Newly Diagnosed with Type 1,New Joiner! Questions & Help Please

[Type1Post30]

Hi all,

I have recently been diagnosed with Type 1 Diabetes and naturally it has been quite the shock at the age of 32. I would consider myself fairly active, running 15-20k per week and also playing various other sports when I can! I was rushed into hospital on the 21st of June having probably gone the best part of 2 months without producing insulin, consequently my ketones were through the roof and I was lucky I went in when I did. Anyway, it is great to meet the team and I was hoping I could run a few questions past the group

1. I bought a Dexicom to consistently monitor my blood glucose levels with alerts set up but now find myself waking up in the middle of the night and having to eat as my levels are too low. This probably happened before I purchased the product (last week) but I was none the wiser. How important is it to eat in the middle of the night if you are below 4mmol/l? Or could I turn my alerts off and sleep through it until the morning if I generally feel ok? Alternatively what is a quick healthy snack to eat each evening before I go to bed based on experience.
2. My sugar levels seem to drop quite significantly when I exercise, and quickly when I am running. I probably need a level close to 12mmol/l to ensure I can complete a 45 minute run. Is there any foods which I can eat before hand to help ensure they stay relatively stable throughout?
3. I was told initially my my doctor to take 20 units of the long acting insulin in the morning and 6 units for each meal. Can I adjust this quite significantly dependent on what I am eating? For example I might have just fish and salad one evening which means I would need less units.

I will be speaking my DSN over the next few days but wanted to run this past the community first.

Thank You!
James

 

[helli]

Welcome @Jamesnott
We are here to answer questions, listen to rants and have a laugh about diabetes.

Sounds as if your diagnosis was a big shock. Unfortunately, age, fitness, weight, etc. make no difference to Type 1. No one seems to know exactly what causes it although there are various theories around viruses.

Regarding your questions:
1. It is important to correct lows at any time of the day. The reason for this is that our body is very good at adapting. It will get used to 3.5, then 3.0 then... and you don't have far to go before you lose hypo awareness.
However, I strongly recommend checking any CGM with a finger prick before correcting. They can suffer from compression lows - a false low reading when pressure is applied to the sensor which is possible if you lie on it

2. It is common for levels to drop with some exercise (other exercise may cause your levels to rise). I lack energy to exercise when my levels are above about 7 or 8. Therefore, rather than starting high, I would take some sugar with me on my run/cycle. For example, I add a small amount of fruit juice or squash to my water bottle and sip it on my run to maintain my levels. As I drink when I exercise, this is less of a change to my routine.

3. Yes, you can adjust your insulin doses but you should talk to your nurse about this. You will need to carb count and calculate your dose according to how many carbs. You may also find you need to reduce your basal dose after exercise as it can result in lows up to 48 hours afterwards (this may be the cause of your overnight lows). If you are interested in learning about adjusting insulin doses, you may find the Bertie Online course (Google it) useful. Most areas run a course called DAFNE (something like Dose Adjustment for Normal Eating) - Bertie is the online version of this.

There is a lot to learn about Type 1 (after more than 15 years, I am still learning) and it can become overwhelming. That is why Diabetes Burnout is a genuine risk. Because of this, I urge you not to run before you can walk. I am sure there is a string desire to know everything and get perfect levels all the time but it is important to have balance in your life and not let diabetes take over .

 

[everydayupsanddowns]

Welcome to the forum @Jamesnott

Glad you have joined us!

I think this is at the root of the challenges you are currently experiencing…

3. I was told initially my my doctor to take 20 units of the long acting insulin in the morning and 6 units for each meal. Can I adjust this quite significantly dependent on what I am eating? For example I might have just fish and salad one evening which means I would need less units.

These will have been starting points. But diabetes doesn’t stay still, and over time, and with circumstances (42 different ones!) your doses and timings of doses will need adjusting from meal to meal, and as the weeks and months roll on. Diabetes even changes with the weather - with warmer weather generally making people more sensitive to insulin.

Adjusting mealtime doses to balance with the specific foods you are eating (specifically the total amount of carbohydrate) is commonly called ‘carb counting’. There’s a brief overview here:

The nuts and bolts of carb counting

When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...

www.diabetes.org.uk

You may also find it helpful to adjust doses (downwards) around planned exercise and activity, along with taking fast acting carbs.

Finding the right balance will involve a bit of experimentation. Some find it easiest to plan exercise before breakfast, when they have relatively lower levels of ‘insulin on board’.

Regular overnight hypos should be avoided. Most likely culprit is that your basal (long acting / background) insulin needs to be reduced.

Speak to your clinic about how to make adjustments. Generally a fairly cautious approach (reduce or increase dose by approx 10% and see how things go for a few days) is the sort of thing you’ll be encouraged to try.

Hopefully, before long you will be offered a structured education course like DAFNE or BERTIE, to help you tweak your own doses. There are online versions in the ‘useful links‘ thread if you want to press on while the pandemic slows lots of this stuff down.

Everyone’s diabetes is slightly different, and behaves slightly idiosyncratically. Ultimately the world expert in your diabetes will end up being you. 🙂

 

[Inka]

Welcome @Jamesnott 🙂

I’ve bolded your question because I think it’s important. Never ever ignore a hypo and especially not one at night.

1) How important is it to eat in the middle of the night if you are below 4mmol/l? Or could I turn my alerts off and sleep through it until the morning if I generally feel ok?* Alternatively what is a quick healthy snack to eat each evening before I go to bed based on experience.

As @helli has said, check the result with a fingerprick if you can, but it is extremely important to correct a hypo especially at night. Hypos can be serious and potentially very dangerous if you drop too low. Longer term, if you frequently drop low you run the risk of losing your hypo awareness which is dangerous obviously but will also mean you could lose your driving licence if you have one. Good bedtime snacks are things like a small bowl of cereal, a plain digestive biscuit or two, oatcakes and peanut butter, etc.

2) If I was doing a 45 min run, I’d want to start around 9 and top up with carbs as needed during the run. Depending on the time of the run, I might also reduce my mealtime (bolus) insulin before the run. For something like a long hike, I take Coke, Dextro, mintcake, flapjacks, etc, so I can top up the carbs when needed. Beforehand, I’d eat carbs like bread, cereal, flapjack. I mentioned flapjack twice because I find them the perfect mix of quick and slow carbs.

3) Yes, you can adjust your mealtime insulin according to the carbs in your meal. I was taught this on diagnosis but for some reason some Type 1s aren’t. Push to be shown how to do this. Always err on the side of caution. Nobody ‘controls’ Type 1 - we constantly strive to do the best we can. It’s like pinning jelly to a wall. Pace yourself, learn gradually and don’t expect perfection.

Other points - if you’re frequently going low at night, you might need a different basal insulin ie one that’s taken twice daily. That way you can adjust the evening segment and take less to avoid hypos.

What basal insulin do you take @Jamesnott ?

 

[Ljc]

Hello @Jamesnott . Welcome to the forum and the club that no one wants to join.
Night time hypo’s are best avoided if possible as they can be more dangerous .
Also having too many hypo’s can cause you to lose hypo awareness.

Were you given a blood glucose (BG) level that you should not be below to go to bed . If so I would temporarily raise that level till you have spoken to your DSN/team, you should have a contact number or email so you can contact them between your appointments.

I keep my diabetes kit and hypo treatments close to me most of the time and us always by my bedside when I am in bed , just in case . I also have hypo treatments in every room including the loo as one if my hypo signs at night is waking suddenly with an absolutely desperate need to wee.
I have Lift glucose tablets in my kit , loo and handbag . small cans of coke in the kitchen , orange juice if I can’t face Coke.

Initially they will need to tweak your insulin units frequently of both your insulin’s as our needs vary, not only individually but with what we are doing or have done

I use a Libre which is similar to a CGM . They both sample interstitial fluid rather than blood, their is a time delay from when glucose hits the blood to when it shows in the interstitial fluid around 10 minutes. also at hyper and hypo levels they are not as good as a fingerpick, their can be a bug difference.
So what I do when hypo is finger prick to get BG level and treat if necessary, then immediately scan so I can see the direction of travel. I carry on in this way every 15 minutes till I am above 4.0 on the fingerpick. At night I would then have a few biscuits or a small snack to keep my BG from dropping again.

If driving the rules for driving after a hypo are different more stringent in fact . I no longer drive other here will know the regs

 

[Type1Post30]

Welcome @Jamesnott
We are here to answer questions, listen to rants and have a laugh about diabetes.

Sounds as if your diagnosis was a big shock. Unfortunately, age, fitness, weight, etc. make no difference to Type 1. No one seems to know exactly what causes it although there are various theories around viruses.

Regarding your questions:
1. It is important to correct lows at any time of the day. The reason for this is that our body is very good at adapting. It will get used to 3.5, then 3.0 then... and you don't have far to go before you lose hypo awareness.
However, I strongly recommend checking any CGM with a finger prick before testing. They can suffer from compression lows - a false low reading when pressure is applied to the sensor which is possible if you lie on it

2. It is common for levels to drop with some exercise (other exercise may cause your levels to rise). I lack energy to exercise when my levels are above about 7 or 8. Therefore, rather than starting high, I would take some sugar with me on my run/cycle. For example, I add a small amount of fruit juice or squash to my water bottle and sip it on my run to maintain my levels. As I drink when I exercise, this is less of. change to my routine.

3. Yes, you can adjust your insulin doses but you should talk to your nurse about this. You will need to carb count and calculate your dose according to how many carbs. You may also find you need to reduce your basal dose after exercise as it can result in lows up to 48 hours afterwards (this may be the cause of your overnight lows). If you are interested in learning about adjusting insulin doses, you may find the Bertie Online course (Google it) useful. Most areas run a course called DAFNE (something like Dose Adjustment for Normal Eating) - Bertie is the online version of this.

There is a lot to learn about Type 1 (after more than 15 years, I am still learning) and it can become overwhelming. That is why Diabetes Burnout is a genuine risk. Because of this, I urge you not to run before you can walk. I am sure there is a string desire to know everything and get perfect levels all the time but it is important to have balance in your life and not let diabetes take over .

Thank you, really helpful. Especially the note regarding the CGM, I will continue to use the finger prick if I am low!

 

[Type1Post30]

Welcome to the forum @Jamesnott

Glad you have joined us!

I think this is at the root of the challenges you are currently experiencing…



These will have been starting points. But diabetes doesn’t stay still, and over time, and with circumstances (42 different ones!) your doses and timings of doses will need adjusting from meal to meal, and as the weeks and months roll on. Diabetes even changes with the weather - with warmer weather generally making people more sensitive to insulin.

Adjusting mealtime doses to balance with the specific foods you are eating (specifically the total amount of carbohydrate) is commonly called ‘carb counting’. There’s a brief overview here:

The nuts and bolts of carb counting

When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...

www.diabetes.org.uk

You may also find it helpful to adjust doses (downwards) around planned exercise and activity, along with taking fast acting carbs.

Finding the right balance will involve a bit of experimentation. Some find it easiest to plan exercise before breakfast, when they have relatively lower levels of ‘insulin on board’.

Regular overnight hypos should be avoided. Most likely culprit is that your basal (long acting / background) insulin needs to be reduced.

Speak to your clinic about how to make adjustments. Generally a fairly cautious approach (reduce or increase dose by approx 10% and see how things go for a few days) is the sort of thing you’ll be encouraged to try.

Hopefully, before long you will be offered a structured education course like DAFNE or BERTIE, to help you tweak your own doses. There are online versions in the ‘useful links‘ thread if you want to press on while the pandemic slows lots of this stuff down.

Everyone’s diabetes is slightly different, and behaves slightly idiosyncratically. Ultimately the world expert in your diabetes will end up being you. 🙂

Great thank you! I will look into the education courses. They definitely seem the best way way forward

 

[Type1Post30]

Hello @Jamesnott . Welcome to the forum and the club that no one wants to join.
Night time hypo’s are best avoided if possible as they can be more dangerous .
Also having too many hypo’s can cause you to lose hypo awareness.

Were you given a blood glucose (BG) level that you should not be below to go to bed . If so I would temporarily raise that level till you have spoken to your DSN/team, you should have a contact number or email so you can contact them between your appointments.

I keep my diabetes kit and hypo treatments close to me most of the time and us always by my bedside when I am in bed , just in case . I also have hypo treatments in every room including the loo as one if my hypo signs at night is waking suddenly with an absolutely desperate need to wee.
I have Lift glucose tablets in my kit , loo and handbag . small cans of coke in the kitchen , orange juice if I can’t face Coke.

Initially they will need to tweak your insulin units frequently of both your insulin’s as our needs vary, not only individually but with what we are doing or have done

I use a Libre which is similar to a CGM . They both sample interstitial fluid rather than blood, their is a time delay from when glucose hits the blood to when it shows in the interstitial fluid around 10 minutes. also at hyper and hypo levels they are not as good as a fingerpick, their can be a bug difference.
So what I do when hypo is finger prick to get BG level and treat if necessary, then immediately scan so I can see the direction of travel. I carry on in this way every 15 minutes till I am above 4.0 on the fingerpick. At night I would then have a few biscuits or a small snack to keep my BG from dropping again.

If driving the rules for driving after a hypo are different more stringent in fact . I no longer drive other here will know the regs

Thank you - I have just bought some of the Lift Glucose tables. I am currently using the Dextro tablets but they don't seem to kick in that quickly, or only raise BSL very slowly unless I have 4/5.

 

[Ljc]

I prefer Lift too , Also they taste a bit nicer.

 

[Ljc]

Sorry I meant to ask you, what insulin’s are you on

 

[Type1Post30]

Sorry I meant to ask you, what insulin’s are you on

I am on the Abasaglar KwikPen & NovoRapid FlexPen

 

[rebrascora]

Hi and welcome from me too.

It sounds like you might not have been given the 15 rule for hypos?? ie. 15g carbs which equates to 3-4 Gluco or Lift tablets (or jelly babies) and test again (finger prick) after 15 mins. If you are not above 4, then repeat. The Dexcom (or Libre) may actually show that you have dropped lower in that 15 mins because of the 10-15 min lag behind BG levels which is why it is important to check with a finger prick to see if you are recovering, rather than just eat more hypo treatment because your Dexcom shows that you haven't recovered. It is also useful to know that the glucose starts getting absorbed in your mouth so chewing your hypo treatment well can actually mean that it has a faster impact than a couple of chews and swallowing it.

You may find that your insulin needs drop in this early stage after diagnosis, because it is often the case that you will still have some insulin producing cells remaining and once they have had the strain taken off them by injected insulin, they stage a bit of a recovery which is called the honeymoon period. It can mean insulin doses need tweaking quite a bit so do keep in regular contact with your diabetes clinic to get support.
DAFNE courses are starting back up in person in my area so do ask about getting onto the waiting list. It is an intensive course but so much more than just carb counting. It is all about teaching you how to stay safe in any number of real life situations. You also get to spend time with other Type 1s which is a huge benefit in itself and gives you an appreciation of just how variable diabetes can be and learn how to problem solve for each other, so that if/when your diabetes changes as it often does, you have the skills to meet the new challenges it throws at you.

 

[Inka]

I am on the Abasaglar KwikPen & NovoRapid FlexPen

How is your blood sugar during the day? Would you be open to a basal requiring two injections a day as I mentioned in my longer post above @Jamesnott ?

 

[Type1Post30]

How is your blood sugar during the day? Would you be open to a basal requiring two injections a day as I mentioned in my longer post above @Jamesnott ?

I am averaging 8.3 in the day now, which I think is ok? If I can get anywhere between 6-10 I am happy at the moment. I was also recommended changing my long insulin dosage to 4 units in the evening before bed and 20 units in the morning. I haven't done that consistently though when my levels are already pretty steady before I go to bed.. Otherwise I would worry that they could drop too low (similar to last night)

 

[Type1Post30]

Hi and welcome from me too.

It sounds like you might not have been given the 15 rule for hypos?? ie. 15g carbs which equates to 3-4 Gluco or Lift tablets (or jelly babies) and test again (finger prick) after 15 mins. If you are not above 4, then repeat. The Dexcom (or Libre) may actually show that you have dropped lower in that 15 mins because of the 10-15 min lag behind BG levels which is why it is important to check with a finger prick to see if you are recovering, rather than just eat more hypo treatment because your Dexcom shows that you haven't recovered. It is also useful to know that the glucose starts getting absorbed in your mouth so chewing your hypo treatment well can actually mean that it has a faster impact than a couple of chews and swallowing it.

You may find that your insulin needs drop in this early stage after diagnosis, because it is often the case that you will still have some insulin producing cells remaining and once they have had the strain taken off them by injected insulin, they stage a bit of a recovery which is called the honeymoon period. It can mean insulin doses need tweaking quite a bit so do keep in regular contact with your diabetes clinic to get support.
DAFNE courses are starting back up in person in my area so do ask about getting onto the waiting list. It is an intensive course but so much more than just carb counting. It is all about teaching you how to stay safe in any number of real life situations. You also get to spend time with other Type 1s which is a huge benefit in itself and gives you an appreciation of just how variable diabetes can be and learn how to problem solve for each other, so that if/when your diabetes changes as it often does, you have the skills to meet the new challenges it throws at you.

Super useful. And thanks for providing the 15 rule.
One question - If I had a reading of 4.0 then, and decided to take 4 lift tablets accounting for 15g carbs, would would I expect my levels to rise to within that 15 min period? And also would that be enough to see me through the night if it happened at 2ish lets say? Or would I need to eat something more substantial?

 

[Inka]

8.3 sounds good to me 🙂 I agree that taking an extra 4 units of your long-acting (basal) insulin at night in addition to your 20 units in the morning seems unwise if you’re going low at night. I was more talking about a change of basal insulin type eg to Levemir. That would give you more flexibility because you’d be able to change your morning and evening amounts independently.

As I said earlier in this thread, avoiding hypos at night is very important:

http://forum.diabetes.org.uk/boards...iner-questions-help-please.94753/post-1089726

.

 

[rebrascora]

Super useful. And thanks for providing the 15 rule.
One question - If I had a reading of 4.0 then, and decided to take 4 lift tablets accounting for 15g carbs, would would I expect my levels to rise to within that 15 min period? And also would that be enough to see me through the night if it happened at 2ish lets say? Or would I need to eat something more substantial?

It is very much a case of trial and improvement with diabetes because, as said, our bodies all respond slightly differently.

What is currently happening when you have used Dextrose tablets for lows during the night? What does the Dexcom show you your levels do afterwards and what sort of waking level do you get?

For myself, on 4 at 2am I might only take 2 Glucose/Dextrose tablets and be quite confident that I would be safe for the rest of the night as my basal is currently keeping me nice and level so there would be no reason for my levels to drop again unless I had done a lot of exercise the day before, in which case I would probably have reduced my evening basal dose before I went to bed. I can't think of an occasion when I have had longer acting carbs during the night, but then I am extremely responsive to carbs, to the point that I never take more than 3 Lift tabs or jelly babies for a hypo and often just 1 or 2.... I know that is contrary to the rule I just gave you but this is where you become an expert in your own diabetes. The rules are to guide you and keep you safe at least until you get it figured out for yourself and I do feel that Libre and Dexcom are fantastic bits of kit for fine tuning your diabetes management to how your body works.

I am on split dose Levemir and absolutely love it as a basal insulin as it allows me to adjust it on an almost daily basis if need be to suit my body's needs and irregular routine.

The best bit of advice I can give you is to experiment, particularly whilst you have the Dexcom, and document everything so that you can see what works and what doesn't..... Always with a view to keeping yourself safe first and foremost. So if you try 4 lift tablets and a digestive biscuit and you wake up high the next morning, you over did it, so next time you are in that situation, try just the 4 Lift and see what happens. If your levels rise too high and then drop again, then a combination of less Lift tabs and a digestive biscuit might work better for you. If levels go too high and stay high with 4 Lift tablets then you can consider whether 3 or even just 2 might be ideal in that situation. It is all about balancing things and fine tuning that balance as you get more experienced.

I think it can be important to experiment with your bedtime BG limit too. Which means that if your bedtime BG is below a certain level you eat a few carbs to bring it up, often a combination of carbs with some fat and protein to slow the release of the carbs, so toast and pate, cheese and biscuits, a digestive with peanut butter etc.
When I was doing a lot of exercise regularly I needed to bump my evening reading up above 10 or sometimes 12 at bedtime to keep me from hypoing through the night even having reduced my evening basal dose of Levemir to 0 and I would still just dip into the red occasionally at 3-4am for me.

Everyone is different and you need to find what works for you as an individual but there are several different things you can tweak to see what works best in any given situation. It might be making sure your levels are higher when you go to bed and having a slow release bedtime snack to prevent you hypoing through the night. It might be finding the right combination of fast and slow acting carbs to deal with a low through the night as a second option (prevention being better than cure of course) and if necessary it might be changing to a different basal insulin which better suits your body's needs and your lifestyle.

 

[SB2015]

Welcome to the forum @Jamesnott

You have already had lots of answers to your questions.

It sounds like you are getting your head round things, and as your levels are now settling it will be well worth speaking to your DSN about getting on an education course. However you could talk to them about about starting to carb count to help you to start making adjustments to your quick acting insulin (Novorapid).

Your Basal Insulin (Absalgar) is the one that will be responsible for any hypos in the night. talk to your DSN about making adjustments as you want to avoid night hypos.

Jeep the questions coming and let us know how you get on.

 

[Type1Post30]

It is very much a case of trial and improvement with diabetes because, as said, our bodies all respond slightly differently.

What is currently happening when you have used Dextrose tablets for lows during the night? What does the Dexcom show you your levels do afterwards and what sort of waking level do you get?

For myself, on 4 at 2am I might only take 2 Glucose/Dextrose tablets and be quite confident that I would be safe for the rest of the night as my basal is currently keeping me nice and level so there would be no reason for my levels to drop again unless I had done a lot of exercise the day before, in which case I would probably have reduced my evening basal dose before I went to bed. I can't think of an occasion when I have had longer acting carbs during the night, but then I am extremely responsive to carbs, to the point that I never take more than 3 Lift tabs or jelly babies for a hypo and often just 1 or 2.... I know that is contrary to the rule I just gave you but this is where you become an expert in your own diabetes. The rules are to guide you and keep you safe at least until you get it figured out for yourself and I do feel that Libre and Dexcom are fantastic bits of kit for fine tuning your diabetes management to how your body works.

I am on split dose Levemir and absolutely love it as a basal insulin as it allows me to adjust it on an almost daily basis if need be to suit my body's needs and irregular routine.

The best bit of advice I can give you is to experiment, particularly whilst you have the Dexcom, and document everything so that you can see what works and what doesn't..... Always with a view to keeping yourself safe first and foremost. So if you try 4 lift tablets and a digestive biscuit and you wake up high the next morning, you over did it, so next time you are in that situation, try just the 4 Lift and see what happens. If your levels rise too high and then drop again, then a combination of less Lift tabs and a digestive biscuit might work better for you. If levels go too high and stay high with 4 Lift tablets then you can consider whether 3 or even just 2 might be ideal in that situation. It is all about balancing things and fine tuning that balance as you get more experienced.

I think it can be important to experiment with your bedtime BG limit too. Which means that if your bedtime BG is below a certain level you eat a few carbs to bring it up, often a combination of carbs with some fat and protein to slow the release of the carbs, so toast and pate, cheese and biscuits, a digestive with peanut butter etc.
When I was doing a lot of exercise regularly I needed to bump my evening reading up above 10 or sometimes 12 at bedtime to keep me from hypoing through the night even having reduced my evening basal dose of Levemir to 0 and I would still just dip into the red occasionally at 3-4am for me.

Everyone is different and you need to find what works for you as an individual but there are several different things you can tweak to see what works best in any given situation. It might be making sure your levels are higher when you go to bed and having a slow release bedtime snack to prevent you hypoing through the night. It might be finding the right combination of fast and slow acting carbs to deal with a low through the night as a second option (prevention being better than cure of course) and if necessary it might be changing to a different basal insulin which better suits your body's needs and your lifestyle.

Morning,
Last night I did go for a swim early evening and did find my BG levels dropped to 4ish at about 10. So then I took your advice and had a couple of biscuits with peanut butter (+ 4 Dextrose tablets) on before i went to bed and they rose to 9 after an 1.5 hours or so - good news! As I slept they dropped again to its lowest at 4.1 at 03:30 before rising again to anywhere between 6-7 afterwards. I woke up this morning and it was at 7.0. So a better night all in all...
Is it normal to see your levels drop sporadically throughout the night too before rising again Assume so but wanted to check.
Regarding the basal insulin - is this supposed to stabilise my BG levels purely by reducing and glucose in my system throughout the day when I haven't eaten? ie does it act as a catalyst to absorb glucose similar to the Nova Rapid but just covers snacks etc throughout the day? My reason for asking is because I was told to take 4 units before bed, which I am currently not doing because I believe if I did my levels would drop too low, so it is just the 20 units in the morning.
Thanks again!

 

[Type1Post30]

Welcome to the forum @Jamesnott

You have already had lots of answers to your questions.

It sounds like you are getting your head round things, and as your levels are now settling it will be well worth speaking to your DSN about getting on an education course. However you could talk to them about about starting to carb count to help you to start making adjustments to your quick acting insulin (Novorapid).

Your Basal Insulin (Absalgar) is the one that will be responsible for any hypos in the night. talk to your DSN about making adjustments as you want to avoid night hypos.

Jeep the questions coming and let us know how you get on.

Thanks for this, I am feeling better with it all now, lots of steps though. I have a call with my DSN next week where I will get myself booked on a course. Regarding the long insulin of 20 units each morning, it is not worth me adjusting this unless I was going too low right throughout the day?