Purls of Wisdom
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Only if I have to.
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What age were most of you diagnosed
- Thread starter Jenny65
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Sorry I don't quite understand your reply. I probably phased the question wrong I meant are you still on set doses or have you moved on to carb counting and adjusting insulin to match the carbs.
Purls of Wisdom
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I ve moved on to carb counting and finished with it too. My insulin got changed to Levemir (6 twice a day to14 now). NovoRapid fluctuates between 4 - 6. Not that it is working for me. Remarkable ups and downs hence constantly aware and little concerned. Hope this answers your question. X
Leadinglights
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When you say not working what do you mean?
Have you been given a carb to insulin ratio to follow so you can adjust your dose for the carbs you are going to have?
You may need to be thinking about the timing of injecting your NovoRapid, pre bolusing for example.
What do you mean finished with it?
Purls of Wisdom
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Not working for me meaning I am having huge spikes and valleys. 7: 10 for breakfast. 1:10 for lunch and dinner. Wait for 15 mins exactly after injecting and before eating.
Purls of Wisdom
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By finished here I meant that I do not have to keep a diary. Sorry for causing confusion. Unintentionally of course.
rebrascora
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For many of us, 15 mins isn't long enough prebolus time. For instance I need 45mins prebolus at breakfast time and that is with Fiasp in order to prevent my levels spiking up to mid teens. With NovoRapid, it was nearer 75 mins each morning..... which was why I swapped. I need 15-20 mins at lunch or evening meal unless my levels are higher than 8 when I do my prebolus scan and if my levels are above 10, I can sometimes wait over an hour for them to come down before I eat in order to prevent spikes. I have a general rule that I don't eat if my levels are above 8, but ideally below 7, otherwise they will just go high and stay high and I will need corrections later. With Libre I can watch my levels and see when they have come down. This was not really possible with finger pricking so Libre really changes things in preventing spikes by watching for the insulin kicking in and dropping my levels and that is when I eat.
Do they come back down to where you were before eating. If they do then raditos are working.
Purls of Wisdom
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How did you manage to work this out? I was told 15 mins and I ve stuck to that.
Purls of Wisdom
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Yes they do but after giving me enough grief.
rebrascora
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By gradually extending the prebolus timing by 5 mins each day until I stopped spiking but didn't hypo. I got the advice from people on this forum. My consultant was horrified when I told him, especially about the 75 mins at breakfast time but he couldn't argue with my records. I don't actually time it these days, I just scan regularly and I now know when I see my levels starting to drop and get to about 5-6 that I need to eat. I have a fast digestive system but slow response to insulin, particularly on a morning, so the 45 mins is quite extreme but 15 mins would not be enough for many people, so it is worth carefully experimenting with that prebolus time.
Now that we have Libre and we can watch and see when the insulin starts kicking in and bringing our numbers down, it is much easier to sort this problem of mistiming. When we were mostly just finger pricking, we would often not even know that we were spiking high and then crashing back down, because we didn't test, so we just blindly followed that 15 (or 20min) prebolus time and were no wiser. Now with Libre we can see the spikes and take steps to reduce them.
If you start in range and are back in range by the next meal, then it is this timing which is the problem. If you start in range before a meal and spike but don't come down by the next meal then it is likely insufficient insulin and your ratio is wrong (or your carb count was wrong) but may also be timing. If you start in range and then drop into a hypo before the next meal then it is likely too much insulin. If you hypo during the meal or shortly afterwards, you probably waited too long between injecting insulin and eating. It takes some careful experimenting to find the right timing for your body with the insulin you use and the food you eat. The timing can also vary according to the level you start on. Using Fiasp, if my prebolus reading is in the 4s I will likely need much less time for the insulin to work than if my levels are above 8 and if they are above 10, I might be waiting well over an hour.
Ok if they come back down then your radtios are okay.
Purls of Wisdom
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Dear Barbara, thank you for explaining things in great detail. First time I read it, it sounded like rocket science. In equally plain English I am going to ask you few questions which surfaced immediately. My BG levels mostly stay up. Once or twice a week I go in a hypo. e.g. yesterday, I went in red 3.8 on libre2. Gluco Meter read 4.9. Good job I did not hit the 6 Dextrose Tabs in one go. I was feeling kind of hollow, hungry and shaky. I was going to a party. To be on the safe side, I ate a digestive. I ate sensibly. Drank water. Small portions of food. No dessert. But my BG levels ranged from
14.7 at 9:15pm
21.7 at 2:00am
18.4 at 3:00am.
18.2 at 4:15am
17.8 at 7:00am
17.1 at 1:00pm
the trend finally changed. Maybe cos I was rushing around to get organised for the train journey.
8.4 at 4:00pm
The old sensor had expired. New one was already applied, waited for it to activate.
10.2 around 6:45pm.
As you can tell that I did not see any other colour bar orange for almost 19 hours. If any one on this fab forum can make little sense and convince me? That would be absolutely lovely.
The other DSN returned my call last week and mentioned the dreaded word hormones. Can also affect the BG readings I was told. Great as my life is not complicated enough as it is.
Just for my general knowledge, how long does it take to learn these does and don'ts?
My next question is to all the kind and patient people who are not as new as myself -
Is there any other ways to trick this ailment such as food pairing? Has anyone mastered this art? Practiced it? Everyone's thoughts are more than welcome.
Thank you.
Purls of Wisdom
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My range has been set between 4 and 14 as opposed to between 4 and 10. Time in range is 56%. Firstly there is a big difference between the factual range and an average. To me it appears as if I have been let loose with an untrue picture and false expectations to begin with. To make matters worse, I ve seen much higher readings frequently in last 3 months. This does not give me any confidence in myself in regards to how I am tackling things. I am always hungry. Mostly high numbers. Either my ratios are wrong or the amount of insulin. If I seldom brave it, take 1 unit extra, I slip in a hypo. There is no respite in my case specially. I don't seem to be doing anything right for doing wrongs otherwise readings would ve improved or shown some positive signs by now.
That's .ine .oan over. Reached Euston, London. I shall try to put diabetes on the back of my mind and enjoy the wedding. More later. Be safe! Stay well!
rebrascora
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There is no mention there of food and drink ie the amount of carbs or insulin other than that you ate sensibly and small portions but when you injected your bolus and how much is relevant for understanding the numbers and of course how much you ate and when you started eating.
If it was a buffet, they are notoriously difficult to bolus for and I usually end up needing some up front plus 2 or 3 corrections afterwards to bring levels back down. I treat those as special occasions and don't have any set rules for them other than keeping a close eye on my Libre and injecting some more insulin when the numbers keep going up. It takes time and experience and confidence to deal with those situations so at this stage you just have to accept that they mess up your stats but obviously, whatever insulin you had wasn't enough, so give yourself a bit more next time. Once the 4 hours is up from your bolus injection your levels are not going to come back down on their own so a correction dose of bolus insulin would be required but if you haven't been advised regarding corrections then that is something to ask about at your next appointment. They will usually give you a suggested correction dose. This is often 1unit of insulin will drop your levels by 3mmols, so if you were at 17 and you wanted to be down to about 7 you need to drop 10mmols. If 1 unit drops you 3mmols then 3mmols will drop you 9mmols so you might choose to use 3.5 units of insulin as a correction to bring you down into range. It is always wise to err on the side of caution at least at first when you are administering corrections but gradually as you build up experience you will find what works for you and become more confident. I have found with my new insulin Fiasp that I need more insulin and 1 unit will usually just drop me 2 units so my correction factor is 1:2 now
Corrections can be used in between meals but usually not within 3-4 hours of a previous injection because that insulin will still be working to drop your levels or more commonly at your next meal. So if I woke up on 10.6 and I was going to have a breakfast of 35g carbs and my ratio is 1:10 I would have 3.5 units for breakfast plus 2 units correction because 2 units will drop me about 4mmols which would correct my 10.6 down to a reasonable 6.6. So in total I would inject 5.5 units of insulin for my breakfast before I even set foot out of bed, because after that my levels will start to rise due to Foot on the \Floor syndrome. I then get up and potter on getting washed and dressed and make my breakfast and get a cup of coffee and keep a close eye on my levels and once I see the arrow starting to angle downwards and my numbers hit 6 or usually high 5s on the Libre I start to eat my breakfast. For me that is usually about 45 mins after injecting my bolus although with a reading of 10.6 it might need nearly an hour or perhaps longer. My levels will not come down at all unless I inject that insulin and probably just start to rise.
So the fact that your levels stayed high mid teens all night and the next day until well into the afternoon is presumably because you didn't inject any insulin to correct it and perhaps didn't eat anything?? Or maybe you injected a bolus for the food you ate but no correction to actually bring those high levels down. It would be interesting to know if you had any breakfast or lunch today or were you waiting for those levels to come down as per my suggestion not to eat when you levels are above 8? You have to inject insulin first though because otherwise they will not come down.
I can't remembers which basal insulin you take and when you take it but those numbers being so stable from 3am to 1pm suggest your basal is holding you pretty stable (assuming you were fasting during that time) so that is one positive from that situation.
Purls of Wisdom
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Dear Barbara, you ve been diagnosed not so long ago and you know so much. I do not have the guts make any change unless I am told. I genuinely applaud how you have taken charge of something which is very personal and most important to you. Hats off!
rebrascora
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It didn't happen overnight but I picked everyone's brains here on the forum and experimented on myself and went of a DAFNE education course and all these things helped me to build my confidence and figure out the best way for ME to manage MY diabetes. It comes with trial and error and you learn more from the errors than you do the successes, so don't be hard on yourself when things go wrong, especially if you did your best, but try to work out how you could have managed it better so that next time you have something else to try to see if you can get a better result.....
Anyway, enough of diabetes.... You have a wedding to attend and enjoy. Have a great time but keep yourself safe!
Jenny65
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Reading all these replies its strange how we were all diagnosed in different ways some with no symptoms picked up randomly, and others with signs it may have been on the cards. One thing I have realised is that the treatment and advice from GPs etc is also very different.
I was on a work call just now with a colleague, I mentioned my recent diagnosis and he said he is also type 2 and you just eat normally and increase exercise, he said your brain needs sugar to function, then he said he also had high cholesterol (same number as mine) and a fatty liver (he had 2 scans), he is on metaformin for the Diabetes, statins for the cholesterol and another medication for high blood pressure. He asked me what I had been prescribed I responded, well nothing. I am about to see the diabetes nurse and have a scan in August but on a waiting list for the cholesterol. He said but what has your GP told you to do in the meantime, what have they prescribed, told you to do if you feel unwell etc. I said all she said was look at the NHS website and dont google, so he suggested I call my GP make and appointment and ask these things as waiting 8 months for statins if needed is too long.
I have made an appointment with my GP but she is not available for 6 weeks, so still a wait
So I was wondering, when you were first diagnosed were you prescribed medication or did, you have to wait for your diabetes clinic for medication, advice etc.
I was on a work call just now with a colleague, I mentioned my recent diagnosis and he said he is also type 2 and you just eat normally and increase exercise, he said your brain needs sugar to function, then he said he also had high cholesterol (same number as mine) and a fatty liver (he had 2 scans), he is on metaformin for the Diabetes, statins for the cholesterol and another medication for high blood pressure. He asked me what I had been prescribed I responded, well nothing. I am about to see the diabetes nurse and have a scan in August but on a waiting list for the cholesterol. He said but what has your GP told you to do in the meantime, what have they prescribed, told you to do if you feel unwell etc. I said all she said was look at the NHS website and dont google, so he suggested I call my GP make and appointment and ask these things as waiting 8 months for statins if needed is too long.
I have made an appointment with my GP but she is not available for 6 weeks, so still a wait
So I was wondering, when you were first diagnosed were you prescribed medication or did, you have to wait for your diabetes clinic for medication, advice etc.
i was dianogisoed after being rushed to hospital in DKA two days after being told by a doctor now i had a thort infection(so why i'm not keen to expact guess work of the doctors currentlly)
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