Help with fluctuating Bgs continued!

[Sutrer]

Hi everyone, thanks for all the advice on my previous posts. Found alot of it very useful and insightful!
Anyway here is the latest:
Last night I decided to increase my lantus 2u to 24u at 5pm and see how I go. As a result everything seemed ok and this morning at 8am i woke up with a reading of 5.9mmols which i was very pleased with. However thru the morning it started to rise and at 11am it was 10.3mmols and I hadnt eaten. All I'd had was 2 vending machine coffees. So at 1.30pm I had 2 sandwiches(brown bread) and some tomato soup and an apple and took 13u to compensate for the high I'd registered at 11am. I have just taken my reading about 15mins ago and it has now risen to 16.3mmols!!
Does anyone know why this might be?
I have now taken an additional 4u of novorapid to bring this high reading back down.
Do you think the reason for my high sugars is due to the food I've eaten or do you think tonight I should maybe take half my usual Lantus dose and take the other half in the morning?
Any help you guys and gals can give me would be great, thanks to my new found friends, Dan (sutrer)
P.S. dont think the problem is taking too little novorapid for lunch as in the evenings for my main meal I usually only need to take 8-10u of novorapid.
thanks again

[duck]

What do you mean two "vending machine" coffees? Any carbs in those coffees? Also, as you may see here, some people have definite blood glucose increases from caffeine consumption.

What is your correction factor for highs?

[Sutrer]

have to admit dont know what carbs the coffee holds but have never noticed an issue with coffee in the past. not too sure what you mean by correction factor but usually if I take 4u it brings my sugar down by about 7-8mmols so thats how I gauge it usually

[Simon]

It still looks as though the Lantus is running out early. Are you injecting it into your leg? You will get a longer lasting response there than in your abdomen.
It might be best to take a slightly reduced dose in the evening and make up the shortfall in the morning then gradually take less in the evening and more in the morning until you're 50/50. You might find you need to gradually increase the total dose as you do this.

[Aftiel]

Caffeine is evil (for me.)

I LOVE caffeine (Diet Mt. Dew rocks,) -- however drinking bunches of it absolutely elevates my BG.

It doesn't effect everyone this way, but it certainly does me.

Establish a pattern with your meals, and work your insulin dosage into that pattern.

For example:

eat breakfast, and drink a bottle of water - no matter if BG is high or not. Feed your body, and allow it to get used to that meal every morning.

Otherwise, you end up chasing BG levels with insulin - then throwing food in at random intervals - and your body remains confused.

Chasing your insulin with food, or skipping meals here and there to "correct" BG is something I am not a fan of personally.

Our bodies need fuel - establish a solid routine of nutrition on a schedule - then adjust your insulin to it.

That is after all what our pancreas would do if it worked :)

Most of all, don't get discouraged - as others have said here, diabetic control is more of an art form than a science.

p.s. I give my Lantus shot in my leg also, and it is good for 20-22 hours, which works out nicely.

- Aftiel

[Cinnabon]

Sutrer,

Is there anyway you can find your Carb to insulin ratio, you will be mazed at how much this will help you.

[jen_slc]

It does look like your Lantus is running out from noonish onwards with your high bg reading late afternoon. However, I'm not sure I would attribute your morning bg rise to that because it seems a bit early for Lantus to start running out then (you're only 15-18 hours into it). I've found that I can wake up with a normal bg but be super high at lunchtime if I skip breakfast because of a liver dump - I've been able to fix the situation by eating breakfast, even just a small piece of toast. It 'reminds' my body that I'm not starving and that it doesn't need to dump any glucose in preparation for the day.

Have you tried fasting to see what happens to your levels when you don't eat? I might do that before splitting, just to see how Lantus is working in your body. If you eat a decent breakfast with the correct dose of insulin, then fast until dinner, what happens to your bg? If it remains stable, Lantus is not your problem and you should look into your carb counting and ratios. If it starts creeping up, you know your current dose of Lantus isn't covering you. But seeing as how you wake up at ~90-110 (5-6mmol?), I'm not sure you'd want to keep upping your Lantus because you might start waking up low in the morning and it would still run out late afternoon (that's just my personal experience), in which case I would go with splitting doses. Then once you have your basal dose figured out you can tweak your meal ratios to make sure those are set to what they should be, because they could potentially differ for every meal.