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- Thread starter Jrsmith
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trophywench
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- Type 1
Well - most of us on this forum understand a lot of things about living with diabetes and empersonating a pancreas too if we have T1 like you.
How do you treat your D? - MDI or pump? Which insulin(s)? Do you use Libre or what? Have you done a carb counting & dose adjustment course?
How do you treat your D? - MDI or pump? Which insulin(s)? Do you use Libre or what? Have you done a carb counting & dose adjustment course?
MDI. My long acting is Tresiba and my short acting is Fiasp. I started the Libre about a year ago, before I was on the Libre I never even checked my sugars so I guess that’s a start. I’ve done a carb counting course when I was really young, around 10 I’d say? But that is a bit fuzzy, I sort of have an idea but it’s been a long time so things change as you gain/lose weight. My glucose are either HI or below 4, I deal with hypoglycaemia everyday but I also deal with hyperglycaemia everyday aswell. I can never get a healthy balance of in between 4-7.
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Welcome to the forum @Jrsmith
Sorry to hear how difficult you are finding your diabetes. It sounds like you've been left to your own devices, and not really given the help you need.
Bouncing from high to low like that is really rough, and myst make you feel pretty grim.
Hopefully by sharing experiences with other forum members you can begin to make some improvements, and get some ideas to consider.
Great that you have access to Libre, and can now see your levels, but that can be a bit frustrating and discouraging if you see your levels bouncing all over. It is a really important part of the puzzle though, so don’t stop!
It will take some effort, and it won’t all get fixed immediately, but we CAN help, and give you some pointers for you to improve your diabetes management and improve your quality of life.
If you’d like a refresher on your carb counting toolkit, there's a free online course called BERTIE that will really help
www.bertieonline.org.uk
Sorry to hear how difficult you are finding your diabetes. It sounds like you've been left to your own devices, and not really given the help you need.
Bouncing from high to low like that is really rough, and myst make you feel pretty grim.
Hopefully by sharing experiences with other forum members you can begin to make some improvements, and get some ideas to consider.
Great that you have access to Libre, and can now see your levels, but that can be a bit frustrating and discouraging if you see your levels bouncing all over. It is a really important part of the puzzle though, so don’t stop!
It will take some effort, and it won’t all get fixed immediately, but we CAN help, and give you some pointers for you to improve your diabetes management and improve your quality of life.
If you’d like a refresher on your carb counting toolkit, there's a free online course called BERTIE that will really help
Bertie Diabetes
www.bertieonline.org.uk
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Welcome to the forum @Jrsmith . I am glad that you have found us.
Sorry to hear that you have struggled with your diabetes recently, and I am sure that by tapping into the wealth of experience on here you can find things that can be helpful to you.
As Mike said the Libre will give you a lot of info so try to stick with it, through this time, even though at present it might be showing you what you don’t want to see.
It is often good to focus on one small thing at a time when tackling a problem. Perhaps start with one meal, such as breakfast. This is the one I find easiest to keep consistent, so the carb counting can be easier and once done that’s it. Do you know how many carbs you are eating then. I know that I was surprised by my spikes from this when I first got the Libre.
Things that can reduce the spikes:
Sorry to hear that you have struggled with your diabetes recently, and I am sure that by tapping into the wealth of experience on here you can find things that can be helpful to you.
As Mike said the Libre will give you a lot of info so try to stick with it, through this time, even though at present it might be showing you what you don’t want to see.
It is often good to focus on one small thing at a time when tackling a problem. Perhaps start with one meal, such as breakfast. This is the one I find easiest to keep consistent, so the carb counting can be easier and once done that’s it. Do you know how many carbs you are eating then. I know that I was surprised by my spikes from this when I first got the Libre.
Things that can reduce the spikes:
- The potion size.
- The timing of your bolus. I see you are using FIASP which is faster than Novorapid but you may need to kinject it a little earlier
- The type of carbs. Many cereals contain a lot of sugar which converts very quickly. You could switch to lower sugar options or perhaps toast.
I would add "Your starting level" to this, especially when using Fiasp. The speed at which Fiasp works seems to depend greatly on what my starting levels are. If I am in double figures, it can take an hour to start working whereas if my levels are in the 4s, I will hypo immediately.
If you can learn how to use Fiasp, it is great but it can be would incredibly frustrating ******** until you work it out.
Like @Jrsmith my levels were yoyo-ing a lot when I first started using it, especially when I was thinking I was injecting water to treat a high.
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
My first question is going to be have you done a basal insulin test recently - if ever? Unless we get our basal insulin dose as right as we possibly can - no amount of fiddling with bolus insulin is going to solve it. As that changes with the weather - basal testing is not a once a year task!
My second Q is, what sort of structure does your life have at the moment? Are you working, at uni, what? And finally, are you skint and trying to house, feed and clothe yourself, or still at home?
My second Q is, what sort of structure does your life have at the moment? Are you working, at uni, what? And finally, are you skint and trying to house, feed and clothe yourself, or still at home?
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Hi and welcome from me too. So pleased you have found us and I hope we can give you some tips and advice to improve things as riding the BG roller coaster is rotten physically and mentally.
I agree with the suggestions above....
1. An in depth course like DAFNE (Dose Adjustment For Normal Eating) or the online equivalent (BERTIE) will definitely help. If you can get an in person placement on a DAFNE that would be the ideal because you get to spend a week with other Type 1 diabetics and learn from them as well as having a highly qualified DSN run through your readings every day and spot problems and explain how to correct them as well as the coursework giving you the knowledge to do that for yourself after the course.... It is about so much more than just carb counting and it will improve your knowledge and confidence enormously. Ring your diabetes clinic and ask to be put forward for a DAFNE course.... but no harm in doing BERTIE online in the mean time.
2. Totally agree with @helli. I use Fiasp and it is not straightforward for many people. You have to take time to figure how best to use it for your body. I expected it to be a straight swap that just worked a bit quicker but it is quirky. Like @helli, if my levels are above 8 it takes much longer to work but often I also need to stack corrections to get it down. It can just seem like I am injecting water for all the effect it has and it can be hours so I tend to use it to correct when my levels are 8 and drifting upwards rather than let it get to 10 or above. Finding the balance between patience at waiting for that correction to work and knowing when it needs some extra help takes trial and error. I use my Libre to assess when it needs help in that when I see my levels starting to rise a bit after an hour or so, for me that indicates I need another shot.
I gave up with Fiasp after my first 3 month trial when I changed from Novo(not so)Rapid. The second time I tried Fiasp I promised myself I would give it a full year. The first 3 months were so frustrating again that I would happily have given in without that promise, but another month later I started to get to grips with it and we now get along much better, but there was a lot of rollercoaster in between and I still regularly need to stack corrections to get my levels down.
The other thing to be aware of is that it seems to be much more responsive to exercise than NR so if a correction doesn't work and you are able to go out for a walk etc, that can certainly help and may bring you down more sharply. than you expect.
I still need 45 mins prebolus time most mornings to prevent my levels going above 10 even if I wake up in the 5s, but if I wake on a 4 then usually just 30 mins. I always inject for breakfast before I get out of bed and then make my breakfast so that it is ready to eat when my Libre shows the Fiasp kicking in and then I potter on getting washed and dressed and having a coffee until I see my levels starting to drop a little and then I eat. I rarely go above 8 at breakfast now although I will admit that occasionally I get distracted and drop just ever so slightly into the red... I have Libre 1 so no alarms to alert me that I am dropping low..
3. Having the right basal dose and also the right type of basal insulin makes all the difference in the world and is one of the main benefits I got from attending DAFNE. I think many people assume once your basal dose is sorted, that is it.... maybe even for life, but basal needs vary over time and seasons and temperature and activity levels and illness and countless other factors. Being able to spot when it needs adjustment is really important. Libre makes that so much easier than conventional finger pricking because you can see what happens when you skip a meal and of course overnight. If your basal dose isn't correct you are always going to be chasing your tail with mealtime insulin. If I am feeling frustrated with my diabetes management (other than after I changed to Fiasp), 9/10 it is because my basal dose needs adjusting. People describe it as the foundation for your diabetes management and if it is wonky, your levels will be all over the place with everything else.
Would just like to add that I drop below 4 most days according to Libre....I am currently showing 73 hypo events over the past 90 days. Libre exaggerates and many of those are in reality low 4s rather than 3s, so I don't worry too much about it and the important thing is my Time in Range (TIR) is very high 90% in target (3.9-10) over the last 90 days.
I think the old 4-7 range is unhelpful and demoralizing and one of the things I like most about Libre is the Time in Range/Target feature because spending 70% of the time within that wider 3.9-10 range is more achievable than the old 4-7 before meal targets in my opinion. I now treat my diabetes more like a computer game where I look to improve my TIR and get a personal best whereas with the 4-7 target I felt like I was failing a lot of the time and it didn't encourage me to try harder.
Anyway.... I have rambled on far too much but hope some of what I have written is helpful. As @SB2015 mentioned. Take it one stage at a time. Change only one thing and fix it before you move on to address the next problem. If you change more than one thing at once you will just confuse the situation. Personally I would recommend checking your basal first because that impacts everything else, so it it is wrong it knocks everything else out.
Good luck and if you don't understand anything then just ask.... or if you are having a frustrating day and just want to moan about it.... feel free. We all understand the need for that here.
I agree with the suggestions above....
1. An in depth course like DAFNE (Dose Adjustment For Normal Eating) or the online equivalent (BERTIE) will definitely help. If you can get an in person placement on a DAFNE that would be the ideal because you get to spend a week with other Type 1 diabetics and learn from them as well as having a highly qualified DSN run through your readings every day and spot problems and explain how to correct them as well as the coursework giving you the knowledge to do that for yourself after the course.... It is about so much more than just carb counting and it will improve your knowledge and confidence enormously. Ring your diabetes clinic and ask to be put forward for a DAFNE course.... but no harm in doing BERTIE online in the mean time.
2. Totally agree with @helli. I use Fiasp and it is not straightforward for many people. You have to take time to figure how best to use it for your body. I expected it to be a straight swap that just worked a bit quicker but it is quirky. Like @helli, if my levels are above 8 it takes much longer to work but often I also need to stack corrections to get it down. It can just seem like I am injecting water for all the effect it has and it can be hours so I tend to use it to correct when my levels are 8 and drifting upwards rather than let it get to 10 or above. Finding the balance between patience at waiting for that correction to work and knowing when it needs some extra help takes trial and error. I use my Libre to assess when it needs help in that when I see my levels starting to rise a bit after an hour or so, for me that indicates I need another shot.
I gave up with Fiasp after my first 3 month trial when I changed from Novo(not so)Rapid. The second time I tried Fiasp I promised myself I would give it a full year. The first 3 months were so frustrating again that I would happily have given in without that promise, but another month later I started to get to grips with it and we now get along much better, but there was a lot of rollercoaster in between and I still regularly need to stack corrections to get my levels down.
The other thing to be aware of is that it seems to be much more responsive to exercise than NR so if a correction doesn't work and you are able to go out for a walk etc, that can certainly help and may bring you down more sharply. than you expect.
I still need 45 mins prebolus time most mornings to prevent my levels going above 10 even if I wake up in the 5s, but if I wake on a 4 then usually just 30 mins. I always inject for breakfast before I get out of bed and then make my breakfast so that it is ready to eat when my Libre shows the Fiasp kicking in and then I potter on getting washed and dressed and having a coffee until I see my levels starting to drop a little and then I eat. I rarely go above 8 at breakfast now although I will admit that occasionally I get distracted and drop just ever so slightly into the red... I have Libre 1 so no alarms to alert me that I am dropping low..
3. Having the right basal dose and also the right type of basal insulin makes all the difference in the world and is one of the main benefits I got from attending DAFNE. I think many people assume once your basal dose is sorted, that is it.... maybe even for life, but basal needs vary over time and seasons and temperature and activity levels and illness and countless other factors. Being able to spot when it needs adjustment is really important. Libre makes that so much easier than conventional finger pricking because you can see what happens when you skip a meal and of course overnight. If your basal dose isn't correct you are always going to be chasing your tail with mealtime insulin. If I am feeling frustrated with my diabetes management (other than after I changed to Fiasp), 9/10 it is because my basal dose needs adjusting. People describe it as the foundation for your diabetes management and if it is wonky, your levels will be all over the place with everything else.
Would just like to add that I drop below 4 most days according to Libre....I am currently showing 73 hypo events over the past 90 days. Libre exaggerates and many of those are in reality low 4s rather than 3s, so I don't worry too much about it and the important thing is my Time in Range (TIR) is very high 90% in target (3.9-10) over the last 90 days.
I think the old 4-7 range is unhelpful and demoralizing and one of the things I like most about Libre is the Time in Range/Target feature because spending 70% of the time within that wider 3.9-10 range is more achievable than the old 4-7 before meal targets in my opinion. I now treat my diabetes more like a computer game where I look to improve my TIR and get a personal best whereas with the 4-7 target I felt like I was failing a lot of the time and it didn't encourage me to try harder.
Anyway.... I have rambled on far too much but hope some of what I have written is helpful. As @SB2015 mentioned. Take it one stage at a time. Change only one thing and fix it before you move on to address the next problem. If you change more than one thing at once you will just confuse the situation. Personally I would recommend checking your basal first because that impacts everything else, so it it is wrong it knocks everything else out.
Good luck and if you don't understand anything then just ask.... or if you are having a frustrating day and just want to moan about it.... feel free. We all understand the need for that here.
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