Rise of the levels

[Wifeypage]

I was diagnosed LADA in December 2018. But October 2019 I was put on insulin. I’ve had 3 meetings since.
Since then I have only been on minimal insulin of humilin I. 6 units breakfast and novo rapid 2 at breakfast and 2 at dinner.
In trying to take back control of food from Xmas etc so back to checking bloods to see where I’m at. The general level at between 15-21mmol. My wake up bloods are 14-16 mol
tonight for the first time I was able to get my post meal bloods under ten at 8.8 with insulin. First time under ten since last Monday when I started intense checking. But just checked again nearly 3 hours after I last checked and they have risen to 13.5. I haven’t eaten anything either drank water and one cup of tea
Any advice greatly appreciated.

 

[DaveB]

Hi. You need to be shown how to carb-count and not use fixed amounts of the Novorapid for meals. This means taking account of the amount of carbs in each meal and adjusting the amount of insulin for each meal. I think you need to insist that you are shown how to do this. You may also need your Humulin adjusted and the DN should guide you on that.

 

[Inka]

You clearly need more insulin as @DaveB says. Have you tried doing a basal test? I suspect you need more Humulin and probably Novorapid too. You need to adjust that depending on your carbs.

 

[Wifeypage]

You clearly need more insulin as @DaveB says. Have you tried doing a basal test? I suspect you need more Humulin and probably Novorapid too. You need to adjust that depending on your carbs.

Without sounding stupid what is a basal test? I’ve been left to this from the beginning. They wanted me to attend a carb counting class buy only soo I knew what it was they said I never needed to count yet. But then Covid struck and I’ve heard nothing

 

[Wifeypage]

Hi. You need to be shown how to carb-count and not use fixed amounts of the Novorapid for meals. This means taking account of the amount of carbs in each meal and adjusting the amount of insulin for each meal. I think you need to insist that you are shown how to do this. You may also need your Humulin adjusted and the DN should guide you on that.

I know my type of diabetes gets worse as time goes on etc and this is what it looks like it’s doing. As I said to @Inka I’ve been left to it and no contact from anyone no support. Allot of the information I have found out is through my own learning. Sadly the weight I originally lost is creeping back on to which is a pain

 

[Inka]

Without sounding stupid what is a basal test? I’ve been left to this from the beginning. They wanted me to attend a carb counting class buy only soo I knew what it was they said I never needed to count yet. But then Covid struck and I’ve heard nothing

No question is stupid 🙂 A basal test is to check that the amount of basal insulin you’re taking is the right amount to keep your blood sugar steady and in range in the absence of food. Heres some basic information:

https://www.diabetes-support.org.uk/info/?page_id=120

It really annoys me when Type 1s aren’t taught to carb count. It’s impossible to have proper control without it. When I was diagnosed almost 30 years ago, it was absolutely routine to be taught basic carb counting immediately after diagnosis. Then a few years later that all seemed to slip. It’s rubbish. You can’t control without counting carbs.

When you don’t have diabetes, you’re body automatically responds to the carbs you eat by producing the right amount of insulin. With Type 1 that obviously no longer works so you need to count the carbs in what you’re about to eat, and then have the correct amount of insulin for that carb amount. It’s not a hard thing to do.

But it’s always best to make sure your basal insulin is at the correct amount first because that’s the foundation you build on. You say you’re on Humulin I - that often needs to be injected twice daily (because its effect doesn’t last 24 hrs). That would be something else to discuss with your team.

I hope that makes sense - do ask if it doesn’t, and do ask as many questions as you want. As I said, no question is silly.

 

[trophywench]

OMG!!!!

I'm sorry all - it looks to me like they started you off on very conservative doses of both insulins and deliberately chose an intermediate insulin instead of a proper slow release one for your background dose to treat your body mega gently. Yes - suddenly vastly lowering BG pdq can cause more problems - to eyesight for one - so 'conservative' is considered better - but requires A LOT of very regular oversight and review/alteration to begin with, which appears to have been completely forgotten about!

There's no way in this day and age that a newly diagnosed Type 1, or a person at your stage of LADA should be automatically using Humulin I - it was introduced in the early 1980s and was a very useful stopgap in between injecting animal insulin via syringes once or twice a day and the later arrival of insulins enabling a multi dose routine, which has been firmly established since approximately 1995 in the UK.

Your dose of it is woefully inadequate - and with your BG running as high as it is - every bit as dangerous to your health as starting on too high a dose would have been. I wholly concur with the Link Inka posted to the basal testing and you need to start that off with you very first block of testing tomorrow.

But - who is advising you - GP or hospital clinic? If you haven't contacted them already for advice then do that NOW please. Should preferably be a hospital diabetes clinic - they are all still working.

 

[helli]

Should preferably be a hospital diabetes clinic - they are all still working.

Unfortunately, that is not the case every where.
I know of some diabetes consultants who are now working in the covid wards and my DSN has contracted covid herself.
So, whilst I agree that the OP should be working with a dedicated diabetes team (not all are hospital-based), it may be a little harder than usual to make contact.

 

[grovesy]

Unfortunately, that is not the case every where.
I know of some diabetes consultants who are now working in the covid wards and my DSN has contracted covid herself.
So, whilst I agree that the OP should be working with a dedicated diabetes team (not all are hospital-based), it may be a little harder than usual to make contact.

Partha Kar on twitter was saying just a couple of days ago that many teams had been redeployed to wards.

 

[trophywench]

I agree with you @helli - as long as the team has the expertise is the main point !