7.15 am Got up this morning reading 20.4 with downward arrow ,had a late night snack of a slice of toast with peanut butter , took 11 units 6 for breakfast 5 for correction, it is now 9.00am and I'm reading 13.6 but still had no breakfast, how long do I wait, if I eat breakfast now would I be high once again dinnertime 12ish, do I just skip breakfast and wait till dinnertime to reinject and have something to eat....Thanks
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Lyumjev timing
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rebrascora
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Obviously I am far too late in replying, but in that situation I wait until my levels drop below 8 if at all possible before eating otherwise I will be high all day.
It is also worth knowing that when your levels are very high you become more insulin resistant, so many of us need different correction doses for different BG levels and generally more insulin the higher you are. So at 8 I only need 1 unit, so 1 unit drops me 3mmols, but between 8-10 I need 2 units and above 10 1 unit might only drop me 1.5mmols, so I have to be quite heavy handed with the insulin. I have found that Fiasp is particularly wimpish once levels get above 10 and often you would think I had just injected water and it doesn't shift my levels at all until I get cross and jab some more ie stack corrections which is really frowned upon so I am not recommending it. Lyumjev supposedly a fast insulin like Fiasp, so perhaps it is also like Fiasp in that it is more susceptible to high BG levels that NovoRapid seemed to be when I was on it.
Of course the ideal situation is not to let levels get that high in the first place but sometimes it's easier said than done. Do you have a high alarm set on your CGM and would you consider doing a correction if it went off through the night? That is what I do.
Out of interest how did things play out this morning? Did you eventually eat breakfast or just skip it and what did your levels come down to?
It is also worth knowing that when your levels are very high you become more insulin resistant, so many of us need different correction doses for different BG levels and generally more insulin the higher you are. So at 8 I only need 1 unit, so 1 unit drops me 3mmols, but between 8-10 I need 2 units and above 10 1 unit might only drop me 1.5mmols, so I have to be quite heavy handed with the insulin. I have found that Fiasp is particularly wimpish once levels get above 10 and often you would think I had just injected water and it doesn't shift my levels at all until I get cross and jab some more ie stack corrections which is really frowned upon so I am not recommending it. Lyumjev supposedly a fast insulin like Fiasp, so perhaps it is also like Fiasp in that it is more susceptible to high BG levels that NovoRapid seemed to be when I was on it.
Of course the ideal situation is not to let levels get that high in the first place but sometimes it's easier said than done. Do you have a high alarm set on your CGM and would you consider doing a correction if it went off through the night? That is what I do.
Out of interest how did things play out this morning? Did you eventually eat breakfast or just skip it and what did your levels come down to?
Hi,
Personally I think twice about late night snacks, unless it’s helping to treat a hypo, Otherwise a late night snack needs a late night bolus for me.
I wouldn’t have food if it’s over 10 (can’t be helped sometimes if eating out) preferably 6/7/8 is ideal, I monitor Libre correcting as required prior, so to hopefully arrive under 10 ready to eat.
Have you got your basal requirements in the right sort of range?
Personally I think twice about late night snacks, unless it’s helping to treat a hypo, Otherwise a late night snack needs a late night bolus for me.
I wouldn’t have food if it’s over 10 (can’t be helped sometimes if eating out) preferably 6/7/8 is ideal, I monitor Libre correcting as required prior, so to hopefully arrive under 10 ready to eat.
Have you got your basal requirements in the right sort of range?
Back again, any advice appreciated....before breakfast 06.45...finger prick reading 10.4
Breakfast was granola weighed equalled 30.2 g plus a splash of milk and half dozen blueberries...
Took 4 units just before,
09.15 took a reading its now 14.8 so two and a half hours later it's still up , didnt think I needed to take the LYUMJEV any earlier or should I have, so is it take it earlier or change carb ratio...Thanks
Breakfast was granola weighed equalled 30.2 g plus a splash of milk and half dozen blueberries...
Took 4 units just before,
09.15 took a reading its now 14.8 so two and a half hours later it's still up , didnt think I needed to take the LYUMJEV any earlier or should I have, so is it take it earlier or change carb ratio...Thanks
Barnsley1978
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Hi again,
My morning reading always seems high but I do sometimes have peanut butter or nuts on a night. Does the high fat make this high?
Inka
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It shouldn’t do @Barnsley1978 It’s more likely to be insufficient basal insulin or Dawn Phenomenon.
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I was wondering that too @Kol
If my basal needs have changed and my basal needs tweaking it often shows itself with my meal doses not working as I’d expect them to.
Have you ever run a basal check @Charl ?
How To Successfully Test Your Basal Rate
Are you looking for basal rate information and testing instructions? Perfect! You're in the right place!
Last lyumjev was 06.30 reading 11.9
Had breakfast etc
It's now 10.00..reading 10.2 with a falling arrow, this is usually the time of day when I have a snack...couple of crispbread and peanut butter, would it be ok to have them plus a correction dose or is it to early...Thanks
Had breakfast etc
It's now 10.00..reading 10.2 with a falling arrow, this is usually the time of day when I have a snack...couple of crispbread and peanut butter, would it be ok to have them plus a correction dose or is it to early...Thanks
rebrascora
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Do you normally bolus for the crisp breads and peanut butter?
How long did you prebolus your breakfast Lyumjev? On a reading of 11.9 it is going to need quite a long time to get working before you eat. If it was me, I would need at least an hour and a half between injecting and eating breakfast if my levels were that high when I injected. The problem is that when BG levels are high to start with there is insulin resistance to overcome as well as morning liver dump and the carbs in the food pushing levels higher whilst the insulin is fighting against resistance.
I agree with @Inka that it would be unwise to inject a correction if levels are at 10 and coming down. I personally would not eat the snack unless my levels were below 8 and I would bolus for it. Obviously we are both a bit late in offering you our advice with this situation. What did you do and how did you get on?
How long did you prebolus your breakfast Lyumjev? On a reading of 11.9 it is going to need quite a long time to get working before you eat. If it was me, I would need at least an hour and a half between injecting and eating breakfast if my levels were that high when I injected. The problem is that when BG levels are high to start with there is insulin resistance to overcome as well as morning liver dump and the carbs in the food pushing levels higher whilst the insulin is fighting against resistance.
I agree with @Inka that it would be unwise to inject a correction if levels are at 10 and coming down. I personally would not eat the snack unless my levels were below 8 and I would bolus for it. Obviously we are both a bit late in offering you our advice with this situation. What did you do and how did you get on?
rebrascora
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I was the same switching from Novo(not so)Rapid to Fiasp. I needed 75 mins prebolus time at breakfast with NR and was lead to believe that I would just need 10 mins with Fiasp. I actually mostly need 45mins with Fiasp, which is obviously an improvement but still not great. If my levels were above 10 I would need much longer though, but mid range 5 or 6mmols, I need about 45mins. If I am in the 4s I just need 30mins, but in the 8s, I need an hour.
I found for me the most important thing was to inject as soon as I woke up and before I got out of bed, because I have a strong liver dump which starts as soon as I get out of bed and so the insulin needs to go in the minute I wake up and I keep it on the bedside table ready.
Ideally I keep my levels below 10 if I absolutely can, because I know once I get above 10 I am fighting a long and frustrating battle and will need much more insulin to overcome it than I would otherwise, so I don't eat if my levels are above 8 and I proactively correct if my levels are heading above 10. Last night my high alarm went off at 4.18am on 9.3 with an upward sloping arrow and the graph showed that they had been trending upwards all night (so I knew it wasn't a rebound from a compression low) and so I jabbed 2.5 units and went back to sleep. My low alarm, set at 4.5, went off at 6.30am but I didn't eat any carbs because DP was about to kick in and I was 6.7 by the time I got up, so my 2.5 units, which I thought was a little bit heavy handed, turned out to be spot on. If it had been earlier in the night, I would only have given myself 2 units, but as it was getting towards morning and I know the Fiasp has at least a 3 hour activity profile I felt I was fairly safe to inject 2.5 at that time.
I find it amazing that my sleepy brain has learned to factor in all these considerations when I have just woken from the depths of sleep and I can calculate and inject a correction and be back to sound sleep again in minutes. Same with treating hypos.
I found for me the most important thing was to inject as soon as I woke up and before I got out of bed, because I have a strong liver dump which starts as soon as I get out of bed and so the insulin needs to go in the minute I wake up and I keep it on the bedside table ready.
Ideally I keep my levels below 10 if I absolutely can, because I know once I get above 10 I am fighting a long and frustrating battle and will need much more insulin to overcome it than I would otherwise, so I don't eat if my levels are above 8 and I proactively correct if my levels are heading above 10. Last night my high alarm went off at 4.18am on 9.3 with an upward sloping arrow and the graph showed that they had been trending upwards all night (so I knew it wasn't a rebound from a compression low) and so I jabbed 2.5 units and went back to sleep. My low alarm, set at 4.5, went off at 6.30am but I didn't eat any carbs because DP was about to kick in and I was 6.7 by the time I got up, so my 2.5 units, which I thought was a little bit heavy handed, turned out to be spot on. If it had been earlier in the night, I would only have given myself 2 units, but as it was getting towards morning and I know the Fiasp has at least a 3 hour activity profile I felt I was fairly safe to inject 2.5 at that time.
I find it amazing that my sleepy brain has learned to factor in all these considerations when I have just woken from the depths of sleep and I can calculate and inject a correction and be back to sound sleep again in minutes. Same with treating hypos.
rebrascora
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Once levels get to mid teens many of us find that we become very insulin resistant and our usual correction factors simply don't work. I personally believe that the faster insulins like Lyumjev and Fiasp, which I use, are particularly vulnerable to this insulin resistance and I need to be a lot more heavy handed with the correction doses at this level. I often think of a number and then almost double it, so in your situation I would have thought 4 units for the correction, then doubled it to 8, then perhaps reduced it by one and jabbed 7units and kept a close eye on my levels through the morning with some small high carb foods, like dried fruit (figs or apricots), to hand in case my levels dropped into range a bit too quickly and the drop needed "steadying". This is just me and what usually works for me but over the weekend I had a day where I ended up injecting the best part of 30 units in stacked corrections over the course of the day, which is obviously very risky and not recommending it, but I still failed to bring my levels down into range until the next day. Sometimes you just have to be much more heavy handed with the insulin than you expect at these levels, but if you do, you have to keep a very close eye on things whilst that insulin is active.
Hi @Charl
How are you doing with Basal requirements? it is very very difficult to manage food / bolus without a stable background of insulin.
Cheers.
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