Mid 4s

[Matthew James Hardy]

Hi everyone on the whole my levels are usually good however in the past 2 weeks or so been hitting lot middle 4s for example 4.5 4.6 throughout different times of the day my diabetic nurse has lowered my insulin I was taking 4 for breakfast 5 for lunch 6 Novarapid for tea and 27 at night Absaglar now am taking 3 for breakfast 4 for lunch 6 for tea and 26 at night what could the problem be here doesn’t seem to have altered it much from the 4s

 

[Northerner]

Hi everyone on the whole my levels are usually good however in the past 2 weeks or so been hitting lot middle 4s for example 4.5 4.6 throughout different times of the day my diabetic nurse has lowered my insulin I was taking 4 for breakfast 5 for lunch 6 Novarapid for tea and 27 at night Absaglar now am taking 3 for breakfast 4 for lunch 6 for tea and 26 at night what could the problem be here doesn’t seem to have altered it much from the 4s

Hi Matthew, insulin requirements can change over time and it sounds like you may need to make further reductions in order to keep those levels a little higher. Sometimes it can take a while and the alterations to doses can be quite significant - unfortunately, diabetes can throw these kinds of problems at us from time to time Have you not been taught how to carb count yet, i.e. to match the novorapid dose to the amount of carbs in your food?

 

[everydayupsanddowns]

Good that your nurse is reducing your insulin, regularly being in the mid 4s is technically fine, but it’s also a bit close to the edge.

In a non-d person the pancreas generally produces approximately half the daily insulin to cover background needs and half to cover meals. It’s not exact and can vary from person to person, but looking at your insulins I wonder if your background is set right.

Fortunately, this is something you can check, with a little effort.

It might be worth you found some fasting basal tests to see whether your current dose is working as it should. There’s a good write-up about basal insulin and how to check it here:

https://www.diabetes-support.org.uk/info/?page_id=120

 

[Matthew James Hardy]

Going on a course in July to learn how to carb count got a bit of a dilemma when was testing my glucose strips with the alkaline or whatever stuff it is decided to do a quick testing of my blood 2 hours after lunch and they were 3.9 good job i checked but the thing is I had a bacon sandwich for lunch with a yogurt and not really feeling a hypo at 3.9 is slightly worrying me when feeling absolutely fine in myself no symptoms of a hypo at all not sure whether my machine isn’t right or am just not having any effect

 

[Northerner]

Going on a course in July to learn how to carb count got a bit of a dilemma when was testing my glucose strips with the alkaline or whatever stuff it is decided to do a quick testing of my blood 2 hours after lunch and they were 3.9 good job i checked but the thing is I had a bacon sandwich for lunch with a yogurt and not really feeling a hypo at 3.9 is slightly worrying me when feeling absolutely fine in myself no symptoms of a hypo at all not sure whether my machine isn’t right or am just not having any effect

Sometimes the strength of your hypo symptoms may depend on how quickly your levels are falling - if falling very slowly then it is possible to not really notice any symptoms when you are around 4.0 - the bacon sandwich may have played its part on this occasion by digesting slowly and causing your levels to drop more slowly. At other times you can feel hypo when you are not hypo because your levels are dropping quickly. Experience will help over time, but in the early days it can be quite confusing/alarming.

Also, if you're getting quite a few mid-4s during the day it may be that your body has grown accustomed to quite low levels and the symptoms of a hypo don't 'kick in' until you drop much lower. The advice in this case is to try and run your levels a bit higher for a while in order to restore your symptoms to higher levels - this is much easier said than done!

Your meter is probably fine, they are not 100% accurate, so best advice is just to be prepared and treat what looks like a low cautiously, then test again after 15 minutes. If I found I had a 3.9 with little or no symptoms, for example, I'd probably just have a small amount of relatively slow-acting food (I go for a Belvita biscuit, usually, as they work well for me), and then test again after 15 minutes. A Freestyle Libre is especially useful in situations like this because it shows you the 'direction of travel' of your blood sugar levels so you can make a more informed choice.

 

[HOBIE]

Going on a course in July to learn how to carb count got a bit of a dilemma when was testing my glucose strips with the alkaline or whatever stuff it is decided to do a quick testing of my blood 2 hours after lunch and they were 3.9 good job i checked but the thing is I had a bacon sandwich for lunch with a yogurt and not really feeling a hypo at 3.9 is slightly worrying me when feeling absolutely fine in myself no symptoms of a hypo at all not sure whether my machine isn’t right or am just not having any effect

Good for you going on the course. Everyone learn something from them.😎

 

[Pamela Giddings]

I am not on any medication but am testing glucose levels to check effect of certain foods. I had some high protein bread for early lunch with pesto and mayonnaise. By 3pm my levels were 4.3 but not feeling it. I think it has helped reading this thread and replies as I can get my head round how time vs blood glucose level decline can make a difference.

 

[Matthew James Hardy]

Still get loads of these middle 4s and different times of the day they have knocked my insulin down a few times now still same result should I be worried by this as just posted on another thread my HBAC1 has rapidly gone down from 141 now to 41 in the space of 4 months

 

[everydayupsanddowns]

I think it’s good that you are aware that these results are fine, but don’t give you much ‘wiggle room’.

It may be part of your ‘honeymoon period’ which is different for everyone, but can involve your remaining beta cells having a bit of a second wind when supported by injected insulin.

It also seems to be more common for people diagnosed after 18 to retain fragments of insulin production to help ‘smooth the curves’. Doesn’t happen for everyone, and doesn’t necesssarily last permanently, but some people can live 50+ years with T1D and still have a tiny amount of cpeptide/insulin production.

Getting intensive management in the early years is thoght to help prolong this, I think.

 

[Pumper_Sue]

Still get loads of these middle 4s and different times of the day they have knocked my insulin down a few times now still same result should I be worried by this as just posted on another thread my HBAC1 has rapidly gone down from 141 now to 41 in the space of 4 months

It sounds to me as if you are going through the honeymoon period where your pancreas is chucking out insulin again before it's final cough and splutter. Once it's popped it's clogs you will be a lot more stable.