Struggling

[Bruce Stephens]

I have a trail Libre in my cupboard I was sent but I can’t inject my arms so no idea how I’d get a sensor there.

Alcohol and a friend 😉? It uses an applicator so you don't actually see anything happening. It makes a sharp noise, admittedly. Could you ask a DSN to do it for you (anyone who's done it before, really, so knows what to expect)?

 

[StephB]

Have you run a basal test recently? It means skipping a meal or two, but might really help you see whether your meal doses are causing the drops, or if it’s a general background slide.

My basal need changes very often - at least once a month it needs a little tweak (easier on a pump), but getting my basal ‘mostly right’ on MDI was a massive breakthrough for me and solved a lot of seeming ‘diabetes randomness’

There’s a method here which might help?
https://www.mysugr.com/en/blog/basal-rate-testing/

Never even heard of this? I’ve always ate at my exact times throughout the day and injected what ive been told. Will definitely have a look into this!

 

[StephB]

Alcohol and a friend 😉? It uses an applicator so you don't actually see anything happening. It makes a sharp noise, admittedly. Could you ask a DSN to do it for you (anyone who's done it before, really, so knows what to expect)?

I don’t drink. Scared it’d be the death of me with all these hypos!! But gosh I need one. I don’t really know anyone that’s done it. I actually don’t know many diabetics, well type 1, i 9th know type 2s and I’ve never known them to use a sensor.
I could ask my nurse when I go in December maybe.

 

[everydayupsanddowns]

Never even heard of this? I’ve always ate at my exact times throughout the day and injected what ive been told. Will definitely have a look into this!

Are you counting the carbs in your meals and adjusting meal doses to match?

Or do you take the same doses each day and aim to balance them by hitting a particular carb count?

 

[Bruce Stephens]

Scared it’d be the death of me with all these hypos!!

Yes, wouldn't help!

I could ask my nurse when I go in December maybe.

Seems worth a try. At least you can talk about it.

 

[StephB]

Are you counting the carbs in your meals and adjusting meal doses to match?

Or do you take the same doses each day and aim to balance them by hitting a particular carb count?

I was told to stay on 10 units breakfast, 12 units lunch, 14 units dinner then 22 of levemir.

I’ve never done carb counting however I have read up on it, but I mainly go with if it’s high have more insulin if it’s low take less. I’m still quite new to the 4 a day injections, definitely feel like I don’t know enough about it that I should know!

My needle phobia stopped me from doing it but I decided to do so as I was having sometimes 4 hypos in one afternoon and we thought it may be the insulin‘s fault. Until August this year I was on Humalin M3.

But I mainly keep my food the same, only really changing what I eat and when at the weekends when I’m not working and I don’t seem to have the issues then. The carb goal was what I did when I was first injected back when I was 13. However, everyday my breakfast is the same, my lunch varies a little but not much, dinner is the thing I change most and before bed I rarely eat anything and if I do it’s like a piece of toast or something light.

 

[Inka]

@StephB The first few times I inserted my Libre, I used a mirror just to reassure myself I’d got it ready to click in the right place. After that I imagine a clock face and know what bit of my arm to insert in. It’s less painful than injections. Injections in my arm often bruise me - the Libre doesn’t.

To psych myself up, I watched the insertion video a number of times over the period of about a week before having a go myself.

 

[everydayupsanddowns]

I was told to stay on 10 units breakfast, 12 units lunch, 14 units dinner then 22 of levemir.

I’ve never done carb counting however I have read up on it, but I mainly go with if it’s high have more insulin if it’s low take less. I’m still quite new to the 4 a day injections, definitely feel like I don’t know enough about it that I should know!

My needle phobia stopped me from doing it but I decided to do so as I was having sometimes 4 hypos in one afternoon and we thought it may be the insulin‘s fault. Until August this year I was on Humalin M3.

Multiple Daily Injections is much more flexible than M3, that’s for sure!

Keeping to (fairly) fixed doses and sticking to common/known carb counts for each meal in the day is certainly a workable system. A little adjustment of the ‘normal’ doses based on your BG before the meal can be really helpful too.

But if I went back to the system you are using (which I used for many years) I’d also want to consider adjusting the basic ‘normal’ doses depending on what happened AFTER the meal on previous days that week.

Eg if I’d had an afternoon hypo the day before I might take my lunch dose down a notch (perhaps 1 unit?) the following day.

Also “hypos breed hypos”, so once you’ve had one in a day you are statistically more likely to have another, so it might be worth making small adjustments to the dose following a hypo?

If you find these dose tweaks seem to have too large an effect, you could ask for a half unit pen?

Sounds like you are adapting to MDI really well, but remember that you know your diabetes probably better than anyone - so give yourself permission to make cautious adjustments to your doses, based on what you can see happening at the time, even if your HCP has suggested just sticking to the same doses every day.

There are a lot of factors outside of the food you are eating (temperature, level of activity, how stressed you are, hormones) which can affect the performance of your doses day-to-day and week-to-week, so keeping track of current dose performance, and a little ‘crystal ball gazing’ to try to predict what might be needed next can help a lot 🙂