Lie in!

[gillrogers]

Gosh, I don't want to get up this morning. I want to sleep in lol. I know not alot of people cant but just once in an odd while I wish I could. I have to get up, do my morning basal and have my breakfast by 7.30 or it screws my routine up. I guess we all have that problem. Has anyone found a way round it ?

I often hear don't let the dB rule you but how on earth don't you with this one?. All ideas greatly received,

 

[Lucyr]

I take my basal at dinner time to avoid this issue. Why do you need to have breakfast by 7:30? You should be able to skip breakfast if you don’t want it.

 

[gillrogers]

I'm on a split basal , I'm always hungry lol and my odd sporadic work routine that I have to work round says to fit meals in I need to have my breakfast by 7.30, to get lunch in for 12 and dinner in for 5.30. pain in the arse, so perhaps it's my part one job ruling me lol

 

[Lucyr]

If you’re having a lie in though you should be able to skip breakfast and just have lunch. Keep the basal next to bed then you don’t need to get up for it, or change the timings to do it a bit later on.

 

[gillrogers]

If you’re having a lie in though you should be able to skip breakfast and just have lunch. Keep the basal next to bed then you don’t need to get up for it, or change the timings to do it a bit later on.

I do and I would but my night time levels are very differant to my day time levels. At the moment I'm on 5 units for the day and 2 at night. Last week I was on 8 during the day with 2 at night

 

[Lucyr]

I do and I would but my night time levels are very differant to my day time levels. At the moment I'm on 5 units for the day and 2 at night. Last week I was on 8 during the day with 2 at night

I don’t understand what this has to do with the timings. if you don’t want to take your morning basal at 7:30am take it at 9am or 10am or any other time in the morning. If you need to shift your evening basal back too to do that then shift that back too.

 

[gillrogers]

I don’t understand what this has to do with the timings. if you don’t want to take your morning basal at 7:30am take it at 9am or 10am or any other time in the morning. If you need to shift your evening basal back too to do that then shift that back too.

So because I need a higher dose during the day and a lower one at night if I'm understanding you correctly Lucy then moving the times of the dose won't affect it. I did it like that because I have to work a busy bar in the eving and on my feet for 5 -6 hours and have found that even with reducing my bolus for my evening meal , over night I would drop so the lower dose basal, which goes down to 1 when I work done earlier stops that. That was my understanding of how it works.

 

[Lucyr]

Yes, it’s the number of units of basal you take in the evening that affects your overnight levels, not what time you take your morning basal.

 

[Proud to be erratic]

OR switch to a single and less flexible basal, such as Tresiba, which last up to 40 hours. This means you can have a nominal basal time (I use 8am) but if I take a lie in, no problem I can take my basal 2 or 3 hrs later. The consequence is that the regulating for irregular BG activity, is done entirely on your bolus, along with the normal dosing for carbs.

At the end of the day insulin is insulin and your body doesn't know that bolus is shorter lived than basal, it just finds out as the hours tick by. So my basal is optimised to give me a relatively level BG throughout the night and although that means it is not necessarily optimised for daytime, I use the shorter lived bolus to adjust as the day unfolds. I try not to stack my bolus doses, so I will normally be a minimum of 4 hrs between bolus dosing, so if I've got things a bit wrong (or the D fairy is waving her mischief wand) I'm sometimes above 10 for a while. But at the next opportunity I then correct.

I have a more aggressive correction ratio if my high resists my intentions! I sometimes correct without bothering to have a meal and thus bolus is correction only, no food.

 

[trophywench]

Well - the important thing for all of us is to make your diabetes fit your life rather than rearrange your life to suit the diabetes!

 

[rebrascora]

I have my insulin under my pillow along with my Libre scanner so that I can wake up scan inject and go back to sleep without having to set foot or arm out of bed and JBs and Dextrose are on bedside table.
I have my alarm set for at least half an hour before I intend to get up because my morning basal needs a head start to help counteract FOTF. So most mornings, the alarm goes off, I inject my Levemir and I go straight back to sleep, then I have a second alarm set to wake up, scan and Inject my Fiasp for breakfast. The I get out of bed and start my day.
If I want a lie in I just don't set the second alarm, but I still take my basal when the first one goes off.

Like @Lucyr says, if you want a lie in and don't have enough time to fit breakfast in before lunch, then skip breakfast and just have lunch or if you are hungry when you get up, just have a late big breakfast/brunch (I sometimes have a 2 course breakfast .... yoghurt, berries and seeds followed by a fry up or omelette with salad) and then skip lunch. The whole purpose of a basal/bolus system is to enable you to be flexible about if and when you eat and what you eat.

 

[gillrogers]

Yes, it’s the number of units of basal you take in the evening that affects your overnight levels, not what time you take your morning basal.

Thanks Lucy

 

[gillrogers]

Well - the important thing for all of us is to make your diabetes fit your life rather than rearrange your life to suit the diabetes!

Well that's what I'm trying to do but don't seem to be getting anywhere. Dbn keeps telling me I'm doing fine, I think things go awry for me when something unexpected happens like this and I don't understand why and can't see a reason for why. Nurse kept telling me this week that she couldn't see any problems. That just said to me she wasn't reading my graph etc properly or she would have seen I was dropping too soon after meals just sat doing nothing and having to snack on glucose to stop it . I want to be up and doing things instead of having to wait an hour to see which direction I'm going in. I know I have my alarm but just for doing simplist house work I can drop past it quickly and the sensor doesn't kick in until too late to stop. Perhaps I'm too busy trying not to let it rule me that it is. I can't get to a place where I'm confident to be able to forget about it. It doesn't help with feeling hungry nearly all the time despite eating enough as 5hats usually the indicator that my blood sugars are with going down or too high. Gosh sorry I've gone off on one

 

[rebrascora]

Gill, don't be sorry. There are clearly issues to sort out but one of the forums main functions is to provide a place to "vent" where people understand the frustrations. Can you post a typical graph which shows this problem of you dropping quickly after a meal and is it every time or just sometimes and do your levels go high after you have carbs to treat or stop them.
Two things come to mind as being the problem.... The Lyumjev is working a bit too quickly or maybe your carb:insulin ratio is wrong or if it is happening intermittently, it could be something like the "pizza effect" where some foods which are particularly fatty (creamy pasta is another) or high in fibre like lentils will take a long time to release their carbs so your bolus insulin kicks in before you digest the meal and what you need to do in that situation is inject some of the bolus up front and the remainder afterwards.
Alternatively it may be that your basal is too high and the combination of that and the bolus is taking you down. Seeing a typical example of your graph might help us indicate which it is.

If you are hungry all the time, I wonder if perhaps you need to be eating a bit more fat and protein as that has made a huge difference to me in not needing so much food and being able to skip meals without feeling hungry. It depends if you are back up to a normal BMI or not. If you need to put on weight after the initial weight loss at diagnosis then being hungry and eating more may be normal. If you are at a healthy weight then it may be the balance of macro nutrients or perhaps that you are taking too much insulin and needing to feed it..... You are carb counting aren't you.... not fixed doses?

Sorry, just read your signature so, you are obviously carb counting.

 

[Proud to be erratic]

So because I need a higher dose during the day and a lower one at night if I'm understanding you correctly Lucy then moving the times of the dose won't affect it. I did it like that because I have to work a busy bar in the eving and on my feet for 5 -6 hours and have found that even with reducing my bolus for my evening meal , over night I would drop so the lower dose basal, which goes down to 1 when I work done earlier stops that. That was my understanding of how it works.

Been mulling over this; your latest reply to Lucy reminded me to read it again.

As I understand the above you are adjusting for your evening shift activity by both reducing your evening meal bolus and by reducing your bedtime basal.

How do you know what ratio applies for the basal? If you arrive at a 1 unit of basal, by how much are you anticipating your BG to lower? What % reduction are you using for your evening bolus?

Different point. In the blob of insulin post, you mention not liking to inject in your stomach (abdomen) and only use your thighs. Because the advice on injection technique talks about varied speed of responses from different injection sites and the abdomen is the preferred option, I wonder if you are giving the D fairy further opportunity to cause mischief? It's possible that bolus into your thighs before your evening shift and standing for the next few hours is accelerating your bolus and its dissipated in much less than the normal +/- 4 hrs, whereas your basal as you go to bed is slowed down because you are lying rather than walking. I'm speculating here, not from a position of good knowledge. I inject my 1x long lasting basal into my thighs, because I know that it's inflexible and last up to 40 hrs, so once my basal routine is established it doesn't matter if it gets delayed by starting in my thigh. But I put my bolus into my abdomen to give it the best chance of arriving promptly, yet not being pushed by exercise. I don't do sit-ups!!

 

[gillrogers]

Thanks Barb, my suspicion is that it's the Lyumjev being too strong or quick . It seems to happen on warmer mornings and days. Particularly when I'm getting moving around sooner after my meal. I know I can take the Lyumjev up to 20 mins after a meal so I'm experimenting. Plus I need to remember to drop my bolus at the meal prior or I now believe I have a knock on effect after lunch. For a while mind I've been thinking my lunch bolus is a wee bit to high as I never have peak, I stay levelish but as I'm usually sat doing paperwork it's never been a problem until the day I got whizzing around in the morning and forgot to lower my morning bolus.

So I've reread the NHS guidelines table on excercise / activity and working on dropping my bolus 25% this morning and see what happens. I lowered my basal last weekend by 3 units so can't see I need to do that again.

 

[Proud to be erratic]

Well that's what I'm trying to do but don't seem to be getting anywhere. Dbn keeps telling me I'm doing fine, I think things go awry for me when something unexpected happens like this and I don't understand why and can't see a reason for why.

Your Dbn who you think isn't listening .... is that a Diabetes Specialist Nurse at a Hospital or your Surgery nurse who has an overview on behalf of the Practice for their D patients? My DSN used to tell me I was doing all right, even though the evidence was clearly to the contrary. I realised she was trying to reassure me (but deep down I couldn't help thinking she was deflecting a problem) and to stop me stressing - which is, as we know, bad for DM anyway.

Nurse kept telling me this week that she couldn't see any problems. That just said to me she wasn't reading my graph etc properly or she would have seen I was dropping too soon after meals just sat doing nothing and having to snack on glucose to stop it . I want to be up and doing things instead of having to wait an hour to see which direction I'm going in. I know I have my alarm but just for doing simplist house work I can drop past it quickly and the sensor doesn't kick in until too late to stop. Perhaps I'm too busy trying not to let it rule me that it is. I can't get to a place where I'm confident to be able to forget about it.

Yes, I recognise that dilemma all too well. And, although my DM has entirely different origins it has got better, as I've learnt more and started to hear and understand better the signals my body sends me.

It doesn't help with feeling hungry nearly all the time despite eating enough as 5hats usually the indicator that my blood sugars are with going down or too high. Gosh sorry I've gone off on one

I agree with @rebrascora that this is exactly why this forum is so useful and whether it's a rant or a deep technical question someone will offer a thought or well-founded response.

 

[Proud to be erratic]

So I've reread the NHS guidelines table on excercise / activity and working on dropping my bolus 25% this morning and see what happens. I lowered my basal last weekend by 3 units so can't see I need to do that again.

My endo, who co-authored a recent paper on D and exercise, told me to think about 50% or more reduction in my Novarapid bolus. He even said I might find I need no bolus if my meal was quite low in carbs. In practice I apply a 50% or 60 % reduction for my 100gm carb breakfast, when I'm going to be full on that day and if I'm low at midday I now often take a low carb high protein snack, with no bolus.

 

[gillrogers]

Wow that's alot. I'm only cleaning and in the garden. I'm not doing like intense excercise.

 

[rebrascora]

Cleaning and gardening are two activities which are renowned for lowering BG levels..... along with grocery shopping for some unknown reason.... and walking of course. Exertive exercise where your body is under stress usually pushes your BG levels up in the short term but will lower them in the longer term.