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Nov 24, 2012
SA2010
69 posts
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Topic: General Discussion / Hypo one day high the next day after similar meal - Delayed Activity impact / new pen? Strange BG readings - an unexpected Hypo 22/11/12 @ 19:56 and the second day with similar evening meal unexpected high ! It seems that we are always getting readings we do not understand. Does not add up.Could it be : 1. change of pen ? switched from NovoPen 3 Demi to NovoPen Echo as from lunch time on 22/11/2012. Only difference I noticed is that the Echo continues to release insulin at end of dose whilst end is pressed. Similar to what Solostar does for Lantus. The leaflet says count to 6 seconds - but maybe this is a new factor to take into account. The NovoPen 3 Demi hardly released any. Almost none. 2. Delayed effect of activity causing the hypo. An hour travel for eye check in the afternoon.? 3. A glass of red wine with meal? Hypo was one hour after meal so quite quick. The wine bottle was opened a few days earlier. Does this change how red wine behave? I have had red wine before with no significant impact to BG. 4. A thought: Is it possible that QA:CP ratios should be different depending on BG level? For the 2 evening meals pre meal BGs were 6.0 and 10.1. The accuracy of the Accu-Chek Expert is probably about 1 mmol as a repeated test for the 2nd day gave BG 9.3 (variation 9.3-10.1 for same time). Maybe ratios should be lower if BG below 7.0 and higher if above 8.0? Just a thought that it is not as simple as just having +/- QA corrections Any views? PS Also Beans were implicated in high BG reading on 21st November. Nuts and Beans always get implicated for me and perhaps should be counted - partially?. Simon |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos Ahh I see thank you
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Hypos Well, yeah, there is no chewing, but I think its more to do with not having to be broken down in the stomach, it just gets digested almost instantly, and so the valuable carbs can be processed and distributed.Its not exactly the same way, you would put 15g of carbs for your hypo as 0 + 1.5. So the 0 lets you know and others/HCPs that you were not having any meal time carbs with insulin, but that you are just having carbs uncovered by insulin. Obviously writing it in CPs [Carbohydrate Portions] helps from a DAFNE point of view |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos
Re liquid being quicker that's because your not having to chew something for ages. Re put in the carb amounts of the hypo treatment - would this be the same way as I enter for meals? Supposing I'd had 20g or 30g carbs? |
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: Questions for HCPs / Hypos If your getting hypos before your next meal that suggests the dose is too much for that meal......If you had a hypo quite quick after the meal/injection then the dose timing could be a consideration, ie you may need to reduce the time between injecting and eating.... |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: Questions for HCPs / Hypos Hi novorapidboi26,I've just posted some replies on my other "HYPOS" topic in the General Discussion section
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Hypos I used to have jelly babies, but I thought they were too many calories... .....so moved to Asda's chosen by you ISOTONIC SPORTS DRINK....I also find liquid is much quicker at treating hypos.... If you could put in the carb amounts of the hypo treatment as 0+1.5 or 0+2 it will tell you and others that you had something to treat it..... There is no doubt that timing of your BI, even when on a single dose can be experimented with, for example some folk take there dose in the morning for whatever reasons. For you however it looks like the dose it too much so I would keep your dose time the same until you get a morning BG within 1-2mmol/l of your pre bed test for more than 2 days in a row..... |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos Hi novorapidboi26,I've just posted some replies on my other "HYPOS" topic in the Questions for HCPs section
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos
Thanks for your wee example from your diary
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos
Yes I'm going to continue to drop my BI dose. Exactly!! I usually treat hypos with 4 x jelly babies or 4 x fruit pastilles then when BS is back up again if at home 1 x round bread with a smearing of jam just to give the bread some taste. Yesterday though what happened no jelly babies eek so I had water with 3 x tspns of sugar which seemed to work a lot quicker. I HATE dextrose tablets! Thanks for mentioning about the "dose amount as opposed to timing". |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: Questions for HCPs / Hypos "I think the timing of your injection is OK in terms of changing, its only with dose changes that only one should be done at a time, according to DAFNE..What are your reasons for wanting to inject after the meal? Have you been getting hypos in between meals?! Thanks for confirming re the timing of injections/dose changes. The reasons for wanting to inject after the meal is because I thought maybe it might slow things down a bit and help to prevent hypos but then again maybe not. I've not been getting hypos in between meals. Please don't give me any more hypos to contend with lol 
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Hypos Just a wee example from my diary showing how much easier it can be to see whats going on....... |
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Hypos It would seem you need to continue to drop your background dose.....Make sure you get your BI time right on the diary too, makes it easier to read......also keep your comments short, again, just because it makes it easier to read... You seem to be having a lot of hypos though, constantly, you must feel like its never ending...... How do you treat your hypos, and can you put that information into the diary also please....  I think that the lows your are experiencing are down to dose amount as opposed to timing. With a split dose of Lantus and with Levemir you can consider changing the times of dose to earlier/later in the evening.....but with a single dose, It wont make much difference I would imagine... |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: Questions for HCPs / Hypos "If your Lantus dose is still in question then you shouldn't be changing your QA dose....That's how I would look at it anyway.... DAFNE teaches to change only one thing at a time in order to keep as little variable in the equation as possible, and that your background dose should be spot on before any meaningful changes are made to QA doses...... So you have decreased your Lantus to stop the hypos coming, yet you have increased your pre dinner insulin ratio....... One may be cancelling out the other......" This is exactly what I thought ie one thing at a time. I know it's my lantus/BI at fault, I'm having to much of it. But now I don't know where the ++++ I'm upto also do I keep on with the decreasing of the lantus/BI and maybe alter the teatime/dinnr dose back to 1:10 instead of 1.5:10?? very  ! |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: Questions for HCPs / Hypos "Has your change in Lantus been confirmed as correct and working, ie....overnight tests and carb free meals during the day....."No |
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Nov 23, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos "How is your dose of 32 going then? What have the numbers being saying?" also if you look at my comments since Tuesday/Wednesday I've been bringing my lantus/BI an hour earlier each night. |
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: Questions for HCPs / Hypos Has your change in Lantus been confirmed as correct and working, ie....overnight tests and carb free meals during the day.....If your Lantus dose is still in question then you shouldn't be changing your QA dose.... That's how I would look at it anyway.... DAFNE teaches to change only one thing at a time in order to keep as little variable in the equation as possible, and that your background dose should be spot on before any meaningful changes are made to QA doses...... So you have decreased your Lantus to stop the hypos coming, yet you have increased your pre dinner insulin ratio....... One may be cancelling out the other...... Ask your DSN how you you are supposed to determine what each of these changes has done to your blood sugar if the changes happen at the same time...... I think the timing of your injection is OK in terms of changing, its only with dose changes that only one should be done at a time, according to DAFNE.. What are your reasons for wanting to inject after the meal? Have you been getting hypos in between meals? |
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Insulin Pump approval You would still inject for any carbs you had in the pre bed snack, but if it was cheese you wouldn't. The cheese does digest and although mostly fat does get converted into glucose. But it happens very slowly. But the theory is your body is aware that there is fuel in the gut being processed and so does not get the pancreas to release glucagon, or at least not as much, therefore keeping the liver from spitting out huge amounts of glucose.Normally most people have had nothing in there for 7-8 hours so your body needs a kick up the bum to get going........[dawn phenomenon]...... August was a while back, and together with the change in seasons, I would say its time for some background testing again to see if you need to tweak your dose.... |
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Nov 23, 2012
novorapidboi26
1,819 posts
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Topic: General Discussion / Hypos If your having scary hypos then you have to be safe and make sure you have treatment with you at all times.....As you are experiencing them at all times of the day it would definitely be the Lantus you need to look at. There could be some QA changes needed but you will never know the exact extent of that until your Lantus is pinned down.... How is your dose of 32 going then? What have the numbers being saying? Having something before bed is fine I suppose but the right thing to do when in a period of dose adjustment of your background is not to have anything..... I think the point Vic made about not being strictly DAFNE is that you shouldn't need to have any carbs before bed provided your doses are right. This has came hard for a lot of people who have always eaten something to avoid a hypo overnight.........but if this is happening, your dose is wrong.... So if you do have a snack that's fine, but you wont be able to record any meaningful BI test results, and therefore delaying you getting the right dose pinned down which will then let you investigate your QA doses.... |
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Nov 23, 2012
Ahmentep
99 posts
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Topic: General Discussion / Hypos Hi,I ALWAYS have supper! Quite a substantial supper too, sometimes an actual cooked meal. Always have done. Even so, I sometimes have hypos during the night. I don't see why it is 'anti dafne' to do so. Surely the whole priniple of DAFNE is that you should be able to eat normally, that is what the 'NE' stands for after all. Kind regards, Roger |
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Nov 23, 2012
Ahmentep
99 posts
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Topic: DAFNE Online Mobile / How to upload diary from app to website Hi Marke,I taket it that your explanation refers to the ipad/iphone app. I run the Android app on two devices and neither automatically upload when I make an entry. I have to press the upload button. Kind regards, Roger |
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Nov 22, 2012
marke
681 posts
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Topic: DAFNE Online Mobile / How to upload diary from app to website Hi, You don't is the short answer If you have diary upload turned on all you need to do is add a new entry whilst you have data coverage ( this means you can browse to a web site on your phone, where the app is installed) and the app will automatically upload any entries that are not already on the site. Why doesn't it do this automatically anyway ? Well the problem is, it would need to keep checking all the time if it could connect to the site in the background, this would flatten the battery quicker and unnecessarily use up your data allowance. By only doing it when you have added an entry it knows there is at least one entry to upload and so it is worthwhile connecting to the site to do this. Whilst adding the new entry it checks if any others need to be uploaded and uploads them.If it still doesn't work when you add a new entry then you don't have data coverage or your user account details are wrong but this should cause an error message to appear. |
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Nov 22, 2012
vic demain
87 posts
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Topic: General Discussion / Hypos Get yourself running around 10 - 12 for a while by reducing Lantus first, then perhaps reducing ratio of QA. Yes it isn't stricktly DAFNE but I always take a couple of biscuits at bed time. Need to get away from the danger of too many hypos. |
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Nov 22, 2012
mum2westiesGill
502 posts
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Topic: General Discussion / Hypos I'm having them all over the place really ie on waking, during the day/evening & in the early hours. The worst ones have been if I've woken early or in the early hours, especially if it's had to be an assisted one with my hubby ie the whole of my body is twitching and jerking = not very pleasant at all !!!What would be the first thing you'd look at doing? I've decreased my basal/lantus first from 42u to 36u then from 36u to 32u, I only did the latter on Tuesday 20/11/2012. Since Tuesday I've also started to bring the time of my dose earlier in the evening from11:00pm - done it by an hour each evening. Also wondering if a bit of supper ie a sandwich might be an answer to get me right through the night. Humalog/QA - before meals - carb counting Lantus/BI - evening |
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Nov 22, 2012
Leigh Gilmore
4 posts
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Topic: General Discussion / Insulin Pump approval I've never heard that about snacking before bed, it sounds an interesting idea. I think I would find it odd to have a snack of more than 1CP without taking insulin though, I'd probably end up injecting out of habit!I last did background checks through the night (3 and 6) when I did the DAFNE course in August. It was those that highlighted the problem in the first place. |