Levels dropping uncontrollably

[bufc07]

I genuinely don't know the best way forward anymore, I'm constantly adjusting my basal doses + insulin ratios and every time I inject for meals my levels drop. It's getting to the point where I am avoiding taking insulin because I know my levels will drop.
Sometimes they even drop with no insulin on board.
I worked out, for my past two evening meals I have injected 1 unit per 27 grams of carbs and still dropped a bit.
Any advice welcome because I really can't do with this anymore.

 

[everydayupsanddowns]

Yikes @bufc07

Those graphs look EXHAUSTING to live through. No wonder you've reached the end of your tether.

Remind me how long you've been diagnosed? Is there a chance you have some beta cells spluttering and splurging out insulin having been supported by insulin doses for a while. (For some people the 'honeymoon' period is more of a nightmare).

It feels like you may need a complete reset.

Perhaps start with some systematic basal testing - which is a faff, but at least it'll show you what's going on when you don't have meals/bolus doses adding to the wobbles. There's a write-up here:

https://www.mysugr.com/en/blog/basal-rate-testing/

Insulin ratios suggests you are carb counting - which is good. So hopefully once your basal is 'more or less right' you'll have a more stable platform from which to tentatively try adjusting doses.

And try not to correct / rage bolus for at least 4-5 hours after any rapid insulin. Let any dose run its course before adding more. Stacked doses can be unpredictable.

Do you have a half-unit pen(s). Sounds like you need as much flexibility as possible.

 

[bufc07]

Yikes @bufc07

Those graphs look EXHAUSTING to live through. No wonder you've reached the end of your tether.

Remind me how long you've been diagnosed? Is there a chance you have some beta cells spluttering and splurging out insulin having been supported by insulin doses for a while. (For some people the 'honeymoon' period is more of a nightmare).

It feels like you may need a complete reset.

Perhaps start with some systematic basal testing - which is a faff, but at least it'll show you what's going on when you don't have meals/bolus doses adding to the wobbles. There's a write-up here:

https://www.mysugr.com/en/blog/basal-rate-testing/

Insulin ratios suggests you are carb counting - which is good. So hopefully once your basal is 'more or less right' you'll have a more stable platform from which to tentatively try adjusting doses.

And try not to correct / rage bolus for at least 4-5 hours after any rapid insulin. Let any dose run its course before adding more. Stacked doses can be unpredictable.

Do you have a half-unit pen(s). Sounds like you need as much flexibility as possible.

I'm 16 mate, diagnosed about a year and a half ago now.
It absolutely is exhausting. I find myself checking my levels too often, maybe 3-4 times an hour because no matter what it just seems to be up then down.
Since my diagnosis I have always been typically up and down with my levels, but, it's never been THIS bad.

 

[mashedupmatt]

Those are some interesting graphs @bufc07 - and as @everydayupsanddowns says that must be exhausting - you are mainly "in range" though so you are doing really well despite the rollercoaster - a year and a half in means you definitely could be still in the "honeymoon period" which is anything but that (I've just finished it, hopefully!) where you are still producing some insulin naturally and it is very erratic (I know from recent experiences!) - it would be useful to know what insulin you are using and how much basal you are taking because that has a big difference for lots of people? And a 1/2 unit pen is a MUST whilst going through this transition

 

[bufc07]

Those are some interesting graphs @bufc07 - and as @everydayupsanddowns says that must be exhausting - you are mainly "in range" though so you are doing really well despite the rollercoaster - a year and a half in means you definitely could be still in the "honeymoon period" which is anything but that (I've just finished it, hopefully!) where you are still producing some insulin naturally and it is very erratic (I know from recent experiences!) - it would be useful to know what insulin you are using and how much basal you are taking because that has a big difference for lots of people? And a 1/2 unit pen is a MUST whilst going through this transition

Fortunately I do have a half unit pen yes. And I'm on novorapid and lantus. Just dropped it down to a whopping 4 units every evening

 

[mashedupmatt]

Good - how much Lantus are you taking, and when(and record it on Librelink too) If you record your insulin intake using your smart pen (must be a Novopen Echo (which are brilliant!)) on your Libre too, that will help you spot any patterns or abnormal patterns

 

[Inka]

I’d also add to look at your pre-bolus timings. This can make a big difference. For example, if I pre-bolus too close to my breakfast, I’ll shoot up and then plunge down just like your graph. However, injecting a bit earlier means a smaller spike and a gentler decline. It’s a pain, for sure, but it does help.

Also, consider where you injecting your bolus. Different body areas can have different absorption times. Finally, it might be your age: a growth spurt, hormones, etc. If so, it will settle.

 

[everydayupsanddowns]

I'm 16 mate, diagnosed about a year and a half ago now.
It absolutely is exhausting. I find myself checking my levels too often, maybe 3-4 times an hour because no matter what it just seems to be up then down.
Since my diagnosis I have always been typically up and down with my levels, but, it's never been THIS bad.

Ah OK - you really are at the sharp end, with honeymoon 'contributions' from your remaining beta cells, hormones, growth spurts, stress, and general teenage-life chaos.

Hang in there, keep gritting your teeth and doing your best to weather the storm. It will get easier.

 

[bufc07]

Ah OK - you really are at the sharp end, with honeymoon 'contributions' from your remaining beta cells, hormones, growth spurts, stress, and general teenage-life chaos.

Hang in there, keep gritting your teeth and doing your best to weather the storm. It will get easier.

I've come to the conclusion that it was a dodgy Libre that made it look a whole lot worse than what it actually was - the thing that tipped me over the edge - I went downstairs to do my basal injection at 7.1 with a down pointing arrow, and came back up 3-4 minutes later to see 9.2 with a stable arrow.
So *hopefully* once I put a new one on things might end up being a bit better. But I genuinely do appreciate the suggestions nonetheless.

 

[everydayupsanddowns]

Ah yes! That can certainly throw you off - especially when you’ve got used to them being pretty reliable, and then one just doesn’t ‘seat’ right in the tissue and goes all “Norman Collier” (reference for the kids there!)

Check @helli ‘s useful thread about CGM precautions / limitations (pumping and tech sticky), and keep yourself well hydrated to encourage your interstitial fluid to follow capillary blood changes.

Fingers crossed the next sensor is much more steady for you.

 

[Tweety99]

Hey!I totally get how frustrating it can be to constantly adjust doses.t might be worth consulting a dietitian or an endocrinologist to analyze your diet and insulin dosing.ometimes changing eating habits can really help.Also keep an eye on your glucose levels before and after meals.Additionally remember that stress and routine changes can impact your levels too.keeping a journal might help you spot patterns.You're not alone in this, and support is really important!
🙂

 

[mashedupmatt]

Had a few dodgy sensors recently - if they are miles out contact Abbott and they will send a replacement - my last one lost connection almost every hour but my latest one is spot on and is in line with finger pricks (quite close, which is adequate) - It sometimes feels like buying a lottery ticket