insulin

Hello

I did the dafne course around a month ago after the course my blood sugars seemed to stabilise but now they are raising overnight, it seems to be that for a few weeks that amount of insulin works and then all of a sudden it seems as i need more and then this will work for a few weeks and then it needs changing again. Has anyone else experienced this? Also the diabetic nurse thinks i am on to much insulin for my bodyweight but i seem to keep needing more insulin, could this be because i am taking to much insulin and my body is not using it properly and that's why the doses are constantly changing?

Thanks

Hi sorry I don't have any advice but just wanted to say that I am having the same problem with my blood sugars raising overnight! Last night i went to bed and my sugars were 7.9, this morning they were 13! My diabetic nurse is thinking of changing which background insulin I'm on as I've tried having more background before bed and it's not working! X

Have you tested during the night? I did the DAFNE course in 2007, and a lot of effort was put into getting BI right - including testing during the night. I still do this if I think my BI needs adjusting (it used to be really tedious, but now as I get older waking up during the night seems to be an increasingly common occurrence).

Sometimes a high morning BG can be an indicator of a night-time hypo, or be a result of the dawn phenomenon. A few "during the night" tests will help to clarify whether it is either of these, or whether it is "simply" (as if anything is ever simple!) bodily changes requiring more BI.

Hi

I have tested through the night and don't seem to be having hypos and it Doesn't seem to be dawn phenomenon as they raise any time during the night. I think I just need to get the split dose right as I don't really want to up the BI as I find this drops me during the day, it's just so frustrating!

Ellen, what BI are you using and do you split the dose?

Hi

I'm on levemir and on split doses, when I did the dafne course I started on 7 in the morning and 12 at night then had to go up to 6 in the morning and 13 at night, I'm currently trying 5 in the morning and 14 at night and will see how that goes.

I had similar problems and my diabetes nurse advised me to increase my evening Levemir by 2 units and that seems to have sorted me out.
I think there are changes going on in our bodies all the time, so things are bound to go awry occasionally.

I think I may have to up the Levemir to 20 instead of 19 and see how that goes, I just didn't really want to up it because the diabetic nurse thinks I'm on to much insulin for my body weight but maybe I need a little bit more than they think.

My approach to insulin doses are you need what you need to keep BG levels steady.............

the matching up of doses to body mass is nothing more than a guide........

as long as your getting what you need that's the main thing.....

ideally you want to get the background as tightly tuned as you can which will mean you can drop down your meal time ratios as well........

Hi Ellen,

There are lots of reasons why your insulin needs can change:

1) Change of season - usually less required in summer than winter, but not always.
2) Exercise activity. I find when I am on holiday and out of my exercise routine that my BI doses almost need to double to have the same effect.
3) Pre-menstrual hormones can cause a blunting of your insulin sensitivity.
4) If the area you are injecting isn't changed on a regular basis, then that part of your body can become much less sensitive to insulin. One of my friends has changed where her pump attaches from her abdomen to her arm, and found that she needs to reduce her doses as her abdomen has been receiving insulin for so long that it is no longer sensitive. Her arm though has no such issue.
5) The insulin may have spoiled and you may find that a fresh pen fixes things.
6) You may need a different basal insulin. I'm on Levemir and have been for over a year, but over the last couple of weeks I am getting painful lumps wherever I inject it. I now inject half of the usual amount into two separate sites which seems to be relieving the issue. Splitting your dose into two (injected at the same time, but in different areas) can increase the absorption.
7) For myself, I find that when I have more carbs than usual, I need more BI to process that overnight. If I cut down on carbs, then I find I need to drop my basal too to avoid hypos.

There are other possibilities too. All the best with it.
Warwick.