some help please

First I am on Levemir and Novorapid. My meal time ratio's are 1/1.

I take 9 levemir in the morning at 8am then 12 levemir at 8pm. Before daphne I was on 11 at night but during daphne it was put up to 12 due to my numbers being higher in the morning than they were at night. I did a 3am test before it was put up and my blood then was 9.9 which was why my levemir was increased.

It seems to have worked as my numbers are either same in the morning or less than they were at night but now I'm beginning to see another pattern with my BG.

After my 8am BI I generally go back to sleep as I suffer from Fibromyalgia as well and generally try to get as much sleep as I can. Though I don't let myself sleep past 12pm unless my sleep has been bad, sadly this week that has been the case. I do notice when I get up around 8am that my bloods sometimes can be a little higher though not higher than the bg from before bed. Generally they sort themselves out if I sleep some more.

I generally go to sleep pretty late sometimes as well due to not being able to fall asleep. again sometimes worse some days than others. this week has been one of those weeks where I can't get to sleep so I read until I feel like I can fall asleep. Or I don't eat for a few hours after waking up due to not feeling hungry at all. I have tried to eat once before while feeling like this but it caused me to be nearly sick.

Past five days my BG before breakfast have been really good (for me at least) but if I eat four hours later they have risen higher even though I've counted my CP's correctly. I did a test this morning to see if it was my ratio so did a 1 to 1 1/2 ratio but still got the same result. My blood was higher than the breakfast BG.

Noticing these patterns I've been eating the same thing for breakfast though I've noticed it happen with other foods too. So was just wondering if anyone had any suggestions?

I don't actually have my diary on here as I find it a little confusing but here is my diary since Sunday. Also something I forgot to mention is during daphne I did carb free meals before afternoon dose of levemir and my numbers stayed steady.

Sun -

8am - 9 BI
12:49 - BG 8.1, CP 10, QA 10
17:21 - BG 9.9, CP 12, QA 12+1
19:50 - BG 7.7, CP 9, QA 9, BI 12
3:00 - BG 16.4
Notes: I took units for the meal at 19:50 and worked them out right except once I got to eating I couldn't eat all that was on my plate so I did what someone suggested and tried to estimate how many cp's were left and had some juice to the equivalent of that. I think I may have worked that our wrong though possibly.

Mon -

8am - 9 BI
12:47 - BG 9.3, CP 7, QA 7+1
16:18 - BG 13.0, CP 6, QA 6 (was told not to do corrective doses if the gap between corrective doses was under four hours)
20:00 - BI 12
21:52 - BG 14.2, CP 7, QA 7+2
2:21 - BG 8.3
Notes - tested ketones due to higher numbers was 0.0

Tues -

8am - 9 BI
12:45 - BG 8.4, CP 7, QA 7
17:25 - BG 13.1, CP 6, QA 6+2
18:29 - CP 5, QA 5
20:22 - BI 12
22:32 - BG 14.7, CP 12, QA 12+2
2:37 - BG 15.1
Notes - decided to test next morning a higher ratio due to BI keeping BG steady the previous week during carb free meals

Weds -

8am - 9 BI
13:00 - BG 10.0, CP 6, QA 9+1 (woke up at 10:15 and just read until I felt like eating forgot to do blood reading)
17:20 - BG 14.6
17:33 - BG 13.7, CP 9, QA 9+2

Also I do suffer from mood swings from my fibromyalgia so no idea if they can cause my BG to rise or fall at all. Also I'm on the contraceptive implant so one thought that popped into my head is that maybe this week I may have been on my period which could be a possible cause too. But then I do see that pattern sometimes in the morning from breakfast to dinner.

Oh and since Sunday I've been eating the same meal for breakfast. Scones from Aldi which have 31g of carbs per scone and I have two. Normally I round them up to 7 CP's due to already knowing they effect me differently in the morning than they do later on. But today I rounded them to 6 cp's.

Don't know if I worked out the ratio right with 6cp's. Anyway any help is much appreciated. I do feel more rough this week with my pains flaring up a bit more so I suppose that could be a cause due to the stress from it. But would like to hear what someone else thinks. Also no idea if this is the right place to post this topic as I'm new on the site.

Edit: Will be testing my ketones again later. Oh and I don't know if this can effect BG results but I do have to squeeze my finger a little to get enough blood to do the test. This was suggested by my doctor since I have my needle thing set to the highest and still have trouble getting enough blood. I use the BG Star metre at home and have the Accu Check mobile for when I'm out of the house. Will be testing next meal with both to make sure both have a similar reading.

Edit 2: May be best to try my normal regime next week as just after finishing writing this and posting it I got news that my great aunt just died. But still thanks to anyone who reads or replies to this. Any help is appreciated.

Hello,

To answer some of your questions:

1) Yes, menstrual cycle affects your BGs. There are two phases to a menstrual cycle - follicular - start of menses to ovulation at mid-cycle and luteal - period from ovulation to beginning of next period. The luteal period tends to make you more insulin resistant due to release of estrogen and progesterone during that time.

2) Yes, stress and grief also make us more insulin resistant. Again this is due to certain other hormones such as adrenaline and cortisol.

3) I won't address the Fibromyalgia, as I didn't even know what it was until I looked it up. This website though seems to indicate that getting blood glucose levels down does improve it - http://www.naturalchoicesforyou.com/page/594047

4) I don't think that squeezing the finger is an issue when finger pricking. I was taught to do it that way by my diabetes educator.

Looking at your readings, they mostly seem to be a bit higher than desirable. I don't see any evidence that you have been having hypos, or even getting particularly close to getting a hypo with no readings below 8, so I would suggest increasing your BI. The DAFNE golden rules say to make a change of 10%, and wait 2-3 days before making any further changes. I suggest that you increase your morning Levemir by 1 unit to 10, and monitoring what happens. I'd expect to see your readings during the day drop a little, but probably not below 5.

If you can use the diary function of this website, then that would be great. The users of these forums tend to be pretty good at reading our own and others' diaries from lots of practice, and it makes it easier to identify trends and to help us make helpful suggestions.

Best regards,
Warwick.

Thank you for your reply. I will try increasing my BI to 10 in the morning and try to use the diary online. I don't usually have highs during the rest of the day just seem to this week but I presume once they are going lower again that I may decrease it back down to 9? It's just that before this week I only usually got a high when I've had to guess work my cp's or after breakfast at lunch. Last week I went down to 4.8 four hours after eating and being at 6.7. Will try and do the diary later and upload last weeks data as well as this weeks hopefully that will help. And possibly some of my diary from before dafne.

Have you considered Alternative Site testing? A new cap may be required for your pricking device.

I was told to only use my fingers due to it being the most accurate for testing and apparently a less painful area to use. I got a new pricking device last week which seems to be working a bit better but I will try with another cap if i have to use the other one again. Thanks :-)

Welcome to the forum
Don't be intimidated by the thought of the online Diary. I'm a Luddite - and even I found it simple to use....and look at all the typing to the forum you'll be saved doing!
Your rounding is fine. Up to 6.49 round down to 6. 6.5 and up..round up to 7.
Could you tell us which lancet device you have? Maybe we can suggest alternatives from our group experience that may suit you better.
I use a Roche Softclix II...which is donkeys years old and I have thought about getting a different one.
Following on from alturn's comment I heard some time ago that there is one that can be used one-handed on different parts of the body but can't remember whether it is combined with a meter or not.
Anyway, when I looked on a medical supplies website I noted that there are at least 16 different manufacturers of these devices out there, so I would hope that we can help you find one that suits.
Try the online diary. Hope you find it easy to use.
Regards
Garry

Thank you :-)

I've managed to upload information into the diary from the 30th January. I found its easier for myself to use the app to add the information to the diary. Though I didn't add the injection sites as I write those down differently to how the diary lists them.

The only place I do my QA is my thighs however because other places it causes me some pain and I do my BI in my stomach. Just wondering is that okay? It's just that I've tried everywhere else with my QA and it does cause me pain for some hours afterwards. Also my BI seems to work better from my stomach and I didn't like the idea of doing both my QA and BI in my thighs.

I don't know what the lancet devices themselves are called only that I have the one I got with the BG Star metre and the one that comes with the Accu-Chek Mobile metre. The latter seems to work better however.

Edit: I tried adding my diary to the post but it doesn't do it. No idea if I'm doing it correctly or not.

Edit2: Never mind worked out what I was doing wrong. I listed from the 5th to the 15th to show the differences I was talking about before this week but I can post this weeks as well if it would be easier to read than what I put into my original post. Also no idea how to change ratios or how to get rid of them for the times I'm not eating so sorry that they are showing for every entry

Edit 3: Honestly don't mean to keep editing my post but my memory is like a sieve and just remembered something else I've been meaning to ask. If you have more than one metre is it normal for them both to have different readings? I do use the results from my new metre as the other is now only a backup in case that one breaks. But this morning I decided to test to see if there was a difference at all as I used my backup when I misplaced my new one.

Found it for breakfast though. Which was when I tested to see if both metres were close or not.

"Tested on both metres 11 was on my new accu-chek mobile. Got 12.1 on my bg star. Same finger same drop of blood." - is from my latest diary entry.

I would say your entries are fine - much easier to read.

I usually use the opposite - thighs (tend to bruise) and buttocks (though requires some flexibility, especially left using left hand) for BI and stomach for QA as believe stomach gives faster release over a shorter period - not so important for BI.

If you are having pain, cold be your needles could be changed? I started on 8mm then 6 and now 4mm as I had very little fat anywhere to inject into, not so bad now at 10 st. Sometimes get a pit of pain. On DAFNE course I think someone said injecting large amounts with small needles caused them pain, but your units don't seem to be large.

The ratios list can be edited - open up your blood glucose diary, scroll down yo "add diary entry" and should see "Ratio (QA:CP)" with an "edit list" option. Click "edit list" - ratios should appear with tick boxes. Tick/untick as required.

Meters may give different readings, I would say a difference of about 1 isn't anything to worry about. It could be caused by a different sample, even if you repeat with the same meter BG may be different. My readings are on Xpert & Optium (backup and ketones) so its probably a general issue (there is another post about this subject somewhere where differences were larger).

Hope this makes sense and helps. It's very easy to forget to add something so you're not alone.

I sadly bruise no matter which injection site I use, though less painful with my thighs. My diabetic nurse put me on the 4mm as she said with me being at 11st that maybe the 5mm was what was causing the pain before. Though she also said the pain could be from my fibromyalgia so will see if changing the sites works out better over the next few days. Will try and use my stomach for my QA and see how I go. Then do my BI in my thighs.

Yeah it makes sense, thanks for the tips and telling me how to edit ratios on the diary.

Most HCPs seem to recommend QA stomach and BI thighs as the insulin absorption times seem to line up best for most people.
If you can't do that though..don't worry. We are all different.
Are you filling in your diary on computer, or by mobile?
Lots more facilities available by computer.
Regards
Garry