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I’m a newbie with Type 1

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
rebrascora said:
Do you double check these hypos during the early hours with a finger prick? The reason I ask is that Libre are prone to what we call "Compression Lows" where if you lie on the sensor for any significant length of time, the chemistry of the interstitial; fluid changes due to the pressure applied and that causes the sensor to give a false low reading. You can sometimes tell a compression low because there will be a sudden dip whereas a genuine nocturnal hypo will usually be more of a slow steady descent on the graph. Always important to double check any lows or very high levels before making a decision about treating them unless you are very obviously hypo.
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Thank you for this, Libre can throw you off at times! Yes I finger prick for all highs and lows, I just don’t understand why I’m still dropping through the night! My long acting is at such a minimum (being a newbie), it’s been suggested that it might need shifting to the morning.
 
I don't bother pre-bolusing when eating out. The occasional spike is not going to kill me and the impact of a hypo when the food takes longer than expected is greater. Plus, I don't know how big the portion is until I see it and I am not going to wait 15 minutes as my food gets cold while the rest of my table are tucking in.
Far safer and sociable to bolus when I see the food and eat straight away.
 
T Howell said:
Thank you for this, Libre can throw you off at times! Yes I finger prick for all highs and lows, I just don’t understand why I’m still dropping through the night! My long acting is at such a minimum (being a newbie), it’s been suggested that it might need shifting to the morning.
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Do you have a half unit pen?
They are invaluable, especially when you are on small doses.
 
I still inject as we order when eating out and if the food is a bit late coming I will eat a jelly baby if necessary if I am getting a bit low or a gulp from my partners juice or a small piece of bread if there is bread on the table. I am likely to need a correction later anyway, but I like my levels to be in the 5s when my meal arrives and if I need to engineer that with the odd 5-10g carbs before it arrives, I will do so. Having Libre enables me to do this. I couldn't really do it easily with only finger pricks.
 
T Howell said:
I agree! We went for a coffee and toasted sandwich when out Christmas shopping. I asked how long for the food to know when to bolus. 20 minutes so I waited 5 and jabbed. After 40 mins I asked how much longer as I’m diabetic! They went into panic and gave a slice of cake.. and the sandwich was still another 30 minutes! Lesson learned to wait for the food before bolus!
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Last night had girls night in, Chinese and few drinks. Took an hour and 20 minutes to be delivered, had a digestive to keep me going. No sooner had I ate it when Chinese arrived, wii bit high for a while
 
helli said:
I don't bother pre-bolusing when eating out. The occasional spike is not going to kill me and the impact of a hypo when the food takes longer than expected is greater. Plus, I don't know how big the portion is until I see it and I am not going to wait 15 minutes as my food gets cold while the rest of my table are tucking in.
Far safer and sociable to bolus when I see the food and eat straight away.
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I totally agree! I did a pre bolus for mother in laws birthday meal at The Ivy, when it arrived the portions were nothing like I imagined! So I just had to have a dessert 🙂
 
helli said:
Do you have a half unit pen?
They are invaluable, especially when you are on small doses.
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No unfortunately not, whole units with semglee :(
I guess hospital could suggest a half unit basal?
 
T Howell said:
Thank you for this, Libre can throw you off at times! Yes I finger prick for all highs and lows, I just don’t understand why I’m still dropping through the night! My long acting is at such a minimum (being a newbie), it’s been suggested that it might need shifting to the morning.
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Semglee is insulin Glargine isn't it, which I believe has a peak of activity about 5 hours after injecting it, so injecting first thing in the morning might be better if you are getting genuine nocturnal hypos with taking it at night.
My overnight basal needs are very susceptible to exercise, so if I have done a lot of exercise or physical activity that day, I have to reduce my evening basal dose, which is already small, sometimes down to zero, as my muscles seem to suck the glucose out of my blood stream whilst I sleep to replenish their stores.
 
rebrascora said:
which I believe has a peak of activity about 5 hours after injecting it
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Bear in mind this is not a sharp peak and is not experienced by everyone.
The risk of injecting in the morning is that many people find it does not last a full 24 hours. Therefore, it maybe running out at the same time as Dawn Phenomenon hits resulting in a spike when you get up.
I used to take my Lantus (the “original” Glargine of which semglee is a “biosimilar”) with my evening meal rather than just before I went to bed. As I usually go to bed 4 or 5 hours after eating, the activity spike was mostly over by the time I went to sleep and I could cover the basal gap with bolus.

The other option for @T Howell is a more modern basal such as Levemir or Tresiba which are flatter and available in reusable half unit pens. But they are more expensive.
 
I very much doubt anyone will be transferred to Levemir now that it's discontinuance has been slated for 2026 in the UK.
 
T Howell said:
No unfortunately not, whole units with semglee :(
I guess hospital could suggest a half unit basal?
Click to expand...
Well worth having half unit pens for bolus as well in the early stages, as your needs will be lower, because your body is likely to still be producing some of its own insulin for a while. For your overnight it would be worth considering an alternative insulin which allows half unit pens as it sounds like you have already eliminated the possibility of compression lows, so being able to reduce basal by half units would help you in making adjustments.
 
T Howell said:
it’s been suggested that it might need shifting to the morning.
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When I was on Lantus (another ‘glargine’ like Semglee) I also had overnight lows until I switched it to taking it at breakfast. This meant that the 24 hrs dose was fading overnight (when I generally need rather less) rather than it ramping up to full strength. Basal at breakfast time helped reduce overnight lows significantly, while keeping daytimes in check.

Since having been on an insulin pump, and more recently a Hybrid Closed Loop I’ve been able to see that additionally I need very little basal at all overnight on about 10% of nights, with no real pattern (thanks diabetes!). In some ways it was a bit reassuring to discover that it was just my diabetes being annoying, rather than me ‘doing it wrong’.
 
And I split my basal (abasaglar) as I was going low overnight - same dose in a 50-50% split means a smaller peak in the early hours. That's my working theory anyway.
 
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