New type 1

[Rory Delap's Long Throw]

Exercising with a decent amount of bolus insulin on board is risky. NovoRapid lasts about 5 hours but the first 2 hours are when it is most active so exercising within that time after injecting will be the cause of your hypo. Many people learn to reduce their bolus by a few units if they plan to exercise after a meal, or take on more carbs. Exercise affects your levels (generally lowers them) for up to 48 hours afterwards and for me it is my evening levels which are most responsive to exercise, so I have to reduce my evening basal dose after exercise otherwise I will hypo through the night. Obviously you can't do that with taking a single dose of basal in the morning, so maybe push your levels a bit higher than normal at bedtime if you start to notice nocturnal levels dropping due to exercise earlier in the day.

What do you have your low Libre alarm set at? Mine is 4.5 which usually gives me plenty of time to prevent a hypo but some people have their low alarm set higher at 5 or even 5.6. You are missing a trick in my opinion if you set your low alarm at 3.9 as by then you have no opportunity to prevent a hypo, just to treat it, so it might be worth considering raising your low alarm if it is currently 4 or below.

Funny I did the same after week 1, alarm now set to 5 to try and give me plenty of warning and it definitely helps.
The point on novirapid is helpful, I wasn't aware of the exact timeline it works, but will experiment with gentle exercise this weekend and some pre workout carbs

 

[JonathanGi]

I would suggest that you don't totally rely on the alarm. I still get good hypo warning signs (even after 57 years) and I sometimes think I am better when I listen to what my poor, elderly body tells me!

 

[JonathanGi]

Stoke is a very windy ground. Did that help the windmilling Rory? Fantastic attacking weapon though!

 

[SimonP]

Re the comments about low carb - it depends what you eat now (though as others have said a rapid reduction in carbs if your fixes doses are working will result in rapid hypos too, so be careful.)

I agree that there's no need to go low carb (which is <100g of carbs a day or something along those lines), but I must say I do find it much easier to eat fewer carbs than I easily could at a given sitting (and I therefore look to pad meals out with things that aren't carb-laden so I'm not hungry, which has the added benefit of likely being healthier than focusing on carbs).

I could probably manage to consume 200g of carbs for supper (my large meal of the day), but this would require 20U of insulin, and therefore any mismeasurement/misestimation issues will result in a larger error than eating say 80g of carbs (which I tend to aim for). Less insulin and fewer carbs makes life easier - if you're got it (carb quantity/carb ratio/how "good" is your current batch of insulin) wrong you can correct upwards more easily (as you don't need to eat so much to fix the effect of more insulin and also have less chance of dropping very quickly with less IoB) and likewise down (requires less correction insulin and as you won't rise so fast the insulin will be more effective as you can catch it earlier).

In addition to mistakes involving quantities (or carb ratios, or insulin effectiveness), matching the absorption/activity profiles of insulin and carbs can be difficult and they are rarely absorbed at the same rate. Therefore people typically take their bolus in advance of their meals. Fewer carbs means smaller excursions if the rates don't match well (and there is a limit to how early you can take bolus if you are going to eat something with lots of carbs that is digested and absorbed relatively quickly).

With large quantities of carbs splitting bolus can help as you have less on board at any one time and therefore are not committed if you gave too much/too early, but unless your meal is both high carb and slowly digested (like pizza) there are still limits to what can be fixed for a given absorption rate mismatch.

There is an additional advantage in that less food means it's digested over a shorter period, which means you don't need to deal with potentially stacking insulin when you get to the next meal of the day (though I reckon with 200g of carbs I could probably skip a meal as my usual daily intake is ~260g)

All bets are off when exercising, I eat at least 60g of carbs an hour without any bolus if it's a long day out, though that tends to be staggered (and digestion is also slowed when exercising).

 

[nonethewiser]

Great lad great ex football is Rory, as your name implies @Rory Delap's Long Throw he had one hell of a throw on him.

Agree with others, just stick to a sensible diet & don't go down route of extreme restrictive & punishing diets like Bernstein one, life is to short my friend & food should be enjoyed, type 1 doesn't change that.

 

[helli]

Funny I did the same after week 1, alarm now set to 5 to try and give me plenty of warning and it definitely helps.
The point on novirapid is helpful, I wasn't aware of the exact timeline it works, but will experiment with gentle exercise this weekend and some pre workout carbs

I recommend Googling "NovoRapid profile". This will show you a graph of the activation of the insulin over time. It is a "lab version" of the graph - everyone will vary and the speed may vary depending upon what you are doing and what your starting BG is. But I found it useful to understand when the peak is and how it tapers off.

 

[trophywench]

Other thing is Lantus - yes I know very well the hospital have told you it provides a very steady amount of insulin for 24 hours - but it doesn't ! It initially works up to a peak after 4 - 5 hrs, then thereafter settles down to a steady amount over the next however long it happens to stay active for you. No way Pedro can you me or the hospital tell you exactly how long that might be since every human body is, literally, different!