It's been a while!

[lizabetic]

Hello everyone,

I don't remember the last time I posted on here. I have been M.I.A. Though you can find me on twitter (same name) I seem to post a lot there hah 🙂

Been pretty up and down recently! Am just about to start my final year exams at uni and am properly trying to get a hold on the levels!

My hba1c rose to 8% and i think this is because I got really slack at meal time numbers. Also my doses have gone up which I think it cause my weight has ever since i started insulin (and i wasnt sick when i started it). I think i got a bit carb-happy and now everywhere does GF pizza that obviously just added to it!! But I've tried to cut down, not too much bread and eating low carb/GI foods 🙂

I have been on novorapid only the past year but I've always struggled with Dawn phenomenon which is a pain in the backside... so as a result of this and the hba1c the various endos I keep seeing have pushed for me too take basal. Ooooook. Basal is going to do nothing for DP anyway as it won't respond to it. I've had varying results from it so far... Taking 4 - 6u a few week stints. It seems I can go to bed on a good level 5-7 and still wake up 8/9 BUT also wake up middle of the night feeling very odd and floaty - probably low but not conscious enough to check? Wake up feeling like c**p too! If I go to bed higher then I still wake up 8/9 but rise once I'm up to 12! So that's the first issue I've come across. Secondly it makes my day time levels so much harder I seemed to get stuck at 13s or 12s after giving appropriate insulin with food (aim for 1u:10g) and the units I am taking should be lower as a result of the basal but they are just not. When I don't take basal okay I need 6u novo depending what I eat but it works and I can run okay levels! Basal is just causing so many issues! I'd be willing to up it if it wasn't for the fact I obviously go low running good levels.

I'm sort of wondering if I do still have my own basal (thinking I definitely do) then if injected basal is being resisted from working or perhaps my livers kicking out cause it doesn't recognise it. There is definitely some underlying thing going on and I did request a cpeptide but the people I see at clinic seem uncooperative to say the least!

I spoke to a nurse on the phone, wasn't impressed. She just told me to take 7u and that was it. Spoke at me. I don't have a DSN and I've requested one but that seems to be all I get! I'd appreciate someone sitting and talking it through with me :-/I'm keeping up 6u for a few days at the mo so will aim to update you how thats going, so far it's just made day time levels harder.

Has anyone else had a similar response on basal insulin? Speak soon 🙂 x

 

[Caroline]

Nice to hear from you. I missed you

 

[Northerner]

Hi Liz, as you may remember, I'm quite a lot like you in respect of my insulin needs. For the past year I have been on novorapid only, having ditched the lantus after 4 years.

It does sound to me like you are possibly dropping low in the night, especially the way you describe how you feel, because this used to happen to me. I used to force myself to test though, and was almost invariably low, usually low 3s but on rare occasions upper 2s. I wonder if, for people like us, the liver response is more likely and perhaps less over the top than in people who are producing no insulin? By that I mean, maybe the signalling that you are dropping low is stronger, so your liver is more likely to react before things get too drastic, and also it doesn't flood you with glucose and leave you on a massive high?

I'm not sure what the solution could be for you. I'm generally OK if I am exercising regularly, but if I don't for a period (a week or so) then my waking levels will start edging up towards the 7s, even an 8 in the past week. Exercising restores me to good numbers - I woke to 4.9 this morning.

Are you testing when your 'feet hit the floor' or have you been up and about for a while before you test? I test straight on waking, but if I was to leave it then my levels would climb, possibly be quite a bit and fairly soon after getting up. What I do is test, then inject novorapid for breakfast even though I might not eat for 45mins-1hr. Essentially, I also inject to cover the DP, given that I am currently on 8 units for a single slice of Burgen bread, about 12g carbs! 😱 By lunchtime I only need to inject for the food, so it is the early morning that requires extra cover that I suppose might be offered by a basal, although there isn't a basal available that would just cover me for just 2-3 hours after waking - I suppose I'm effectively using the NR as a basal!

Have you actually done some basal testing now you are trying the lantus, so yu can see what is happening throughout the day and night? It would be worth finding out. Even better would be the loan of a CGMS so you could see your complete profile and where action might need to be taken.

 

[lizabetic]

Northerner your reply was absolutely fab 🙂 thank you for making actual sense of it but that is what I keep thinking too! I do get low feelings in the 4s so clearly am set higher, and I never get false hypos only shakes when I'm dropping quick!

Would love to exercise at the moment but I am sat on my backside revising for exams. When during the day do you exercise? At night? Once I'm all finished with uni Ill attempt to get into routine for this see if it helps. At the moment I'm thinking of requesting metformin!

My testing is as I am in bed haha! Then before I've eaten, which is currently significantly higher by 3-4 points in around an hour! Not usually like that without basal. I know I've always needed higher morning insulin, it seems to work for me!

I haven't done basal testing mainly cause well at the moment sitting exams I just can't afford broken sleep. Bear in mind I also have M.E. which makes it worse, though sometimes because of that ill wake during the night and test 🙂 and good joke there about the CGMS ;-) I bloody wish! I know it would help immensely.


My day today I haven't gone below 10 😱 and I've been sat in the sun which ought to help you would think. Injected more than enough insulin for food too, 6u for breadsticks and dip (44g carb) and it didn't budge. Only time it started going down (only to 12 though)was after no carb lunch hah, and I didn't inject then!

On another really positive note... Got a call from GP today and they are arranging a meeting with me and DSN and GP. Am really hoping this will help and something will come of it! I'm being sure to record my sugars. will try another day of basal tomorrow perhaps Friday depending how tomorrow goes cause I can't afford to sit my exams in the teens

 

[lizabetic]

Hope I'm alright posting in here again, thought I'd update on the situation...

So lasted 3 days on levemir, completely gave up with it. So next morning wasn't great and I suspect it was GF wraps I had! Here's a list though...

Wake up: 11.9
post exam: 8.3
4u cover lunch, hummus and veg and coffee. This is where it gets odd... 16.7, 15.2, 12.4, 11.2, 9.5 ( all within 20mins of each other, I was hella shakey! ) until finally 8.8 and ate some breadsticks and dip (5u).
Before bed: 10.4


Woke at 4am bloods 11.1 (can't remember what I ate but suspect tricky bolus hah)! Gave 2u
6.30am woke: 9.7 , 5u , scrambled egg on toast (and pre bolus 25mins!)
Post exam: 6.2 (hurrah!)
Lunch had ~34g carbs inc. coffee. (5u)
2hrs post lunch... hypoooo feels at 4.3
After dinner out (6u): 9.2

This is where I realised I had 5 test strips to last me the bank hol weekend and hence didn't test much woo! But morning bloods yesterday were 10.4 I had 2 (!) hypos during the day so clearly ran low. Seems that a quick bolus as I'm up works to bring it down as well as a pre bolus of 25mins. I'm guessing that my secondary insulin has REALLY packed up now, and before I was likely producing an amount. Hence why timings seem crucial. I will get back on the ball come tues when I get test strips.. I am such a donut!!!!