Spiking and hypos since using libre

[Kaylz]

in the our de France

Didn't know it belonged to you and yours LOL xx

 

[rebrascora]

@Kaylz.... Not sure what happened there but spotted that someone had nicked my T

@Greys Have you managed to have lunch yet?? Hope you are OK?

 

[Greys]

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.

Would love to exercise after eating, but due to high intensity, can't really exercise on a full stomach. Interesting info on how liver works.

 

[Greys]

@Kaylz.... Not sure what happened there but spotted that someone had nicked my T

@Greys Have you managed to have lunch yet?? Hope you are OK?

Ate my lunch an hour after injecting when level was 8.3. tomorrow I have decided to eat breakfast and then skip lunch to see what my basal is up to. I love my food, so dreading skipping my evening meal and breakfast, but will have to at some point to get on track with all this. My stomach will wonder what's happening. Lol

 

[Greys]

In all seriousness though, this was starting to get me down, so I'm glad I posted on here to seek advice from others in the same situation as me. Don't know about you, but friends and family never seen to fully appreciate how hard this can be at times and I feel quite alone in my struggle.

 

[rebrascora]

What are your levels like now?
I used to be like that but now I often skip lunch and don't miss it. Since I changed my diet to LCHF I no longer feel hungry. I enjoy my food but it is quite liberating not feeling like I am waiting for my next meal and I feel fitter and healthier than I have for 20 years! And I don't have to calculate and inject for that meal which makes my diabetes management a little easier.

 

[rebrascora]

In all seriousness though, this was starting to get me down, so I'm glad I posted on here to seek advice from others in the same situation as me. Don't know about you, but friends and family never seen to fully appreciate how hard this can be at times and I feel quite alone in my struggle.

We all feel like that about the forum. We "get it", whereas non diabetics (even health care professionals) can by sympathetic but don't fully understand. Having people to bounce ideas off and learn from is a huge benefit.

 

[Greys]

What are your levels like now?
I used to be like that but now I often skip lunch and don't miss it. Since I changed my diet to LCHF I no longer feel hungry. I enjoy my food but it is quite liberating not feeling like I am waiting for my next meal and I feel fitter and healthier than I have for 20 years! And I don't have to calculate and inject for that meal which makes my diabetes management a little easier.

Just checked 6.7 and no spikes . Glad LCHF works for you and you are managing yours diabetes well.

 

[rebrascora]

I don't think that health care professionals encourage us to experiment enough. Not sure if it is part of their training and culture to be the ones in control and managing things but we have to deal with this day in day out, meal by meal and we have to become the expert in our own personal diabetes. Being given facts like Fiasp gets to works in 5 mins isn't helpful but the chances are no one ever told that nurse that they tested it and sometimes it takes 50 mins. He/she is just going off what they were told by the rep/manufacturer or their tutor. Real life is often very different because we are all individuals and yes Fiasp does work that quickly for some people but by no means everyone, just like NR doesn't work in 20 mins for everyone.

 

[rebrascora]

6.7 sounds like a great result so far. Is it steady ie horizontal arrow?

 

[Greys]

6.7 sounds like a great result so far. Is it steady ie horizontal arrow?

Hmmm increased to 8.6 now but still with horizontal arrow. I used to use humalog, but was never advised to delay injecting. Was told by nurse that fiasp works quicker than humalog, now I'm not so sure.

 

[trophywench]

HCPs - well none of us would be here without em, one way or the other .... BUT!!!! in answer to the question Who treats your diabetes? the only correct answer is 'ME! (but with help from X,Y & Z)'

@rebrascora - 0.25u/kg is correct but I'd think between 18 & 20 hrs myself - takes a long while to tail off to absolutely nowt. That was not at all apparent to me till I started using a pump. I had 14u in the am and another 4u approx 21.30 in the evening - leading me to think I hardly needed any overnight - yet my highest hourly basal rate is around midnight! Then plummets pretty sharpish.

 

[pm133]

Hmmm increased to 8.6 now but still with horizontal arrow. I used to use humalog, but was never advised to delay injecting. Was told by nurse that fiasp works quicker than humalog, now I'm not so sure.

Hi @Greys. Not sure I can add much to others comments but just a few thoughts:

It's beginning to sound like your basal isn't correct.
I think you might also have an issue with waiting an hour after waking up before you eat anything which could be causing your liver to dump glucose.
Exercising before eating will mess with your levels too.
To go from 6.0 to over 12.0 before you've even eaten anything is a red flag for this.
If this were me, I would bolus immediately after waking and eat within about 30 minutes. Your glucose levels should increase by about 2-3 mmol/L at the most. I'd exercise 2 hours after eating when levels were at their highest to prevent hypos.

Finally, did I read correctly that you are bolusing at a 1:1 ratio? That seems quite high. Is that normal for this type of insulin? I'm on Humalog and using 1:7 ratios for all meals. If I take more insulin than that I am almost guaranteed to have a hypo if I do any sort of exercise at all.

I think all those things need looking at.

You mentioned not exercising on a full stomach but could you wait a couple of hours after eating and then exercising? If I exercise after my bolus has worn off (equivalent to you doing this pre-breakfast), my glucose levels can go up.

 

[rebrascora]

@pm133 1:1 is a pretty standard ratio for quick acting insulin. It actually means 1 unit of insulin for every 10g carbs not 1g because they are referred to as Carb Portions or CPs in DAFNE terms. Your ratio I assume is in reality 1:0.7? ie 1 unit of insulin to every 7g carbs which is higher... ie you need more insulin for the amount of carbs.

 

[rebrascora]

8.6 was a good result an hour and a half after eating (if my calculations on the timing of your lunch were correct!). How did your levels go for the rest of the afternoon?

 

[Inka]

@pm133 1:1 is a pretty standard ratio for quick acting insulin. It actually means 1 unit of insulin for every 10g carbs not 1g because they are referred to as Carb Portions or CPs in DAFNE terms. Your ratio I assume is in reality 1:0.7? ie 1 unit of insulin to every 7g carbs which is higher... ie you need more insulin for the amount of carbs.

Not everyone uses the DAFNE terms and I find it can be a bit confusing. For that reason, I usually try to put the units in eg I’d say that as 1:10g, and 1:8g, etc. Confusingly, some people call a Carb Portion 15g. There’s also another way I’ve seen people use that apparently also came from DAFNE (?) and swaps the two around.

I’ve always used 1 unit to X amount of carbs and that way was taught for many years, and still is by DSNs in many areas. I find it more intuitive, but that might just be me.

Like @pm133 I too read 1:1 as 1 unit to 1g. Although that seems high, it’s not impossible with IR, including in pregnancy. A friend had that ratio near the end of pregnancy.

Diabetes is always fun! Particularly if you like Maths!

 

[rebrascora]

Thanks for that. It may well be a regional way of expressing it, depending upon the training programs in any given area. I agree 1unit of insulin to1g carbs would be quite high for a "normal" (whatever that is) type 1 Will be interesting to find out what the real meaning of @Greys 1:1 ratio actually is?

 

[Inka]

As I understand it, the Portions/Exchanges came first, then those faded. When I was diagnosed, although in a way portions were still used because my carb list had ‘how to make up 10g of carbs’ and ‘how to make up 15g carbs’ etc, so you could look through the list and plan your meals, the focus was more on grams overall eg you’d be told to eat 40g carbs for breakfast. We were on twice daily insulin then, of course.

Then with the advent of MDI and adjusting bolus insulin, your meal amounts would be converted into a ratio eg 1 unit of insulin covers 10g carbs, so if you wanted 50g carbs for breakfast not 40g carbs, you could then work out the dose.

I don’t understand why DAFNE changed things. Using the previous system would have made more sense, I feel. I mainly see 1:10g but I’m always aware that sometimes we need to check if no units are given - ie gs or CP. Usually it’s 1:Xgs that’s more likely but I think you might be right about @Greys system. I’m totally invested in knowing now

 

[helli]

Diabetes is always fun! Particularly if you like Maths!

As a mathematician ... or, rather an engineer ... I know what you mean about the fun of diabetes maths.
However, my engineering background often shudders when I read some of the terminology. The 1:1 ratio is one and my personal bugbear (although I try to keep it to myself) is describing a graph that goes up and stays high as. "Spike". To me this is a plateau. A spike goes up, comes back down and is shaped like a spike.

 

[Inka]

@helli I want to shout “YEEEESSSS!” Very emphatically but that would be sad so I won’t say anything