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My D - need some help please

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Thu 10.10
16.9 - during night - 3:19
13.5 - fasting - 7:16
10.8 - lunch - 13:29 - 4u QA + 1u corr
21.5 - dinner - 18:57 - 6.5u QA - no correction done due to having beer 2 pnts, from previous experience beer does push my levels right up 😡
17.6 - bedtime - 22:34
 
How much beer did you have......?


Thanks for questioning, yes it was 2 pints of beer but you've jogged my memory & I also had a bag of quavers - the large one 😱
 
Everyone is different but for me personally I wouldn't 'not correct' a 21.5 just because I had a few beers......

I assume this was because you expected to drop because of the alcohol....?

I actually don't need an insulin reduction till the next day personally...

Did you correct the bedtime 17.6?

Do you take insulin for your beer? If you regularly have say 2 pints in a sitting/night, you could take insulin for it........10g roughly a pint I think...
 
Do you take insulin for your beer? If you regularly have say 2 pints in a sitting/night, you could take insulin for it........10g roughly a pint I think...

That's what I quite often do (after a bit of trial and error)

Just got fed up of being in the teens after a couple of pints!
 
Gill,

I think you need to establish yourself a set of basic groundrules, you seem to be constantly firefighting and for me its impossible to tell from your numbers what is going on.

The positive thing is you have addressed to yourself you want to get on track.

The first thing you need to do is some REAL basal testing with no food or alcohol consumed at all. I still think (I can remember saying this a while back) that your basal is way too high. And infact its your QA ratios and approach to snacking / drinking and carb counting that is out?

Me for example:

1 ) I need to bolus for any snack over 5g carbs (10 grams will push me up by 3mmol/l)
2 ) If I drink beer, I need to bolus for it
3 ) The foods you eat - Chinese's etc - Full of the other things on top of carbs - such as proteins and fats. They can play havoc with the BG a little later on.

I dont think anyone could suggest a way forward until you have basal tested.

1) Ensure your basal is thee or there abouts
2) Look at your QA ratios for each main meal time of day
3) Look at how things such as beer and snacks can effect you.

Break it down and tackle it one step at a time

Just my opinion - Hope it makes sense

Benny
 
Fri 11.10
9.7 - fasting -8:38
7.8 - breakfast - 11:00 - 3 CPs - 4u QA
12.3 - lunch - 14:31 - 3.4 CPs - 5.5u QA
4.3 - dinner - 19:22 - 4 CPs 19.1 - bedtime - 22:25 - 24u BI


Sat 12.10
no test - fasting
19.4 - breakfast - 10:23 - 1.5 CPs - 6u QA
14.5 - lunch - no lunch, not hungry
15.2 - dinner - 20:07 -
18.8 - bedtime - 22:23 - 24u BI
- BI - 22:26 - 24u

Sun 13.10
no test - fasting
no test - breakfast - no breakfast
5.9 - lunch - 14:06 - 4.2 CPs - 4.5u QA


Sun 13.10 (cont)
10.4 - dinner - 19:24 - 3.1 CPs - 4 5u QA
11.0 - bedtime - 22:43 - 24u BI

Mon 14.10.13
3.6 - fasting/hypo - 8:12 - had jelly babies x 4 (20 CPs)
6.4 - hypo check - 8:32



Mon 14.10.2013 (cont)
13.8 - 11:13 - breakfast - 3 CPs - 5.5u QA
13.1 - 14:25 - lunch - 3.5 CPs - 4.5u QA
8.7 - 18:26 - 6u QA
15.6 - 22:44 - bedtime
- BI - 22:45 - 24u

Tue 15.10.2013
no test - fasting
11.0 - 10:31 - breakfast - 1.5 CPs - 1.5u QA
no test - lunch - no lunch
13.5 - 19:33 - teatime - 5 CPs - 5u QA
18.4 - 22:13 - bedtime
- BI - 22:15 - 24u

Wed 16.10.2013
4.9 - 8:49 - breakfast - 1.5 CPs - 1.5u QA - yey got one BG in target range 🙂
15.5 - 14:09 - lunch - 4.8 CPs - 8u QA
9.0 - 20:13 - teatime - 3 CPs - 4u QA

😡 😡

So now is it going to be
- 2 or 3 nights on the run basal testing
- decrease basal from 24u to
- increase basal from 24u to
 
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Wed 16.10.2013 (cont)
14.3 - 22:36 - bedtime - also BI 24u

Thu 17.10.2013
no test - breakfast
8.7 - 14.55 - lunch - 4.8 CPs - 6u QA
14.0 - 18:22 - teatime - 4 CPs - 6.5u QA
7.2 - 22:33 - bedtime - also BI 24u

Fri 18.10.2013
4.4 - 11:09 - breakfast - 3 CPs - 2.5u QA
10.6 - 12:55 - after breakfast
15.6 - 14:48 - lunch - 5 CPs - 8.5u QA
 
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Fri 18.10.2013 (cont)
9.3 - 19:21 - teatime - 3.2 CPs - 4.5u QA
11.9 - 22:59 - bedtime - also BI 24u

My targets at the moment are:
4-7 - breakfast
4-7 - lunch
4-7 - teatime
8-12 - bedtime
 
Sat 19.10.2013
6.0 - 10:29 - breakfast - 1.5 CPs - 1.5u QA
7.8 - 13:35 - lunch - 3 CPs - 3.5u QA
6.0 - 18:43 - teatime - 3 CPs - 3u QA
14.2 - 22:30 - bedtime - also 24u BI
 
Sorry Gill, didn't know you were posting on this thread - so I'll repeat the question I PM'd and emailed in response to your queries, on here. I presume you understood the explanation of what the '0.2u Insulin' meant.


Say your BG is a perfect premeal 6.5 and you are going to eat 37g of carbs, that should be 3.7u of insulin, shouldn?t it. What does your meter actually tell you to take? ? I don?t know this - as I only had the meter when I had the pump - so with me it will say I need 3.7u and that?s exactly what I will bolus. You can?t do that though and can only inject to the nearest 0.5u at best depending on what pen you have. So what does it say?


But now I have another question.

What is your 'Target' BG set at on the meter?
 
Sorry Gill, didn't know you were posting on this thread - so I'll repeat the question I PM'd and emailed in response to your queries, on here. I presume you understood the explanation of what the '0.2u Insulin' meant.

Hi Jenny,
That's ok - I got your pm & email - thank you very much for this.

The 0.2u is the insulin which is unused or what you still have on board


But now I have another question.

What is your 'Target' BG set at on the meter?

I posted all my targets which are set on my meter on this thread

"Accu Chek Aviva Expert Bolus Advisor - got it - helppp! Reply to Thread"
Settings for my meter

my time blocks:
0.00 5.30
5.30 12.00
12.00 16.00
16.00 21.30
21.30 0.00

my targets:
8 lower target/12 upper target
4 lower target/7 upper target
4 lower target/7 upper target
4 lower target/7 upper target
8 upper target/12 upper target

my carb ratios:
1 unit insulin/10 grams carbs
1 unit insulin/10 grams carbs
1 unit insulin/10 grams carbs
1 unit insulin/10 grams carbs
1 unit insulin/10 grams carbs

my Insulin sensitivity/corrections:
1 unit/3 mmol
1 unit/3 mmol
1 unit/3 mmol
1 unit/3 mmol
1 unit/3 mmol
 
Right, so the meter will try to correct you to 10 in the early hours and 5.5 the rest of the time, cos it goes for the middle of whatever range you enter, with 4 being the minimum number you are allowed to enter. The 10 is too high for starters.

And 5.5 as a daytime target is marginally on the low side IMHO, with long acting insulin floating about, but 4 is also too low as the bottom really, you'll have far better results to start with if you aimed for a midpoint of 7 and changed it to 6.0 to 8.0.

NB It doesn't actually use that 4 there in the Time Blocks, to understand when it has to tell you that you are hypo - it does that anyway below 4 every single time whatever it says in the time blocks.

You have to remember (if you ever knew this?) that your A1c will always be lower than your meter average so if you set the mid-range too low, you'll have a ridiculously low A1c, which wouldn't be healthy.

I know it sounds counter-intuitive but if you initially aim for a higher number and you can get that to even you out, then it will be comparatively easy to tweak that.

Having told the meter what you want to be, which is on the high side anyway - why aren't you taking it's advice? Except when you've had a lot of alcohol in the evening of course, and surely you don't have THAT much most nights? On the nights you do indulge you could just ignore the correction dose it comes up with, or halve it or something? Or would you typically actually be too hissed to be sensible about it? You have to learn to accept what it says and that can be hard, been there done that myself.

You don't appear to have answered the other question about what it would tell you if you entered an odd number of carbs, that doesn't work out to a whole number - does it round up/down or not?
 
From memory when I was using the Expert it would do all the calculations (meal carbs and + or - correction to get you to mid-range, then round up or down to nearest 0.5u or 1u depending on what you had said your pen allowed.
 
Sun 20.10.2013
2.3 - 10:28 - hypo - 1.5 CPs - 0u QA - jelly babies x 4
6.8 - 10:44 - breakfast - 3 CPs - 3.5u QA
no test - lunchtime - no lunch
11.5 - 19:04 - teatime - 5.7 CPs - 7.5u QA
16.2 - 22:36 - bedtime - also 24u BI
 
Sun 20.10.2013
6.8 - 10:44 - breakfast - 3 CPs - 3.5u QA
no test - lunchtime - no lunch
11.5 - 19:04 - teatime - 5.7 CPs - 7.5u QA
16.2 - 22:36 - bedtime - also 24u BI

Did you snack in the evening after your meal Gill and/or nibble on anything between breakfast and teatime?
 
Did you snack in the evening after your meal Gill and/or nibble on anything between breakfast and teatime?


Yes during the evening whilst sat watching tv - x factor, strictly 🙂 - I had 1 but may have been 2 mini scotch egg 4.3g carbs each & 1 small bag of discos 😱
 
Yes during the evening whilst sat watching tv - x factor, strictly 🙂 - I had 1 but may have been 2 mini scotch egg 4.3g carbs each & 1 small bag of discos 😱

There is absolutely nothing wrong with snacking in the evening Gill, but you simply *MUST* dose for it if you want to avoid those very high levels at bedtime.

Kp Crisps - Discos- Salt & Vinegar 28g Bag
Serving Size: 28 g, Calories: 145, Fat: 8g, Carbs: 16.9g, Protein: 1g

So along with your scotch eggs you are having what looks like 20g of carbs with no insulin.

The good news is that on the basis of your current settings posted elsewhere you are getting almost exactly the rise one might expect. Roughly 3mmol/L per 10g of carbs and (with not all the correction finished and snack digested) you rose around 4 mmol/L.

I think it's quite difficult for people to give you their thoughts too if you are not mentioning these snacks - without that snippet of information it could look like your basal was waaaaaaay to low, when in fact it was more likely to be the snack that caused the rise 😉
 
There is absolutely nothing wrong with snacking in the evening Gill, but you simply *MUST* dose for it if you want to avoid those very high levels at bedtime.



So along with your scotch eggs you are having what looks like 20g of carbs with no insulin.

The good news is that on the basis of your current settings posted elsewhere you are getting almost exactly the rise one might expect. Roughly 3mmol/L per 10g of carbs and (with not all the correction finished and snack digested) you rose around 4 mmol/L.

I think it's quite difficult for people to give you their thoughts too if you are not mentioning these snacks - without that snippet of information it could look like your basal was waaaaaaay to low, when in fact it was more likely to be the snack that caused the rise 😉


Thank you Mike,
So if I'm having tea and doing my bolus at 19:00 pm approx then I decide I may like to snack on a little something at about 21:00 ish would you bolus for that then? Also when snacking should I get the bolus advice from my accu-chek bolus advisor?

Re the "absolutely nothing wrong with snacking in the evening" sometimes I thnk I'm doing wrong and maybe that's why i miss out or get ambarresed at mentioning the little "snippet of information"
 
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