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mark1979

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Type 1
Hi All
Just joined been diabetic for 30 years and need some advice on how to lower sugers as been struggling for past 20 years to lower them
 
Welcome @mark1979 🙂 Are you on injections or a pump? Which insulins do you take? Are you high all the time or just occasionally through the day? Tell us more and we’ll make suggestions🙂
 
Hi im on injections i take novarapid and toujeo.. im high most of the time but when i do get it in range it drops rapidly. Just feels like i cannot win :(
 
Have you done a basal test? And do you carb count - count your meal carbs and adjust your Novorapid, that is?

Getting your basal dose right is the first step. It’s supposed to keep your blood sugar steady in the absence of food. You don’t have to starve yourself all day to test if it’s right. You can split the day up into segments. If your basal dose is wrong, it makes everything harder. It’s like the foundations of a house. You have to get that done before you ‘build your house’ - ie make sure your bolus (mealtime) insulin is right. It sounds a pain, but getting the Toujeo dose right (if it needs changing) will make things easier.

Once your basal insulin is ok, then you can move on to your meal and your Novorapid. I’ve found my mealtime ratios can change and then change back again so don’t assume they’re right. I take one meal at a time and sort the ratio for that meal, then move to the next meal.

Another thing to mention is the timing of your Novorapid. Injecting far enough in advance of your meal can make a massive difference.
 
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Just wondering how long you have been on Toujeo and what basal you were on previous to that @mark1979 ? Toujeo suits some but not others. As you're on quite a high dose, have you thought of splitting it into 2 injections, both at the same time to aid absorption. Which brings up the next question, do you have any lumps that might be hindering absorption?
 
Hi and welcome from me too.

How long have you been on 80 units of Toujeo? I think there is a misunderstanding with people who have been diagnosed a while that basal insulin doses don't change, when in fact they quite often need regular adjustment.
If your levels are around 9-12 when you don't eat then that suggests your basal dose is not enough. You could therefore consider increasing the basal dose or incorporating some daily exercise into your routine. A brisk daily walk, if you are able, can make a significant difference to basal needs.

I agree with @Pattidevans that Toujeo doesn't suit everyone and splitting the dose between 2 sites can be helpful. I inject 22 units of Levemir at the moment but I split it into 2 injections of 11 units, one into each buttock for better distribution and to try to avoid any issues with injection sites developing.

Anyway, those would be my suggestions. Let us know what you decide to try and how you get on.
 
Hi i was on lantus at 103 units changed a year and a half ago ...had my injection sites checked regularly and not got any lumps...but i will have a go st splitting the dose. Thanks
 
rebrascora said:
Hi and welcome from me too.

How long have you been on 80 units of Toujeo? I think there is a misunderstanding with people who have been diagnosed a while that basal insulin doses don't change, when in fact they quite often need regular adjustment.
If your levels are around 9-12 when you don't eat then that suggests your basal dose is not enough. You could therefore consider increasing the basal dose or incorporating some daily exercise into your routine. A brisk daily walk, if you are able, can make a significant difference to basal needs.

I agree with @Pattidevans that Toujeo doesn't suit everyone and splitting the dose between 2 sites can be helpful. I inject 22 units of Levemir at the moment but I split it into 2 injections of 11 units, one into each buttock for better distribution and to try to avoid any issues with injection sites developing.

Anyway, those would be my suggestions. Let us know what you decide to try and how you get on.
Click to expand...
Hi i will split the dose , i work in a warehouse and walk allday do around 15000 steps a day. I will start adjusting my dose from tomorrow. Thanks so much
 
Just wondering what your total bolus doses are? I remember some years ago on one of the International forums, or it may have been a FB group, there was a member on a similarly high basal dose as you @mark1979. He was running high and very frustrated by it. Couldn’t lower his levels even though he kept increasing his dose. Very counterintuitively someone suggested that he start to lower his basal gradually. He did this and whilst he didn’t initially see better numbers, they were no worse. By the time he got to about half the dose he was seeing improvements and IIRC he ended up on about 1/3 of his previous basal. I am not suggesting you do this, but it might be worth discussing with your diabetic team. Wish I could remember where I read it all.
 
Pattidevans said:
Just wondering what your total bolus doses are? I remember some years ago on one of the International forums, or it may have been a FB group, there was a member on a similarly high basal dose as you @mark1979. He was running high and very frustrated by it. Couldn’t lower his levels even though he kept increasing his dose. Very counterintuitively someone suggested that he start to lower his basal gradually. He did this and whilst he didn’t initially see better numbers, they were no worse. By the time he got to about half the dose he was seeing improvements and IIRC he ended up on about 1/3 of his previous basal. I am not suggesting you do this, but it might be worth discussing with your diabetic team. Wish I could remember where I read it all.
Click to expand...
Thanks ever so much i will give the diabetic nurse tomorrow
 
mark1979 said:
Hi i will split the dose , i work in a warehouse and walk allday do around 15000 steps a day. I will start adjusting my dose from tomorrow. Thanks so much
Click to expand...
I find that there is a big difference between steps and actually walking. I am pretty fit and have horses so I do quite a bit of manual work, but going out for a daily brisk walk is making an enormous difference to my basal needs. I think it is that I set quite a brisk pace so that I am walking to a prolonged and set rhythm with my walking and breathing and I incorporate hills which cause be to breath quite a bit harder going up them of course and get a bit sweaty.

I am not in any way suggesting that you don't work hard in your job but just that it is a different sort of exercise and getting into a routine and rhythm of walking or running or cycling or swimming can be very different.
 
Sorry to hear diabetes is giving you the runaround, and I can completely understand how draining and frustrating that must be fir you - sounds like you are working really hard at your diabetes management, but not getting the results you deserve.

You’ve had some interesting thoughts already, which hopefully might give you some avenues to explore. I’m just wondering what the split is between your daily basal dose, and all your daily bolus doses. Are they roughly even? Most people with T1 tend to have a split of their TDD somewhere between 40:60 and 60:40. Do your meal doses total roughly 80 units?
 
everydayupsanddowns said:
Sorry to hear diabetes is giving you the runaround, and I can completely understand how draining and frustrating that must be fir you - sounds like you are working really hard at your diabetes management, but not getting the results you deserve.

You’ve had some interesting thoughts already, which hopefully might give you some avenues to explore. I’m just wondering what the split is between your daily basal dose, and all your daily bolus doses. Are they roughly even? Most people with T1 tend to have a split of their TDD somewhere between 40:60 and 60:40. Do your meal doses total roughly 80 units?
Click to expand...
Hi its about 50-60 units depending on what meals i have that day... had a good day to day by splitting my toujeo had lower blood sugars and even a hypo before tea
 
I would be interested to know if this trend continues tomorrow.
 
mark1979 said:
Hi its about 50-60 units depending on what meals i have that day... had a good day to day by splitting my toujeo had lower blood sugars and even a hypo before tea
Click to expand...

Glad you had a better day - hope it’s the start of things settling for you.
 
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