I'm just inconsistent

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Plastirion

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Relationship to Diabetes
Type 1.5 LADA
Hi
Although I have been trying to get my head round carb counting since being diagnosed Jan last year my insulin requirements vary so much and wondered if other people have similar problems and is it all part of getting to know oneself.

In the morning I only need 1 unit of Novarapid in spite of having a glass of orange and 2 Weetabix covered with skimmed milk. Lunch is usually a sandwich and fruit and 1 unit or 2 depending on how active I'm going to be. And then the evening comes and all goes haywire. No matter how accurate I try to be with my carb counting I seem to either hypo or find I have a reading of 10 point something when I go to bed. I can have a similar meal two nights on the run and get different readings. Can I do anything about this? For my Lantus at night I take 16 units. Novarapid at tea time is usually 6-8. Would appreciate any advice, dietician hasn't been much help

Joan
 
Hi Joan, when you are on such low doses it can be very difficult to get the amounts right. Do you have a pen that does half units? This might help with more accurate dosing (ask for a novopen demi if you don't have one). As a Type 1.5 it's possible that your pancreas is spluttering out some insulin erratically which is also going to mess up your calculations. I know that others on very low doses of fast acting or who are in their honeymoon period can have a lot of problems avoiding highs and hypos. I would say though that your highs of 10 before bed aren't excessively so - this, along with the need for a greater proportion of NR in the evening may be due to your lantus not lasting the full 24 hours - in some people it only lasts for around 18 hours. You might want to talk to your nurse about splitting the does to get better coverage throughout the day and night.

I hope things settle down for you, it must be very frustrating - just keep trying to do your best 🙂

p.s. I'll move this to the General Message board where it may be seen by more people 🙂
 
Thanks for that. Did question whether the Lantus was lasting 24 hrs and was assured that it would be but I'm questioning it again. Certainly wonder if a 1.5 NR would be useful. Had a drink with a friend tonight for the first time in ages and wondered how that would affect me but its 9.4 so that will do - well done me!!
Hope your hypos have settled down. By the way think you do a grand job
Joan
 
Plastirion said:
Thanks for that. Did question whether the Lantus was lasting 24 hrs and was assured that it would be but I'm questioning it again. Certainly wonder if a 1.5 NR would be useful. Had a drink with a friend tonight for the first time in ages and wondered how that would affect me but its 9.4 so that will do - well done me!!
Hope your hypos have settled down. By the way think you do a grand job
Joan
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Glad to hear you were able to enjoy the drink Joan - without dire consequences! 🙂 I'm surprised your nurse has confidence that lanus will last 24 hours for you, it's well known that it varies between people - as with anything where diabetes is concerned! Thanks for your kind words 🙂 Far fewer hypos now that I am getting to grips with the insulin doses I require after getting a bit fitter!
 
Hi Joan,

Sorry you're finding it tricky, you'll get there I'm sure.

I would definately get a half unit pen IMMEDIATELY it will help you if you're on low doses.

Perhaps you could spend a week noting down your levels what you eat and what insulin you take onboard. Then you might be able to work out some ratios carbs to insulin. I basically work out the carbs and then depending on activities etc I may inject 1 for 1 or I may half it, or half it and round it up or down, with me it's not a precise science yet!

A lot of people find they need less in the morning (I think) and I think I do as well but am not too successful in the morning myself yet! Some days when I am very active I would say inject 1 unit and test later and correct, as I would rather be 8,9,10 than shakey stevens at 3!

Hope you sort out the yo-yoing soon

Rossi 🙂
 
Not sure what to suggest, since as Northener says, your pancreas may well still be occasionally splurging a bit of insulin (thanks for that - a little consistency please!).

If you wanted to observe how your Lantus is lasting during the evening you could always miss an evening meal (and not inject any insulin for it) and drink only water. Choose a day when you are not unusually active, make sure it's more than 4 hours after your last NovoRapid and test your BGs every hour or so until bedtime. If your Lantus is doing its job properly your levels should stay within a mmol or two during the evening. If they rise significantly then suggests your Lantus might be running out. Repeat the test a few times if you want to be completely sure (and can cope with missing out on your evening meal again!).
 
Thanks everyone for your advice its given me some ideas and I'm pleased that its not only me who finds this is certainly not an exact science just trial and error.
Joan
 
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