New poor control

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Sunshine81

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Type 1
So, I had a cold around 4 weeks ago, but not covid. Since then I my control has dropped from being in target 80% (yes, I am a control freak) to between 20-60% of the time. I'm not sure of my residual pancreatic function has finally given up, whether my insulin resistance (exaggerated by a certain medication I have to be on) has got worse, whether my injection technique is rubbish (should you see some leakage after jnjecting) or is there more hidden sugars in what I'm drinking (more so alcohol, as my soft drinks are all sugar free). I'm worried about increasing my insulin (currently toujeo 40, Novorapid 6-8 with meals), as I'm going to bed high (I'm a late night snacker but take insulin with it) and throw in a correction dose just for good measure. Woke up 9, went to bed 15.9.

Advice welcomed!
 
What alcohol are you drinking? Beer and cider might need boluses. For your injection technique, are you counting to 10 and leaving your pen in while you do so?

It’s possible your beta cells have just declined. Have you done a basal test? You can use that to judge whether your basal needs adjusting.

Are you carb counting and adjusting your bolus insulin?

While you sort this out, it might be easiest to avoid late-night snacks or keep to carb-free ones at least.
 
Cider... I love myself some Cider!

I'm counting to 10 , sometimes longer, but it's 50:50 as to whether I have some leakage, which I don't understand!

My sister recently passed away, so late night snacking and carbohydrates in general is an emotional comfort, which I would like to stop, but currently not in the position to.

How do I do basal test? I saw that you can do it for pumping, but didn't know you could on a basal/bolus regime?
 
Sunshine81 said:
How do I do basal test? I saw that you can do it for pumping, but didn't know you could on a basal/bolus regime?
Click to expand...
There's a link here (and some of the more general ones like BERTIE will also cover the principle):

forum.diabetes.org.uk

Useful links for people new to diabetes

These links provide useful information, particularly to those newly-diagnosed. You can also browse the Recommended Books and Links sections for further information :) Contents: Type 1 Section Insulin Pumps Section Type 2 Section General Help and Information Section Complications and screening...
forum.diabetes.org.uk forum.diabetes.org.uk
 
Sorry to hear about your BG wobbles @Sunshine81, and sincere condolences for your sister. That must be really tough. :(

Significant stress and emotional upheaval like that can certainly mess with your BG levels.

Sounds like a basal check to ensure things are ticking over OK in the background would be a good start.

One other observation is that some HCP suggest that for non-Ds the likely split between what they naturally emit for background needs and meals is often about 50:50, though obviously it depends on how big your meals are!

It just struck me that at 40 : 18-24 you are close to the edge of what I’ve seen considered of the normal range of splits 60:40 to 40:60.

Might be worth considering if the basal check suggests things are OK there?
 
Sunshine81 said:
@everydayupsanddowns , I didn't quite get what you meant about my splits?
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Haha! Yes I was confusing myself too!

If we take the mid point of your bolus as 7u per meal, you end up with a Total Daily Dose

40 + 21 = 61

The theoretical 50:50 split would be 30.5u basal, rather than 40u, which might suggest your basal is a bit high, and your boluses not high enough?

Your current split is 65:35 - which is a little outside the expected range.

If you have all 6u meals, the TDD is 58, with a split of 69:31 - Which would be even more outside the expected range.

I think the reason it struck me as odd, I think, was because my split is always the other way around - mostly bolus and not much basal!

But there’s a saying on the forum “you need what you need” so all that might be meaningless! :D
 
Thank you. I had started to think my bolus doses weren't high enough. I find it mentally hard to give myself 10units with carb heavy meal such as chips, but I know I need to bite the bullet. Will attempt to do a basal test now and be a little more aggressive with my bolus afterwards. I guess I may need 8-10 with meals, but don't like going hypo... Will need some fine tuning.
 
Do you have a half unit pen @Sunshine81 ? That way you could make smaller incremental increases (in your boluses) and might find that less stressful?
 
Don't have half a pen, but as I've had to take some prednisone for a delightful wheeze chest, my sugars are all over the place, but I think I realised that I was underestimating my carb meals, so will try to be abit more accurate once off the steroids
 
Sunshine81 said:
Don't have half a pen, but as I've had to take some prednisone for a delightful wheeze chest, my sugars are all over the place, but I think I realised that I was underestimating my carb meals, so will try to be abit more accurate once off the steroids
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The steroids may well be making your levels be all over the place as they do have the reputation for increasing blood glucose so may be worth taking more care with the carbs whilst you are taking them.
 
Sunshine81 said:
Don't have half a pen, but as I've had to take some prednisone for a delightful wheeze chest, my sugars are all over the place, but I think I realised that I was underestimating my carb meals, so will try to be abit more accurate once off the steroids
Click to expand...

Ah, yes, the steroids could well be pushing you higher. Many people have to increase their insulin when on steroids.
 
Started steroids yesterday, not keen to stay on them. Chest feels better. Will try to get away with not taking anymore.
 
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