Tresiba reductions because of recent hypos and 4's

[rebrascora]

Gill you should not have done a correction at the 2 hour stage because some of your lunchtime insulin will still be working. It may well just be that the glucose from your carbs has hit your blood stream before the insulin.
That is the sort of ill advised correction the nurse might have been referring to.

That said, if you had injected 4 units at lunchtime plus a correction unit which is what I would have done then you would have a similar result to what you have done in that you have injected 5 units of insulin... 3 food bolus for lunch and then 2 correction units afterwards.

We will see if it was a wise decision or not but bear in mind that at tea time you will still have some of that 2 unit correction active, so if your levels are still high, don't be tempted to do another correction with your evening meal.

 

[mum2westiesGill]

Thanks and definitely no more corrections until about 9pm tonight and that's of course only if needed. I think I'd better just stick to meal to meal testing unless of course I felt hypo. As @Sally71 said in my back to basics thread all the in-between tests tell you is that you’ve gone higher which will happen anyway after eating.

 

[Lucyr]

If your target blood glucose in my sugar is set at the higher end of your normal range, say 10, then it will knock some insulin off when you are below that. It could also have been that there was still insulin for breakfast that meant it rounded down. You can always override it though, it only gives suggestions of doses.

 

[Deleted member 25429]

Thanks and definitely no more corrections until about 9pm tonight and that's of course only if needed. I think I'd better just stick to meal to meal testing unless of course I felt hypo. As @Sally71 said in my back to basics thread all the in-between tests tell you is that you’ve gone higher which will happen anyway after eating.

If you match the insulin to the carbs and inject you don’t necessarily go higher because you’ve eaten

 

[Deleted member 25429]

If you match the insulin to the carbs and inject you don’t necessarily go higher because you’ve eaten

With me it’s the timing of the injection that makes the difference

 

[Deleted member 25429]

If your target blood glucose in my sugar is set at the higher end of your normal range, say 10, then it will knock some insulin off when you are below that. It could also have been that there was still insulin for breakfast that meant it rounded down. You can always override it though, it only gives suggestions of doses.

As you say it is a suggestion, for advice only not set in stone

 

[everydayupsanddowns]

Thanks and definitely no more corrections until about 9pm tonight and that's of course only if needed. I think I'd better just stick to meal to meal testing unless of course I felt hypo. As @Sally71 said in my back to basics thread all the in-between tests tell you is that you’ve gone higher which will happen anyway after eating.

Hope your 9pm check sees you back in range Gill 🙂

 

[mum2westiesGill]

Friday continued
18:19pm - 6.2
19:16pm - 4.2 - teatime - meal test
20:33pm - 4.2 test re entered into my bolus adviser because we ate out - I had pizza but not a full one 43g of carbs 3u of humalog
23:47pm - 4.1 - bedtime - below 8mmol so a bit later than this had a bedtime snack of 1 bag of mini choc chip cookies 13g of carbs

Sat 10/7
7:53am - 4.2 - another morning waking up in the 4s for me which I personally think is a bit low - 16u tresiba taken - I've reduced my Tresiba from 18u to 16u so we'll see what the next few days brings

 

[mum2westiesGill]

If your target blood glucose in my sugar is set at the higher end of your normal range, say 10, then it will knock some insulin off when you are below that. It could also have been that there was still insulin for breakfast that meant it rounded down. You can always override it though, it only gives suggestions of doses.

 

[Sally71]

3u is what the bolus adviser said at lunchtime and I just take what the bolus adviser says. Should I have rounded it up myself and taken maybe 4u at lunchtime?

A little update I've just tested again so it's now 2 hours after my lunch
17:01pm - 12.1 not in target - over target and 2u humalog correction done.

I don't usually test in-between meals so this correction in-between a meal is a first.
Because I usually only test meal to meal I wouldn’t have known to do a correction now and would my level of come back down anyway?

This has been really annoying me, the programming seems to be the same as Roche pumps and I couldn’t see why there was a difference. However, it has just dawned on me that if you had a pump and input 36 carbs with a ratio of 1:10, it would give you a bolus of 3.6 units, because a pump can do that. Because you have pens, it has to round it. So it rounded the first one up, but that means you had too much, so maybe it rounded the second one down to compensate. On a pump for those two meals you would have had a total of 7.2 units, it has given you a total of 7 which is closer to the exact amount than 8.
Do you only have a whole unit pen? I thought I read somewhere that you can do half units, is there not a setting where you can tell it to round to the nearest half unit? Or have I got that wrong, if you only have a whole unit pen then you have to round to the whole unit!

 

[mum2westiesGill]

This has been really annoying me, the programming seems to be the same as Roche pumps and I couldn’t see why there was a difference. However, it has just dawned on me that if you had a pump and input 36 carbs with a ratio of 1:10, it would give you a bolus of 3.6 units, because a pump can do that. Because you have pens, it has to round it. So it rounded the first one up, but that means you had too much, so maybe it rounded the second one down to compensate. On a pump for those two meals you would have had a total of 7.2 units, it has given you a total of 7 which is closer to the exact amount than 8.
Do you only have a whole unit pen? I thought I read somewhere that you can do half units, is there not a setting where you can tell it to round to the nearest half unit? Or have I got that wrong, if you only have a whole unit pen then you have to round to the whole unit!

This is the settings on MySugr - at the moment as you can see I've got it on full insulin units but obviously I could change it.


This is my pen - Humapen luxura which has got half units on it.

Because I've decreased my tresiba again this morning is it too many changes in one go if I also changed the MySugr settings to half insulin units?

 

[SB2015]

Hi Gill

this is a quick post and I have not used My Sgr so apologies if it sounds a silly question. When I got my half unit pen I also needed to tell my machine that did my bolus calculations that I could deal with half units. Is that programmed into your My Sugr?

A machine/app will sometimes advise different amounts of insulin for the same number of carbs, if it takes account of the insulin on board/active insulin/ the insulin that is in you that is still working. again I am not familiar with MySugr So someone more knowledgeable may be able to advise.

 

[Sally71]

No I think it would be perfectly OK to change to half units now, you’re not changing how much insulin it thinks you need, you’re only making the doses more accurate.

 

[mum2westiesGill]

Hi Gill

this is a quick post and I have not used My Sgr so apologies if it sounds a silly question. When I got my half unit pen I also needed to tell my machine that did my bolus calculations that I could deal with half units. Is that programmed into your My Sugr?

A machine/app will sometimes advise different amounts of insulin for the same number of carbs, if it takes account of the insulin on board/active insulin/ the insulin that is in you that is still working. again I am not familiar with MySugr So someone more knowledgeable may be able to advise.

@SB2015 no need for apologies. Yes MySugr bolus calculator has got the settings for insulin units.

 

[mum2westiesGill]

No I think it would be perfectly OK to change to half units now, you’re not changing how much insulin it thinks you need, you’re only making the doses more accurate.

I've changed it to half insulin units

Here's my breakfast level etc
9:57am - 6.0 - 45g of carbs 4u humalog

 

[mum2westiesGill]

14:54pm - 7.0 bgl in range 70g of carbs 7u of humalog advised

 

[Deleted member 25429]

I have a different view on all of this . I wouldn’t use an app to tell me what I need . Only I know what I’m doing / have been doing . For example I walked the dogs just after I’d eaten at lunchtime. If I’d used an app it would have told me to inject . I knew I was walking so didn’t bother I was 4.2 before lunch 4.6 after lunch . 4.4 before I had my tea . If I’d injected I would have been hypo whilst walking . I use my own judgement sometimes it works well on the odd occasion it doesn’t and I just correct one way or the other

 

[Lucyr]

This is why we say apps give a suggestion they don’t make the decision. It doesn’t have to be one or the other, you can combine an apps suggestion with your own knowledge to refine the dose. Most do also have options for exercise, illness etc that can give a starting point for the adjustment (based on what you program in), my meter does.

I have a different view on all of this . I wouldn’t use an app to tell me what I need . Only I know what I’m doing / have been doing . For example I walked the dogs just after I’d eaten at lunchtime. If I’d used an app it would have told me to inject . I knew I was walking so didn’t bother I was 4.2 before lunch 4.6 after lunch . 4.4 before I had my tea . If I’d injected I would have been hypo whilst walking . I use my own judgement sometimes it works well on the odd occasion it doesn’t and I just correct one way or the other

 

[Deleted member 25429]

This is why we say apps give a suggestion they don’t make the decision. It doesn’t have to be one or the other, you can combine an apps suggestion with your own knowledge to refine the dose. Most do also have options for exercise, illness etc that can give a starting point for the adjustment (based on what you program in), my meter does.

I just think there are so many variables for example on days I have finance reviews which are stressful I need more . Maybe it’s my age but I prefer to rely on my brain and common sense not turn to an app

 

[Sally71]

Good for you, but not everyone is able to do that or has the confidence to