PEI and Creon. Advice on recalibrating my insulin please

[sololite]

I am 62 year old LADA diabetic. 5 years into my diagnosis and out of the honeymoon period.

I've been chugging along nicely for last 5 years using the same basal dose and 1:10 insulin carb ratio.

I've recently been diagnosed with PEI and am taking Creon with my food.

This seems to have triggered a general rise in blood sugars and I am experimenting to find my correct basal and rapid doses.

I re-read my 'Think Like a Pancreas' book and was overwhelmed by the calculations. My diabetic team advise me to re-read my DAFNE course book.

I am wondering if anyone else experienced this and has some advice please, in particular is there anything I can learn from my Libre graphs that will help me get the right insulin dose?

Thanks for all guidance.

 

[khskel]

Fellow creonista here.

First of all have you done a basal test to check how your levels are without rapid acting insulin being thrown into the equation? Get your basal sorted on its own. I'll post a link to basal testing when I get a chance.

Once you've got your basal sorted look at your graphs. Are your levels post meal returning to pre meal levels within 4 - 5 hours? If no the dose is probably too low/high. If yes are there any spikes or dips before the levels return to normal. Possible timing issues. Spiking could mean you need to jab a bit sooner, dipping could mean you need to delay a little.

Make changes as required but cautiously.

That's the way I do it and it seems to work for me.

The main thing is to get your basal right first.

 

[khskel]

Basal Testing Made Easy

Here's a link for basal testing, which will hopefully clear up the myths for anyone starting on their pump journey http://diatribe.org/issues/13/learning-curve Plus this might help as well. http://diatribe.org/issues/26/thinking-like-a-pancreas

forum.diabetes.org.uk

Link for basal testing.

 

[sololite]

Thanks for your instant reply and advice! I will digest it as you might say 🙂 and report back

 

[nonethewiser]

Also have PEI & take Creon, tbh don't recall insulin needs going up but I'm on pump so basal rates do change occasionally.

Agree with above about getting basal dose sorted then look at meal time ratios.

One other thing, when diagnosed with PEI & started on Creon my consultant requested a Dexa Scan, result was I had Osteopenia so started on treatment, maybe worth requesting scan if not done already.

 

[eggyg]

I was on Creon before becoming diabetic so don’t know anything else. What I will say is my Hba1c is always pretty good, quite often get 100% days on my Libre so I must be doing something right! My ratios do differ on occasion but I don’t stress, I need what I need. A basal test sounds like a good start to your Creon journey. Good luck.

 

[sololite]

Also have PEI & take Creon, tbh don't recall insulin needs going up but I'm on pump so basal rates do change occasionally.

Agree with above about getting basal dose sorted then look at meal time ratios.

One other thing, when diagnosed with PEI & started on Creon my consultant requested a Dexa Scan, result was I had Osteopenia so started on treatment, maybe worth requesting scan if not done already.

Thanks for this advice. I will do. Regards Chris

 

[sololite]

I was on Creon before becoming diabetic so don’t know anything else. What I will say is my Hba1c is always pretty good, quite often get 100% days on my Libre so I must be doing something right! My ratios do differ on occasion but I don’t stress, I need what I need. A basal test sounds like a good start to your Creon journey. Good luck.

Well done on your excellent control. I will do a basal test shortly. Regards Chris