Thanks Kaylz - Yes, I think I've done the DAFNE basal testing i.e. a carb-free lunch - my BG stays more or less the same until before supper. In the morning I have 40g of carbohydrate and 7 units of novorapid. That brings my BG down by lunchtime but it's high until it comes down.
No Inka you weren't unclear. Today I had 2 boiled eggs and my BG went up as I said :-(
Thanks so much for the suggestions everyone.
Hi Kathy,
Sorry to hear you're having these issues. There has been some good comments from the other posts. It's tricky starting new insulins (
particularly Tresiba because you have to wait a few days before making any changes and seeing the effects). I too use Tresiba Degludec, 20units each morning for past couple of years. My basal has been very steady throughout the 24hrs of the day.
I hope i'm not trying to tell you things you already know as you have had type 1 for a lot longer than I have but here goes....
You said you "think" you've done basal testing. If you are having the problems you describe, like Kaylz said, first point to start looking is at
24hr basal testing. To get a full picture of the entire day, this needs to be done at more than just lunchtime, it needs to be done at all times of day (not all on same day though) by missing various meals across numerous days. One day do breakfast, another day do lunch etc
You are having problems at 3am and waking.
The 3am hypo is the most important thing to deal with and I'd be dealing with that first before trying to sort the morning issue. It's usually best to only alter one thing at a time (especially with Tresiba). I'd be reducing my basal by just 1 unit. So for me, reducing from 20 units to 19units on Saturday morning at 8am for example, then wait about 48hrs for that change to come through, so about 8am Monday morning. As you probably know, a 1 unit reduction or increase in basal can have a huge affect of blood sugars, so just 1 unit at a time. Then i'd check my 3am blood sugars on Monday night and at waking. Once this is sorted (if it can be) then look at morning rise problem. The problem being, a reduction in basal may sort night time hypo but may lead to constant rises the rest of the day. Ultimately it may well turn out that a pump might be the best solution, but i'd give it a good chance first.
If I've gotten night time sorted then i'd look at the morning rises, I would try skipping breakfast one morning, no food at all. See what happens, by checking blood sugar once an hour, either with finger prick or the libre. See what is happening to my basal levels during that time (is it still rising and by how much? 3mmol or more?), obviously I wouldn't do any exercise during the basal test as that will have an effect on it's own. I usually get a blood glucose rise every morning whether I eat or not and have to take a correction within my breakfast bolus to counter this, which is not an issue. It may be necessary to increase bolus insulin with an extra unit of bolus insulin with the breakfast to counter the rise every morning.
btw, I need to bolus for my breakfast 25mins before breakfast is eaten to prevent a huge spike and I'm also on a much higher ratio at breakfast, more than 1unit for each 10g carbs.
