My Blood Glucose Diary - all comments welcomed!

Here are the cps for the last few days. However I can't record the amount of qa as I would never trust doing this when going to bed to sleep. Any comments on this or what to do would be very helpful.

Mon 01/04
buttr pffs 3 - 6.2g ech = 18.6g/2 CP

Tue 02/04
trt sze bscts 2 - 13.7g ech = 27.4g / 2/3 CP

Wed 03/04
trt sze bscts 2 - ditto

Thu 04/04
trt sze bscts 2 - ditto

Fri 05/04
sndwch 2 rnds/bsct

also sometimes I have a sandwich:
1 slice bread - 17.7g - 2CP
2 slices bread - 17.7g ech = 35.4g/3/4 CP

Thanks I will start to record supper cps in my BG diary

If you know your bs before supper then the qa you take would work with the cps you are taking. I do wonder if this is why you are high on am, as supper will raise you bs by 4-6mmol with nothing to lower them. .may be worth trying a 0.5:1 ratio at supper and see how that goes if you dont want to do a 1:1. I do understand where coming from about taking qa at bedtime, but if you are having cps then you will need some qa.

Hi Vickyp,

Thanks! So how many units for 0.5:1 ratio please?

0.5 units per cp or per 10g so if cps was 2 you would take 1 unit of qa...essentially half the total number of cps and thats how much qa you take...to the nearest whole unit if you dont have half unit pen (or pump)

You seem a little unsure about your background level and I'd get that right first before you start to play with mealtime ratios as background needs to be set right first so you know that's not tainting your mealtime readings. Otherwise you could be correcting for your BI with QA.

Although you are getting some highs in the morning it's important to remember that this can be caused by your body making a panicked reaction to a hypo and over compensating, I've found there are 3 ways to asses this.

1) set an alarm for the middle of the night and test yourself if the reading is low then your background is making you hypo in the night.

2) have a carb free meal. Have your breakfast, take on some carbs and the required QA Insulin, but for lunch have a dressing free leafy salad, if your say 6.5 at lunch and then hypo before dinner the only insulin in your system is your background and so it must be to high and you should immediately reduce it.

If you get to dinner and your high (so long as you haven't had any carbs or sugars since your salad) then your background insulin is low and you should increase it but by no more than 2 units for the day (so 1 unit per injection as you have two background injections a day) and then monitor the situation for 4 days before making any other changes to either your background or QA inslins. If you change 2 things at once you don't know which is doing what.

If your reading at dinner is +/- 2 of your lunch reading though then your background insulin is about right.

One important thing to note with this is if you test at lunch and your high you can't take a QA correction, if it's very high then take the correction and do this test another day, if you take QA though then there are 2 insulins in your system and so if you hypo you can't say for sure if it was the background insulin or the QA that made you hypo.

3) This is the lazy man test (not something a doc/nurse is likely to suggest) and not only really any good if your high on your background dose. When you have your evening meal give yourself an extra 4CPs that you take no QA insulin for. When you take your pre-bed reading (atleast 3 hours after the QA from your evening meal so it's pretty much worn off) you should then be quite high. If when you wake up you have dropped more than 3 units then your background is likely high and you have been hypoing in your sleep.

Thank you Travler

Help/comments needed please on the last 3 days results
Mon 08/04 - Wed 10/04(so far)

Initial thoughts now that your overnight BI is pretty much spot on, is that you seem to be going higher from when you get up until you get some food inside you.........

this might be dawn phenomenon, or your overnight BI running out........

So you may want to think about taking your BI when you get up............this could also mean that your daytime BI might run out earlier in the night, but you should cross that bridge when you come to it...

If you are experiencing the morning liver dump then your best to get food and insulin in as quick as possible.

I get up For work and have a small yogurt straight away, this was tackle the DP..............I still do it and I am on a pump, old habits die hard........

hypos in the afternoon, naturally you would assume to much insulin at lunch, or breakfast in your case........

So that's what I would think about evaluating...................unless however you suspect the BI is out...........have you done daytime test of thought recently......

Help/comments needed please on the last 5 days results
Thu 11/04 - Mon 15/04(so far)

Friday and staturday you appear to have had no carbs or QA in the morning and yet your BG has plummeted from high to hypo by lunch. Also as you're hypoing in the night why have you not lowered your BI shots from 10 to 8 both AM and PM? DAFNE guidelines say that if you hypo from BI you reduce it immediately.

Also on Sunday and Monday your breakfast corrections are 1 unit to high in each case. You want your Blood Glucose (BG) to be 6 and 1 unit of QA will drop you 3 BG units.

So on Sunday with a BG of 10.2 you gave a correction of 2 units of QA.

2QA x 3 = drop of 6BG

10.2 - 6 = 4.2 which is a hypo

So on Mondaywith a BG of 13.4 you gave a correction of 3 units of QA.

3QA x 3 = drop of 9BG

13.4 - 9 = 4.4 which is a hypo

That said I'm not sure your breakfast ratio is correct but until you get the background fixed you can't work that out.

My advice would be drop the BI from 10 to 8 for both shots. Repeat the fasting test and see what results you get. It may be that this is a little low and you will want 9 & 9 or one as a 9 & one as 8, but with the number of hypos you have exhibited in 5 days taking off 4 units of BI (2 AM + 2 PM) would seem a wise precaution as you can always bring it back up again if it's to low.

leave your meal ratios at they are for now as you can only change one thing at a time but when you take corrections do the maths to work out where that will put you if each unit drops you 3BG units, if you work out that a correctionwill put you under a BG level of 6 then make the correction smaller.