Stupid diabetes (carb counting D:)

Status
Not open for further replies.
SilentAssassin1642

SilentAssassin1642

Well-Known Member
Relationship to Diabetes
Type 1
So we know yesterday was rubbish with that random 17.

I've had a day very much the same...

breakfast woke at 5.1 - had my usual 30g porridge which is always 7u novorapid (something like 34g carbs)

two hours later 4.5 - fair enough, so I have a biscuit at coffee break - not a sweet one just this hobnobby thing

1 hour later 3.4 :( have glucotabs and a biscuit.

pre lunch 13.6 D: Decided to just have my sandwich (c32g carbs, cant remember the exact amount), packet of bbq hula hoops (16g carbs). Go for 5u novorapid with a 3u correction...

2 hours later 15.7 😡 exactly the same problem as yesterday. Is my ratio off at lunch do you think? Do I need more insulin than a 1:10 ratio? I'm still very confused and very very wary about playing with insulin amounts, the thought scares me silly. 4u correction (working on a 1u for 2mmol/L bring down)

45 mins later (4pm) 7.5, ok to walk home on I think

Get home and I'm 2.4!!! (5.21pm) I'm starting to think my correction ratio is well off...

Pre dinner - 6.6 - third of a chicken pie, mash and carrots - again cant remember exact numbers but the pie was about 38g carbs, worked the potato out to be 7u worth and I had lots of carrots so have 1 u for that). Split dose 6u and 5u. At half 8 I was 11.3 so just taken the last lot of NR.

I'm expecting to go either very high or very low...I'm so fed up of these mid afternoon highs and I'm so scared. I don't like it at all. Don't know if its stress or what thats causing it...or whether my ratio is off.
 
Hi Sam, it's tough to get it right isn't it? I'm always a bit high in the afternoons (9ish) but I find if I correct at all then I hypo after walking home. I think everyday exercise such as walking has a massive effect on BG levels and the insulin you need - e.g. I normally walk 1.5 miles to work and back, which I don't think is major exercise. I just had three days of not doing any walking as I was visiting family and I was over 12 at all times!

Maybe you could try taking a bit more insulin at lunch (e.g. 1.2U:10g) and then have a small banana or something an hour before walking home. Also, I'd say try to avoid between-meal corrections for a week or so, as they can send you yo-yoing. At 2 hours your Novorapid could still be working (especially if you injected somewhere fatty, e.g. if I inject into a buttock it's really slow to start work) and so then your correction would cause an overlap. Try to work on just getting the meal ratios right and your levemir right for now.
 
Yes see you are getting the hang of it. You know what to look for and you know what to change but are just nervous of doing it. You are doing fab. Yes I would agree with you that the lunch time ratio now needs altering. Try 1 : 8. Keep the correction as it is or maybe at that particular time of day, as this has happened before, if you need to correct make it 1 units takes you down by 3 mmols, just for that period.

So what I am suggesting is that :

1. Lunch time ratio is 1 : 8 carbs

2. Afternoon only correction is now 1 unit down by 3 mmols (not 2 mmol)


You really are doing great.

How many glucotabs did you use in the morning as you shot up to 13.6 by lunch? Try something different next time. Either only use the glucotabs and leave out the biscuits (radical eh!) or decrease the amount of glucotabs and keep the biscuit.

The new way of thinking and I don't know how far this has got around yet is that even on MDI you now don't need long acting carbs after a hypo. They (whomever 'they' is) say that your basal insulin (long acting) should keep you up once you have used the quick acting carb to get up. This would make sense as it is what we do in the pumping world (no long acting carbs) but obviously your basal insulin is quite different from the pumping basals.

I don't suggest you remove the long acting carb altogether just maybe at that time of day to see what happens. You may have to test more.

Just a thought but great going, keep it up. 🙂
 
Can I just say that I think you lot are brilliant! 🙂

Have you ever thought of taking up rocket science? I'm sure that it would be a breeze for you! 😉

Andy
 
Last edited:
Mmm depends if the rocket is going to move or not, not sure I have time to go to the moon (if you were talking to me by the way 😉) I have a forum I belong to..............
 
Hi Sam

I would not have done the second correction dose on the 15.7. It is only just over 2 greater than when you ate which is where you would hope to be if the dose was correct. If you tested again at 3 hours you may well have found it was dropping. Then at 5 hours were are you ? You would hope to be back were you started but if you are a lot lower then your basal could be too high.

Stress can cause havoc with your Blood Sugars - you may find that when you are home at the weekend you need a different ratio.
 
What bread are you having? (thinking out loud here)

Also it is fine to correct at two hours, the whole idea is that you don't spike and don't need to correct. If you included a correction in your lunch time injection, which you did, you should have been way lower than what you were before lunch ie 13.6. What are you correcting down to?
 
I don't think I explained what I was trying to say properly.

I was not saying that you can't correct at 2 hours. I was just thinking that there were adjustments for being low, then for being high and that maybe the underlying problem is that the basal is too high, which could have shown up if there had not been a further adjustment. Its just that there are so many variables and it may help to try and reduce them. I know that the DSNs I speak to tend to be very much against adjustment doses in that they think it tends to send you in circles. I know what they are getting at but sometimes you just have to adjust or you risk running high for a long time.
 
Quite right Margie.

Correcting is fine but if Sam knows the carbs were perfectly counted then it would seem like the ratio is out so that needs adjusting.

Hopefully once some tweaking has occured then correcting will be only occasionally and not every day at that time.

Not sure why your DSN's don't like adjusting though, I find that an odd thing for them to say. Diabetes is not a constant, it is very variable and changes all the time, loads of tweaking is necessary whether on a pump or MDI. The really only regime that can't cope with too much alteration is mixed insulins, another reason they should be banned or made illegal or something. 🙂
 
If it were me I'd probably want to try to eliminate the mid-morning hypo first before I adjusted the lunch ratio. I know it wasn't a particularly low one but I'd be reluctant to make changes to a different ratio with variables like the effect of a hypo treatment etc... Did you have an earlier low before your high the previous afternoon?

How satisfied are you with your basal level? Have you had a chance to test it at all? That's probably where I'd start.

Of course this is just what I'd do, mainly based on DAFNE 'rules' I have to say! There are so many different ways to approach it all, not necessarily a case of anything being right or wrong, it's what works for you. It can be so frustrating and take a while to get things working but it's so worth that time in the long run, it may not seem like it but it's all good progress, even if it doesn't seem to be going right it's all information to help you get there!🙂
 
Adrienne said:
Yes see you are getting the hang of it. You know what to look for and you know what to change but are just nervous of doing it. You are doing fab. Yes I would agree with you that the lunch time ratio now needs altering. Try 1 : 8. Keep the correction as it is or maybe at that particular time of day, as this has happened before, if you need to correct make it 1 units takes you down by 3 mmols, just for that period.

So what I am suggesting is that :

1. Lunch time ratio is 1 : 8 carbs

2. Afternoon only correction is now 1 unit down by 3 mmols (not 2 mmol)


You really are doing great.

How many glucotabs did you use in the morning as you shot up to 13.6 by lunch? Try something different next time. Either only use the glucotabs and leave out the biscuits (radical eh!) or decrease the amount of glucotabs and keep the biscuit.

The new way of thinking and I don't know how far this has got around yet is that even on MDI you now don't need long acting carbs after a hypo. They (whomever 'they' is) say that your basal insulin (long acting) should keep you up once you have used the quick acting carb to get up. This would make sense as it is what we do in the pumping world (no long acting carbs) but obviously your basal insulin is quite different from the pumping basals.

I don't suggest you remove the long acting carb altogether just maybe at that time of day to see what happens. You may have to test more.

Just a thought but great going, keep it up. 🙂
Click to expand...

Thanks adrienne, I'll give the 1:8 a go today, see how that pans out. Problem may be today that I am taking left overs of last nights pie 😱 we shall see. A split dose may do the job. I'll also havea go with that correction dose:

With the hypo, I had what I had on me. The biscuit was a club bar *hides in shame*. But yesterday, I had the same issue and was also at 11 before lunch and that was after a digestive. Maybe i'm allergic to biscuits? lol/
 
Status
Not open for further replies.
Back
Top