Type 1s - re changing target from lower target to higher target

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mum2westiesGill

mum2westiesGill

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Relationship to Diabetes
Type 1
For example I've changed mine from 5-8mmol to 6-10mmol and my BGs have gone up. Should I be worried?
 
No because that’s why you changed your target! When you do corrections now your bolus adviser is aiming to get you to a level of 8, whereas before it was aiming for 6.5. So of course your levels will go up.
8 is not bad at all though, and I think you changed your target upwards because you have lost hypo awareness and are hoping to get it back? In which case you will have to just live with your levels being a bit higher for a while, because that’s the only way to get your hypo awareness back. In the long run it won’t hurt you to be just a bit higher for a while.
I know you’re scared because you were in DKA a couple of years ago - you admit though that what caused that was because you got really uncaring and were missing out whole injections and so on. You don’t do that any more, you work really hard trying to keep your levels under control, so you don’t need to panic! You’d have to be in the high teens and above for most of the day to be in danger. Keep up the good work!
 
Sally71 said:
No because that’s why you changed your target! When you do corrections now your bolus adviser is aiming to get you to a level of 8, whereas before it was aiming for 6.5. So of course your levels will go up.
8 is not bad at all though,
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Thank you!

Sally71 said:
and I think you changed your target upwards because you have lost hypo awareness and are hoping to get it back?
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Yes that's correct. My other little worry is if this doesn't work and I don't get the hypo awareness back.

Sally71 said:
In which case you will have to just live with your levels being a bit higher for a while, because that’s the only way to get your hypo awareness back. In the long run it won’t hurt you to be just a bit higher for a while.
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Sally71 said:
I know you’re scared because you were in DKA a couple of years ago - you admit though that what caused that was because you got really uncaring and were missing out whole injections and so on. You don’t do that any more, you work really hard trying to keep your levels under control, so you don’t need to panic! You’d have to be in the high teens and above for most of the day to be in danger. Keep up the good work!
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Yes I'm really scared but like you say I do all my injections now so I shouldn't need to panic. The worrying thing is how do I explain to my diabetic nurse why my levels have suddenly gone up?
 
Tell her the truth, tell her that you want to get your hypo awareness back and the only possible way of doing it is to run your levels a bit higher for a while. If it works, great, if it doesn’t well at least you tried and it won’t do you any long term damage. Your nurse should not complain, if she’s any good she should understand and respect what you are trying to do, it’s your body and your life not hers!
 
Sally71 said:
Tell her the truth, tell her that you want to get your hypo awareness back and the only possible way of doing it is to run your levels a bit higher for a while. If it works, great, if it doesn’t well at least you tried and it won’t do you any long term damage. Your nurse should not complain, if she’s any good she should understand and respect what you are trying to do, it’s your body and your life not hers!
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Thank you and how long would you be tempted to keep it at 6-10mmol?

Edit:
We're having a chinese for tea. I always inject afterwards with takeaways or meals out because I don't know how much I'm going to eat. I'm not looking forward to seeing my bedtime BG!
 
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It takes a few weeks depending on how bad awareness is and how well you manage to stay in the slightly higher range. Your body gradually ‘resets’ so you can sense hypos again hopefully,

When somebody has lots of hypos, their body gets used to them and thinks this is Normal. It’s kind of like the opposite of False Hypos.
 
mum2westiesGill said:
Thank you and how long would you be tempted to keep it at 6-10mmol?

Edit:
We're having a chinese for tea. I always inject afterwards with takeaways or meals out because I don't know how much I'm going to eat. I'm not looking forward to seeing my bedtime BG!
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There aren’t set rules we can give you for these things. Give it some time and see what happens to your hypo symptoms. Try to pay attention to your body when you do drop low during this time too, see if you can spot subtle signs you might not have noticed before.
 
I'm not sure what to do about this so any advice would be great.
In my first post I said that I've changed my target from 5-8mmol to 6-10mmol but now unlike my first post where my BGs went up they've come right down with lots of them being below 6mmol and even 2x in the 3s! At this rate I'll have shares with dextrose.
 
Double-check your targets, ratios, etc are set correctly everywhere. Then think of possible reasons eg more active, rushing around extra, shopping, weight loss, etc etc.

It won’t be to do with your changed targets, but if you’re correcting in the 4s and 5s (which is correct) then you will naturally correct more often to start with. Think if you’re having too much basal, or if any meal ratios need adjusting.

If all’s well,then it’s just one of those S*DS Law things where the diabetes does the opposite of what you’re expecting.
 
That could mean anything, basal not quite right, correction or carb ratios need adjusting, or just that the stress/different food etc of Christmas is messing things up. Wait until life is a bit more back to normal and then see what happens.

By the way you do know don’t you, that you only need to eat Dextrose if you are actually having a hypo, i.e. below 4? If you're in the 5s or 4s you are below target but not actually hypo, your bolus calculator will do an adjustment to bring you back up again at the next mealtime and you don’t need to be eating any glucose.
 
Inka said:
Double-check your targets, ratios, etc are set correctly everywhere.
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On MySugr app I noticed target range is set correctly but should hypo be set to 6.0mmol and should hyper be set to 10.0mmol?
Screenshot_20211225-190521_mySugr.jpg

Inka said:
Then think of possible reasons eg more active, rushing around extra, shopping, weight loss, etc etc.
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No changes there

Inka said:
It won’t be to do with your changed targets, but if you’re correcting in the 4s and 5s (which is correct) then you will naturally correct more often to start with.
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If you mean correcting in the 4s and 5s with dextrose then yes that's correct.

Inka said:
Think if you’re having too much basal, or if any meal ratios need adjusting.
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I'm thinking I'm having too much basal which I've been thinking for a while. I'm currently on 15.0 units of tresiba.
 
Sally71 said:
That could mean anything, basal not quite right, correction or carb ratios need adjusting, or just that the stress/different food etc of Christmas is messing things up. Wait until life is a bit more back to normal and then see what happens.
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Here I'm sure I'm having too much basal because whenever I tried to do the basal testing a few weeks ago I had to abandon the tests because I was dropping

Sally71 said:
By the way you do know don’t you, that you only need to eat Dextrose if you are actually having a hypo, i.e. below 4? If you're in the 5s or 4s you are below target but not actually hypo, your bolus calculator will do an adjustment to bring you back up again at the next mealtime and you don’t need to be eating any glucose.
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I thought with me changing my target to 6-10mmol that every time I go below 6mmol ie 4s and 5s that depending on whereabouts I am in the 4s or 5s that I had to take 1/2, 1, 1&1/2, 2 etc dextrose to try and keep me above 6mmol as much as possible. I've been taking them then waiting 15 minutes then testing again etc like you do when you're hypo
 
Hypo is below 4, you shouldn’t change that. You can be below target but not hypo. Target range just means where you would like to be as much as possible, you can set that wherever you like. Hypo means so low that it starts to affect your brain function, which is below 4. At 5 or 6 you are perfectly safe and should be functioning normally, you just choose to be a bit higher than that if you can. You only need Dextrose when you are dangerously low to bring you up quickly, otherwise you can just correct by reducing boluses at mealtimes.
As to what level you set hyper at, people vary at what they prefer but usually about 14, I’d leave it at whatever it is.
If you think your basal is the problem try dropping it by a unit and see what happens, you can always put it back up again if it turns out that wasn’t the problem, nothing is irreversible
 
Sally71 said:
Hypo is below 4, you shouldn’t change that. You can be below target but not hypo.
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Thanks I will leave that as it is.

Sally71 said:
Target range just means where you would like to be as much as possible, you can set that wherever you like. Hypo means so low that it starts to affect your brain function, which is below 4. At 5 or 6 you are perfectly safe and should be functioning normally, you just choose to be a bit higher than that if you can. You only need Dextrose when you are dangerously low to bring you up quickly, otherwise you can just correct by reducing boluses at mealtimes.
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I set the target range to 6-10mmol from 5-8mmol because I've lost my hypo awareness so even just below 3 I get a shock when I test my BG and see that I'm 3 or below.
Then since I changed my target range every time I've tested and see that I'm below 6mmol so like in the 4s or 5s I've been having the dextrose to try and bring me up a bit higher over 6mmol.

Sally71 said:
As to what level you set hyper at, people vary at what they prefer but usually about 14, I’d leave it at whatever it is.
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Again thanks and I will leave that at 10mmol.

Sally71 said:
If you think your basal is the problem try dropping it by a unit and see what happens, you can always put it back up again if it turns out that wasn’t the problem, nothing is irreversible
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I'm really thinking of dropping the basal but as you say just by 1 unit then do the usual diabetic malarkey of having to wait 3,4 or how ever many days until I see any changes arghhhh!!
 
Yes I understand why you’ve increased your target range for now (I hope it works!). It’s just that if you test and are in the 4s and 5s you are below target but not actually hypo so you don’t need to panic and start eating glucose, especially if you are about to have a meal, just let the bolus calculator subtract a bit off your meal bolus to bring you up again. Nobody expects you to be in target range all the time, it can’t be done, but you only need to start eating Dextrose if you are below 4 and actually hypo. Well unless you want to eat Dextrose in the 5s but it seems like unnecessary palaver to me when you could just be getting on with whatever else you are doing!
 
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