PattiEvans
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Hi all
Sometimes it's just so lovely to have people to bounce thoughts about with. Recently I've been doing some very intensive testing and keeping a BG diary so I can show the Endo at my appointment on 12 April which is to find out if he will support my application for a pump. Looking at the BG diary it does throw patterns into perspective. I've come up with some thoughts and I'd appreciate your input.
To start at the beginning. I had a Hba1c under 6 for 8 years but it's been creeping up and last week it was 6.5. No not disastrous, but it's been arrived at by highs and hypos that I've not really had to deal with until the last 2 years.
I've been on 2 x 500mg Glucophage SR for ages. I was moaning to the nurse at the GPs (who's always been brill) that I thought my insulin needs were too high and getting in the way of losing weight, so she told me to gradually increase the met, first by another 500mg and then later to a total of 4 x 500mg. A while ago I had either a tummy bug or it was because I had increased up to 3 x 500mg and so I was reluctant to raise it again, but eventually I did. When I had first raised it to 3 x 500 I noticed a drop in insulin needs and about 3 weeks after increasing it to 4 x 500mg I noticed a further drop in needs. So gradually over the whole period my Levemir went from 15.5u at night and 15u in the morning to 12u night and 12.5u daytime. I was having hypos quite a long time after lunch which these days is normally about 1.15. I would hypo around 7.30 - 8pm. So I deduced it must be my Levemir and reduced it to 12u in the morning. I then noticed that even if I went to bed with an hour's bolus on board my night time BGs were rising in the first half of the night. I did wonder about this and then I recalled that the less Levemir you take, the less time it lasts in terms of hours, so I deduced that my daytime Lev was running out sooner and I daren't increase it due to the evening hypos. So I thought I would compensate by raising the night time Lev. This seems to have worked last night when I raised it .5u.... does anyone follow my line of thinking? Or am I mad?
Conundrum no 2. As I reduced the daytime Levemir the evening hypos got earlier and I realised that actually it must now be my lunchtime bolus that was to blame and I reduced my ratios. That didn't work but suddenly I had a light bulb moment. Because my FBGs have been terrible and continue to rise through the morning I end up doing quite a large correction dose with my lunch - and if all my other needs have decreased, it must be my correction ratio that's also dropped? Does that make sense?
If it weren't for the changes in needs caused by the metformin it would all be easier to see, but it really is confusing issues right now.
Sorry to go on so long, hopefully someone can make sense of it all!
Sometimes it's just so lovely to have people to bounce thoughts about with. Recently I've been doing some very intensive testing and keeping a BG diary so I can show the Endo at my appointment on 12 April which is to find out if he will support my application for a pump. Looking at the BG diary it does throw patterns into perspective. I've come up with some thoughts and I'd appreciate your input.
To start at the beginning. I had a Hba1c under 6 for 8 years but it's been creeping up and last week it was 6.5. No not disastrous, but it's been arrived at by highs and hypos that I've not really had to deal with until the last 2 years.
I've been on 2 x 500mg Glucophage SR for ages. I was moaning to the nurse at the GPs (who's always been brill) that I thought my insulin needs were too high and getting in the way of losing weight, so she told me to gradually increase the met, first by another 500mg and then later to a total of 4 x 500mg. A while ago I had either a tummy bug or it was because I had increased up to 3 x 500mg and so I was reluctant to raise it again, but eventually I did. When I had first raised it to 3 x 500 I noticed a drop in insulin needs and about 3 weeks after increasing it to 4 x 500mg I noticed a further drop in needs. So gradually over the whole period my Levemir went from 15.5u at night and 15u in the morning to 12u night and 12.5u daytime. I was having hypos quite a long time after lunch which these days is normally about 1.15. I would hypo around 7.30 - 8pm. So I deduced it must be my Levemir and reduced it to 12u in the morning. I then noticed that even if I went to bed with an hour's bolus on board my night time BGs were rising in the first half of the night. I did wonder about this and then I recalled that the less Levemir you take, the less time it lasts in terms of hours, so I deduced that my daytime Lev was running out sooner and I daren't increase it due to the evening hypos. So I thought I would compensate by raising the night time Lev. This seems to have worked last night when I raised it .5u.... does anyone follow my line of thinking? Or am I mad?
Conundrum no 2. As I reduced the daytime Levemir the evening hypos got earlier and I realised that actually it must now be my lunchtime bolus that was to blame and I reduced my ratios. That didn't work but suddenly I had a light bulb moment. Because my FBGs have been terrible and continue to rise through the morning I end up doing quite a large correction dose with my lunch - and if all my other needs have decreased, it must be my correction ratio that's also dropped? Does that make sense?
If it weren't for the changes in needs caused by the metformin it would all be easier to see, but it really is confusing issues right now.
Sorry to go on so long, hopefully someone can make sense of it all!
