Mmm complicated

[Catareta]

Well my HBa1c results are in 9.5% from 8.9% (post dafne) so not impressed.. am really struggling and my DSN has knocked my basal to 32u BD (so bring on the weight gain)

Seem to have high BS in the morning then stays high all day above 10.9mmols except for an occasional lower reading that really doesnt make sense.

What would be the next step in my case?? (besides a no-carb diet)
Already on 500mg metformin BD - can only tolerate that...

Am looking into the pump and will enquire on the 28th March!

Many thanks

 

[Northerner]

Hi Catareta, sorry to hear about the increase When do you normally take your levemir? Depending on the timing it might be worth splitting the dose so that you can give more for the early part of the day when you appear to be more insulin resistant. Overall, to have levels consistently above range would suggest that your basal is too low, so hopefully the increased dose will help you achieve better levels. What sort of levels do you go to bed on?

 

[AJLang]

Sorry to hear that you are having such a difficult time, I hope that it gets better for you.

 

[Catareta]

Thanks Northerner

I take 32 @ 9am and 32 @ 9pm...

I go to bed at various ranges from 6.9 and 11.9 - one of the best readings sometimes xx

 

[Northerner]

Thanks Northerner

I take 32 @ 9am and 32 @ 9pm...

I go to bed at various ranges from 6.9 and 11.9 - one of the best readings sometimes xx

I wonder if there is scope for changing the way the levemir is split then, and/or altering the timing of the doses - might be worth running past the DSN. A pump would probably improve things too as you could vary the basals to suit your levels more closely, plus I believe people generally need less insulin on pumps. More metformin would also possibly help, given that you appear to have insulin resistance - if you don't think you can tolerate more of the ordinary tablets, perhaps the slow-release version would be better (Glucophage SR). Do you correct the levels with Humalog, or do you stick to fixed doses?

 

[Ellie Jones]

A lot do but not all do find that they have a reduce background insulin using the pump, really depends whats going on with the basal profile really...

But I do wonder though if your flutuating night readings is being effect by food types, such as delayed spikes caused by pastry, pasta, rice and high fat content foods such as cheese sauces/dairy products! Or perhaps something in your routine that might be different and you could actually be looking as far back as the previous evening!

Have done a fasting test to check what your basal profile is actually like? I know that DAFNE doesn't actually encourage this but it's the only real way of finding out if it's set correctly or not?