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Spiking and hypos since using libre

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
@Inka
Sounds like I need to do some research on Fiasp. Just spoke to DSN at length after leaving a message on helpline and she had no suggestion as to what may be happening or what I could do to stop the night time hypos but if they continue, to ring the helpline back! She was supportive of my strategy to go to bed at the top end of range ie 9-10 and reduce my daytime Levemir a bit but was equally in agreement that it was unlikely that my morning Levemir was taking me down 21 hours later.
The only thing I can say that is likely to negate the Fiasp being responsible is that I am using a very minimal amount of it.... 7 units in total yesterday and just 3units the day before so not like there is much going into my system to disrupt things.
 
@rebrascora - have we ever pointed you at the graph to get a better idea of what Levemir does and for how long? First, you need to calculate how much Lev per kg of body weight you use, then you most likely need to increase your screen resolution fair bit, before you try and follow the line of the rate per kg from the LH axis to see how long it's meant to last you. (This came direct from Novo Nordisk when Levemir was launched, same as all other insulin profiles on that site - and the forum is still (just about) going too)

Levemir – detail « Diabetes Support Information Exchange

www.diabetes-support.org.uk www.diabetes-support.org.uk
 
Thanks @trophywench for the graph.
It looks like I am at the very bottom end of that graph using 0.25 units per kilo (I am currently dosing 16 units in the morning and none at night and I am 64kg) so I don't think it shows anything any different from what I was already assuming..... unless I am interpreting it wrong.... ie that at my level of dosage, the single dose of Levemir should peter out at about 17-18hours and therefore can't be responsible for my hypos. Would you agree with that interpretation? Just want to be sure I am not missing anything obvious. DSN didn't think it could be the Levemir.
 
Apologies to @Greys for accidentally hijacking your thread 😳! Hopefully we are all learning in the process.
 
rebrascora said:
Yes, that is Foot on the floor or health care professionals may refer to it as Dawn Phenomenon.
I inject my basal and bolus insulin as soon as I get up and I add an extra 1.5 to 2 units to cover Foot on the floor but keep my breakfast ratio to the same as my other meals as I don't relate the extra Fiasp for FOTF I need to my food. Those 1.5-2 units are irrespective of what I eat or even if I don't have breakfast. You would have to rethink your ratios if you adopted this approach. Then I prep breakfast so it is all ready to eat as soon as my levels start to drop, have my coffee, get washed and dressed and say hello on the forum here and wait for my levels to change direction and ideally get below 6 before I eat.
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Thought as I'm sitting at my desk I'd give your 'wait and see when levels drop before eating strategy'. I injected about 20 mins ago and my results keep climbing! Starting to think are they ever going to drop.
 
@Greys... do let us know how you get on experimenting with the timing of your bolus. Fingers crossed it helps you reduce those spikes and fine tune your HbA1c a bit. Not nice going up to mid teens and then coming crashing down.
 
rebrascora said:
I have to confess I am suffering more night time hypos now than I ever have before and it is since I started using Fiasp but can't be directly linked to it as last night's hypo was 12 hours after my last Fiasp injection (only 2 units anyway) and no night time basal. I do wonder if something in the Fiasp has changed how my body responds to insulin or how my liver works. I have however also increased my exercise since starting on the Fiasp so that will also me impacting things.
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Yes same here
 
Greys said:
Thought as I'm sitting at my desk I'd give your 'wait and see when levels drop before eating strategy'. I injected about 20 mins ago and my results keep climbing! Starting to think are they ever going to drop.
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Interesting. I find it takes disproportionately longer for the Fiasp to work if my levels are high to start with and I seem to need a higher correction dose with Fiasp than NR. The fact that your levels are increasing at lunchtime before you eat suggests your basal insulin is not keeping you level unless you had the munchies earlier and ate a snack.
 
So
Inka said:
I don’t have a Libre, partly for the reason you mentioned @Greys and because I do think it can be a ‘curse’ as suggested. We all have to live our lives - controlling the diabetes but not letting it take over and be our life.But I do echo all the above advice to pre-bolus more in advance. I’d also suggest a change of insulin if that definitely doesn’t work. Fiasp simply isn’t right for some people and can lead to worse control.

Did you change your basal amount after a basal test?

It’s concerning you’ve said you’ve never had so many hypos. If it was me, I’d look at my basal again, then look at each mealtime ratio and possibly lower all or some and simply pre-bolus more in advance. If that didn’t work, I’d dum
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Inka said:
I don’t have a Libre, partly for the reason you mentioned @Greys and because I do think it can be a ‘curse’ as suggested. We all have to live our lives - controlling the diabetes but not letting it take over and be our life.But I do echo all the above advice to pre-bolus more in advance. I’d also suggest a change of insulin if that definitely doesn’t work. Fiasp simply isn’t right for some people and can lead to worse control.

Did you change your basal amount after a basal test?

It’s concerning you’ve said you’ve never had so many hypos. If it was me, I’d look at my basal again, then look at each mealtime ratio and possibly lower all or some and simply pre-bolus more in advance. If that didn’t work, I’d dump the Fiasp.
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Basal test? I assume you mean a non carb day to check my levels are correct? Sorry I haven't done this before
 
rebrascora said:
Interesting. I find it takes disproportionately longer for the Fiasp to work if my levels are high to start with and I seem to need a higher correction dose with Fiasp than NR. The fact that your levels are increasing at lunchtime before you eat suggests your basal insulin is not keeping you level unless you had the munchies earlier and ate a snack.
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I finished exercising and checked, my levels were 4.7 but decreasing. I felt a bit funny so took one Jelly baby, thats when they started increasing. Now at 9.7 after taking fiasp 50 mins ago. What is going on???
 
Someone mentioned a suggested rule of not eating if your BG was above 8 which seems to be worth bearing in mind in general rather than just when waiting for insulin to kick in. I like wait until I am mid 5s or 6s before I eat when I am waiting for bolus to work but my digestive system is very quick at breaking food down and getting it into my blood stream. Yours may not be so quick so err on the side of caution and eat as soon as it starts to come down until you get more experience at testing it.
 
@Greys Basically, yes, but divide the day into segments and do one segment at a time so you don’t have to starve yourself. I find not eating at all best not just avoiding carbs.
 
@Greys it isn't so much done in one day, we generally break a basal test into different time blocks done over a week or so
xx
 
Are you confident that the Libre is reading correctly. Have you checked it with a finger prick?
That said I go disproportionately high with a tiny amount of carbs. Try a non carb snack like a piece of meat or cheese to see if that will stop the rise.
 
rebrascora said:
Are you confident that the Libre is reading correctly. Have you checked it with a finger prick?
That said I go disproportionately high with a tiny amount of carbs. Try a non carb snack like a piece of meat or cheese to see if that will stop the rise.
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Just did a finger prick test 8.3
 
You might also find it more helpful to exercise after food to help reduce the spike rather than before.
If you did quite high intensity exercise it will trigger the liver to release glucose. If you exercise after food, the glucose from the food should keep the liver quiet and stop it releasing more and the muscles will just mop up the glucose from the food, but may need to reduce bolus for the meal before exercise and/or top up on carbs later.
 
It becomes quite fascinating seeing how the body works through the Libre. They are now starting to use it on top level athletes like some of the cyclists in the our de France to optimise performance.... that will be the next big market for Libre I think.
 
rebrascora said:
It becomes quite fascinating seeing how the body works through the Libre. They are now starting to use it on top level athletes like some of the cyclists in the our de France to optimise performance.... that will be the next big market for Libre I think.
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Abbot have collaborated with a sport science company and released a Libre with app for the sporting market.
I think it is more around analysis after the fact rather than during a game/race/match
 
@helli Yes that was what I was referring to although wasn't sure it was on the market yet.
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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