Yoyoing bolus ratio and basal

[gillrogers]

Had a week of starting a drop 20 to 30 minutes after dinner. Sorted with a glucose tab, expected a high spike but didnt get one and just levelled off. Every day! But each day i reduced my bolus by half and each day it happened again. Yesyerday i dropped my daytime basal by half and it didnt happen. Today though i raised my day time basal back up and its done it again tonight but worse. Ive done nothing but eat glucose all eveing and im.going lower and lower. This seems like bolus but it should be more or less worn off by now. However ithink im dropping during the day before dinner and afyer the lunch bolus has worn off is too fast. I seem to come down faster than i do post meal. my gp now has a specialist gp in diabetes starting up a weekly clinic for diabeyes patients so ive got an appointment booked with her tomorrow. Will be interesting to see what she has to say.

So im still munchingng glucose at a rate of 1 tablet an hour. Bg rises by about .4 mmol then syarts to fall again. So guess my basal is too high.

 

[gillrogers]

Given my morning basal halfca unit less and here we go again!

 

[rayray119]

Are you not under a hospital diabetes clinic

 

[gillrogers]

Are you not under a hospital diabetes clinic

Yes, but im increasingly feeling that they are just gelping me with the probkem in the immediate time and not overall. Im talking to my gp today whos a db specialist. Im so fed up and stressed with this. I feel likenothing will gappen until such time that i get admitted to hospital and even then with the pressures theyre under itll be a quick fix to sort the immeadiate problem again to getme back out.

 

[rayray119]

Yes, but im increasingly feeling that they areah just gelping me with the probkem in the immediate time and not overall. Im talking to my gp today whos a db specialist. Im so fed up and stressed with this. I feel likenothing will gappen until such time that i get admitted to hospital and even then with the pressures theyre under itll be a quick fix to sort the immeadiate problem again to getme back out.

Ah okay I only asked because find the clinic are more knowledge then gp diabetes nurse. But other people have the opposite when I first dianoisged a gp diabetes nurse ask me how I treated hypos I told her I would eat some sweets and her words were "no a glass of orange are a banana" a glass orange juice yes that's fine but not a banana for a actuall hypo.

Anyway I hope you get good advice from the nurse. It. May just be that you are really senistive to insulin

 

[helli]

Yesyerday i dropped my daytime basal by half and it didnt happen. Today though i raised my day time basal back up and its done it again

It seems to me that you are tweaking your dose too often.
Why did you raise your basal today when it was fine yesterday?
Try to keep your dose the same for a few days before changing so that you can see trends rather than one offs.

Are you keeping a diary of more than your BG levels so you can identify trends in things like food, exercise, stress, hormones ... even weather? All of these things can affect our diabetes management and you need to work out what is causing them to fall on some days and not others rather than just reacting to the highs and lows.
But to look for trends, you need to keep some things stable.

 

[rayray119]

Yes the aboves a good point actually when I was on the DAFNE course it was said the only time to make a change off one instance is a hypo overnight all other times wait for partan

 

[gillrogers]

It seems to me that you are tweaking your dose too often.
Why did you raise your basal today when it was fine yesterday?
Try to keep your dose the same for a few days before changing so that you can see trends rather than one offs.

Are you keeping a diary of more than your BG levels so you can identify trends in things like food, exercise, stress, hormones ... even weather? All of these things can affect our diabetes management and you need to work out what is causing them to fall on some days and not others rather than just reacting to the highs and lows.
But to look for trends, you need to keep some things stable.

It wasnt fine though, i ended up high all day. Yes im.keeping a diary in my libre. Im seeing this constant trend of being on a basal that lowers me 2mm to 3mmol after my bolus has depleted. So then i lower my basal by half and i dont come down. Dbn wants me on a basal thats way too high at night. So i lowered it and ive still got problems. Thing is i cant keep anything stable for long enough to sort things out. Or ill sort that problem.out and it just raises another. Im 99% sure this is down toy fluctuating thyroid but they wont do anything about it. My kevels keep going either low or almost too high.

Its not from exercise, cos i dont. Im so sensitive when i get moving , i know low air pressure will make my basal drop but that's stable at the mo. Stress makes me go high but not these days it seems.

 

[helli]

. Yes im.keeping a diary in my libre.

Are you recording details about exercise, stress, food, alcohol, weather and more on your Libre app?
Are you reviewing that detail over more than a week to spot trends such as certain food types having more impact than you would expect (not all carbs are equal) or days (and following days) with more exercise cause issues or days when you are more stressed or warmer days or colder days?

I know I would not be including that much information on the Libre app. I need something I can look at in detail over times and make comparisons. But then I am a "spreadsheet-oholic"!

 

[gillrogers]

Are you recording details about exercise, stress, food, alcohol, weather and more on your Libre app?
Are you reviewing that detail over more than a week to spot trends such as certain food types having more impact than you would expect (not all carbs are equal) or days (and following days) with more exercise cause issues or days when you are more stressed or warmer days or colder days?

I know I would not be including that much information on the Libre app. I need something I can look at in detail over times and make comparisons. But then I am a "spreadsheet-oholic"!

Yes its in my libre app. Chapter and verse lol, sometimes i feel though i just cant cope with it all the influences.

 

[rayray119]

It wasnt fine though, i ended up high all day. Yes im.keeping a diary in my libre.

There are times where I end up high all day. But I wouldn't change anything until that's happened for a few days. When it's comes to adjustments unless it's purposesly adjusting for excises or the fact I've had a busier day I went for things to become a pattern

 

[gillrogers]

Just thought, perhaps i need to lower my daytime basal but up my lunch bolus. And lower my evening basal. ‍♀️

 

[rayray119]

Have you done a background test?

 

[gillrogers]

No ive not got the weight onme to do those now. I was missing meals 2 or 3 times a week. My basal fluctuates so much as im sensitive to so many day to day factors. If im dropping 2-3 mmoll in an hour or two after my bolus has worn off then that says if my basals to high or not.

 

[rayray119]

No ive not got the weight onme to do those now. I was missing meals 2 or 3 times a week. My basal fluctuates so much as im sensitive to so many day to day factors. If im dropping 2-3 mmoll in an hour or two after my bolus has worn off then that says if my basals to high or not.

You don't have to go all day without eating you can split it up for example when I wanted to do a morning background test I just didn't eat backfast that morning some people find there bolus actually lasts longer then the standard 4 hours. You could probably eat just as you would normally just later on when. I did evening background test before I had something to eat after I was done(it wasn't much but if could have been more)

 

[gillrogers]

You don't have to go all day without eating you can split it up for example when I wanted to do a morning background test I just didn't eat backfast that morning some people find there bolus actually lasts longer then the standard 4 hours. You could probably eat just as you would normally just later on when. I did evening background test before I had something to eat after I was done(it wasn't much but if could have been more)

I know , but spliting over 3 days still meant me missing meals and calories. There are days when my bolus looks lije its lasted the 4 hours clearly and days where i feel its lasting 5 . I just cannot work it out. I have too much go wrong at once most days since i came oit of my honeymoon period.

 

[rayray119]

I know , but spliting over 3 days still meant me missing meals and calories. There are days when my bolus looks lije its lasted the 4 hours clearly and days where i feel its lasting 5 . I just cannot work it out. I have too much go wrong at once most days since i came oit of my honeymoon period.

As I said you can still eat as much calories just later on. Let's say you wanted to do an evening test from 5 to 9 or 10 you could have lunch at 12 or 1. And then you coulld still have dinner at 9 or 10(I know that's about late for most people to eat normally) you don't have do it on 3 consecutive days either.

 

[gillrogers]

As I said you can still eat as much calories just later on. Let's say you wanted to do an evening test from 5 to 9 or 10 you could have lunch at 12 or 1. And then you coulld still have dinner at 9 or 10(I know that's about late for most people to eat normally) you don't have do it on 3 consecutive days either.

Eating that late is too much for me and i haveno idea yet what my bolus ratio wpuld be other than much different at the usual tea time. Im struggling working out 3 meals at the times i have them now. and i certainly cant pack in two meals worth of calories into one meal. Therea no way my system.can cope with that. It would have to be consecutive days as my basal changes very quickly.

 

[rayray119]

Eating that late is too much for me and i haveno idea yet what my bolus ratio wpuld be other than much different at the usual tea time. Im struggling working out 3 meals at the times i have them now. and i certainly cant pack in two meals worth of calories into one meal. Therea no way my system.can cope with that. It would have to be consecutive days as my basal changes very quickly.

It's advised if you snacking ( to use radto closesest if different in this case I would use dinner radto. The idea of Basel bolus regain is you don't have to stick to set meals times(I used to be obessed with routine at first). Well I might still try a stick to a routine because it is a little easier I don't obessed about now.

By way anything I'm saying isn't judgement at all just trying to offer advice.


Can I ask have you ever done DAFNE(when I did it there were people on it that had been diagnosed for years)

 

[gillrogers]

Blooming surgery just rung to tell me theyve cancelked my appointment and cant say when theyll remake it for!! i give up!