How do you explain this?

[sirius]

I am trying to adjust the dose of my bolus insulin (Humalog). I decreased the basal Insulin (Landus) from 18 to 16 units, because I had hypos in the morning. I take landus in the night at 2330 h. Now, the hypos have stopped in the morning.
Every night I take one glass of milk 30 min after my Landus, around midnight. Go to bad at 0130 in the morning.
When I was taking 18 units Landus and my bs were up from 130, in the morning I had bs below 80. If it was 180-190, in the morning my bs was 100-110. Lower then <120, I had a hypo in the morning 40-65. The thing is that, when I have bs below 80 I feel it like I have hypo. Isn’t the normal sugar from 60-110?
I decreased the landus to 16 units to avoid hypos in the morning and said to myself I should work now on the bolus insulin.
How do you explain this? These are my latest bs results.
Before I start with 16 units Landus, I measured my bs, it was 140. In the morning bs was 116. I took 2 units Humalog. After 2h 30 m >>158, before lunch >>144. Then I stopped with measurings. Before Landus at 2330 h it was 225, took again 16 units Landus…in the morning my bs was 75. I increased my bolus to 4 vice 2 units from the previous day (because I had higher bs). After 2 h.30m my bs was 61 and my hands were shaking. I took 130 g cola. Before lunch it was 143. PLEASE HELP.

[archimeech]

sirius, this is the problem with diabetes. Even after 21 years of having the disease, I still don't know what to do to keep it running well. My doctors don't know, and they just hope for the best numbers possible. You have to change it and keep the new bolus/basal for at least 1 month to see the pattern of the new amounts.

[sirius]

Yeah...I know that the bs can be a real pain…. I have diabetes from December 1998. My question is have I made a mistake with decreasing the basal insulin? I am using 16 units Landus for three days now and what a change!!! From hypos I have too highs during the day, even though I am increasing the bolus insulin. It is same like I am not doing anything with these changes, only feeling too sleepy and without energy. Insulin resistance maybe, due to three days before PMS? I try to count carbs too. As I said in my previous post, only when I had normal bs before I take Landus at 2330, I had hypo in the morning with 18 units Landus in the night. With 18 Landus my bs during the day were not high as now with Landus 16.

My latest results with the change >> Landus 16.
- I started with: (09:30 h) Humalog 2>>1500 h Humalog 6>> 2030 h Humalog 4>>Landus 16 (bs at 2330h 140)
In the morning 116>> after 2.30 h. 158>>before lunch 144>>????>>>before Landus at 2330h 225

- Yesterday: insulin dose >>Humalog change to 4>>Humalog 6>> Humalog change to 6>>Landus 16
In the morning bs 75>>after 2.30 h. 61>>took 130g cola>>before lunch 143>>after 2.30 h. 166>>before dinner 194>>before Landus at 2330h. 134.>>Landus 16 units

- Today: Humalog 4>>Humalog change to 8 units>> Humalog 6???>>Landus 16
In the morning 143>>after 2.30 h. 174>>before lunch 155>>after 2.30 h. 201>>????
So, you see I am out of control. Where am I wrong?
Should I keep the Landus 16 dose or? I am tired. I didn’t have any exercise for the last three days, just working in the office from home.

[rzrbks]

When I have hypos in the morning, I just eat something at night, before going to bed that will take longer to metabolize

cheese and crackers or ham or turkey on crackers, peanutbutter----foods with higher protein so that the body uses it slower

that generally get rid of the hypos-------I never decrease my basal amount unless I have a week or so with hypos during a time of the day when I Know that my B/G should be stable----in the last year or so, I would only drop the basal amount for a few days---up to a week, then it would be time to raise it again


I've been using 18 units of Lantus a night for the last 1 and 1/2 years---several times I have had to drop it to 16 units for a few days and once went to 15 of about a week. I've always had to bring it back to the higher amount when my B/G #s started running close to 115/ 6.4 because my morning target is 85/4.7 to 93/5.2

If I'm off those #s then I first try changing my bedtime snack, if that doesn't work, then and only then do I mess with my Basal dosage.

So far this routine has worked for me since my worst A1c has been 5.7.

Hope something in this ramble helps you.