Totally confused

Hi All,
First time posting on here looking for help/advice.
I have been diagnosed as Type 1 for almost 2 years now and completed DAFNE just under 6 months ago. I seem to be stuck at a level of about 10.5 to 12 for most of my readings. I may get the occasional high 16+ or manage to get Reading down to about a 9 but averaging a 12. I know the DAFNE principles and try to apply them but it seems like the bigger correction I do the less sensitive I am to Novo Rapid. For example couple of days ago I was at 12.1 breakfast and had 4CPs so took 4+2 QA and at lunch I was 9.7 seems to be correct yet yesterday I was 15.6 at lunch had 11CPs and took 11+9 QA (split 10 and 10 in 2 sites) yet only a 10.6 at tea. So the more correction I do the less sensitive I seem to be.

Also I have NEVER had a hypo either. Can sometimes get my reading do to 5 - 7 had a lowest reading of 4.8 not sure how I can make massive corrections and still not drop my levels down to the hypo area.
Cheers

Hey!

Would say to try a no carb meal for lunch and breakfast and if your blood levels are not in range its due to your background insulin and you may want to think about increasing that

best of luck

Hey I did a carb free lunch and done a carb free breakfast too (not on the same day) and my levels stay within 1 m/mol so I think my background is at the right amount. I just really struggle with QA insulin.

So the BI is holding. Which injection sites are you using for the QA? Stomach is typically quickest.

As you were diagnosed in recent years I wonder if you could have been in the "honeymoon" period for some time. During this phase a type 1 body is actually still producing some insulin naturally, but not enough to keep blood glucose in check. Eventually, weeks, months, or even years later no insulin is produced naturally at all and you need to take more of it.

It sounds like your current QA:CP ratio is inappropriate with those kind of correction doses. I think you need to increase the QA in that ratio.

Finally I would keep an eye on your weight to make sure the QA corrections aren't causing you to gain too much. Weight gain can lead to increased insulin resistance.

Good luck.

Hi Caveseboy

Like other posts, I'd suggest your QA:CP ratio is wrong, and maybe if you increase the ratios that'd sort things out? The reason I say this is that it strikes me that the correction you did after your lunch BG 0f 15.6 was a really big one. If I had a BG at that level I'd only need to take a +4 correction to bring it down to around 6 - and I'm bound to be relatively less sensitive to insulin than you as I've had T1 for 34 years. If your background insulin is holding your BG at a level result over a long fasting period e;g; overnight, then I'd suggest you might not be on the right QA insulin for you. Your Diabetes Specialist Nurse could have some thoughts/advice on that one.

Hope these suggestions are helpful. Good Luck.

Yeah it is weird though as if I am a like a 9 at lunch my ratio of 1:1 is right as i am around the same at tea. My teatime ratio is at 2:1 but I am always high at bed. I am not sure if it is because I am taking a larger dose of insulin it is being less effective.
I do find it weird like you say you only need a +4 correction to lower a 15.6 blood sugar. I would expect the same but I can take a BIGGER correction and still not hypo. Having never had one I do find this weird!!!!!!!

Hi Caveseboy

What occurs to me is it could be your BI that's the problem. I had something similar happen to me about 6 years ago. I've always taken my BI dose (which at that time was Levemir) once a day at around 11pm. I found after about 4/5 years that my BG was shooting up high after my evening meal. In most cases Levemir works for a full 24 hours but occasionally (as for me) it only works for 12/15 hours. My Specialist Nurse suggested taking it twice a day, but I didn't want to do that so she switched my BI to Lantus, which doesn't have the same problem. Since going on Lantus my BI has worked for the full 24 hours.

As for why you've never had a hypo - can't make any suggestions there. As you say - very weird! What I do know is that for all of us, our bodies destroy a certain amount of the insulin we inject. Maybe in your case if you inject a big corrective dose your body destroys most of the dose? Does that sound like a possibliity? If that is what's happening then maybe a different QA would work better for you? A third possible solution would be to try adding in a T2 medication to improve your insulin sensitivity. Like most T1s that have been on insulin for a long time I'm on twice daily doses of Metformin. If I miss a dose of Metformin at any time I can really see the difference in in my BGs. It's an ancient medication but it's still one of the most effective ones. Some things to think about anyway. If you decide I'm talking rubbish then just ignore me. Good luck.

Hi Caveseboy,

Would have to agree with David01 - it may be that you are insulin resistant. I had this issue recently and seemed to be pumping insulin into me with no effect. I went on Metformin about 6 weeks ago and have halved my daily dose and my corrections are working much more effectively. Like you I was never having hypos no matter how much insulin I seemed to take. Might be worth talking to your healthcare professional about it.

David01 said:
Like most T1s that have been on insulin for a long time I'm on twice daily doses of Metformin.