Some advice please

Hi

hoping someone can advise me on my diary. My morning BG is always high, no matter how much evening BI I take.
Was told the BI would not lower your BS. I knows about the dawn phenomenon and 3am testing.
I have tried taking more BI insulin to cover any liver dumps, or less case it was lowering my BS.
Last night I took 22 units of BI to see if it would cover the dawn phenomenon. Went to bed at 1am at 8.4, had a carb free supper. The lat QA was at 10.30pm and that would've been in my system upto 3am. But I woke up with a BS of 17.9!!
A couple od weeks ago I thought I had it sorted, that didn't last long.
The HCP told me it was because I was eating no carbs and my body was craving glucose so sending a message to the liver to give it some. If my sugar is high why is the brain asking for some?

am having 2 slices of toast for supper tonight to put that theory to the test.

You can see how confused |I am, I hope.

thanks in advance and best regards

Derek

ps weighed myself tonight and I have gained 10lbs since graduating from DAFNE. I blame the massive amount of insulin I am having to inject.

Hi, well BI won't affect Dawn Phenomenon so don't try to use it to do that. Also I'm a bit worried about the variations in your BI in the evening. You shouldn't be changing it that radically and that often. You won't see a pattern if you keep changing it so much so quickly. You need small changes and slowly (2-3 days at least between changes).
The tues/weds/thurs you hypo-ed and so this could case fluctuations in your BG's. You need to settle on getting your BG right and changing it slowly. A few days of high BG's is NOT going to cause any damage and it will let you get things under control slowly.
ALL insulin affects your BG, thats its whole purpose so I don't know who told you BI doesn't affect it. Yes BI is primarily to keep you BG steady not cover CP's but it does have an effect and it is the key to good control. Get it correct and you will find things much easier.
It does look though from your readings that you are insulin resistant, you seem to need a lot of insulin for not much CP and if I injected that much QA I would be straight to A&E ! Have your Diabetes team not discussed insulin resistance with you ?

Hi marke
Thanks for your reply.

The HCP told me BI does not lower your BS, although I suspected it did.
You are right about me having to take a lot of insulin, never used to be like that. I would never have dreamed of taking that amount of insulin.
If I have a portion of rice (200g) I need 24 units. Before I would have maybe taken 14.
Last night bedtime you can see what carbs and insulin had and I woke this morning with a BS of 13.7!! This is really p^^ing me off,
Tonight my BS was in the normal range, had 2 CPs and 8 units of QA so will see what my BS is in the morning. If it is high then I am very confused and clueless.
I took 18 BI last night and 18 tonight as you are right I was chopping and changing too often.

thanks and best regards

Derek

You cant really compare, but I am about 16-17 stone, so overweight and my BI requirements are 30 in the morning and 38 at night, with a 3:1 carb ratio at breakfast, the remainder are 1.5:1........

So, although we are not the same, my point would be, get your BI doses up, and continue to do so until you hold steady, you may be resistant to insulin but I suspect you could do with more BI, BI does lower your blood sugar if the dose is too high for your livers rate of glucose secretion...........

The theory of rising BGs/liver dump when there are no carbs present is correct, or at least for me, but this wouldn't normally happen overnight when your body knows it should be asleep, only when the internal clock goes off and tells the liver to start dumping glucose in the morning (Dawn Phenomenon) would carbs help in turning off/suppressing the dump...........

I realised this last week when I decided to go carb free at breakfast for a few days, BGs went up until lunch.........

Thanks for your reply novoraoidboi26. I am 19.5 stone and was under 19 before dafne, was trying to loose weight cutting out most carbs but diabetes nurse "streesed" to me my body needed carbohydrates, so I am taking carbs now and you can see the result, high BS and over 7lbs weight gain.

You can see last nights bedtime BS, CP and insulin taken at 11.45 and I woke at 8.45 with a BS of 13.9!!

I've tried taking upto 22 BI at night and still high. On sat 21/5 had 22 BI at 11.45, bed at 1am with an 8.4 BG and tested at 7.50am with a BG of 17.9!!

What type of BI do you take? I had been on Humilin Isophane for years with the same high BS in the morning, put me on Lantus and had greater control but didn't feel right on it and asked to try animal insulin. Been off lantus for a couple months now and don't feel any better so it probably wasn't the lantus that was making me feel bad.

Got DAFNE review on 6th June so see what they say.


Bests regards

Derek

I am on Levemir Insulin, been on Lantus and Humilin I, Lantus didn't last 24 hours and I tried Humilin I to tackle DP as it has more of a peak, but it didn't help.......

I admitted defeat to DP purely because I didn't KEEP upping my dose as it wasn't having an effect, I was still high in the morning, so I stopped increasing, it took a fresh look from my DSN to get me to try and keep increasing it, that is the step wise approach we have been taught at the DAFNE courses, it sometimes easy to forget that.....

Its all a process of elimination, and it may be the case that your morning highs just wont be beaten and a pump will be needed, but you need to try increasing first, starting wit the overnight dose, our BI requirements can change all the time, sometimes quite considerably, its a pain, but that's Diabetes for you........

this is a joke!!

looking at all the insulin I had this morning and my BS before breakfast, which was 1 slice of toast and 2 boiled eggs. Just tested before lunch and I am 13.4!!!

Just how insulin resistant am I!!

There could be many reasons for this, but if it was me, on ratios as high as that, I would, as I have ranted on before, get the BI up , right up, dont be scared..........

You can get help with resistance, like metformin, but that comes with a whole load of other problems/side effects............

Any chance of not eating lunch, and no correction, and posting dinner time readings..............?

Hi

Sorry for taking so long to reply. I increased my BI to 22 last night and it is better. This morning BS was 9.7 but I suspect my BI is only lasting maybe 9 hrs. The duration is 8-14 hrs. Took it last night at 11.30, 8.30 this morning was 9.7 but by 9.15 when I had breakfast was up to 11. I hope | understand it correctly.

As for metformin. Was on that for years. At first 2 x 500mg then upped to 2 x twice a day. They never told me what it actually done or any side effects just that it can help with weight loss.
I used to have severe problems with my bowels. When I needed to go, I needed to go.

I never suspected it would have anything to do with the metformin but it wasn't until late last year I was in hospital for a suspected DVT ( it wasn't a DVT it was phlebitis) and the doc there asked about medications I was on and if I ever had any problems with my bowels!!
She told me the metformin would be causing the bowel problems I was having so I stopped taking the metformin ad have been fine ever since.

Keep going with the 22 units and try and have a carb free night, I know this may be hard to do, but its worth it in the end, and it means you can change your dose confidently............

The main use of metformin is to help your body process insulin better, so dropping your resistance to it, used commonly in type 2 patients, whose main problem is resistance...............but as you have experienced it can upset the stomach, sometimes referred to as metfartin..........this in turn I would imagine lower your appetite and contribute to loss of weight.......

Resistance is also helped by activity, the more your muscles works, the more doors they create to let fuel in, and so absorb insulin much faster............but I am sure you have been hassled from the HCPs about that............