High blood sugars

[Irish_Fiona]

Ok. On Monday I was my diabetic clinic, I mentioned to my doctor that I'd been having some hypos at night time so he decided to try me on levemir, instead of my usual lantus. He told me to take 11 units at night, exactly the same as my lantus. After the first shot next morning I woke up and my bs was 16.9 so that night I raised the levemir to 17 units...next morning I woke up and it was still high, around the 15 mark. It's been high every morning and I've raised it accordingly. Last night i took 20 units of levemir, when I went to bed my bs was 8. This morning I woke up and it was 18!!! What on earth is going on?! I really think that tonight I'm going to go back on my lantus again tonight because I have retinopathy and can't afford to be having these extreme bs swings. Anybody had a similar problem?

Fiona

[Cinnabon]

I think you are having a liver dump and this change didnt help too much. I think you should discuss this w/ your doctor and tell him your priority right now, is taking care of your retinopathy. Once that is more settled than you can try another drug, just my opinion.

[DeusXM]

I had exactly the same problem with Levemir. I found that for me, it simply didn't work at all. I was having to comp. bolus every two hours and not once did my BG ever go below 12.

It got to the stage where I tripled my basal dose, from 20u of Insulatard to 60u of Levemir and it was still doing nothing whatsoever. I stuck it out for a week and then went back onto Insulatard.

[Irish_Fiona]

I think I will definitely go back on lantus tonight, but can somebody please explain to me what a liver dump is? Thanks :)

[Cinnabon]

Another one of those wonders of our Diabetes... lol

http://www.diabetesforums.com/type-one-diabetes/7749-liver-dump.html?highlight=liver+dump

[am1977]

Well, Fiona,

I'll try to tell you what I know (not saying that that's much, lol :p). It sounds to me like you might be going low in the middle of the night. To compensate for that your liver releases sugar it has stored for such occasions. Needless to say , many people rebound from being low to the other extreme. Have you tried setting your clock for 2 or 3 am and testing? You may be surprised to find you are low at that time. :eek:

I know that's a pretty basic explanation, but I hope it clears things up a little. I know others here can give you a better, more detailed explanation of this, so hopefully you'll hear from them soon. :wink:

Take care.

[Cinnabon]

AM is very right, that 3 am test speaks a lot. You might want to try this.

[Irish_Fiona]

Oh, I had never heard of that before, I test my blood sugar at 3am and see what happens. Do you still think I should come of the levemir though? Also I have got REALLY bad water retention since I went on it...and it's no where near that time of the month either...
Thanks

[MarkMunday]

.... Do you still think I should come of the levemir though? ....
By all accounts, Levimir is a good basal insulin. But it is not as long-acting as Lantus. And you really need to split the dosage into two shots a day to get full 24 hour coverage.

If you doubt that Levimir is working properly for you, test it. The best way to test your basal insulin action is to skip a meal. I find that lunch or dinner are best for this. The DP can be a complicating factor in the morning.

After skipping a meal, your blood sugar should stay about the same. If it doesn't your basal insulin isn't doing what it is supposed to be doing. If your blood sugar goes down, you are getting too much basal insulin action. If your BG goes up, you aren't getting enough of it.

For the test to be meaningful, your blood sugar needs to be reasonably stable before the skipped meal. Also bear in mind that it can take a while for a new insulin to settle down.

Cheers,

Mark

[Irish_Fiona]

*Update*
I switched back to lantus, first early morning reading was 5.4 *puffs out chest with pride*. It has been continuously good since then. i have also started my low carb diet again, eating mostly fish and salads, eggs for breakfast and nuts and cheese for snacks. ALL my water retention has gone, my appetite has decreased, my blood sugars are close to perfect, and I feel GREAT. I know this diet is for me, obviously it's not good to over dose on the fat and protein but I've thrown my bread and pasta in the bin. This is the only diet that works for me. When I started eating the traditional high carb diet I promptly put on a stone in weight and felt terrible. I don't care what my doc says this time, I'm sticking to this.
Oh, btw, the hypos at night have stopped too. I don't know whether my novorapid was peaking at night from what I had for dinner- and being on the low carb diet has stopped this- but they've stopped.

Fiona

[am1977]

That's great, Fiona :top:

I wish I could say the same. I'm struggling at the moment trying to get this thing under control :frown:.

Anyway, best of luck and do keep us updated with your progress :wink:

[Irish_Fiona]

I will. Thanks am1977.

Have you ever thought about a low carb diet?

[MarkMunday]

.... i have also started my low carb diet again, eating mostly fish and salads, eggs for breakfast and nuts and cheese for snacks. ALL my water retention has gone, my appetite has decreased, my blood sugars are close to perfect, and I feel GREAT. I know this diet is for me ....
Way to go Fiona!

It sounds like you have got it all sorted. Your doctor and CDE are probably not happy about the low-carb diet. Allay their fears by having a kidney function and lipid profile test done now. And repeat the test every six months.

My experience over the last two years of low-carbing has been that my kidney function hasn't changed, triglycerides have dropped substantially, LDL cholesterol has declined moderately, and HDL cholesterol (the good kind) has increased a lot. This is an excellent outcome. And it is the opposite of what the endo expected. But it seems to be in line with what most diabetics on a low-carb way of eating experience. Go figure!

Cheers,

Mark

[Irish_Fiona]

Thanks Mark!! Can I just ask, what do you eat if you're low?

[am1977]

I will. Thanks am1977.

Have you ever thought about a low carb diet?


I'm considering it... question, though, how low carb is "low carb"? As it is, I don't think I consume a lot of carbs. However, I do feel like getting some carbs in your diet is important. They are what fuels your brain and gives you energy :vroam:.

What do you eat on a typical day?

Thanks for your concern :)

[Tyna]

I am having the same problem moving from Lantus to Levemir. I think I have my morning shot worked out, now it's just to get the nighttime one right. I have also noticed a significant increase in the amount of basal insulin I am using. I'm happy to know that I'm not the only one who is struggling with this same problem. I am, however, going to try and stay on levemir if I can, because it comes in a penfil instead of having to use a syringe with lantus. The penfil is a lot more convenient for me.

[MarkMunday]

Thanks Mark!! Can I just ask, what do you eat if you're low?
Fiona,

The best way to treat a low is with sugar or glucose tablets. They act quickly. And you can measure the amount of carbs you are ingesting. Sugar is the easiest because it is generally available. I normally put some in a glass, add a bit of water, swirl it around and gulp it down.

Not the most enjoyable activity. But, fortunately, I don't have to correct lows very often. As you know, a low-carb diet means that you don't have to inject as much insulin and blood sugar levels are a lot less volatile.

I know that a teaspoon of sugar contains about 5 grams of carbs. And I have as many spoons as I think I need, based on the meter reading, to get my blood sugar back into the target range. With some practice, you get good at judging how much is required.

Drinks like orange juice and Coca Cola also work fast. But you don't know how many carbs you are getting. And getting the quantity right is difficult. Anything slower acting, like fruit or bread, works too slowly. Getting the quantity right is a guessing game. And too often trying to correct a low starts a roller-coster ride.

Cheers,

Mark