Normal or concerning?

[LittleSunflower]

Don’t feel silly injecting one unit. I was on one unit basal for quite a while. You need what you need. 🙂 Yes, this sounds like your honeymoon. The insulin has probably allowed your remaining islet cells to rest and recover a little. That’s why early introduction of insulin for Type 1s is good. Even if a person only needs tiny amounts, it helps preserve the cells longer. When your honeymoon ends, you’ll notice your blood sugar going up and that you need more insulin. This happens gradually but sometimes in fits and starts.

Ha - you guessed right about my feelings on the Novorapid Good luck with your chat to the hospital next week. You’re doing great and honestly coping very well🙂

Have you had a period where you didn’t need insulin again? My levels have been dropping to anywhere between 5-6 before my bedtime snack and then back up to 10.4 after that’s digested and before I sleep. I’ve been setting an alarm for 3am but my levels are anywhere between a 5-7 at that time again. Today my libre alarm went off, 4.4 at waking! Blood said 6 so I know that’s quite a difference but thankful for the alarm. I seem to have the Dawn phenomenon thing because as soon as I get up and out of bed, my sugars raise by 1-2mmols - is that what that is?
Because I’m only on the 1 unit of Levemir, I don’t feel comfortable not taking any. Whereas if I was on more than 1 unit, I would definitely be reducing my dose due to my levels dropping in the night again.

The call with the hospital was pointless, they didn’t even know I had a libre, asked me to connect to them and said they’d ring again in 2 weeks to discuss my level data.. that’s it end of phone call!?
I miss the community team so much.

 

[Inka]

@LittleSunflower I skipped injections to see what happened but I never completely stopped my insulin. I can’t remember the precise details now but I believe I stopped all insulin for around a week. My blood sugar was ok and I could get good numbers by testing 4 times a day, but extra tests showed I was going up to 10 or 11 or even higher in between times. I could see that my own insulin was kicking in and bringing my blood sugar down by itself, but I wanted to help those islets go on as long as possible, so I always went back on my insulin even if it was tiny amounts eg my 1 unit of basal. I didn’t want to spike too high and then ‘wear out’ my islets by making them get my blood sugar down.

I believe that that was what helped my honeymoon go on so long - using insulin to help not exhaust the remaining beta cells.

Dawn Phenomenon is where your blood sugar increases before waking. Mine starts doing that from around 3 or 4am. I didn’t have a noticeable DP when I was first diagnosed (presumably because my body was helping out). I only noticed it years later. However, rising blood sugar when you get up is a different thing called Foot On The Floor - ie ‘stress’ puts it up as soon as you get out of bed. I have that too. The rise you got is quite small so I wouldn’t worry.

 

[trophywench]

'Foot on the floor phenomenon' is just the name that a gang of us on DSF came up with years ago to cover what happened to us because it definitely isn't 'Dawn phenomenon' if you see what I mean, because it always happens after we get out of bed rather than before. Breaking our fast usually stops it rising pdq, but eating does usually mean we need to bolus for brekkie. Easier and quicker for me on work days therefore to just eat summat normal and bolus so I used to have one weetabix with milk before putting my top clothes on and driving to work.

 

[LittleSunflower]

I had a 3 month repeat HBA1C this morning which hurt more than it ever has done.. totally forgot to take my 1 unit of insulin this morning as I had to walk to the surgery and was worried about hypoing on the way back. (All ok, I was fine)
I do not even remember taking it so I must’ve missed it. Only remembered when it came to lunch +2:30 hours after the usual time I inject. Am I in trouble? Such a silly mistake of mine

 

[helli]

@LittleSunflower if you are taking small doses (1 unit), do you have pens that support half unit?
Being insulin sensitive, these may be very useful (and there is nothing wrong with taking half a unit).
I do not know if half unit single use pens are available but I always recommend reusable pens as these take up less space, are more robust and better for the environment.
If you are not already using half unit pens (and reusable pens), I strongly recommend requesting them for your prescription.

 

[rebrascora]

I doubt very much it will make a difference with it being such a small dose and it seems like your pancreas has picked up a lot since it got a bit of help from the Levemir. You could inject it now if you are sure you didn't inject it before but it would be interesting to see how you manage without any. Things won't go too far astray. Just goes to show how something that was such a big deal the first few days can become so routine you can't remember/be sure whether you did it or not even in this short space of time

 

[LittleSunflower]

@LittleSunflower if you are taking small doses (1 unit), do you have pens that support half unit?
Being insulin sensitive, these may be very useful (and there is nothing wrong with taking half a unit).
I do not know if half unit single use pens are available but I always recommend reusable pens as these take up less space, are more robust and better for the environment.
If you are not already using half unit pens (and reusable pens), I strongly recommend requesting them for your prescription.

The hospital said they’d prescribe half unit pens as I am super sensitive to insulin but that was 3 weeks ago and I haven’t heard anything more in regards to this. It’s on my list of things to ask for, thank you

 

[LittleSunflower]

Me again!
My libre alarm went off half an hour ago, 14.5 arrow facing upwards.
Tested for ketones, result 0.04.
My current blood level is 17.2.
I’ve drank some water and been on a short walk, any advice? When do I need to test again?
I haven’t been this high since diagnosis. (My anxiety and stress probably isn’t helping either)

 

[rebrascora]

Hi
Sounds like your honeymoon period may be coming to an end. Have you started using NovoRapid yet and if not do you have any that you can use?
What is the Libre showing now?

 

[LittleSunflower]

Hi
Sounds like your honeymoon period may be coming to an end. Have you started using NovoRapid yet and if not do you have any that you can use?
What is the Libre showing now?

Hello, I was thinking this too as @Inka said my levels may rise when it does. I haven’t started Novorapid yet, I have 5 pens in the fridge, new and still sealed!

One hour later, my libre says 12.8
blood says 13.0
ketone blood test said Lo

 

[rebrascora]

Since it has come down a bit I would be tempted to have a unit of Levemir tonight rather than break open the NovoRapid when it hasn't been sanctioned by your HCPs yet, which was what I was going to suggest if it hadn't come down.

What did you have to eat this evening? Was it something unusually carby or have you perhaps had the Covid vaccine recently as that is causing major fluctuations for many people myself included?

 

[LittleSunflower]

Since it has come down a bit I would be tempted to have a unit of Levemir tonight rather than break open the NovoRapid when it hasn't been sanctioned by your HCPs yet, which was what I was going to suggest if it hadn't come down.

What did you have to eat this evening? Was it something unusually carby or have you perhaps had the Covid vaccine recently as that is causing major fluctuations for many people myself included?

My levels are still dropping quite a lot when I’m asleep. I’ve been advised to have a level between 9-10 before sleep due to this as previously mentioned.

I had some southern fried chicken, beans & a slice of wholemeal bread for my dinner which calculated to around 42 carbs.
I was 7.9 before dinner, 9.1 an hour later and then the high happened about two hours after. During this time, I did have overwhelming anxiety, not a full on panic attack but very anxious nonetheless which I think may have influenced the rise too.
No, I haven’t had the vaccine yet.

 

[rebrascora]

If it continues to drop towards bedtime then I wouldn't use any Levemir but I would be very cautious about having a snack before bed .... maybe just one biscuit if you need something to bring levels up a bit and contact the hospital team tomorrow as it looks like you could do with starting the NR with meals.

It is not clear if you were stressed about something and that put your levels up and caused the alarm or if you were stressed as a result of the Libre alarm going off and seeing your levels were so high??

 

[LittleSunflower]

I had my HBA1C result.. it’s 65. Why has it gone up since starting on insulin, is this normal? Panic mode activated

 

[rebrascora]

Considering the very short time you have been on insulin, 65 is a good reading. What was your previous one and when was that?

How did you manage last night? Did your levels settle and what happened this morning after breakfast?

Have you managed to speak to anyone about starting on the NR with meals or even just let them know about your sudden rise last night after food?

 

[LittleSunflower]

Considering the very short time you have been on insulin, 65 is a good reading. What was your previous one and when was that?

How did you manage last night? Did your levels settle and what happened this morning after breakfast?

Have you managed to speak to anyone about starting on the NR with meals or even just let them know about your sudden rise last night after food?

My previous result was 50 in February.
I had one digestive biscuit last night as my levels settled themselves to an 8.3 after the panic of the high.
I went to sleep on a 9.3 Libre reading. I woke with a 5.8.
I only had half a portion of my usual breakfast this morning (wholemeal marmite toast and a cup of decaf tea, I usually have two slices) which took me to 8.0. Usually it’s up in the 11s as it is a 30g meal. So was only 15g this morning.
I have phoned the hospital and left a message as it is an answerphone saying I need more support and guidance with my insulin so hopefully that will get the ball rolling.

 

[rebrascora]

Sounds like you managed last night and this morning brilliantly. Well done! You should have more faith in yourself and panic less because you are doing great

Since February, your pancreas has started to falter and that is why your reading has gone up. You are now able to see all the highs and lows with your Libre but before you got that I imagine there were periods where your levels may have been quite high for longer periods, so that will be why your reading is higher.

HbA1c is kind of an average reading of your BG levels over the past 3 months because it measures the glucose stuck to the red blood cells and they live for about 12 weeks before they die and are replaced by new clean cells which then start to pick up glucose.... so this recent reading covers the period before you started on insulin (which was early April I believe) as well as now and you were getting readings in the teens at that time so that will have had an impact on this reading. I am sure your next one will be a bit better. It took me 1.5 years on insulin to get my reading down to 48 and it will have gone up a little since then.

The fact of the matter is that managing diabetes with insulin is very complicated and getting back to a reading of 50 will actually be a major achievement and may take some time and experience, which you don't yet have. The important thing is to avoid hypos and slowly learn how to manage your levels and figure out tactics which work for you... and usually, just when you think you have got it figured out, things will change and you will have to have a rethink. Your goal should be to aim for an HbA1c below 65 next time even if it is only just one or two digits lower. Slow steady improvement is much better than sudden reductions. We could all get really low HbA1c results if we let ourselves hypo several times a day but it wouldn't be healthy to do so. It may be that your next reading goes up a little bit after you start to use NovoRapid as that will change things and mean you have to learn a new set of rules/tactics for that until you get the hang of it, but if you don't start NR it would go up any way, so don't worry too much if that happens

I find it is really important to set realistic targets with diabetes and I can tell you, and I am sure @Inka would agree, that 65 is a great result for you at this stage, so please don't worry about it.

My HbA1c was 112 at diagnosis and despite being incredibly strict with my diet and cutting out almost all carbs, which was a massive change for me, it went up to 114 five weeks later. After starting on insulin, my next reading was 90 and then 78 I think and it took me a year and a half to bring it down to 48. I don't know if I will be able to achieve 48 again but if I can keep it to 55 or below I will be reasonably happy.

 

[Inka]

I had my HBA1C result.. it’s 65. Why has it gone up since starting on insulin, is this normal? Panic mode activated

Coincidence 🙂 Your islets were failing and then you started on insulin. The cause of your higher HbA1C is the former not the latter.

Re your Novorapid pens, are they disposable ones and are they half unit pens? I didn’t think you could get half unit disposable pens? If they’re not half unit, do ask for a reusable half unit pen instead. You then simply add a Novorapid cartridge and can use the same pen for ages. The reusable pens are better, more robust and more environmentally friendly. Mainly, they’re just better all round.

 

[LittleSunflower]

Me again! My libre is currently saying I am 15.5 so I did a blood test and it says 13.8.
I also tested for ketones by blood test and it said 0.8. The first nurse I met with when we did an insulin start said anything over 0.7 is to be concerned about but I haven’t been given any advice on treatment wise. I haven’t got a medical team to call as I’ve been discharged from the community team and the hospital clinic don’t work weekends. I have a headache which I usually get when I’m high. Slightly panicking (again). Any advice? Should I ring 111? Thanks x

 

[Inka]

Test again by fingerprick - what are you now? Drink plenty of water that will help. I don’t think you’re on the NR yet? But you’d use that to correct. However as it’s evening and we’ve no idea of your correction factor then it would be best to wait a little and keep drinking water.