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Lilmissemz

Lilmissemz

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Relationship to Diabetes
Type 2
Hello, hello!

I am not officially a newbie but not posting for nearly 10 years probably officially qualifies me as one. So hello (again)!

It had been a pretty uneventful 9 years really until May this year. I got covid, had pericarditis, had a heart attack and DKA. My DKA levels were 5.2% All the medical staff said they had never seen them that high. I was in hospital for 17 days.

As a result, I am now on insulin - and for the girl who hates needles that's some feat. Although it is a bit easier than getting blood/cannulas done. I'm on Apidra & Toujeo and have a libra 2 now, which I both love and hate, in equal frustration.

My GP is rubbish, my diabetes team have not seen me (yet), except to show me how to stab myself. They are not seeing me until the end of September! I know I am not a new diabetic, but having insulin is a brand-new regime, which I am still not used to. But hey ho, I'm here now. I have my up-and-down days like I am sure everyone here does. Some days it's a doddle and some days I just can't get my finger to bleed .

So hi everyone. It's good to know that I don't have to do this alone!
 
Welcome back @Lilmissemz 🙂

Glad you have reconnected with us!

We have lots of folks with various different flavours of diabetes who are using different sorts of insulins to help them manage their diabetes - so there are lots of folks to compare notes (and frustrations!) with.

So fire away with any questions - or simply offload and vent. We understand!
 
Thanks Mike, it's great to have the support. I will definitely be adding some questions to the boards. 🙂
 
Thats what we're here for! Welcome back
 
Hi and welcome back from me too, although very sorry that you have been through the mill with Covid and all the worrying issues that came with it and now needing insulin. So pleased that you remembered the forum though and realised that you would benefit from it's support again.

Great to hear that you have Libre but one of the most important things to understand about it is it's limitations and quirks.
So for instance, if you lie on the arm with the Libre on, your bodyweight will compress the tissue under the sensor where the filament is sampling. This can cause what we refer to as "compression lows" so if your Libre alarm goes off during the night and you don't feel obviously hypo, it is important to check with a finger prick before you take a hypo treatment, because otherwise you could well be putting glucose into your body when it is already got enough and end up too high.
It is also really important that when you genuinely are hypo, you check 15 mins after taking your chosen hypo treatment with another finger prick. Libre works by sampling interstitial fluid which is about 15 mins behind blood glucose. It has an algorithm build into the system to try to make up this time lag by extrapolating previous readings to try to predict what your blood glucose is now, from the previous interstitial glucose readings. This works well when your levels are stable or changing uniformly... either going up or coming down, but as you get near the turning point the Libre often overshoots and will take as much as 30 mins to get back on track, so 15 mins after a hypo treatment, Libre usually still shows your levels as dropping further into hypoland when a fingerprick will almost certainly show you are recovering. It is easy to see the Libre showing your levels continuing to drop and panic and eat more and more glucose and then end up far too high.
It also helps to apply your new Libre sensor a day before you actually need it but don't activate it until the old one expires. This is because your body can react to a foreign body being fired into it, even though the needle and filament is sterile. Some people have more of a reaction than others and I am not talking about swelling or bleeding but just a change in blood chemistry at the site, so giving it a day to settle down before you start taking readings from it usually means that it gives more reliable data from the 60 min warm up period.

I think that is all the main issues to know about and will hopefully improve your Libre experience. I use an elastic arm band which has a 3D printed platric watcface which fits over the Libre to give it added protection from getting caught on things like sports bra straps and door ways and vigorous scrubbing in the shower when I forget which arm it is on because of course you can't see it if you aren't wearing a strap. If I wear it for the first 3-4 days it seems to help the adhesive get a really good hold on my skin and after that I tend to just put the strap on when I get in the shower or I am going to be working with itchy sweaty horses that are likely to rub bridled faces up and down my arm/shoulder vigorously. 🙄

How are you managing with the basal bolus insulin system? Presumably you are on fixed doses of Apidra at the moment rather than carb counting and adjusting yourself? How are your levels doing? I don't personally have experience of either of those insulins, but I would hope that they have started you off on very conservative doses to bring your levels down gently, so hopefully you haven't experienced a proper hypo yet.

Anyway, please ask anything at all that is bothering you. I can remember half of what I was told by the nurse when I was started on insulin went in one ear and out the other because it is such a shock and so much to take in, but the people here were great for filling in the blacks and giving me MUCH MUCH more support and information besides, so I do hope we are able to help you find your feet and gain confidence too.
 
Hi Barbara,

Thank you so much for taking the time to write. All of that information was helpful, especially about the Libre. I knew some but not all and I had figured out about compression lows but I wish I had you to tell me that when I first put one on!! 😉 As you say I have only really experienced one real hypo but that was at cardiac rehab, so they were on hand to feed me fast-acting glucose and then digestives to maintain. I find that after I have eaten, there seems to be a delay in the rising of levels as you suggest so I will keep an eye on those.

One of my friends is actually a diabetes specialist nurse on the team I will be seeing, so she has been having a look at my BM recordings each week, at least until I see the team, which thankfully is just over 2 weeks away now. She suggested that if I wanted to have a little play with my bolus levels I could do, which I have done safely. But this is total guess work, which is really annoying as I'm one of those people who needs to understand everything. :rofl:

I have increased my basal insulin with my friends support, just 2 units at a time. It has seemed to have a good effect at the level I'm at now. I had bloods done a couple of weeks back and my HBA1c has gone down from 95 to 53, so I am super happy with that! It shows that my diet change has fundamentally paid off.

Hoping I can keep up with everything and have more answers from the diabetes team in a couple of weeks 🙂
 
Adjusting insulins is as much an art as a science, but sounds like you are making some great progress, well done!
 
Sounds like you are doing really well.

I think it is important for you to understand from the start that diabetes doesn't play by the rules and x+y rarely equals z or perhaps more correctly that z is variable even when x and y are constants, so don't expect it to make sense all the time. Managing diabetes with insulin and adjusting doses is a bit of a dark art rather than exact science. Part calculation, part intuition, part sheer luck! Chasing perfect numbers/results is where madness lies, so try not to have too high an expectation for that. You have to learn to accept that some days it will all play so nicely and other days you do exactly the same things and it goes horribly wrong or infuriatingly not quite right. It helps to blame the Diabetes Fairy on those days or possibly the colour of your socks or the phase of the moon. Mostly it is the DF though. She is an evil little minx.... not a nice sort of fairy at all!

Anyway, well done on a brilliant HbA1c reduction and also for experimenting with some dose adjustments as taking over management of your own diabetes and becoming the "expert" is key to managing it well and the best way to learn is to tweak it here and there and see what happens.... always keeping one eye on keeping yourself safe of course.

Great that you have a friend who is a DSN at your clinic for support out of hours so to speak too.
 
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