New Graduate, questions

Hi, I've just completed my course and was well on the way to understanding how to do correction doses and ratios etc. Over the weekend I did a lot of physical activity and thus got quite a few hypos - I corrected and got my bg's up to a decent level. Because I am home and am more active than I was in the course room, I decided that I may need to reduce my ratio back to 1:1 from 1.5 : 1 , But now at dinner time 6pm I find that I am 17 !!! I had nothing over the top for lunch, roll,salad,ham and strawberries/cream I calculated 4cp's for that.
How had it gone so wrong? or was it the hypo's that have altered my bg's by compensating?
I get so mad when I go high, I hate being up in those sort of numbers.

Hi susieq, you say you did a lot of activity over weekend, did you reduce your QA before the activity? If not that would explain hypos. If the BG of 17 was after the hypos then that would be normal if you took extra sugar to sort hypos, it takes sometimes 12 to 24 hours for BG to return to reasonable figures after hypos.
You have had a week of intensive training and have had to absorb a lot of new info, it's very scary being on your own, remember you can always contact your DAFNE educators for some support.
I was in the same position just over two years ago and was ready to give it all up, but with help
and support I stayed with it and am very glad I did, you should also have a review meeting soon, so stick with it, it will get easier. I use different ratios for when I'm working and when not.
Regards keith.

Thanks Keith. I think I will go back to the ratio's recommended to me last week, and just have less bolus if I am doing something physical. it's not work as such, but mowing the lawn, washing the car etc... and sometimes it's just spontaneous.

I will stick with it, I have to.! It's getting used to it all isn't it?

Yes very much so, my ratios when not at work are 1.5:1 BF &Lunch then 2:1 for dinner reducing to 1:1 BF & Lunch when working still 2:1 for dinner. If you know you will be exercising say after BF reduce the BF QA by 20-30 %, and if spontaneous take extra CHO on board. Good luck and think positive! Keith.

Thanks Keith!!! This morning I am 5.5 !!!!!!! WAHOOOOOOO lol Makes you feel good when a plan comes together eh ?

Positive thinking today. keeping ratio's as they are and tweaking the QA.

If it helps, keep in mind that exercise makes your body use insulin better so you may need less. However, you will still need insulin to get the sugar out of your bloods and into your muscles so you need to catch the balance. I was really impressed with an explanation someone did on another diabetic forum, I will copy it here for reference:

DeusXM said:
I suppose one way of looking at it is like blood glucose is people, muscles are a house, and insulin is like a door on a spring. Usually, the people go into the house, the door shuts behind them, so the door has to be reopened every time and slows down how many people (glucose) can get in. More insulin means more doors, meaning more people get in.

When you exercise, your muscles do the equivalent of shouting 'free beer and money for everyone!', people rush through the doors and because so many people are trying to get in, the springs gets stretched, the doors don't close as well as they should, so more people can get in, so you either need fewer doors (less insulin) or more people (more glucose)

You'll note though that either way, you still need the door. Otherwise you've got muscles shouting about free beer and a load of puzzled people left on the street, getting grumpy and causing damage because they can't get inside. So exercise alone cannot be a treatment for people with T1 - although it can work well for certain types of T2.

From: http://www.diabetes.co.uk/features/diabetes-and-hot-weather.html

"What are the hypo risks from hot weather?

Hot weather can increase the risk of hypoglycemia for those on blood glucose lowering medication.

The Joslin Diabetes Centre notes that the body’s metabolism is higher in hot and humid weather which can lead to an increased chance of hypoglycemia.

Hypos may be slightly harder to spot in hot weather."

This higher metabolism means insulin will be used quicker and therefore with (or even without) exercise could cause hypos.

Hope this helps.

Phil

It's been a couple of weeks now - post DAFNE.. My day time readings are always good, but the morning one always seems to end up at around 9.0 I waited, like I should for 2 days to see a pattern, then increased my bi by 1u.... no change. I don't want to keep upping the bi, as I got it down nicely over the dafne week, can't see why it should just creep up like that.

IS it the hot weather? IS it the food I'm eating before bed... I'm baffled.. or am I just T1 and this is how it is ???

Hi,

There is a thing called 'Dawn Phenomenon' where the body kicks out hormones in the early hours ready to wake you up as a side effect this can raise you BG. Need to do a 3am test to see whats happening.

I used to get up with BG about 9+, 14 to 17 wasn't uncommon. The last month I have been on a low carb diet to loose a few pounds . I have found little or no carbs for dinner leaves my BG perfect in the mornings.

Have a look into dawn and also evaluate how many carbs and what type you're having in the evening? I used to have dinner about 8 or 9 then go to bed around 11 or 12 with loads of pizza/pasta carbs still floating around.

I know this is for me and bit vague, but thats the joys of T1

Hope this gives you some ideas to look into.

Phil

hey i need some advice, iv been doing dafne for over a year now, and i managed to get my HBA1C down to 6.0, but my consultant said ive done great but i need to go back up to 6.5-7.0, as he said im to low and i have been taken more hypos than i should be, worse when i workout. and hes told me to reduce my my bg insulin,(which i do reduce my QA when working out or take an extra cp) but my problem is when i done this my morning sugars were high and my sugars werent running to well during the day ( my fast acting was running out before i was due to eat) but since i put my bg up it was steady, im on a 1 and half to 2 ratio. i put my bg down 1 unit last night i was 6 this morning but then went up to 9.6 for lunch, i dont know what to do, any advice would help, thanks