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Nov 22, 2012
mum2westiesGill 502 posts

Topic: Questions for HCPs / Hypos

Hypos

I'm currently having lots of hypos ie on waking, during the day/evening, during the night.

Things I've changed and when:
1 - BI dose decreased/Tuesday 20/11/2012 - on advice from my DSN
2. - Evening meal ratio changed from 1:10 to 1.5:10/Tuesday 20/11/2012 - ditto.

Would it be too many changes if I also started to take my Humalog right after eating a meal?
I normally take it 15 mins before to let it start working then just on the very odd occasion have taken it after.

Read this in the leaflet
"Humalog is a rapid-acting insulin. Take Humalog within fifteen minutes before eating or right after eating a meal".
 
Nov 22, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pump approval

It sounds exactly like me to be honest, although recently I have managed to get single figures when I get up at 6:40am.

Have you tried a slowly absorbed snack before bed like cheese or toast and peanut butter. Some say that having these foods digesting in our stomachs right until the morning actually helps hold the liver response back a bit.....

I haven't noticed it making a real difference though......

You have real discipline though getting up at 4am all the time to give insulin, I am quite happy to wake on 10-12, at least on injections anyway.....

When was the last time you collected overnight background test results?
 
Nov 22, 2012
AnnaConstant... 5 posts

Topic: DAFNE Online Mobile / How to upload diary from app to website

i have the dafne app but cannot figure out how to upload my diary entries. i have diary upload switched to on but how do you actually upload the entries?
 
Nov 21, 2012
Leigh Gilmore 4 posts

Topic: General Discussion / Insulin Pump approval

Bed is somewhere between 10 and 11 so I can get a decent stretch of uninterrupted sleep. No food at 4, just the insulin. I eat and take more insulin when I get up at 6, but obviously without any more corrective QA if my BG is still above target.
 
Nov 21, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Insulin Pump approval

What time is bed?

Do you eat and take insulin when you get up?
 
Nov 21, 2012
Leigh Gilmore 4 posts

Topic: General Discussion / Insulin Pump approval

I'm on Levemir so am taking the evening dose immediately before I go to bed. If I get up at 4 and test my BG it comes out at around 6-8 most days. If I don't inject 6 units of Novorapid then by 6am when I get up for work it'll be up to around 13-14 and if I let myself have a lie in until say 8, it'll be closer to 19, and needless to say I'll be feeling pretty rubbish! 6 units holds me level though so I'd rather wake up at 4 and suffer the interrupted sleep, but I'm hoping a pump will put an end to that, even if it is a long way off yet.
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / BG Diary entries

just mark it down as normal

a blood sugar reading with an inulin dose next to it

the before bed test doesnt hve a BI dose next to it
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / Lantus - changing time

novorapidboi26 said:
what time are you up at........?

making sure your not running out for waking time is important you see.........

you could maybe try taking it at 8pm with dinner



I'm normally up at about 07:30am - 08:00am ish

I could possibly take it at 8pm with dinner but I thought you had to make the time earlier by just an hour each night.
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / BG Diary entries

But if it was you how would you mark this all down in your dafne diary ie having your BI earlier then also doing a test at bedtime?
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Lantus - changing time

what time are you up at........?

making sure your not running out for waking time is important you see.........

you could maybe try taking it at 8pm with dinner
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / BG Diary entries

I would still test at bedtime, if I was was wanting to see what my BI was doing........

I don't always test before bed though as I know my BI is right, at least for now...

So not all the time, but definitely if your going through a stage of adjustment, which you are at the moment......
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / BG Diary entries

If your last insulin dose of the day is BI (background insulin) and you take this early evening but you don't go to bed until much later would you

- put the BI amount into your diary and the time
then
- test at your actual bedtime ie when you get into bed and mark this as BED

Thanks for any replies Smile
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / Lantus - changing time

I normally take my lantus (BI) at 11:00pm or an hour or so either side. This is usually also my bedtime.
I take humalog (QA) at around 08:00pm ish when I have my evening meal.
I'm going to start taking my lantus earlier in the evening. Any votes on my new time please?
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / Lantus - decreasing

novorapidboi26 said:
Lol,

I realise that must of sound wrong, but I was referring to adding on a few more units to your reduction total....



Ahh I see lol Laughing .

Anyway It's no too late to reduce it again tonight (after already reducing last night) by another 2u so from 34u to 32u (in total from 36u to 32u). I'm also going to start taking it much earlier in the evening. I usually take it about 11:00pm or within an hour either side. Then I'm going to wait 4/5 days / 1 week to see what changes it brings.

I did actually phone my DSN & she confirmed together with me all of the above. DSN also said I could maybe even reduce it to 30u.
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: General Discussion / Lantus - decreasing

Lol,

I realise that must of sound wrong, but I was referring to adding on a few more units to your reduction total....
 
Nov 20, 2012
SA2010 69 posts

Topic: General Discussion / Insulin Pens for NovoRapid & Lantus

Thanks Lauren for the feedback. I have put my request for 'Novopen Echo' to the GP. Will research the clickmaster further before asking to switch to it. In any case I would need to get to the end of my current Lantus batch of 5 pens.

Simon
 
Nov 20, 2012
SA2010 69 posts

Topic: General Discussion / Ratios

Spot on. You round up or down depending on where your BG is at within the target range. You take that into account also if outside target range.

I have switched to a half-unit pen because I am very sensitive to insulin

Simon
 
Nov 20, 2012
SA2010 69 posts

Topic: General Discussion / Lantus - decreasing

Hi

Surely you need to be more aggressive with your Lantus reductions with so low and persistent BG readings and below 3.0. The stepwise chart in the DAFNE Handbook says BI reduction of 1-2 units but also says 10%-20% so in your case I would say that would be a reduction of 4 to 7 units from 36 rather than 1 to 2.

Over time I have come down from a peak of 20 units Lantus day now to just 8 split as 4 and 4 Probably still not my optimum level - I probably need to bring it up to 9 - But each person is different so in your case you need a much higher level

PS: Should get in the habit of putting the Fast Acting CPs in the BG Diary CP fields as it would make it easier to see the action taken on hypos and what effect it had on the BG subsequently.
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / Lantus - decreasing

novorapidboi26 said:
If you are confident enough then yeah, add on the additional units and then proceed with the 3 days testing (3 am etc...)........

Have you been ill........?

Any alcohol......?



Hi novorapidboi26
Thank you for your reply but I was asking about decreasing units.
 
Nov 20, 2012
mum2westiesGill 502 posts

Topic: General Discussion / Ratios

How many units of insulin would you have on a
0.5:1 ratio

for example 5 CPs / being 52.0g of carbs?

would it be 0.5 times 5 = 2.5?

Then with a one unit pen (I don't have a half unit pen) & taking into consideration bs levels being low or high it would be rounded down to 2u or rounded up to 3.

I've never done DAFNE so am I right with my workings out please?
 
Nov 20, 2012
Gibsjoh 2 posts

Topic: General Discussion / Levemir

Yes been using pens for a good few years and had no problems, thought it was maybe the way I have been carrying the spare insulin with me but for some reason just the Levemir vials have been faulty.
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: Questions for HCPs / FASTING TARGET

Well, all targets are specific to each individual, but ultimately we want to be between 4-7 at the before meal occasions and the fasting time........

Fasting target is the range of blood sugar your at when you wake up, most people find they are higher at this time, due to an increased increased insulin resistance [glucagon] and glucose secretion from the liver. These two processes are happening because of the fact you have been fasting and there is no fuel on board......
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: Questions for HCPs / insulin pump

Not an HCP or Pump user yet however I can explain..........

The corrections are programmed into the pump.....

However corrections can change as you know, so in the morning 1 unit could drop you by 3 mmol/l and at night that may go down to 1 mmol/l.....

The pump can accommodate for these varying levels of resistance to corrections at different times of the day.

So by using the information that the user had given it, together with the specified blood sugar targets for that time of the day, its purely a simple arithmetic calculation...
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: Questions for HCPs / exercise query

I think with long periods of light to moderate activity levels you should actually decrease your BI dose, this will deal with a slower dropping blood sugar level and can accommodate for the hours after the activity also....

Now, I am not a great fan of too much exercise so my advice may not be very good, however I would say that option 1 would be good.

Take your normal 1:1 ratio, and also consider increasing the time from injection to actually eating breakfast. This will help you avid hitting the 20+ blood sugar readings.....

As you would have reduced your BI you would find that you may not need extra CPs during or after.........best to test this approach with caution, as you would with any new approach, as we are all different...
 
Nov 20, 2012
novorapidboi26 1,819 posts

Topic: Questions for HCPs / exercise query

I think with long periods of light to moderate activity levels you should actually decrease your BI dose, this will deal with a slower dropping blood sugar level and can accommodate for the hours after the activity also....

Now, I am not a great fan of too much exercise so my advice may not be very good, however I would say that option 1 would be good.

Take your normal 1:1 ratio, and also consider increasing the time fro injection to actually eating breakfast. This will help you avid hitting the 20+ blood sugar readings.....

As you would have reduced your BI you would find that you may not need extra CPs during or after.........best to test this approach with caution, as you would with any new approach, as we are all different...