Help! The nurse from the hospital told me if my morning BS was still above 10..I had to increase my basal from 11 to 12. I did that last night...and I had 3 hypo’s during the night and today I can’t get my BS to stay up. Crawls up for a little while then drops again. I have eaten that many jelly babies, I would be happy if I never saw another one. Is this the Basal causing the lows, or is there something else going on?
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New and feeling like I’m never gonna get there.
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rebrascora
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Hi Chris
How long did you give the previous increase to work before increasing again. Toujeo can take a long time for any changes to have their full effect, so it may well be the further increase in basal which is responsible and possibly a bit of honeymoon effect where your pancreas is trying to be helpful and chucking out a bit of insulin itself here and there which can make things pretty unpredictable.
Morning fasting readings can also be affected by Dawn Phenomenon which might be showing a higher reading than it should be in reality... ie a falsely high reading. When do you take that reading? ... before you get out of bed or just before breakfast or somewhere in between? DP effects people in different ways. Some see a steady increase from the early hours (particularly at this time of year when dawn is early) and others like myself don't see our BG start to rise due to DP until we get out of bed. I have to take 2 units of NR as soon as I get up every morning to counteract DP plus whatever I need to cover breakfast.
If it was me I would drop my basal insulin back down again by one unit and then investigate any possible DP effect in the morning, but be aware you may continue to struggle with hypos tonight until that extra dose of Toujeo gets out of your system.... that would be my thoughts.
Good luck and perhaps have some full sugar coke or orange juice to hand instead of the jelly babies for through the night as liquid sugar is sometimes quicker to take effect and easier than chewing sweets when you wake up in the night.
How long did you give the previous increase to work before increasing again. Toujeo can take a long time for any changes to have their full effect, so it may well be the further increase in basal which is responsible and possibly a bit of honeymoon effect where your pancreas is trying to be helpful and chucking out a bit of insulin itself here and there which can make things pretty unpredictable.
Morning fasting readings can also be affected by Dawn Phenomenon which might be showing a higher reading than it should be in reality... ie a falsely high reading. When do you take that reading? ... before you get out of bed or just before breakfast or somewhere in between? DP effects people in different ways. Some see a steady increase from the early hours (particularly at this time of year when dawn is early) and others like myself don't see our BG start to rise due to DP until we get out of bed. I have to take 2 units of NR as soon as I get up every morning to counteract DP plus whatever I need to cover breakfast.
If it was me I would drop my basal insulin back down again by one unit and then investigate any possible DP effect in the morning, but be aware you may continue to struggle with hypos tonight until that extra dose of Toujeo gets out of your system.... that would be my thoughts.
Good luck and perhaps have some full sugar coke or orange juice to hand instead of the jelly babies for through the night as liquid sugar is sometimes quicker to take effect and easier than chewing sweets when you wake up in the night.
I have no idea to be honest. I have struggled for weeks with high BS, now I can’t get it to stay up at all. I took the increased basal for 3 days like the nurse said to but it was still 13/15 in mornings...which is an improvement but he told me to increase it if it was over 10. The basal is the only thing I can think would be doing it. I have had a load of hypos today. It goes up and I think...great...then not long later its down again. I usually take my levels as soon as I come down in the mornings. Same time every morning. According to the nurse I am not getting DP. I will reduce the basal back down to 11 tonight. I have ordered the MiaoMiao because now I am worried incase I take one during the night and don’t realise. Thank you for your advice...I appreciate it.
rebrascora
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Hi Chris.
How did you manage last night going back to the lower dose and how are things going today? Hope things are a bit steadier.
Not sure how the nurse can be sure you are not getting DP.... or do you have a Libre?
How did you manage last night going back to the lower dose and how are things going today? Hope things are a bit steadier.
Not sure how the nurse can be sure you are not getting DP.... or do you have a Libre?
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Hi all, Yes I found it very scary to be honest. My BS went high again around Midnight so I guess it was the basal. I’m back on 11 and my BS is back to being high in the mornings. I am finding it all very confusing. I really don’t know if I am ever going to be able to do this. I do everything I’ve been told but I still can’t get it right. Sorry just feeling a bit down today. I’ve got to ring the nurse sometime this week so we’ll see what happens. They are so busy though so I am not counting on speaking to anyone. I don’t know what I would have done without this forum and that’s the truth so I thank you all. Yes, by the way, I have a Libre.
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Ugh! Sounds really grim
Have you thought about using either Levemir with 2 different basal doses a day, one for overnight and one for daytime?
Or an insulin pump, with a fully flexible basal pattern?
rebrascora
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I agree with Mike that it may be that the profile of Toujeo just doesn't correspond with your basal needs and a split dose of Levemir would allow you to adjust your daytime and night time basal insulin separately to get a better balance. I need less than half the basal insulin at night than I do during the day so I inject 5 or 6 units of Levemir at night and 16 in the morning to keep me on a levelish playing field. I wouldn't manage on Toujeo at all. Ask the nurse about changing basal insulin.
Ugh! Sounds really grim
Have you thought about using either Levemir with 2 different basal doses a day, one for overnight and one for daytime?
Or an insulin pump, with a fully flexible basal pattern?
Ugh! Sounds really grim
Have you thought about using either Levemir with 2 different basal doses a day, one for overnight and one for daytime?
Or an insulin pump, with a fully flexible basal pattern?
Thanks. I didn’t know you could do that. I will ask the nurse if I get talking to her. Surely they will suggest something soon.
rebrascora
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This is where the forum comes into it's own in terms of learning what is available rather than just accepting what you are given and trying to make the best of it.
There will be people who find Toujeo really suits them and the same with Tresiba. Both are very long acting insulins which provide a steady amount of basal insulin day and night, but many of us have an irregular routine or our bodies have a slightly different circadian rhythm and we need less through the night and more through the day or perhaps less on the days and nights following when we are more active and more when we have sedentary days. I adjust my night time Levemir on a nightly basis by half or one unit, depending upon what I did during the day. So if I have been for a long walk/run that day or a lot of manual work I dial it back in the evening and if the next day I have a fairly inactive day, then I put it back up that night. With your basal insulin, those changes could take 2-3 days to come into effect whereas with mine (Levemir) I see the effect within the next 12hr period.
You can request to try different insulins or ask for bits of kit like Freestyle Libre or a pump or even a half unit pen. Your DSN or consultant will probably want to know why you feel a change might be beneficial or why you think the technology would help you and there may be criteria that you need to meet for them to give you the green light but knowing what is available and asking for it is the first step along with discussing the problems you are having and it really helps to keep a diary of your readings and insulin doses and food intake so that they can see the problems you are having more clearly. It also shows that you are taking an active role in managing your diabetes and I think that makes them more inclined to be supportive than people who blindly follow what they are told to do and don't do anything to help themselves.
There will be people who find Toujeo really suits them and the same with Tresiba. Both are very long acting insulins which provide a steady amount of basal insulin day and night, but many of us have an irregular routine or our bodies have a slightly different circadian rhythm and we need less through the night and more through the day or perhaps less on the days and nights following when we are more active and more when we have sedentary days. I adjust my night time Levemir on a nightly basis by half or one unit, depending upon what I did during the day. So if I have been for a long walk/run that day or a lot of manual work I dial it back in the evening and if the next day I have a fairly inactive day, then I put it back up that night. With your basal insulin, those changes could take 2-3 days to come into effect whereas with mine (Levemir) I see the effect within the next 12hr period.
You can request to try different insulins or ask for bits of kit like Freestyle Libre or a pump or even a half unit pen. Your DSN or consultant will probably want to know why you feel a change might be beneficial or why you think the technology would help you and there may be criteria that you need to meet for them to give you the green light but knowing what is available and asking for it is the first step along with discussing the problems you are having and it really helps to keep a diary of your readings and insulin doses and food intake so that they can see the problems you are having more clearly. It also shows that you are taking an active role in managing your diabetes and I think that makes them more inclined to be supportive than people who blindly follow what they are told to do and don't do anything to help themselves.
You’re right. I will see if I can get a pen with half units. I think this would help a lot. I will also see what they think about changing the Toujeo.
The only thing is, I can’t change my basal dose myself until I do the Daphne. So I’m reliant on them to do that. It is getting there though. I have changed my morning ratio to 1 in 8 and it keep my BS more in range..though I do have a dip mid morning where I have to have a snack. The same after lunch.. 1/8 and it dips around 3 but apart from that it’s pretty much in range. Then 1/15 in evening. It’s not completely right yet but I think a half unit pen would make a difference.
The only thing is, I can’t change my basal dose myself until I do the Daphne. So I’m reliant on them to do that. It is getting there though. I have changed my morning ratio to 1 in 8 and it keep my BS more in range..though I do have a dip mid morning where I have to have a snack. The same after lunch.. 1/8 and it dips around 3 but apart from that it’s pretty much in range. Then 1/15 in evening. It’s not completely right yet but I think a half unit pen would make a difference.
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