Any help please?

I've attached 10 days worth of results.....I'm thorough and a bit ocd with my carb counting so I haven't added all my carb:insulin ratios. I am at a complete loss as to why I'm having all these hypos and also feeling very tired. Last night I even had a carb-free meal of 3xegg omelette with fresh tomatoes although I did have a glass of milk so had 1 unit of insulin to cover that..... my bg went from 6.4 before eating to 10.3 in 30 minutes after eating and was still 10.4 before bed and I hadn't even eaten or drank anything else.

I've actually got OPA this afternoon and its because of inputting my results that I have noticed the hypos, which the night time ones are of particular concern as I luckily woke up with them. The others I didn't get any warning signs at all until it was too late. I'm feeling really down at the minute because of it all.....I'm feeling drained all the time, my little girl is getting a bum deal as I'm constantly tired and irritable I feel like its really getting on top of me now and don't know what to do. I keep getting told by professionals that I've got good control but I still feel like poo..... Crying or Very sad

I hope someone can shed some light.

Thanks

Jackie

There are a few things to say aboutthese results. The most important being you don't reecord your BI insulin most of the time. This is important and it is important that you take it at around the same time every day. What type of BI is it , latus or Levemir maybe ? The second is you test an awful lot quite often with 2 hours of eating. This is not necessarily a good idea since high readings at this point could be down to the timing of your injection ( before or after food) and the GI of the food. That is why it is recommended that you test before meals generally 4 times a day. I'm not criticising you for testing so much its just that high readings can cause oyu to get stressed which will compound the high readings.
Is your reduced level of warning signs what is causing you to test so much ? If you want to help restore your warning signs you should run a bit high for a few days maybe a bit longer to help restore them.
These are just initial impressions, hopefully I and others can look at the readings in more detail and come up with some suggestions

Hi

Thanks for your reply and your comments. The reason that I missed the BI out is that I rushed to input info before I went to hospital.....I always have my BI around 11 at night, 9 units of Levemir. I test a lot because I'm always feeling 'not right' (am I going high or low? symptoms are very similar) so want to know why, although I do have to test before driving which is usually 6 times a day, maybe I shouldn't add them to my DAFNE ones and stick to just noting the ones prior to eating and 2 hours after, would you say that would be better? I understand that its not an exact science with food,their GI and timing of insulin injection but surely I shouldn't be feeling like I'm having diabetic warning signs for 6 hours of a waking day?

I've not long since got home after my ordeal at my OPA. My Hba1c is 46% which I thought was good but the doc says that it shows I'm running at the low end. She had no answers to what I was asking, until she walked out to get a blood form and I was in tears when she came back in......she then listened to me, basically admitting that I shouldn't be feeling like I do but has no idea why I'm feeling like it. Advised me for further blood tests and to seek further advice from Diabetic Specialist Nurse......then to see the Consultant in 3 months!! I shall have to make more of an effort to go back to making a complete and full diary of foodstuffs I'm eating exactly.

hi, sorry I didn't mean to suggest that you shouldn't test OR record the tests. Better to much than to little ! I was just pointing out they you shouldn't do something like apply a correction dose for one of these readings, that was all. Looking at your diary it seems that you are sensitve to insulin, have you been a diabetic for a while ? Have you always been this sensitve to insulin, It also seems unless you have missed out data there are a number of days where you didn't eat any carbs, is this normal ? Personally would feel pretty rubbish if I didn't eat anything but thats just me
One last thing, if you don't see a consultant at the hospital who do you see ? I always see a consultant so I'm curious

Hi

I didn't take offence, I was just explaining the reasons why I'm testing so frequently......can I ask if you feel 'normal' most of the time? This is what gets me, there were only a couple of other people on the DAFNE course and none of them felt as I do so I'm just curious to know how other diabetics 'feel'.

I was diagnosed 3 and a half years ago, at the age of 46! I've carb counted from day one and quite ocd about it, also with correcting I wont correct until after the 2 hours or longer if necessary. Sorry about the erratic input, as I said earlier I didn't fill all the carbs in as I was in a bit of a rush to get the blood test results down to show at my opa. I saw the registrar today, gonna see the Consultant next time, 3 months time! Yeah I seem to need to eat little and often and feel very rubbish if I dont. When you say that I'm sensitive to insulin what do you mean by that?

I do thank you for your replies as its good to hear from someone who is also diabetic, rather than professionals who don't know everything about the day-to-day living with diabetes.

Hi Jax I'm a new Grad of DAFNE and am by no means an expert. I see in you diary and by your comments that you are correcting inbetween meals. At my course we learned that this was to be avoided. Was something I was doing prior and now do not do at all, it makes it so much clearer to analyse the diary to make ratio changes. Also we were taught to record corrections as QA 'normal dose'+ or-'correction' eg 5+2 or 5-1. It's difficult to analyse otherwise.

One of the other grads on one day of the course had a truley scary high reading after breakfast, one which they (and definitely myself given the same reading), would dose up for. However they didn't (DAFNE rules) and low and behold (and almost unbelievably) Lunch time they were at the low end of the target range with no intervention.

When I became a reformed T1 last November (no testing for 18 years to speak of) the first thing they did was get me on new insulin (Levemir and Novorapid) - For the first month or 2 I did not feel at all 'right', felt weird, in a daze, dizzy sometimes, felt like I was high when I wasn't and was basically exhausted etc etc. It was obviosly a shock to body going from 18 years of Actrapid and Protophane but lukily its passed. Could this be a side effect, I don't know, I'd be talking to my specialists if it continued.

Also with the unbelievable amounts of testing I've done over the last 6months I've learned not to trust the extreme readings from the test meters eg the Accu-Chek mobile while a brilliant design and is actually the one I like to use, gives me low readings lower than actual (by as much as 1mmol - so a 3.1 is usually closer to 3.8 - 4.0 for me) and high readings higher than actual while the Optium Exceed gives me readings that are much more accurate (when they test me at hospital the Optium always agrees with their reading + or - 0.1) - The upshot of it is, if I get an extreme reading I always re-check (after rewashing my hands) and usually with the other much more accurate Optium Exceed (Freestyle Optium is it's new name).

If you make an error entering data into your diary it is very easy to edit an entry.
Hover the cursor over the time of the entry you want to change and it will underline...click it and you are in edit mode.

Note from the bottom of the diary page: -

To edit or delete an entry, click on the time for that entry. You can now delete more than one entry at a time by selecting the checkbox to the left of each entry's time and clicking the button above.

Hope this helps you add in the additional data for your record keeping.

Regards
Garry

Hi RichFeed

Thanks for your reply and comments, the most particular one that interested me was you saying how you felt when you transferred onto Novorapid. I had wondered if it was possibly the insulin that was making me feel 'not right' and it was something that I mentioned to my GP, who said that he didn't think that it was. It is something that I am going to mention when I go back to see the Consultant in 3 months time. That and I am going to try having a carb free day (here come the veggies and sugar free jelly!!) to see if I notice any difference there as I will not have any rapid acting insulin.

Thank you Garry too and I am aiming to keep a much more rigid entry on Dafne so that I can get a clearer picture......I've done it in the past but it doesn't show anything clear to be able to change, in that there was no set pattern to having hypos.

Many thanks again for your comments they have really helped.

Jackie

Hi Jackie, sorry for the delayed reply. When I say you are sensitive to insulin I mean your ratio is 0.5:1 where as a lot of people are 2:1 or sometime 3:1 in the mornings. This is typical, as I understand it, in the newly diagnosed because they are still producing 'some' insulin as the last of the islet cells bite the bullet. Do I feel 'normal' ? pretty much, but I am lucky in that I never seem to suffer adverse reactions to any drug. I've had a few over the last 10 years since my immune system went nuts and have not had a problem with anything. I was diagnosed at 34 and like you was probably told you were 'odd' for not developing Diabetes until that age. It IS possible you are reacting to the insulin you are on, its unusual but that doesn't mean its not possible.
With regards to the OPA, I ALWAYS see a consultant and a very good one he is to ! If your GP/registrar don't think its the insulin then they should investigate further not just dismiss your explination without providing an alternative explination.
As we said before if you can fill in the blanks in your diary it will help a lot. To pick up a pattern you need all the data it sounds like you have all the data it just needs adding in.