Insulin

[Proud to be erratic]

Sorry to hear you are having difficulty with night time lows. I would suggest that Toujeo might not be an ideal basal insulin for you if that is happening. Do you have Freestyle Libre to monitor your levels. If not do push to get it because the guidelines have now changed and all Type 1s should be able to get it on prescription but particularly in your circumstances. You would need to get a consultant to prescribe it so if you are not currently under a consultant, then push for a referral.

I'm interested, @rebrascora, to know why you think Toujeo might not be ideal for @Lih?

Given the brain injury that affects short term memory, a single daily dose of a basal optimised for night-time cover, seems a good option; allowing day time bosul to cover both food and any corrections as necessary - rather than trying to juggle and fine tune on a quicker 2x daily basal. I've read a couple of articles recently that emphasise the need for a good night's sleep (which all too frequently eludes me). Which means trying to avoid nocturnal interruptions, if at all possible. Then establish a night routine nearer to mid range, rather than too close to the low end and this could be particularly good once @Lih has Libre 2, with its alarms.

 

[everydayupsanddowns]

Hope you get on well with the Libre @Lih

Have you ever come across those replacement insulin pen caps like Timesulin or Insulcheck? I’m not sure of one is available to fit Toujeo pens, but the idea is that these act as a reminder to the last time you took a dose from that pen.

I wonder if something like that might be useful to you?

 

[rebrascora]

I'm interested, @rebrascora, to know why you think Toujeo might not be ideal for @Lih?

Given the brain injury that affects short term memory, a single daily dose of a basal optimised for night-time cover, seems a good option; allowing day time bosul to cover both food and any corrections as necessary - rather than trying to juggle and fine tune on a quicker 2x daily basal. I've read a couple of articles recently that emphasise the need for a good night's sleep (which all too frequently eludes me). Which means trying to avoid nocturnal interruptions, if at all possible. Then establish a night routine nearer to mid range, rather than too close to the low end and this could be particularly good once @Lih has Libre 2, with its alarms.

I take your point Roland. I was just thinking that if she was having nocturnal hypos then a split dose Levemir would enable adjustment to lower the night time dose and reduce the risk, but lowering the Toujeo dose would do the same thing and then making up any shortfall during the day with QA insulin is a reasonable strategy.
Just out of interest Roland, because I know you have done rather a lot of research on diabetes and using insulin, have you seen the webinar presentation on "Sugar Surfing" by Dr Stephen Ponder or read his book? Would be interested on your thoughts if you have.

 

[Proud to be erratic]

I take your point Roland. I was just thinking that if she was having nocturnal hypos then a split dose Levemir would enable adjustment to lower the night time dose and reduce the risk, but lowering the Toujeo dose would do the same thing and then making up any shortfall during the day with QA insulin is a reasonable strategy.
Just out of interest Roland, because I know you have done rather a lot of research on diabetes and using insulin, have you seen the webinar presentation on "Sugar Surfing" by Dr Stephen Ponder or read his book? Would be interested on your thoughts if you have.

I have the book, not read much yet. I'll PM you and take this topic away from this thread.