Whqt do people do to become more confident

[gillrogers]

I do not believe it! Its done it again tonight! Im thinking now ive not got enough fat on me thighs now, dinner did kick in though after 20 minutes.

 

[Inka]

Try your bum @gillrogers ?

 

[gillrogers]

Try your bum @gillrogers ?

Was thinking that but where do I start with bolus timings? My injection sites feel fine in my thighs but no idea about new areas. To be honest it feels like theres not much fat there either. . All this mess since this started with the lyumjev back in February and trying to carry on withba physical job and then the highs from trying to find my new bolus timings amongst constantly changing basals has made me loose weight. I just dont know what to do now.

 

[Inka]

I think that if you’ve lost a significant amount of weight, it’s important to try to get that weight back on, both for health and also because it should make your injections easier due to a better amount of fat.

I had a similar mess up a few years ago - hypos, highs, weight loss - and it was very stressful. What I did was raise my target range a little, reduce my corrections (to avoid lows) and also reduced my bolus ratios a little. That way I could eat more without the fear of hypos. It took a few weeks to get it right, but it helped enormously.

Then once you’ve got your weight better, you’ll have more physical and mental energy to sort this x

 

[rebrascora]

I inject my basal at 6am as it helps stop a bigger rise before breakfast. I used to do it at 7 but found it too late and gave me similar problems with lunch. Ive considered pushing it back to 5am but i have enough trouble with staying asleep as it is . I dont know

Ok well that isn't the issue then.
I tried setting my alarm for an hour earlier than I intended getting up, to inject Levemir but I soon got sick of that lark! Now I just inject a bit of Fiasp as soon as I wake up and before I get out of bed and that deals with it, but you may not want to do that if your nurse is not wanting you to correct between meals.

I keep going back to that Libre graph you posted and your levels didn't even get down to 6 when they came back up again and it wasn't a massively steep drop, although it was a very steep rise, so you clearly respond faster to carbs than you think, so I really don't think it is you hitting a blood vessel or anything, just panic when you see it starting to drop which is what the insulin is supposed to do. I do understand why it is frightening you but I still think if you hadn't had Libre you wouldn't be aware of it and likely wouldn't panic about it and then eat carbs when you don't need to.
Are you still prebolusing? If so, reduce or stop and just inject and eat for a while to try to get your confidence back a bit. Your Humalog seems to be mostly working pretty quickly except for perhaps that kick in the tail, if that is in fact what we are seeing, or if it is your own insulin production kicking in a bit. Your very low doses , particularly basal, suggest you are probably still making some of your own insulin, possibly quite a bit, so that may be part of the issue although I accept that everyone is different in how much they need.

 

[gillrogers]

I think that if you’ve lost a significant amount of weight, it’s important to try to get that weight back on, both for health and also because it should make your injections easier due to a better amount of fat.

I had a similar mess up a few years ago - hypos, highs, weight loss - and it was very stressful. What I did was raise my target range a little, reduce my corrections (to avoid lows) and also reduced my bolus ratios a little. That way I could eat more without the fear of hypos. It took a few weeks to get it right, but it helped enormously.

Then once you’ve got your weight better, you’ll have more physical and mental energy to sort this x

Im naturally skinny anyway . Can you remember what your target range was? Mines 7-10 now , and i darent reduce my bolus ratios now, my predicted hba1c is 68, its been slowly creeping up all ywar. I know i need more calories too.

 

[gillrogers]

Just a thought, but my hubby is fighting a slight cold or something could it all be caused by me trying to stavr off his bug. I remeber when i had covid my basal came down quite a bit then.

 

[Inka]

Im naturally skinny anyway . Can you remember what your target range was? Mines 7-10 now , and i darent reduce my bolus ratios now, my predicted hba1c is 68, its been slowly creeping up all ywar. I know i need more calories too.

I don’t remember exactly @gillrogers I think my top range was 12 but I don’t remember what I set the bottom range too. It might well have been 7. The important thing I did was not correct, eg I didn’t correct a 9 which I would do normally. I also tried to reduce the rollercoaster. So, for example, I’d be happier staying at 9 all day than lurching between 3.5 and 17, which I had been doing. Levelling things off a bit was important.

(Will post more a bit later - child calling)

 

[gillrogers]

I don’t remember exactly @gillrogers I think my top range was 12 but I don’t remember what I set the bottom range too. It might well have been 7. The important thing I did was not correct, eg I didn’t correct a 9 which I would do normally. I also tried to reduce the rollercoaster. So, for example, I’d be happier staying at 9 all day than lurching between 3.5 and 17, which I had been doing. Levelling things off a bit was important.

(Will post more a bit later - child calling)

Does you basal stay put though? Mine fluctuates quite a bit infact , im luvky if it stays put for two days.

 

[Inka]

Does you basal stay put though? Mine fluctuates quite a bit infact , im luvky if it stays put for two days.

My basal varies through the year, so yes, I adjust it frequently as needed. I adjust my meal ratios to a number of times throughout the year. Not massive changes, but as an example, my evening meal ratio has been 1:10, 1:11, 1:12, 1:13 and 1:15 in the last year (not counting times of illness).

Re putting on weight, I also found MyFitnessPal good as it set a calorie target for weight gain and I could log my food and make sure I hit my calorie target. I increased fats too. For carby snacks, I had slightly less bolus than I thought I needed (to avoid lows and worry about lows).

 

[gillrogers]

OK, that seems to explain what I can make of your graph? Do you have any more graphs? Or even daily patterns.
To your credit, I don’t see any major lows.🙂

Yes theres no major low cos im terrified to get that low. And why i have this fixation on these unexpected drops when i inject for my meal. Yes i can do my daily patterns.

Breakfast has gone without hitch so far.

 

[gillrogers]

Yes theres no major low cos im terrified to get that low. And why i have this fixation on these unexpected drops when i inject for my meal. Yes i can do my daily patterns.

Breakfast has gone without hitch so far.

 

[gillrogers]

My basal varies through the year, so yes, I adjust it frequently as needed. I adjust my meal ratios to a number of times throughout the year. Not massive changes, but as an example, my evening meal ratio has been 1:10, 1:11, 1:12, 1:13 and 1:15 in the last year (not counting times of illness).

Re putting on weight, I also found MyFitnessPal good as it set a calorie target for weight gain and I could log my food and make sure I hit my calorie target. I increased fats too. For carby snacks, I had slightly less bolus than I thought I needed (to avoid lows and worry about lows).

Mybevening bolus does that too. Infact last night indicated that i might need to lower that back by half but thats not what caused the drop to start as soon as i injected.

I use neutracheck to keep track of mine.

 

[helli]

Yes theres no major low cos im terrified to get that low.

What gave me confidence was realising that I can cope with those lows.

When I was first diagnosed, a fellow T1er suggested I deliberately experienced a hypo in a safe environment (at home with my partner) as the fear of the unknown is the worst thing.
I know this is not something a DSN will recommend and not ideal for everyone but it helped me and gave me confidence that, whilst a hypo is unpleasant, I can cope.
Which was good because I lived alone when first diagnosed and very protective of my independence.

 

[Inka]

Did this drop after injecting your basal only start when you changed to Levemir or did it always happen @gillrogers ?

 

[gillrogers]

What gave me confidence was realising that I can cope with those lows.

When I was first diagnosed, a fellow T1er suggested I deliberately experienced a hypo in a safe environment (at home with my partner) as the fear of the unknown is the worst thing.
I know this is not something a DSN will recommend and not ideal for everyone but it helped me and gave me confidence that, whilst a hypo is unpleasant, I can cope.
Which was good because I lived alone when first diagnosed and very protective of my independence.

Hi Helli, ive had hypos and they've taken a long time time out of. It takes me 20 minutes to syart absorbing the glucos and a number of times thats happened and then still no sign of a rise and ive got to wait another 20 minutes. And ive had people here to help me. Its the fear when no one is here which is happening more now due to change d work patterns thats not helping neither is my friend who ended up in a coma etc from one because he was on his own.

 

[gillrogers]

Did this drop after injecting your basal only start when you changed to Levemir or did it always happen @gillrogers ?

I had injected my levemir half hour before. It was on a very steady down , one that doesnt bother me. Then injected my dinner basal and then it started to speed up. But this time dinner visibly kicked in after 20 minutes of eating it.

Injected breakfast into same leg this morning and was fine.

Ive been on the levemir for a couple of years now as i need to be able to do the split doses. Been ok until recently.

 

[Satan’s little helper]

Yes theres no major low cos im terrified to get that low. And why i have this fixation on these unexpected drops when i inject for my meal. Yes i can do my daily patterns.

Breakfast has gone without hitch so far.

OK. I feel we all have different personalities. My story is, I cut my teeth with hypos at school learning how to manage them.
Do you finger prick test when treating hypos. In my experience the meter will tell me I’m recovering before the sensor does? (There can be a sustained sensor lag.) but once back over 5mmol it’s fine with the meter, for me.

Another thought has come to mind. Could your husband have a follower app on his phone (basically checking in on your graph.) your husband could even have a low glucose alarm & missed sensor signal on his phone, too.
He could give you peace of mind checking up you’re OK whilst at work? (Should there be a low.)

 

[helli]

Hi Helli, ive had hypos and they've taken a long time time out of. It takes me 20 minutes to syart absorbing the glucos and a number of times thats happened and then still no sign of a rise and ive got to wait another 20 minutes. And ive had people here to help me. Its the fear when no one is here which is happening more now due to change d work patterns thats not helping neither is my friend who ended up in a coma etc from one because he was on his own.

I too have had hypos that seem to take forever to recover.
But I know I am able to cope.

I had a particularly horrible one this weekend when I had problems with my pump in the middle of the night which resulted in a high at 4am and a prolonged hypo for 3 hours starting at 10am despite eating a tub (not a tube) of Lift tablets and having my basal suspended for all of that time.
And before anyone asks, explaining what happened is not relevant to this thread. What is relevant is whilst I was frustrated and it was unpleasant, I did not need or want any assistance because I have gained confidence that I can cope.

 

[Inka]

I had injected my levemir half hour before. It was on a very steady down , one that doesnt bother me. Then injected my dinner basal and then it started to speed up. But this time dinner visibly kicked in after 20 minutes of eating it.

Injected breakfast into same leg this morning and was fine.

Ive been on the levemir for a couple of years now as i need to be able to do the split doses. Been ok until recently.

You probably think I’m a pain asking for all the details, but to my mind, the thing to do is find out what’s causing the drop: the Levemir injection you’ve recently done; the bolus you’ve just injected; the end ‘kick’ of Humalog from the previous bolus; your own insulin; a combination of those things.

So, I’d try to rule some of those out. I’d delay my Levemir by one hour so you’re not injecting around your evening meal. If you don’t get the drop then, it would suggest your Levemir is the likely culprit. Working in that way, you could do similar for each potential suspect and then find the most likely cause of the drops. One thing I’ve discovered with Type 1 is to assume nothing. It’s best to logically prove or disprove things one by one. You might have already done something along the lines.