BG Diary

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Tony Brewster DAFNE Graduate
South West Essex PCT
4 posts
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novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

is this your week on the DAFNE course..............?

I will assume your on Lantus as there is only one dose, and so I would also comment on the fact that you have changed your dose and not allowed 3 days for it to show its effectiveness, all dose changes should be allowed to work, but especially Lantus as it takes a few days to settle down.............is it Lantus.....?

It seems like the 24 dose was the best overnight, maybe just a wee bit to strong, but you wouldn't know for sure unless you stuck with it for a few days.....

As this dose is still being established insulin/carb ratios wont be able to be tweaked properly..............

I see you have went up to 3:1 at breakfast, most people are more resistant at that time so you could be right there................

Tony Brewster DAFNE Graduate
South West Essex PCT
4 posts

hi, my blood sugar goes up in the morning even when i dont eat, i could wake up norm but be about 17-19 at lunch time. its not really a ration for breakfast its more like assuming what sugar myy liver will pump out and try to match it on top of brekky. this is my week first on dafne. 24 i like because works best when im sleeping. but the mornings are killing me

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

dawn phenomenon but a bit later, that's strange the liver action doesn't happen before you wake..............

if your waking normal, then tackling the liver maybe easier, you can just compensate with some QA insulin at breakfast, nothing is ever simple though.....

you don't need to suffer the highs in the morning, the 24 might be good enough to get you through the night, but it may not be enough for during the day, have you discussed that with anyone.....

Peter DUAG Committee Member
University College London Hospitals (UCLH)
109 posts

Tony, I would suggest you talk to your diabetes team about changing on to a twice daily basel (background insulin) regime. This is recommended for many people and when taken last thing at night and first thing in the morning it has the benefit of increasing the background insulin levels during the morning, which may help with the increases you are talking about in the morning.

Given the number of changes you've made in quick succession it's difficult to know where the problem area are. I would also be thinking about increasing the background dose given that the BG level is high across the day. It would be worth talking about that with your diabetes team.

Good luck.

Tony Brewster DAFNE Graduate
South West Essex PCT
4 posts
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the last few days ive eaten a cereal bar with 22g of carbs in but at 7am i have to have 8 units of QA to cover it, i have monitored my sugar closely i havnt hypod, but if i dont want to wake up at 7am i am actually condemned, BI wont cover the morning rise. I have also tried splitting lantus many times and dosages in the last 6 months, which for some parts of the day worked out good and bad but never covers the morning rise. Im a single parent and i just feel so energyless everyday, im not sure whether a pump would be the best option either, however i think i will discuss having a pancreas transplant because most days i wake up with blurry vision because of this and i dont seem to be able to do anything with injections to prevent it

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

It is a pain I know..................

For best results on Injections, splitting your BI dose is best, this can be with Lantus or Levemir most commonly, Humilin I is another, one will work best...............injecting your evening dose right before bed is best together with another injection when you wake, this gives you a larger quantity of BI in your system at this time, which will help towards getting your waking level down........

This also means that you may be running out of BI on the run up to bedtime, so you will need to compensate with more daytime BI, higher dinner time QA ratio or a combination of both..........

From my own personal experience, carbs are needed when you wake in order to let the liver know you no longer need a dump of glucose as you have refueled manually...............I have wanted to test my daytime dose with a carb free breakfast, or no breakfast at all, but its impossible, as the dawn phenomenon continues right up until lunch unless you refuel with carbs.........

Currently I am carrying out this scenario, I inject at 2230 every night though as opposed to straight before bed, I have also noticed that 15-30 minutes of moderate activity (sweaty and heavy breathing) after dinner also helps as the muscles regain their stores of energy right into the next morning.........

Trying to beat DP can be easy for some, but for other like myself, and possible you, a more strategic approach is needed.....

Have you also considered resistance to insulin at different BG levels, the higher you are the less 1 unit may drop you, this may also help trying to get on target for lunch....

I would also stress again, that in order to be effective, you should not change your ratios by the day, you need to give that ratio a chance for a few days, and only try and change one thing at a time.............so I would recommend concentrating on your BI