Whqt do people do to become more confident

[gillrogers]

Whqt do people do to become more confident when faced ng unexpected drops in blood glucose?

Im terrible, anxiety hits me hard and goes on for days . It doesnt help when im on my own especially from 3am in the morning and my husbands gone to work and not vack until the evening. Then i make mistakes and end up high. Ive got a pump assessment in january nwxt year. But I'm really stressing out over it and my basal is doing what it did this time kast year. Ive gone from two units to half a unit in a week. I just cannot stay level.

 

[Inka]

@gillrogers You’re doing the right thing reducing your basal. I notice you said it did the same thing last year. That’s good - yes, good, because there might be some predictability about it that will allow you to be prepared next year.

When are you going low? Have you also looked at your meal ratios? Are you having small carb snacks if needed, eg if you start to drop late morning?

My Dexcom helps my confidence enormously. I think you’ve got a Libre? Set the Low alarm for 5.6. Also, stock up on a variety of hypo treatments and snacks, as knowing you’ve got everything there helps too. Put a little box of them by your bed if you’re worried about nighttime lows.

 

[gillrogers]

@gillrogers You’re doing the right thing reducing your basal. I notice you said it did the same thing last year. That’s good - yes, good, because there might be some predictability about it that will allow you to be prepared next year.

When are you going low? Have you also looked at your meal ratios? Are you having small carb snacks if needed, eg if you start to drop late morning?

My Dexcom helps my confidence enormously. I think you’ve got a Libre? Set the Low alarm for 5.6. Also, stock up on a variety of hypo treatments and snacks, as knowing you’ve got everything there helps too. Put a little box of them by your bed if you’re worried about nighttime lows.

Well yesterday it was looking like i needed a correction for my lunch, stick test confirmed my libre reading. So gave the correction, prebolused then started to drop and drop not fast but enough to give me a probkem, so ate my lunch, 20 mibutes passed and my drop rate was increasing not decreasing and ended up cancelling out my correction with glucose . Then the afternnon i came back down well but faster than expected . Dropped my evening vasal by half because of the afternoon and thought id got it wrong but hadnt. My dinner worked fine. So lowered rhis mornings basal by half again, now on half a unit of levemir and its already giving me indications that its too much again. But i wont know until lunchtime. Interesting ly my night time basal does the same thing twelve hours later overnight. But cos im not having a meal its only a problem when it is too high.

I dont snack as the way my blood sugar takes 4-5 hours to come down it doesnt allow it. Ive tried it and a snack just stops me from coming down before the next meal even with a bolus if needed. I keep being told im on the right ratios and basal when im adjusting. Ive found that ill drop half an hour after a meal when my bolus needs reducing.

Its this basal drop at lunchtime that always causes problems. Only thing i can think of is wait until 2 pm until lunch.

 

[rebrascora]

I hate to say it but what gave me more confidence was having more hypos and learning that I could deal with them. I didn't set out for that to happen and I adjust my Levemir on a near daily basis to try to prevent them but I still get caught out. I find being high really hard work and frustrating and I have to inject correction after correction (often stacked) to bring my levels down even when they get to 8. This is likely because I eat low carb and protein keeps releasing between meals so it needs those corrections.... or I can exercise off that protein release without hypos being a problem. By comparison, hypos or near hypos are very easily dealt with by eating one or two jelly babies. Ok nasty hypos are unpleasant and still a bit frightening occasionally, but I have enough confidence from experience of dealing with minor ones to know I will be OK.
In the early days when I hypoed I would ring my sister or my partner whilst I was recovering and that was some comfort and I would tell them where I was and either ask them to stay on the line until my levels came up or ring me back in 15 mins to check up on me. Now I am happy to go out for a walk on my own at midnight (I like walking at night when there is no-one around) and deal with a low as I walk if necessary. I was very scared with the first few hypos but for me, the more I have had, the more confident I get about managing them and confidence in my hypo treatment (JBs) and how well and quickly it works and how not to over treat, which I absolutely hate. I average just under one mild hypo a day. It may well be that my low carb diet makes my levels more stable so I am unlikely to have really horrid lows, or dramatic highs, so I usually drift into the red rather than plummet which definitely makes them less scary.

 

[Inka]

What was your blood sugar when you corrected at lunch? Where did you inject the correction and lunch bolus (which body area)?

 

[gillrogers]

I hate to say it but what gave me more confidence was having more hypos and learning that I could deal with them. I didn't set out for that to happen and I adjust my Levemir on a near daily basis to try to prevent them but I still get caught out. I find being high really hard work and frustrating and I have to inject correction after correction (often stacked) to bring my levels down even when they get to 8. This is likely because I eat low carb and protein keeps releasing between meals so it needs those corrections.... or I can exercise off that protein release without hypos being a problem. By comparison, hypos or near hypos are very easily dealt with by eating one or two jelly babies. Ok nasty hypos are unpleasant and still a bit frightening occasionally, but I have enough confidence from experience of dealing with minor ones to know I will be OK.
In the early days when I hypoed I would ring my sister or my partner whilst I was recovering and that was some comfort and I would tell them where I was and either ask them to stay on the line until my levels came up or ring me back in 15 mins to check up on me. Now I am happy to go out for a walk on my own at midnight (I like walking at night when there is no-one around) and deal with a low as I walk if necessary. I was very scared with the first few hypos but for me, the more I have had, the more confident I get about managing them and confidence in my hypo treatment (JBs) and how well and quickly it works and how not to over treat, which I absolutely hate. I average just under one mild hypo a day. It may well be that my low carb diet makes my levels more stable so I am unlikely to have really horrid lows, or dramatic highs, so I usually drift into the red rather than plummet which definitely makes them less scary.

Hi Barbera, wish i could be that confident. Hasnt helped by seeing a friend end up in a diabetic coma that ended up in him becoming disabled a few years before my diagnosis.

If someone is in the house i get them.to sit with me or i used to be able to ring paul when he was at work. But hes changed jobs now and instead of just one meal on my own its all 3. I think i am a bit better at the time of going low and i have found a away not to over treat for the most. I think i end up having to deal with too many possible causes and "what do i do to stop it happening again". I just feel like im non stop moving from one hiccup to another and getting absolutely no where. Im.lucky if i have too good days in a row and that usually happens before a crash and those two days have been showing thr signs of a dropping basal.

 

[gillrogers]

What was your blood sugar when you corrected at lunch? Where did you inject the correction and lunch bolus (which body area)?

My blood sugar was 10.7, bolus goes into thigh as no fat on my tummy, so does basal in other thigh

 

[rebrascora]

I wonder if you are over reacting to what Libre shows you rather than waiting it out. Libre has a delay when levels are changing direction. So if they are starting to drop when you start eating, Libre will show them continuing to drop whereas in reality the food will start releasing and bring you back up. Often Libre will show my levels as 3.8 whilst I am eating or just after but the food I have eaten is actually releasing and my levels are not that low and later the graph will show that I didn't hit the red at all even though I didn't eat any extra carbs, but it would be very easy just to respond to that Libre result and eat more carbs and then end up high. You have to learn to hold your nerve a bit with Libre when it shows your levels dropping when you have eaten food and trust your digestion to be releasing that glucose from the food you have eaten. Even at 4.4 with a vertical downward arrow (as occasionally happens when I get distracted at breakfast time, 1 jelly baby will turn it around for me before I hit the red if I chew it well, so I don't panic if I see that. The Libre might say I dropped below 4 if I keep testing, but the graph shows I didn't and if I finger prick when Libre says I am below 4 I am usually not particularly if it is after a meal. It is just the nature of the algorithm which extrapolates the readings, so if you are dropping fats it will continue to extrapolate your levels dropping until eventually it catches on that actually your levels have come back up. This is just me, but you have to learn how fast your body responds to carbs and hypo treatment and don't allow Libre to panic you. I do sometimes think Libre can be a blessing and a curse. It can be such a temptation to chase the dragon's tail with it. Have you tried a break from Libre and learn to listen to your body for a week or two?

 

[gillrogers]

I hear what youre saying Barbera, hence i back up with a stick test which comfirms the trend . It takes me 20 minutes to start showing a rise and when this happens its takes an hour before i stop dropping , level off for about 5 minuted thrn the rise starts. So i am bitting my fingers to some degree. In that hoir yesterday i went from 10.7 down to 7

 

[everydayupsanddowns]

Sorry to hear your hypos are causing you so much stress and anxiety @gillrogers

They really can be scary can’t they. And nasty ones, or very persistent or unpredictable ones (when we know we’ve done everything ‘right’ and it’s just our diabetes behaving erratically) can really shake you up.

A consultant once advised me never to correct after a hypo, because after one hypo another is more likely, and the erratic wobbling from high to low and back again was likely to be worse for you than must letting the high level come down gradually.

I can’t say I always follow that advice, but I do try to remember it when it feels like I’m starting to ride the glucocoaster.

 

[gillrogers]

Sorry to hear your hypos are causing you so much stress and anxiety @gillrogers

They really can be scary can’t they. And nasty ones, or very persistent or unpredictable ones (when we know we’ve done everything ‘right’ and it’s just our diabetes behaving erratically) can really shake you up.

A consultant once advised me never to correct after a hypo, because after one hypo another is more likely, and the erratic wobbling from high to low and back again was likely to be worse for you than must letting the high level come down gradually.

I can’t say I always follow that advice, but I do try to remember it when it feels like I’m starting to ride the glucocoaster.

Thanks Mike, ive not had hypos lately because I cant let myself get low enough from a fear of them even though i try to get lower, however when i have events like yesterday its knocks me and just shows to me what could have happened if i was lower cos of this damn basal dip at lunch time.

 

[Satan’s little helper]

Hello @gillrogers , what bolus insulin do you use? What time is lunch? (Sounds silly question this one, but some eat later.)
And when did you have breakfast?

 

[rebrascora]

I hear what youre saying Barbera, hence i back up with a stick test which comfirms the trend . It takes me 20 minutes to start showing a rise and when this happens its takes an hour before i stop dropping , level off for about 5 minuted thrn the rise starts. So i am bitting my fingers to some degree. In that hoir yesterday i went from 10.7 down to 7

Dropping from 10.7 to 7 in an hour is not something that you should be concerned about and certainly not panic in my opinion. Will be interested to hear what others think. I would be quite happy with that result.

 

[gillrogers]

Dropping from 10.7 to 7 in an hour is not something that you should be concerned about and certainly not panic in my opinion. Will be interested to hear what others think. I would be quite happy with that result.

It is for me when i just bolused for lunch with a correction on board. It only stopped because i ate a glucose tablet. If it was after my meal rise and back down then no i wouldnt be worried but this was after i had bolused for lunch.

 

[Inka]

My blood sugar was 10.7, bolus goes into thigh as no fat on my tummy, so does basal in other thigh

Ok, the thigh is good 🙂 Do you pinch up before injecting? I’m slim and I do, even with a 4mm needle. I find that works best.

Also, how much correction did you inject? Maybe you’re aiming for too low a number and over-correcting? If in doubt, I aim for a slightly higher number and give less of a correction dose @gillrogers

 

[gillrogers]

Hello @gillrogers , what bolus insulin do you use? What time is lunch? (Sounds silly question this one, but some eat later.)
And when did you have breakfast?

I had breakfast at 7.30 and lunch at 12.45. im.pushing lunch around because this natural basal drop confuses matters terribly. But i dont want it really later than 1pm. Im on humalog for bolus and levemire split 12 hours apart.

 

[Satan’s little helper]

Dropping from 10.7 to 7 in an hour is not something that you should be concerned about and certainly not panic in my opinion. Will be interested to hear what others think. I would be quite happy with that result.

My short response without detracting from Gill’s concern. Neither would I.

 

[gillrogers]

Ok, the thigh is good 🙂 Do you pinch up before injecting? I’m slim and I do, even with a 4mm needle. I find that works best.

Also, how much correction did you inject? Maybe you’re aiming for too low a number and over-correcting? If in doubt, I aim for a slightly higher number and give less of a correction dose @gillrogersi

I pinch up, i only did a half unit. I had my grand daughter here so was covering the rest with pumkin carving. Which we didnt get to start until my blood sugars started rising.

 

[rebrascora]

My short response without detracting from Gill’s concern. Neither would I.

And of course it is the concern and and lack of confidence which is the problem here, hence the title of the thread.

Fear and anxiety are terribly debilitating and we all have fears, some of which are more out of proportion than others. I really wish they could bottle confidence and sell it!
If it helps any, the idea of going to a party or gathering of people terrifies me. So many people and so terrified of saying the wrong thing to someone, I can't think of anything to say to anyone as a result! On the other hand, go out for a walk in the middle of the night when I have the world to myself, is no problem at all, even if I hypo whilst I am out. The human psyche is a funny thing.

 

[gillrogers]

And of course it is the concern and and lack of confidence which is the problem here, hence the title of the thread.

Fear and anxiety are terribly debilitating and we all have fears, some of which are more out of proportion than others. I really wish they could bottle confidence and sell it!
If it helps any, the idea of going to a party or gathering of people terrifies me. So many people and so terrified of saying the wrong thing to someone, I can't think of anything to say to anyone as a result! On the other hand, go out for a walk in the middle of the night when I have the world to myself, is no problem at all, even if I hypo whilst I am out. The human psyche is a funny thing.

Isnt it just. I just wish i had the strength over it. And then it doesnt help when my loved ones as so worried about me. My eldest lost his dad 18months ago and i think hes so worried about something happening to me. Ive just got tohold on until january 24th for my pump assessment. DB nurse has said ihave a very good understanding of my diabetes and diabetes overall after a run through of the pathway so its pretty hopeful.
.im just worried that my hba1c is going too high.