Morning troubles

[Nick9664]

Good morning all.

I have recently left the army after being medically discharged for type 1. I was really active in the army, gym x4 a week and football x3 and on a strict deit.

I left 4 weeks ago and in a state of depression I have not been exercising as much, but my diet has remind the same.

The problem is my morning blood levels are really high and its concerning me.

Typical I will have my evening meal are 7/8 and then go to bed around 10 making sure my levels are below 9. Take my night insulin and the sleep. Getting up for work at 5, when I wake up my levels are always above 8.5. Before I set of for work I have my insulin and have something to eat, it's 40 min to work. When I get there and check my levels they are always above 11, so I take more insulin to bring it down and then suffer a low shortly after it.

Surly this can not be a good routine and its concerning me that I don't have control over it.

Any advice would be extremely helpful.

 

[khskel]

Hi Nick, 40 mins after your breakfast is far too soon to be considering a correction dose as your breakfast insulin won't have reached its peak action by then. What you are aiming for is to be no more than about 2- 3 mmol above your pre meal reading after 2 hours and roughly back where you started after 5 assuming you are on a rapid acting insulin such as novo rapid. Some people find those figures are reached at slightly different times.

What are you having for your breakfast and are you matching your insulin ti the carbs?

 

[grovesy]

Welcome.

 

[Nick9664]

Hi and thank you for the replay.

The only reason I do a correctional dose is because my levels are above 11 when I get to work.

i use to have porridge with protein scoops in it, but my levels went above 13 on a few occasions so I have changed it to have just one weetabix but even this is sending my levels up passed 10 because of mylevels when I wake up are high.

 

[Greyhound Gal]

Hi Nick and welcome. Your readings are very like mine when I was diagnosed and put on insulin. I regularly went into double figures arfer eating because my pre-meal readings were in the 8's.
What you need to remember is, as Khskel says, to try not to rise more than 2-3 mmol after TWO hours and returning approx to pre meal level after 4-5 hours. If you haven't returned to approx pre meal level after this time, then you start to think about a correction dose. However, just to complicate things 🙄, if you are on basal/bolus insulin regime, I wouldn't correct if I was going to be eating again within an hour. I'd add some more insulin to my next mealtime dose.
Re porridge. Many members have problems with it. I have found that if I inject 35 - 40 mins before I eat it I tend to be fine. Breakfast cereals tend to spike most people.
Please don't worry, diabetes is a marathon not a sprint and things will come right. I'm 9 months in and only in the last 6 weeks or so do I think I have finally got my ratios and timings right, just in time for Spring and (hopefully) warmer weather when they will probably need to be amended

Please keep asking questions if you need to and we'll do our best to help you out. There are some good threads on the forum re food ( what did you eat yesterday and food/carb queries) which hopefully will give you some good ideas.

 

[mikeyB]

Hi Nick, welome to the diabetic Army. Diabetes does rather change your life plans, doesn't it?

Can you say what medication you're on, because it sounds to me like your long acting basal insulin needs a tweak. Don't worry too much, it's early days yet, as Greyhound Gal says. You've got another 50 odd years to get this off pat.

And we're always around if you've got any questions.

 

[Nick9664]

Thank you for the replay Grayhound Gal.

I'll try it out. Injecting my insulin (nova rapid) 30/40 mins before I have my breakfast and then hopefully should see some improvements.

I can imagine it is natural for our bodies to build up a resistance towards the insulin as I have had to take more, then when I was first diagnosed.

 

[Nick9664]

Hi mikeyB

Yeah it has been a massive change for me. Normal routine is 6-6-8 of Nova Rapid then 8 of glargine before bed.
And I took them just before I'm about to eat/sleep.

 

[Steff]

Hi Nick a warm welcome

 

[stephknits]

Hi Nick, as folk have said, it will take a while to get to grips with your insulin requirements and annoyingly, these will change over time. Have you been given any information regarding carb counting? There is a great course called DAFNE, for type 1s which you can access once you have been diagnosed for at least 6 months.
What a shock and change of life for you - how are you getting on?

 

[trophywench]

Hi Nick

Your insulin doses certainly do need adjusting - unless you get the doseage of basal insulin (Lantus) right - you honestly have little chance of nailing down the optimal doses of bolus insulin (Novorapid) for food, as exactly as you need to.

Have a read of this article, as it explains what I'm talking about - and how to test properly to see about how to start working it all out better than it is at present.

Before I post the link though - a warning - any change to a Lantus dose needs 3 whole days for anyone to see properly whether it's working or not - so it's not going to be anywhere near instant. As GG said - this is a marathon, not a sprint!

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

Incidentally in the side menu on that page, if you click on 'Insulin Profiles' there are graphs showing the activity of most commonly prescribed ones - which will also show you in black and white what people have already told you above, about the Novorapid.