[blue eyes]

I really hate D right now. Can not do anything right, my numbers are bad (for me anyway) and honestly I’m not sure what to do or what is going on - only changed novo and lantus 2 weeks ago so can't possibly be bad, …… all I've been doing is taking extra novo when I'm high

Last 6 days including today-

Day 1)
*Before breakfast: 11.6 (208)
*2hrs after breakfast 15.6 (280)
*before lunch 19.8 (356)
*before dinner 3.8 (68)
*after dinner 10.2 (183)
*overnight 14.9//268 (correct 2u novorapid – too much maybe, see below)

Day 2)
*Before breakfast 4.2//75 (may be good, but I feel low under 5 and always treat anything under 5//90)
*before lunch 10.1 (181)
*after lunch 22.3 (401)
*before dinner 25.4 (457)
*before bed 11.9 (214)

Day 3)
*Before breakfast 5.1 (91)
*before lunch 16.6//298 (only had soup 11 grams carbs)
*after lunch 21.6 (288)
*before dinner 7.9 (142)

Day 4)
*Before breakfast 16.6 (298)
*before lunch 7.5 (135)
*after lunch 18.8 (338)
before dinner 15.2 (273)

Day 5)
*Before breakfast 9.8 (176)
*After breakfast 17.7 (318)
* Before lunch 12.4 (223)
* After lunch 21.1 (379)
*Before dinner 25.1 (451)
*After dinner 10.9//196 (I felt low!! What do I do? I treated it)
* Overnight 23.4//421 (took novorapid

Today)

* before breakfast 6.9//124 (felt really low, more like an under 3)
* before lunch 11.7 (210)
* after lunch (3 hours after) 25.6 (, sick, ketones 1.1
* before diner (soup // one slice bread) 17.9 (322)
* after dinner 21.9 // ketones 1.3

This is crazy, I cried about D today I think for the first time since I was diagnosed (and I don't usually do stuff like that) . Only real ‘pattern’ I see is I’m nearly always high before and after lunch – hence why I got so upset and told Mum I’m not eating lunch anymore…

Anyway, will see if I can try to ‘fix’ these numbers myself, going to resist calling the DE, not b/cshe isn’t great just sometimes I feel a bit awkward asking for her help - she is a paediatric diabetes educator that's why! Strange, I know, I see an adult endo but get stuck with the paediatric diabetes educator.

[owlyn]

Hang in there. You may just need to adjust the Lantus, or possibly take it in the morning instead of the evening, or maybe even split it. Call your doctor or DE for advice on this one. It can take some time and experimenting to get the Lantus correct.

[shabbie6247]

i agree with owlyn, your basal needs would seem to have changed. but i suspect just increasing your basal wouldnt help here. give your cde a call and ask about adding or splitting your lantus dose so that you take some in the morning as well as evening. this seems to work for some people.

keep us posted

[kgm0612]

Can you give us a list of foods that you're eating throughout the day? If you're eating a lot of carbs, then that'll cause the high blood sugars. If not, you may want to talk to your doctor about adding a fast acting insulin (Novolog or Humalog) along with the Lantus you're already taking.

Karen

[ngueld]

I think you definetly need to adjust your long acting insulin! Exercise helps too (if you aren't already).

I wouldnt treat your lows until you check your blood sugar too!

[tanyatype1]

Talk to your specialist - sounds like your honeymoon period has ended. Don't worry, just consider this week a small set-back - your numbers will be back on track if you keep trying to figure things out. Hang in there - it'll get better.

[cheryl]

I used to sway that way last year, First thing I had to do, was not eat when I was high, what I heard from a good friend of mine, is not eat if you ran really really high, until it is down below....150....I mean I am talking the 200-400 range.....cause your only gonna be higher then crash later...

So there were a lot of celery nights for me which sucked.....

Then I had to test 2hrs after I ate, all the time. change lantus around, first things first I would take my shot test it two time in the night if I was more then 30pts off, it was too much, so then I started to eat the same breakfast and lunch measuring the works....figured what my carbs matched to the insulin I was injecting, I never got it perfect but the massive swings stopped, like I mean I still saw 200's but no 300's. I would correct very lightly for my low's unless it was a active low...So I'd sit and do the coke a half a can, and wait it out.....which is about 20 carbs.........or some juice,

It was hard, I don't know how your managing your diabetes if I made some suggestions you already do I am sorry, but I would seriously test that basal rate....for dinner eat light so you don't have a weird spike.....then start checking it overnight, then you start to see patterns and make correct changes it takes time, but it is so much better then the rollercoaster feeling....

I am so sorry I know how you feel I really do...

Cheryl

[marked]

this disease is so unrelenting. there is no break ya know? you work your butt off getting the best numbers you can, when you get it right, it is only till your next meal,if you get it wrong you can be high all day or you do the yoyo in trying to get back to normal. those who do not inject to live will never ever really understand. we do. go easy on yourself blue eyes.
Mark

[RobiJo]

I know what you mean about those low feelings... When you run high like that normal numbers feel really low. You really have to fight the urge to treat them especially if your really over 150. My understanding is that it feels low because your body isn't used to that number.

I've been running really good lately since getting CGMS, but the first week or two was awful feeling so low all the time at 90.

Also, like Cheryl said, try eating the same thing (or similar) for breakfast everyday and lunch everyday. I do this in general because it's easy. My breakfast is 46g of frosted mini wheats that I eat on my way to work. Lunch is 34g (bread of sandwhich), Pringles 17g, some carrots and ranch, which I don't count. By being regular with your food you can see how the insulin is working each day. If one day you have a big lunch and the next not much at all it's hard to tell what the insulin is doing versus the food.

Good Luck! Talk to your DE, that is what they are there for. I still call my old pediatric one, because she is like a mom to me now. (She's known me since I was 2.) Just got a card in the mail from her today actually.

[Alice]

I know this sounds boring, but try to eat the same food items at meals for a few days. For instance, egg & toast, small amount of juice.

Also, be sure to measure your foods. I know this is where I get sloppy in figuring carbs.

It's really difficult to adjust your meal bolus dosage until your basal is adjusted. I have to adjust mine every few weeks. When I just assume it's the same, my numbers creep up.

Also, try walking a mile or two each day to boost your metabolism and insulin sensitivity.

Good luck!

[rzrbks]

Two questions:

1. Have you checked your basal dosage lately? That is, not eaten for 12-14 hours and check B/g very 1-2 hours to make sure your basal amount is correct.

2. What is normal coverage rate for carbs? 1:15, 1:10, 1:20?
And coupled with that one is, What is your bolus correction rate?

[blue eyes]

Thank you everyone for your help!

I spoke to the diabetes educator. She wants me to take 5 units novorapid in the morning and 4 units novorapid for lunch. Left dinner novorapid (normal amount is 2.5u) and lantus (13 units) the same. I did ask if I should eat less but was told never to cut down what I eat but to increase insulin instead.

I'll see how this goes and then look at whether lantus needs to be changed.

kgm0612 here is a list of what I usually eat:

BREAKFAST: Crumpet toast w/diet jam (32 grams carbs) OR toast w/marmite (26 grams carbs) OR mini cereal packets (20.9 carbs + 150mL milk 7.2 carbs)

SNACK: Either 1 1/2 plain biscuits (7.5 carbs) or 2 plain biscuits (10 carbs)

LUNCH: Sandwich which either marmite and cheese or cheese only (I use the light/diet cheese that has less than 1g carbs). Sometimes sauce sandwich (?? carbs in sauce).

SANCK: Same as morning snack, sometimes have a banana which I hadn't been weighing or working out carbs until recently or weight watcher carrot cake (13 carbs - they're quite small)

DINNER: Either chicken and vegetables - carrot, brocoli, potato (I weight the potato now to 138g for 29.3 carbs) OR stir fry w/rice (it's lower GI rice, again I weigh the rice to 25g for 19.2 carbs) OR fettuccine - weight it also 150g // 42.7 carbs OR seafood dinner which I wont do anymore - very low carb but see a slow increase for 4-5 hours.

Haven't done a whole heap of exercise lately. But will definitely start again, especially as the weather gets warmer!

ngueld: I'm guilty of not checking when I feel low and then treating.

I hadn't thought of the honeymoon ending. I was still very much honeymooning at my last appointment in August (my TDD was 18-20 units) these last 6 days it's been between 25.5-31 units (still less the 1 unit/kilogram). That part always confuses me (the honeymoon and how long it will last). I was caught early and my endo thought maybe the honeymoon could last even anpther 6 months... Now that would be nice.

Cheryl - you've given me some really good advice. I always eat a meal even if I'm high and feel sick - but would stick to something I can hold down, chicken soup & toast. I've always been under the impression you have to eat if you're going to take novorapid. I don't do that all the time (take novo with a meal) just most of the time when I take novorapid I eat something. Haven't been checking overnight unless I wake up so I'll start doing that too.
Silly question, can you test basals when you're on lantus?

Thanks marked - thought you'd all understand. That's how it can sometimes be - like I make changes, it works for a little while and then all of a sudden stops working.

I thought that's why I was feeling low when I wasn't - b/c I've had more high numbers than normal or low numbers. Same with lows, I had gastro last month I nearly every test was 4's or high 3's. I got over it, tested one morning at 3.8 but felt 'normal'. How I feel with highs or lows seems to change easily. I can see how eating the same thing every day will help, I'll give that a go too! RobiJo, that is so nice you still keep in contact with your paediatric DE.

I never weighed any food until last week. I just started weighing as I'm going on a pump Nov 5th. The DE and dietician expect you to be proficient at carb counting.

I haven't checked lantus dose lately, no. Carb ratio, this is only an estimate breakfast is approx 1:8, lunch approx 1:9 and dinner I go with 1:15. It's probably not correct (dinner) all I know is that I am way more sensitive to insulin at night compared to morning and afternoon. The correction rate I have no idea. I'm guessing when I start pumping these figures will be a lot more accurate.

Thanks everyone for all the advice. It has really helped and given me a starting point to get my numbers back to what they have been!!

[rzrbks]

Good luck. Let us know how things are going.

[xMenace]

Your numbers look soooo familiar I found pumping the only way to control this old bag of bones.

[BriOnH]

Everytime fall/winter hits I have to increase insulin. Conversely every spring/summer I have to decrease insuling. This has been a pattern in me for decades. Probably not worth much but thought I would throw it out there.