Levemir doses

[SusieGriff]

I have just seen my consultant and he was very pleased with my numbers etc. except some hypo's i've been having in the daytime, I am sure it's just the bolus amounts I've been giving are a tad out as I can't pinpoint the exact carbs for home cooked food. He suggested reducing my daytime and nightime levemir, but now after 2 days of reductions my reading are shooting up to 15's+ so I think I should go back to my original doses which were 10u daytime 9u night and adjust my bolus doses to smaller amounts. not sure about how to adjust ratios , any advice would be welcome.thanks in advance.

 

[Sally71]

What ratio are you on? I would say just change it by 1 and see what happens. E.g. if you are on 1:10 then change it to 1:11 and see how you go for the next few days. (It seems wrong but the larger the second number, the less insulin it’s giving you because each unit deals with more food)
If you just think you’re estimating wrong though it would be better to adjust your estimates, maybe by 5 at a time and see what happens, you don‘t want to mess up the ratios for food that isn’t home cooked. Don’t change things by too much and only change one thing at a time or you might end up going too far and getting confused about which bit worked.
It’s also possible that you might need different ratios at different times of the day (sorry if you already knew that)

 

[trophywench]

I rarely get the precise carb values for homecooked food correct but usually manage to get it near enough. It does involve owning an accurate set of kitchen scales - where an 'add and weigh' facility is extremely useful but there again, hardly a major investment beyond the realms of possibility. Shedloads of food has nutritional info on the back of the packet, and they're generally near enough too.

Mind you I am assuming here that you can identify those items containing carbohydrate pdq - so the question is, can you?

 

[SusieGriff]

What ratio are you on? I would say just change it by 1 and see what happens. E.g. if you are on 1:10 then change it to 1:11 and see how you go for the next few days. (It seems wrong but the larger the second number, the less insulin it’s giving you because each unit deals with more food)
If you just think you’re estimating wrong though it would be better to adjust your estimates, maybe by 5 at a time and see what happens, you don‘t want to mess up the ratios for food that isn’t home cooked. Don’t change things by too much and only change one thing at a time or you might end up going too far and getting confused about which bit worked.
It’s also possible that you might need different ratios at different times of the day (sorry if you already knew that)

Thanks, I did know people change their ratio's different times of the day, I've not been brave enough to do it, as I'm not really sure. I think maybe I should go a bit higher in the evening as sometimes I have a snack (watching t.v.) sometimes I just get so confused by it all. I find some days I'm a level 5.5 all day long, and then, same meal, same activity ...whoosh up to 13+ . The consultant was a really helpful guy, but they just seem to look at numbers and don't go into the reasoning why.

 

[Sally71]

That happens to all of us sometimes, you do exactly the same things two days running and get completely different results. That’s diabetes for you. If you’re thinking you might need to change some doses, wait until you’ve had the same pattern at least 3 days in a row before you change anything, then change only one thing at a time and see what happens before you change anything else. Can be a bit of a slow process, but it’s far too easy to adjust too far and go from one extreme to the other, or to confuse yourself even further if you change too much at once.

 

[SB2015]

Diabetes likes to keep us on our toes sometimes. As you found with exactly the same meals/activity/… the outcomes can vary. This is just not an exact science, so we just have to do the best tha5 we can.

As others have said, if you have made a change to any of your doses, basal amounts or bolus ratio, give it a few days before deciding to change something else.

You mention that you have a snack in the evening after your meal. Do you bo,us for that in the same way as for a meal. I found it helpful when on injections to try And finish eating at least four hours before I went to bed. I then knew that my bolus was finished. If I did snack I still gave a bolus but was cautious.

I am not sure how long it is since your diagnosis. Have you been able to get onto a carb counting course such as DAFNE (Dose Adjustment For Normal Eating) I found this so helpful not just for carb counting, but also for how to deal with illness and high glucose levels, and most importantly a chance to meet others with T1. There are online alternatives if such a course is not available, such as BERTIE.

 

[SusieGriff]

Diabetes likes to keep us on our toes sometimes. As you found with exactly the same meals/activity/… the outcomes can vary. This is just not an exact science, so we just have to do the best tha5 we can.

As others have said, if you have made a change to any of your doses, basal amounts or bolus ratio, give it a few days before deciding to change something else.

You mention that you have a snack in the evening after your meal. Do you bo,us for that in the same way as for a meal. I found it helpful when on injections to try And finish eating at least four hours before I went to bed. I then knew that my bolus was finished. If I did snack I still gave a bolus but was cautious.

I am not sure how long it is since your diagnosis. Have you been able to get onto a carb counting course such as DAFNE (Dose Adjustment For Normal Eating) I found this so helpful not just for carb counting, but also for how to deal with illness and high glucose levels, and most importantly a chance to meet others with T1. There are online alternatives if such a course is not available, such as BERTIE.

Hi, I've been type 1 for 12 years. always seem to plod along, but since getting the libre2 I'm now much more aware of whats happening and the consultant, of course, sees all my readings, and as I said before it's just him looking at numbers and not actually going into the why's and wherefores, I've reverted back to my normal amount of levemir now and today everything was fine. so, I'll keep an eye on it for a few days and make special care when bolusing, as usually I just guestimate my carbs as I do a lot of home cooking. also, if I do have a snack in the evening I do bolus for it, it's usually around 7-8pm so by the time I go to sleep it's out of my sysytem. btw I did DAFNE about 10years ago. it was very helpful then.

 

[SB2015]

Hi, I've been type 1 for 12 years. always seem to plod along, but since getting the libre2 I'm now much more aware of whats happening and the consultant, of course, sees all my readings, and as I said before it's just him looking at numbers and not actually going into the why's and wherefores, I've reverted back to my normal amount of levemir now and today everything was fine. so, I'll keep an eye on it for a few days and make special care when bolusing, as usually I just guestimate my carbs as I do a lot of home cooking. also, if I do have a snack in the evening I do bolus for it, it's usually around 7-8pm so by the time I go to sleep it's out of my sysytem. btw I did DAFNE about 10years ago. it was very helpful then.

Thanks for all the info. It sounds like you just had a blip. As you say The Libre shows us so much more information , and gives a chance for some fine tuning.

 

[everydayupsanddowns]

Sounds like you are getting on well @SusieGriff

I find smallish tweaks to meal ratios can make a big difference (though like your consultant suggested, my first stop is usually a small change to my basal)

Changes of 10% or so seem to be big enough to make a noticeable difference, but not so big that everything lurches the other way.