I know there's absolutely no excuse, i'm just in despair at the state of my blood sugars at the moment and i'm so embarrassed about going to my doctor about it because i'm terrified they're going to tell me off. I've been a diabetic for 15 years and yet my levels are absolutely disgraceful- ive added a screenshot of a pretty average day according to my libre sensor. I honestly don't know where i'm going wrong. I check often, always have my insulin on time (before eating, and I carb count) and yet it's just totally out of control. It's like my ratios change every day. I know I need to see the diabetes specialist but again, i'm just so ashamed. Has anyone else had blood sugars this bad but managed to get them under control after seeing their diabetes nurse?
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Really embarrassed about the state of my levels
- Thread starter Juscou
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I've never heard of a basal test before, would you mind explaining what that is? Google wasn't very clear.
I'm on novorapid during the day, and levemir once at night.
The big drops are either the time between me having insulin and the insulin actually kicking in (i.e for a meal), or doing a correction dose. I find it so hard to keep my levels steady around food, because sometimes I my insulin takes two hours to kick in, and other times i'm hypo before the meal is even ready :S
I'm on novorapid during the day, and levemir once at night.
The big drops are either the time between me having insulin and the insulin actually kicking in (i.e for a meal), or doing a correction dose. I find it so hard to keep my levels steady around food, because sometimes I my insulin takes two hours to kick in, and other times i'm hypo before the meal is even ready :S
Lily123
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A basal test is something to test whether your basal is the right amount for you. You basically fast for a few hours (after insulin and food has worn off so 5 hours after last correction/food) to see if your basal insulin holds your BG steady.
Levemir has a profile of 12-15 hours depending on the amount and is designed to be taken twice a day because of this so that may be part of the issue
Levemir has a profile of 12-15 hours depending on the amount and is designed to be taken twice a day because of this so that may be part of the issue
Bruce Stephens
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- Type 1
There's a link here:
Useful links for people new to diabetes
These links provide useful information, particularly to those newly-diagnosed. You can also browse the Recommended Books and Links sections for further information :) Contents: Type 1 Section Insulin Pumps Section Type 2 Section General Help and Information Section Complications and screening...
forum.diabetes.org.uk
And as others have said don't feel worried about seeking help. You're having some problems and that's what your DSNs are there for, so let them help. As @Lily123 says, Levemir is a twice a day basal, so just fixing that will probably help a lot (and will, with any luck, be the first thing your DSNs suggest).
Pumper_Sue
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- Type 1
The Drs are not there to tell you off but to help you. No ones perfect and we all need help at some point. Unless you ask for help no one knows you need it.
There's a basal test for pumpers in the pump forum and principle is the same for MDI.
I see you only inject your Levemir once a day most inject twice as it doesn't last 24 hours, well worth looking into that as well.
There's a basal test for pumpers in the pump forum and principle is the same for MDI.
I see you only inject your Levemir once a day most inject twice as it doesn't last 24 hours, well worth looking into that as well.
I remember trialling having levemir twice a day a few years ago but my diabetes team switched me back to only once, although i can't remember why. But this was years ago (at least 5), so probably about time I try it again, lol. I will definitely be open to it if the specialist recommends it.
I'll read through that link now, thank you!
Thank you so much for explaining all this to me, i feel so clueless but you're all being extremely gracious.
I do all my insulin manually, so i'm glad to hear there's a way to do it that doesnt rely on pumps!
I'll read through that link now, thank you!
Thank you so much for explaining all this to me, i feel so clueless but you're all being extremely gracious.
I do all my insulin manually, so i'm glad to hear there's a way to do it that doesnt rely on pumps!
rebrascora
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Hi and welcome.
So pleased that you have come to the forum for help and support as I am sure we can point you in the right direction.
Firstly I would not consider asking a GP for advice on this, you want to be speaking to a DSN.
I am guessing you were diagnosed as a child and have not had the opportunity of an intensive education course like DAFNE (Dose Adjustment For Normal Eating) This may sound like a carb counting course but it is so much more than that and will give you a framework to recognize when your basal needs have changed and your Levemir needs adjusting as well as lots of other situations you might experience like illness and exercise and alcohol and how to keep yourself safe.
As others have said, Levemir works best as a twice a day basal and can be a really good insulin if you have different basal needs during the day and night. For instance I currently need 20 units in the morning but only 3units at night. If I have had a couple of really active days, I might not need any Levemir in the evening otherwise I would hypo but 20 keeps me very steady during the day although it was 24units during the winter and 5-7 units at night. The thing is that your basal need can and do change and you have to learn to recognize this and how to adjust it. I regularly skip meals so it is easy to see with Libre, what my levels do in the absence of food and bolus insulin and find a basal dose that keeps me level and in range. Once you have your basal dose right then it is like a foundation that you can then base your meal ratios on. If basal doses aren't right nothing makes sense and it all becomes very frustrating and erratic..... and hard, unrewarding work!! Get your basal right and life will be so much simpler so well worth skipping a meal once a day every now and then to help figure it out.
Please reach out to your DSN or diabetes clinic for help and do ask about a DAFNE course or whatever your local equivalent is. It is usually a 5 day course but sometimes it a full week and other places they run it as one day a week for 5 weeks. I follow a low carb diet so I was wary of a course with that title ie "Dose Adjustment for Normal Eating" but so very pleased I went on it as it improved my understanding and confidence in managing my diabetes enormously and particularly in adjusting my basal doses to suit my body, which really makes all the difference in the world.
Anyway, please don't feel embarrassed or ashamed about needing help and if anyone "tells you off" then they are very bad at their job and should be sacked! If you don't have the knowledge to fix the problem then it is their job to teach you, not berate you for not knowing. Managing diabetes well is extremely complicated until you learn how your body and your insulin works and match them up and just when you think you have it all figured out your body changes and you have to start figuring it out again, but once you understand that it changes and how to recognize when it has and what to do about it, it all goes a lot more smoothly.
Good luck and do let us know how you get on.
So pleased that you have come to the forum for help and support as I am sure we can point you in the right direction.
Firstly I would not consider asking a GP for advice on this, you want to be speaking to a DSN.
I am guessing you were diagnosed as a child and have not had the opportunity of an intensive education course like DAFNE (Dose Adjustment For Normal Eating) This may sound like a carb counting course but it is so much more than that and will give you a framework to recognize when your basal needs have changed and your Levemir needs adjusting as well as lots of other situations you might experience like illness and exercise and alcohol and how to keep yourself safe.
As others have said, Levemir works best as a twice a day basal and can be a really good insulin if you have different basal needs during the day and night. For instance I currently need 20 units in the morning but only 3units at night. If I have had a couple of really active days, I might not need any Levemir in the evening otherwise I would hypo but 20 keeps me very steady during the day although it was 24units during the winter and 5-7 units at night. The thing is that your basal need can and do change and you have to learn to recognize this and how to adjust it. I regularly skip meals so it is easy to see with Libre, what my levels do in the absence of food and bolus insulin and find a basal dose that keeps me level and in range. Once you have your basal dose right then it is like a foundation that you can then base your meal ratios on. If basal doses aren't right nothing makes sense and it all becomes very frustrating and erratic..... and hard, unrewarding work!! Get your basal right and life will be so much simpler so well worth skipping a meal once a day every now and then to help figure it out.
Please reach out to your DSN or diabetes clinic for help and do ask about a DAFNE course or whatever your local equivalent is. It is usually a 5 day course but sometimes it a full week and other places they run it as one day a week for 5 weeks. I follow a low carb diet so I was wary of a course with that title ie "Dose Adjustment for Normal Eating" but so very pleased I went on it as it improved my understanding and confidence in managing my diabetes enormously and particularly in adjusting my basal doses to suit my body, which really makes all the difference in the world.
Anyway, please don't feel embarrassed or ashamed about needing help and if anyone "tells you off" then they are very bad at their job and should be sacked! If you don't have the knowledge to fix the problem then it is their job to teach you, not berate you for not knowing. Managing diabetes well is extremely complicated until you learn how your body and your insulin works and match them up and just when you think you have it all figured out your body changes and you have to start figuring it out again, but once you understand that it changes and how to recognize when it has and what to do about it, it all goes a lot more smoothly.
Good luck and do let us know how you get on.
Yes you're absolutely right, i was diagnosed at 4 years old and it seems like a lot has changed since then!
Well i was hoping that my GP would be able to refer me to a diabetes nurse? Or do I need to find and reach out to one myself? Sorry if that's a silly question!
Well i was hoping that my GP would be able to refer me to a diabetes nurse? Or do I need to find and reach out to one myself? Sorry if that's a silly question!
Bruce Stephens
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- Type 1
That's likely the way to do it, yes.
In some areas it's usual for people with T1 to be handled by a hospital team, but not everywhere (and not where I am), so to see them again I'd do that via my GP surgery. (And a DSN spends a day or so a month at the surgery seeing patients.)
rebrascora
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OK, so whilst you were at Uni you got transferred to a diabetes clinic near there. Did you ask for a transfer back when you left Uni? Are you back in your home area now or elsewhere? If you are back in your home area you could ring the clinic and see if they can help you direct or if you will need a GP referral. My diabetes clinic has a helpline where you ring and leave a message with your name, date of birth, tel. no. and a brief description of the problem and a DSN rings you back in a few days. Not all clinics will have that facility though so may be worth setting the wheels in motion formally with your GP anyway to get a referral but be aware that there is unfortunately a backlog in most diabetes departments due to Covid.
How far away is your Uni hospital clinic? Just thinking that if you are still on their books and they aren't too far away, that might be quicker.... but still important to get transferred back to your local hosp sooner rather than later unless you envisage yourself moving on through work etc. in the near future.
Bruce Stephens
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I think that's how I'd do it, anyway. As @rebrascora says they have a phone number and email address, and they've got my details (and can look at my LibreView graphs), so for a quick query I'd just contact them directly. I think for an appointment I'd go through my GP for a referral.
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