Starting blood sugar levels

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Mumpie_olgran

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Type 1
Hi all

In amongst the zillion different variables, I wanted to quickly tap into the brains trust in the starting blood sugar levels when working out dosage.

I appreciate that if I have high BS such as greater than 10, then I'll need to bulk up the dosage. But in the last couple of weeks I've also noticed that there's a difference in efficacy even between a starting level of say 5 and 7. Does that resonate with others on the forum, or is it likely I'm seeing patterns where maybe there aren't any?
 
Nope, your observation is correct! However this 'bulking up the dosage' then needs to be analysed 🙂 to fathom out why it has happened. Is it because of a lack of basal insulin at that time of day, or too little mealtime insulin at the meal before? Or - something else entirely .......
 
I don't have that many data points but even from this week, on Tuesday and today I've had near identical days. Woke up to around 6 BS. Same commute and day schedule but for some reason was at 5.5 yesterday when I injected for breakfast (I eat at work) and today 8.5. I had the same breakfast (porridge with a banana) and same Novorapid dose and yesterday I "spiked" to about 6.7. Today I spiked to 12.5

In fairness not for that long but resting state was a bit higher than pre meal

Not exactly a broad sample and doubtless many other factors affecting that I haven't spotted and can't monitor anyway!

Any musings still welcome though
 
Yes, that happens to me too - I find that no 2 days are the same. Just have to go with the flow.
 
One other on a related theme

For me novorapid doesn't kick in that quickly. To the extent that after a few weeks of carefully pushing my bolus earlier and earlier, I now inject around 50 minutes before I eat.

Given the broad guidance that rapid acting insulin is largely through the system in 4 hours, have people found that that's from when it has started to be effective (so in my case basically 5hrs from injection) or from the time of injection?
 
Toooldfortype1 said:
One other on a related theme

For me novorapid doesn't kick in that quickly. To the extent that after a few weeks of carefully pushing my bolus earlier and earlier, I now inject around 50 minutes before I eat.

Given the broad guidance that rapid acting insulin is largely through the system in 4 hours, have people found that that's from when it has started to be effective (so in my case basically 5hrs from injection) or from the time of injection?
Click to expand...
You may find that NR works quicker at different times of the day, so don't assume 50 mins will be the right timing throughout the day every day. For me I needed 75 mins at breakfast time and about 30 mins at lunch time or in the evening and I worked on an activity time of 5 hours for NR and it could very occasionally catch me out with a late surge, particularly after exercise.

I now use FIasp which is slightly faster (45mins at breakfast and 15- 20 mins later in the day) but it has a much shorter duration for me of just 3 hours which I find a benefit. That said it was not an easy or straightforward transition from NR to Fiasp. I had 2x very frustrating 3 months of trying to find a way to make Fiasp work for me, as it is quirky and works differently in different circumstances and I need more of it than NR to do the same job... at times... so I am not necessarily recommending it. The first time I trialed Fiasp, it was a relief to go back to NR at the end of 3 months, which is at least predictable and dependable but yes, sadly not "Rapid". I now manage well with Fiasp, but it was very challenging to swap and the year in between my 2 "trials" probably gave me time to develop additional experience and skill, which enabled me to successfully transition the second time I tried it, but it still was months of frustration before I cracked it and if I hadn't promised myself I would stick at it for a year the second time I would have given in at 3 months and gone back to NR again. Sometimes you have to try something else to appreciate the attributes of what you have now..... "Rather the devil you know as the devil you don't" as the saying goes. 🙄
 
@Toooldfortype1 you may find this useful - 42 factors that affect blood sugars
Unless you live in a bubble that is unaffected by stress, illness, weather, pollen, etc and eat exactly the same food, drink exactly the same drink (alcoholic and not) and never put on weight you will see differences in your levels.
Even if you did the same exercise every day in that bubble you could see differences as your body gets more used to that activity.

As for prebolus time, if you are doing any analysis, in addition to the time of day that @rebrascora mentioned, I would also take a look at your blood sugars before bolusing. This too can affect the speed at which fast acting insulin starts to work. I found Fiasp more pronounced at this than NovoRapid but we experience more insulin resistance at higher levels.

That said, it is important not to let diabetes to take over your life. I recommend finding something that is "good enough" for you and your life. Good enough is different for each of us so it is difficult to advise what this may be for you. Some of us have brains that need perfection in one area, some of us have brains that need more variation. For me "balance" is the key word as my mental health suffers if I aim for perfection.
 
@helli @rebrascora thank you both
That little bible of 42 is gold dust and illuminating. And frankly comforting too
Helli I agree with you on the high starting BS too and in fact prompted this line of enquiry

And furthermore I also hear you on not over stressing it on the diabetes front. At least for the most part, I'm in the stage of actually wanting to learn more and it doesn't really get to me that badly. For the most part 😉 as sometimes it's just %%%!!! annoying!
Thanks for the responses, it continues to help me on what is still very much the early part of my journey
 
rebrascora said:
You may find that NR works quicker at different times of the day, so don't assume 50 mins will be the right timing throughout the day every day. For me I needed 75 mins at breakfast time and about 30 mins at lunch time or in the evening and I worked on an activity time of 5 hours for NR and it could very occasionally catch me out with a late surge, particularly after exercise.

I now use FIasp which is slightly faster (45mins at breakfast and 15- 20 mins later in the day) but it has a much shorter duration for me of just 3 hours which I find a benefit. That said it was not an easy or straightforward transition from NR to Fiasp. I had 2x very frustrating 3 months of trying to find a way to make Fiasp work for me, as it is quirky and works differently in different circumstances and I need more of it than NR to do the same job... at times... so I am not necessarily recommending it. The first time I trialed Fiasp, it was a relief to go back to NR at the end of 3 months, which is at least predictable and dependable but yes, sadly not "Rapid". I now manage well with Fiasp, but it was very challenging to swap and the year in between my 2 "trials" probably gave me time to develop additional experience and skill, which enabled me to successfully transition the second time I tried it, but it still was months of frustration before I cracked it and if I hadn't promised myself I would stick at it for a year the second time I would have given in at 3 months and gone back to NR again. Sometimes you have to try something else to appreciate the attributes of what you have now..... "Rather the devil you know as the devil you don't" as the saying goes. 🙄
Click to expand...
Or to quote another, "the grass is never greener just a different shade of brown" 😉
 
Just to quickly report back. I upped my basal from 12 to 14 and that went well. I've never had a straighter CGM line overnight, it was great. Needless to say my complex "friend" diabetes came back to bite me hard with some massive swings since. Including a pretty debilitating hypo at work followed by some major short temper...

Noting this as a reminder to self to stay strong.

In sporting terms this one feels like a draw at halftime but I do hope my basal positioning has me well placed to eek out a lead in the second half.
 
Torn between responding with a "care" and a "love" but giving you the latter as in the heart to win the second half and claim the match! Good luck! Also loving the reported straight line overnight.... Those always feel like real wins especially if you have changed something to achieve it.
 
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