said:
I would be interested to hear or read that, in context. Do you have a link to Dr Bernstein saying that or a reference to a credible written article by Dr Bernstein?
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I just had a quick flick through Google and found plenty of references to the fact he said it, but couldn’t find anything that explained why he said it. One of the quotes from a Bernstein fan actually said 'but he’s never really explained why…' The only credible argument I came across was that perhaps if you take a very large dose of basal, splitting it into two smaller ones aids absorption. I certainly haven’t come across any other reason for splitting something that’s meant to last more than 2 days in the first place.
 
Pumper_Sue said:
Is Birdbrain still alive?
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Very much so. And that I think was one of the chief appeals to me, that he has been T1 for so many years and seems to be doing so well at an advanced age. Over the past three years I went down a rabbit hole and consumed his monthly (now quarterly) teleseminars soaking up information.
I was using Lantus and heard repeatedly from Dr B that there are possible concerns with it being carcinogenic after European studies. I switched to Tresiba.

It also left a huge impression on me that he believes 4.3 to be the sugar levels of a healthy non-diabetic. And that the further away from this that we get there is an increased likelihood of any of a range of problems. It seems to be so logical and consequently I set off down that path.

I don't consider myself gullible and really chewed over what information he puts out, I mean he seems to be respected by plenty of people and seems to offer so much of what could be filed under common sense.
 
bujanin said:
Very much so. And that I think was one of the chief appeals to me, that he has been T1 for so many years and seems to be doing so well at an advanced age. Over the past three years I went down a rabbit hole and consumed his monthly (now quarterly) teleseminars soaking up information.
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Erm what he doesn't tell you is he is completely hypo unaware and has been for many years.
 
It also left a huge impression on me that he believes 4.3 to be the sugar levels of a healthy non-diabetic.

And that’s the problem @bujanin It’s also the problem for another Type 1 I know who follows Dr B. That person has zero hypo awareness. They’ve had hideous hypos - really awful ones. They’ve improved their targets recently but they still over-correct and have their High alert set at a madly low number.

I refer you back to my previous post about a happy medium. I’d also add that someone can be right about some things (eg Dr B sticks to regular carb amounts for meals, which can be helpful) but wrong about the details - that is, sticking to regular carb amounts can make things easier but those carb amounts don’t have to be as low as 6g or 12g. Same with the trying to stay in a non-diabetic. Yes, that’s sensible most of the time but aiming for 4.3 isn’t.

Try it. Raise your targets a bit and see how much easier things are while also maintaining good control.

@Pumper_Sue is right. Dr B is severely hypo unaware. He’d frequently pass out at work. He also had severe nighttime hypos. Not to be recommended - as you’ve sadly discovered for yourself.

You can change all this though 🙂
 
My daughter's pump tries to keep her at 6.2, which is a perfectly healthy number right in the middle of the range, maybe try that for a while and see if you feel better? Finding the right balance can be hard, when my daughter was first diagnosed I tried to keep her with perfect numbers all the time and would get very frustrated when she got a high one for no obvious reason. But it's not possible to keep it perfect all the time, anyone who claims you can is being a bit economical with the truth. It took me quite a while to learn to relax a bit and accept that some days will be less than perfect, as long as you are not ignoring the situation and are making an effort to keep things reasonably well controlled (I.e. not sitting at either extreme for hours at a time) then you're doing ok. I always remember our DSN saying “there's no point spending the whole time trying to get perfect numbers if that's all you do, you have to enjoy life too”. That helped me a lot!
 
Pumper_Sue said:
Erm what he doesn't tell you is he is completely hypo unaware and has been for many years.
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So how does this information get into the public sphere, is he a friend of yours?
 
Inka said:
Try it. Raise your targets a bit and see how much easier things are while also maintaining good control.


You can change all this though 🙂
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I have raised my low alert from 4.whatever it was to 5.5. It's going to need a recalibration of the mind too but I am here to be helped and to learn so this is where I begin and I am grateful.
 
bujanin said:
So how does this information get into the public sphere, is he a friend of yours?
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Oh it was on the web, I saw it years ago. Personally I wouldn't give the bloke house room but everyone is entitled to their own views 🙂
What you are doing with your basal is more than likely causing most of your problems. So you need to ask for expert advice and even do the basics of reading the patient leaflet which comes with your insulin.
 
Pumper_Sue said:
Having an A1c of 5.7 does not make complications less likely. The ideal is 6.5.
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I suspect (but don't know) that an HbA1c lower than 6.5% (48) would be better than 48, other things being equal. As far as I remember 48 was chosen as a compromise: it's pretty good and setting it lower would encourage people to be low too much (which itself has significant risks). I can believe for someone on a hybrid closed loop which is working well for them, maybe aiming for a lower HbA1c would be beneficial. But probably not significantly beneficial: the improvement isn't linear in HbA1c so reducing from 70 to 60 has much more of an effect than 60 to 50 which has much more of an effect than 50 to 40 (as best they can tell).
 
Elsewhere in this thread someone has questioned whether brittle diabetes is real. As someone without any pancreas I have been described by my Consultant as having brittle diabetes because my BG can swing so rapidly. When I am falling, not in steady state, approaching 4.5 (whether on CGM or from FP), I am already too late to intercept anything but a major hypo. I simply cannot exist at 4.5, never mind 4.3, without a major risk of suddenly plummeting to hypo.

I usually have my alert in the mid 5s and I do sometimes lower that a bit. If my BG naturally with a horizontal trend gently and slowly creeps down into the 4s I won't necessarily always crash into hypo. But the likelihood is great that I will - other than having modest snacks to prevent that. The combination of actively monitoring and thinking through my snack regime makes managing my BG extremely intrusive into my daily lifestyle.

So any suggestion that for me 4.3 is a sensible place to be is coming from someone with no understanding that one size does not fit all. If Dr B is truly saying that (as opposed to others repeating that out of context or just wrongly) then Dr B can have no credibility in my eyes. My Consultant has consistently encouraged me to raise my level to high 6s into 7s if I want to stay safe and bypo free.
 
bujanin said:
I have raised my low alert from 4.whatever it was to 5.5. It's going to need a recalibration of the mind too but I am here to be helped and to learn so this is where I begin and I am grateful.
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Yes . yes yes. Start and aim to get better. Don't do as i do do as i say Once you improve you will look back and say that was the day i set my goal look where i have come.
 
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I tried low carb, and just ended up with rubbish carb/ insulin ratios as i became insulin resistant (1 to 3)
I went to higher carb. My rations is now back to 1 to 20 and i can enjoy bread, biscuits etc and eat less fat, and also I am no longer verging on underweight. My control is just as good as when i was low carb
Mr b ways may work for some, but not me.
Btw some people are just hypo unaware. I always have been. I alert at 5 and have less 1% below 3.9. Hypo unawareness isn't always someone's false
 
bujanin said:
I have raised my low alert from 4.whatever it was to 5.5. It's going to need a recalibration of the mind too but I am here to be helped and to learn so this is where I begin and I am grateful.
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You'll get there. Well done for taking the first step!
 
Pumper_Sue said:
Personally I wouldn't give the bloke house room
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Me neither.
When I read that he thinks all women should go on the pill because our monthly hormones affect our BG too much, I realised he was completely out of touch with half the population. By extension, I assume he thinks women should not get pregnant. Maybe that would wipe out any inherited Type 1.
 
helli said:
Me neither.
When I read that he thinks all women should go on the pill because our monthly hormones affect our BG too much, I realised he was completely out of touch with half the population. By extension, I assume he thinks women should not get pregnant. Maybe that would wipe out any inherited Type 1.
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Does he think the same on HRT ?
 
Pumper_Sue said:
No idea but he was very anti insulin pumps, not sure if he still is.
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Even if you do not like something , is pumps etc not an individual thing you either like or don’t ? A bit like woman . Sound Stereotypical like all men have no understanding of woman which as you know is very Stereotypical.
I will take folks advice and not read about him sounds like me n him would not get on
 
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