Look! I got below 7!

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stackingcups

stackingcups

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First time ever. I'm very irritable and a bit shaky as a result. But still pleased.

I'm meant to be upping the Lantus by 4 units tonight because of the pesky morning number. But I'm also due to speak to my DN tomorrow. Do you think I should speak to her first oh wise ones?
 

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Panic over, I've just realised I'm not due to go up tonight. I just went up yesterday. Brain isn't working right!

So will def have a chat with her tomorrow though as the day time ones are Def coming down. Mornings are stubborn.
 
Congratulations on your first "in range" reading. Your body has been used to much higher levels for a long time so it is probably panicking a bit at going lower than it is used to but it will learn that these normal levels are not a problem once you have a few more of them.
Personally I would stick with 2 unit increases rather than up it to 4 now that you are starting to see progress, but see what your nurse says tomorrow. Are you leaving it 3 days before increasing the dose which is the recommended time scale with Lantus or just 2 days? Also, remember that whilst your nurse is there to give you guidance, you know your body best and intuition is really important with diabetes management so it is OK to listen to advice and take it into consideration but not necessarily follow it, provided you can justify why you did so and of course accept responsibility if/when you get it wrong. Always important to keep a close eye on keeping your self safe with insulin doses.
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I've been doing the increases every 4 days.

Before I started on the insulin I was feeling unwell if I got down to the 11s, so I can definitely see the progress!

Readying myself a pile of notes for the DN phone call tomorrow so I don't miss anything out.

Still feels too early to trust myself with all this. Will just take time I guess.
 
Yay, congratulations on having got below 7!

If you find you get shaky with lower readings it might be sensible to eat something - just not a hypo treatment if it's a "false hypo", something less fast-acting. Do make sure you have some hypo treatments with you all the time in case you get a real one though!
 
Great stuff @stackingcups !

Hope your appointment goes well today.

Are you still only taking Lantus? Or do you have a mealtime insulin as well? Might be worth asking about moving to a full MDI system for added flexibility? (eg you could use a small fast acting dose to correct your morning reading without lowering your afternoon/evening readingsj.
 
I had my evening meal not too long after and felt so much better
 
everydayupsanddowns said:
Great stuff @stackingcups !

Hope your appointment goes well today.

Are you still only taking Lantus? Or do you have a mealtime insulin as well? Might be worth asking about moving to a full MDI system for added flexibility?
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Yep still only Lantus. They've mentioned adding in a bolus later on but my numbers aren't doing what they were expecting. They told me if my morning numbers went down and meal times were high then I'd need to bolus but the meal times are coming down before the mornings.

Also, what does MDI mean?
 
stackingcups said:
Also, what does MDI mean?
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Oops! Sorry - slipped into abbreviation mode.

MDI = Multiple Daily Injections (a separate basal / background insulin and bolus / mealtime insulin)

If you get a bit flummoxed by acronyms and abbreviations on the forum, there’s a list here:

forum.diabetes.org.uk

Acronyms and Abbreviations

Here is an alphabetical list of acronyms and abbreviations you may come across on the forum: Health-related A1c - Shortened version of HbA1c the blood test that checks average BG over previous 6-12 weeks ADA - American Diabetic Association Basal - 'Background', long acting insulin (eg Lantus...
forum.diabetes.org.uk forum.diabetes.org.uk
 
Hmm. DN didn't call, had to call her. She'd seen on my notes that I'd spoken to the hospital and assumed I was in their care now whereas they just don't want to see me for another 3 months.

Anyway I think she's out of her depth with me. Asked about an alternative to Lantus due to the stinging and she named a couple but then remembered they temporarily have their own DSN in the surgery for a bit and she would know more about insulin options so she's booked me in with her on the 24th.

So no change really. She's agreed going up by 4 is too much at the moment.

Wondering if I'm being over anxious in needing the support at this stage
 
Sounds like you have a good DN at the surgery because she knows the limits of her training and understanding. Good that you have an appointment with the visiting DSN although I think you may have pretty much cracked your basal dose by the 24th, but you will likely have plenty of other questions by then.

It is important to be cautious with insulin because it can be so powerful and even be potentially lethal so always best to err on the side of caution. Personally I can't really see any great benefit in increasing by 4 units when you can continue to just do it gradually by 2 at a time and far safer. You also want to lower your levels slowly to reduce the risk of damage to the fine blood vessels in your eyes so that is another reason to take it steady in bringing your levels down. I don't think anyone would criticize you for choosing to continue increasing in 2 units or even just 1 unit now your levels are starting to come down into range.

That is my take on it anyway.
 
stackingcups said:
Thanks. I think I just keep feeling a bit overwhelmed.
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That is totally normal and understandable. And we all feel like that at times but mostly, the more experienced we get, the less frequently it happens.
You are doing great though so whilst I know you would like more support from clinical staff and in normal times, I would like to think that the support would be better, you should be proud of how well you are managing and have more confidence in yourself. Of course, we are here to support you too. I know it is not the same as having a professional person on hand.... There are times when we would all like a "Diabetes Nanny" as my DAFNE course compatriot puts it, to take over all the thinking and responsibility of it for a week or two, but unfortunately there doesn't seem to be such a person, so we just have to muddle along as best we can, celebrate our achievements like your sub 10 reading this morning (WooHoo) and learn from the mistakes we make..... and mistakes are very much part of the learning process, so try not to be frightened of them, as long as you keep one eye on being safe.
 
stackingcups said:
Wondering if I'm being over anxious in needing the support at this stage
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No, I think now is exactly when you need the support - you will need a lot less once you are used to it all and feel as though you know what you are doing, but that takes a bit of time for all of us!

The best options for another basal are probably Levemir and Tresiba - Levemir means two injections, but is good for people who need more at night than during the day or vice versa, and for people who have varying lifestyles (if you are sitting in an office all week but go hiking at the weekend, Levemir is the basal for you). Tresiba is very stable and hangs around for 48 hours so is ideal if you do the same amount of exercise and eat roughly the same amount of food every day. It's one injection a day, like Lantus, but supposedly doesn't peak and trough as much as Lantus does.
 
Oh thanks for those explainations. The DN mentioned both of those but said the DSN would know more. The split dose thing sounds interesting if my morning readings stay high
 
Split dose Levemir is great. I need to adjust my evening dose particularly, on an almost daily basis depending upon how active I have been the day before. Exercise/activity has a huge impact on my overnight basal needs and I need so much less insulin at night anyway that I would never manage with a longer acting basal like Tresiba. With split dose Levemir I can balance my body's needs much more closely.
Of course everyone is different and learning to spot the patterns of your body's rhythm is important to figuring out what might work best for you. That just takes time and plenty of testing.
 
Argh you're all so wonderfully informative. I googled and didn't come up with nearly so much info. I feel like I can go into that appointment with more of an opinion in my own treatment now.
 
stackingcups said:
Argh you're all so wonderfully informative. I googled and didn't come up with nearly so much info. I feel like I can go into that appointment with more of an opinion in my own treatment now.
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And that is really important. Knowledge is power and we need to learn as much as we can to make informed decisions or even steer our treatment towards what we think will be best for us. Obviously our health care professionals will have the final say but we should be able to put our case forward and if they don't agree, they should be able to explain why.

It is sometimes a case of trial and error/improvement with insulin, so whilst we think a different insulin might be better for us for all the right reasons, it doesn't always work out the way we expect. I am on my second trial of Fiasp as I didn't get away with it the first time. I asked to go back to NovoRapid which is sadly not rapid at all for me hence the change in the first place but then when my knowledge and experience improved, I asked to try the Fiasp again and after 6+ months of perseverance and quite a bit of frustration, I have finally figured out how best to use it for me. It was an important part of my learning process to be able to change my mind and go back to my original insulin and then try again when I had a better understanding.

I feel quite strongly that we should be encouraged to experiment more and think for ourselves with regard to our diabetes management but many old fashioned health care professionals are stuck in the mindset of being the ones who make the decisions and that they know best and you have to follow "the rules", but diabetes is very much a condition where we can easily become the expert in how our body uniquely responds and quite possibly make better decisions than our clinicians because we live with it every moment of every day. I think one of the important lessons I learned from this forum is that I am at least an equal partner in my diabetes management and quite probably the lead, so I should have a say in the decision making process providing I can show good knowledge and reasoning.
 
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