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Nov 16, 2010
JayBee
587 posts
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Topic: General Discussion / Levemir versus Lantus In short - both have been hard to get on with for me, for different reasons.See my post in your HCP thread for why. |
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Nov 16, 2010
JayBee
587 posts
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Topic: Questions for HCPs / Levemir issues Shall warn you now - this is a massive post! XD I shall try to break it up into sections....------------------------------------------------------------------------------------------- March 2009 was when I did the course. I can't remember for the life of me when I started Lantus I just know it had been quite a few years before. I changed to Levemir in August 2010... so I've not been on it long. My change over to Lantus wasn't pleasant because I was on Humalin I and I was taking quite a lot at that time. When I changed over and kept the same dosage amount, for a few mornings I wasn't waking up in the morning because my BGs had dropped very badly. Did eventually get things on a reasonable track but it was hard going with a lot of my control being confusing. However I more blame the fact I was in a cloud about my control - eg, no carb counting or anything - that allowed me to struggle, though things were still frustrating once I did DAFNE... but the stuff I have learnt as I've gone along has been valuable to me. With Levemir, it's been the opposite. A lot more highs but I think this is just because of how my body is using it - it is not as 'strong' as Lantus when it comes to sugar levels but heck, keep working at the patterns and I'm sure I'll eventually work out how much Levemir my body needs in comparison! For the record, I've been diabetic for 20 years - turned when I was 5 years old.  Before DAFNE, my monthly hospital test was excellent but I knew I was over correcting - whenever I remotely hit a high (11 or above), I would inject and the boomeranging would go on and on. It reached a point where I said I couldn't take it any more - I was often feeling rubbish and drained of energy (because I technically was never stable with the boomeranging) and I felt all my food understanding didn't apply any more (the doctor joked that it was because I was now past 20 years of age - an old lady  ). This was when my doctor asked if I'd be interested in being one of the first groups in my area to do the DAFNE course.... and well, here I am today. It was funny really, a while before doing the course, he did try to teach me the basics of carb counting and QA ratios but bless 'em, they got the wrong end of the stick. That was very frustrating at first when I learnt about it at the course, but I laugh it off now. ------------------------------------------------------------------------------------------- Anyway! Melissa! Enough about me for the moment! ^_^ Looking at your results that you posted back on page 1 of this thread, you do seem to have a lot of problems going on. I can relate very well to this because my nurse(s) have said that to me a lot in recent months, as well as my hard drilled old habits I used to exercise (the over correcting). It can be hard working out where to start with the problems but keep at it and be strong, you can do this (I know I hope I can LOL). A few starter points to consider from what I can see: ------------------------------------------------------------------------------------------- First Point: It is wise to stop the over corrections (such as the adjusting around 10.30am before your insulin has finished working in the morning and any other of similar circumstance) I use Humalog and I find it runs for about 5 hours (which I think is the average working time for this QA). You have to keep this in mind when sugar level watching. If you don't give it a chance to finish - you won't see what that dose and your BI does together alone. This was such a hard thing for me to stop, but I managed it. Be strong and you can do it too. I know it's horrid to have the highs (boy I know it from the ketone spells I've had in the past two weeks because of my own personal puzzle) but keep working at it. Apply sick day rules if needed - they can be a saver. If you're not sure about that, please seek advice from your DAFNE nurse. I can understand how daunting it can be to inject 5% of your previous dosage total every 2 hours. On the note of ketones, have you been checking your ketones? If they're not kept under control when you go over 13 BG, this can make it even harder for you to get back into a good range.  ------------------------------------------------------------------------------------------- Second Point: Concentrate on resolving the hypos (kind of is a part of First Point) The hypos you had in the afternoon may be happening because of the over corrections - best to do a few days (or more if needed) where you stop the over correcting and see what patterns spring up. Remember, give your body the chance to use the insulin it has on board - it can take up to 5 hours depending on what insulin you take. Be patient, okay? The afternoon hypos may disappear as a result of removing the over corrections! Good luck!  ------------------------------------------------------------------------------------------- Third Point: Don't be afraid to have a CP free meal They're not always fun, but heck, they can be worth it. Omelettes, salads, homemade soup (because shop ones seem non-existent)... eat a CP free meal before a time where there's issues. I've often found that it's better to not correct when doing this because it can distort the pattern. If you're worried about highs, keep in mind that highs over a small period are not as harmful as highs for an extended period of time (eg, years). ------------------------------------------------------------------------------------------- Fourth Point: Use your DAFNE team! Get in contact with the people who ran your course and see if you can set up either an email or phone contact with them. I usually email mine but I have phone numbers just in case. If you are particularly worried about child bearing amongst everything - as well as any exercise planning problems - you are really best to contact your team. ------------------------------------------------------------------------------------------- For the comparison with me... (just to clarify, I've not had any kids!) These are my BGs from last week (latest first, and reverse order on each day - this is just how my blood machine puts the data down in the computer - dates are in american so month is first on dates): -------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------- As you can see, my sugar levels are frustrating too! XD Earlier on, I'm taking less yet hypoing - yet later I'm taking more in places and being high! Madness! Hormones mixed in too! >_< I start with Morning BI (taken at around 7am - depends when I wake up sometimes regardless of my alarm(!)) of 10 and Evening BI (taken at 9pm - again, use my phone alarm) of 7... and at the end of the week it's Morning 8 and Evening 9. Having these times allows me to have an morning over lap because I find I need more insulin in the morning than the afternoon. Do not assume that this may be the case for you - try the 12 hour markers as others have suggested and see how you get on. At start the Ratios go: 1:1, 1:1.5 and 1:1 .... at the end they're all 1:1. Remember: trying to do too much at once is a hindrance to your health. ;) The words I added in the email to my DAFNE nurse are here (just in case you're not aware, your time of the month can make your levels rise too - have you noticed? This is something I'm still working out, hence it's mention at the start): -------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------- My sugar levels have started to show some improvement (I think!) this week but I'm not going to get comfortable yet... shall see how it goes. Good luck with your habit breaking and level control! Keep in touch! Will be interesting to see what results you get after stopping the corrections! :3 |
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Nov 16, 2010
grandma carol
61 posts
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Topic: Questions for HCPs / Help with BI Thanks it was just with the rest being that high agen I wasent sure this is what happend last time I put it down when I went on DAFNE when they told me to put it down to 14 then my BGs went right up and stayed up and it looks like they are doing it agen. Thanks KARL |
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Nov 16, 2010
Karl
83 posts
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Topic: Questions for HCPs / Help with BI HiNo pattern needed to drop it if you had a Hypo - especially if you came from 14.9 24:00 to 3.3 7:45 without an QA! |
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Nov 16, 2010
grandma carol
61 posts
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Topic: Questions for HCPs / Help with BI As my BGs have been upsince 14.30 today 8.3 and 16.00 10.9 and now at 17.00 11.6 before dinner do I still need to drop BI to night as I was 3.3 at 7.45 this morning and I was told to drop BI if I had a hypo thank you. I take BI Lantus at 20.45 thanks. I had droped it on the 13.11.10 as I had 3.9 that morning do I need to do it agen so soon. |
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Nov 16, 2010
MelissaF
56 posts
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Topic: Questions for HCPs / Levemir issues Sorry, just read your posts again. Does that mean that you've been on Levemir since March 2009 or was that when you did the DAFNE course? |
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Nov 16, 2010
karaway
7 posts
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Thank you everyone so much, I too get the breast tenderness and I have found that this month I have only suffered high BGL's for two days and today I am heading back to normal now that my period has arrived. Again, thanks so much it has really put my mind at ease knowing that when you're a female diabetic you're not always going to have perfect BGL's. As much as that disappoints me!!!!! |
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Nov 16, 2010
MelissaF
56 posts
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Topic: Questions for HCPs / Levemir issues Hi again,Thanks for this. Did you find that your highs on the Lantus were mostly in the evenings? Would that tell you that your Lantus was running out (presuming that you used to give your Lantus dose at night)? I've been reading other information and I've found other people saying that switching to Levemir gave them very unpredictable results, especially first thing in the morning and at night which is exactly the problem that I've been having. It appears that this might be a recognised problem with Levemir but I can't work out why. I'm really heading towards just going back on the Lantus again but I'm trying to get all my information together before I make the decision. I'm very bad at over-correcting as well. I think that DAFNE may have made that worse with me in a way although in most respects it's been great. |
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Nov 16, 2010
JayBee
587 posts
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Topic: Questions for HCPs / Levemir issues I will aim to answer fully when Im next at a computer and not at work. Shall post my results even though I have been in contact with my nurse. I ran out of time on my first post so pardon the lack of info. I was on lantus years before I did DAFNE so that is a few years before March 2009. All that time I assumed that Lantus was working 24hrs and the highs were a result of guessworking everything I ate. DAFNE has been a godsend and with all the constant adjusting I used to do in response to any highs, Im amazed Im not dead. That was a hard habit to break. Applying basic DAFNE rules with pattern spotting and actually giving my body a chance to respond - sometimes it can take more than one day (an example already raised is about hypos on this thread - do not correct or you will hypo again - leaue it for 24hrs). We know its frustrating but if you over respond, patterns will be harder to see. Shall post later when Im not on a mobile. XD |
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Nov 16, 2010
MelissaF
56 posts
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Topic: General Discussion / Levemir versus Lantus Hi,I've had some useful advice through the HCPs' forum but I was just wondering if anyone could give me any other feedback regarding using Levemir and Lantus for their background insulins. I'm particularly interested to hear from anyone who has switched from one to the other and which they have found to be the most effective? Many thanks, Melissa |
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Nov 16, 2010
MelissaF
56 posts
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Topic: Questions for HCPs / Levemir issues Hi,Thanks for your post. I've looked back over the Lantus results that I've kept before starting on the Levemir (only about a week's worth unfortunately) and I'm not sure that I did have a problen with the length of time that it was working for. My evening results were more or less fine and those would have been the ones affected wouldn't they (I took the Lantus dose before bed)? Can anyone else advise? I just find the split dose really hard to manage and it just doesn't seem to be working for me. I've been on it for 5 months now and it's not getting any better. In fact, in most ways, it's getting worse. How long have you been using it for? How did you find out that Lantus was only working for 16 hours? Was it messing up your readings at the end of the 24 hour period? When you say irregular patterns? Can you tell me more about that? I find that, even applying DAFNE principles, my results are really unpredictable and often don't seem to make any sense so it is hard to find patterns to alter doses. Have you been given any useful advice by your DAFNE team? I'm stressed by it all because I'm trying to regulate my control to try for another baby and I can't get it good enough. It's taking so long. My instinct just tells me to go back to Lantus again. |
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Nov 16, 2010
grandma carol
61 posts
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Topic: General Discussion / help please yes thsnk you the DAFNE educator told me to drop my BI is I was low in the morning. I have been doing that but there is never 2 or 3 days the same. Now today agen I have had 3 days at 17 and this morning my BGs were 3.3 on getting up. AT 8.45 last night 11.8 at 10.0013 and at 12.0 14.9 then at 4.30 6.8 so Idont know if I should drop it agen. I dident have anything to eat before bed I han had a hypo at 16.00 BGwere 2.7 so had a orange drink On the dat I had2.5 CPs befoer bed I dident have any QAs because I had had the hypo the day before when I had had QAs with the CPS I had had and dident want to hypo agen at the time I just could not get my head round it to have extra QAs at bed time think I might be getting there with it hope my bloods dont go up agen. So I think I have to drop it agen to night. |
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Nov 16, 2010
JayBee
587 posts
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Topic: Questions for HCPs / Levemir issues I'd might as well post considering I'm going through the same - or at least similar issues - with levemir.I was originally on Lantus and for quite a long time I had no idea that Lantus was only working about 16 hours for me. It was thanks to DAFNE that I was able to identify this at all.... so whatever way I look at it, I'm going to be having a split dose for my BI. After a lot of hassle with Lantus after that discovery, I moved over to Levemir which is designed to be a split dose insulin. I was so enthusiastic about it because I thought it wouldn't take me long to get my doses on track. Unfortunately it hasn't been a quick process. Even now, I'm still working it all out - especially when the exercise or the time of the month messes it all up. The irregular patterns dominate my control as well - but I'm not going to give up. |
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Nov 16, 2010
JayBee
587 posts
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Topic: Questions for HCPs / BGL's prior to menstration My menstrual cycle does affect my sugar levels from what I can tell, and in fact, I was thinking about posting something about it here so well done for doing so first. For the record, I'm a 25 year old female.Considering even a year or so after doing DAFNE, I still don't understand what my body does during that time because it seems to shift. When I spoke to my DAFNE nurse, she made it quite clear that often it usually make your sugar levels rise however you have to also remember that it varies from woman to woman on how you need to respond to it. I wouldn't be surprised if it changes each month as well considering I've yet to see what I'm supposed to do for mine. This is why there are no set guidelines about in on DAFNE - you need to learn about your body while on DAFNE, and this is just a big part for a woman about learning about herself when it comes to her sugar level control. Just out of interest, have you noticed when the highs start karaway? I think it's about a week and a day roughly before the physical stuff starts for the cycle for me... so this is often before I've even stopped taking my pill. I've also known at least one diabetic who's erm, "lucky" enough to get breast tenderness before her highs hit, so she takes that as a signal to put her insulin up.... I sometimes wish I had a signal like that(!). XD My DAFNE nurse felt it would it would be best to keep adjusting at each meal to help me work out how much BI I would need to put it up by once I'd gone through the week. However, this was before my last one and surprise surprise, the patterns were not clear for the whole week. Very annoying.
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Nov 16, 2010
karaway
7 posts
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Topic: Questions for HCPs / Hypo - rebound Alan, the liver does shoot out stored glucose but once the body recognises that your blood sugar levels are back within a normal range the liver will reabsorb that glucose. If you correct, you will be correcting for glucose that will be reabsorbed and then you will be hypo again. I hope that makes sense |
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Nov 15, 2010
Simon
578 posts
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Topic: General Discussion / Abusive posting will not be tolerated Earlier today somebody registered on the site and proceeded to write extremely abusive messages on the forums. This was a real person, and not a result of a breach of security in DAFNE Online. Unfortunately it is difficult to stop these, as anybody is free to register on the site.That said, abuse of any nature on the forums or message threads is not tolerated and their user accounts were deleted straight away. The computer that was used to post these messages has been identified using their unique Internet Address (IP) and we are currently following this up. If you do see any abusive messages on the forums, please report them to us straight away by emailing [email protected]. Simon |
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Nov 15, 2010
marke
681 posts
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Topic: General Discussion / help please hi , the DAFNE handbook says here that its 1CP that you should not take QA for. I'm not suggesting that it caused you a problem, I just noticed it and wondered why. Your DAFNE Educator should NOT be telling you to reduce your BI without seeing your BG readings over a number of days and then they should help you work out how to reduce it not just tell you to reduce it without any detail..... |
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Nov 15, 2010
grandma carol
61 posts
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Topic: General Discussion / help please sorry forgot to say about the CPs before bed I was told not to give QA if CP was under 2 did have 3 one night so had 3QA and BGs at 3.20 were 3.7 they were 7.6 at 10.00 when I had the 3 CP and 3 QA so I get a but bothered now about having any dont want to go hypo through night. Sorry if this is a bit vague but my head is all over the place with all this SORRY |
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Nov 15, 2010
grandma carol
61 posts
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Topic: General Discussion / help please I was on 20 of BI before I went on DAFNE and they told me to drop it to 14 but then my BGs were high all the time in the 18.0 16.0 and I was unwell went to see the Doctor and she told me to put it back up so Idid the DAFNE educator then told me to put it back down I left it at 18 then had the 3.9 so put it down to 17 I will leave it like that to see if its ok. This is what I carnt get my head round I did not have bad controal before this carb counting I did have a few hypos but nothing like I am now and I was never high. Everybody says look for a patton but i dont have one. I am going to get a blood moniter on soon to see what is happening THANK YOU |
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Nov 15, 2010
marke
681 posts
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Topic: General Discussion / help please Hi, on what basis were you told to reduce your BI ? Did your DAFNE nurse see the results you have show us ? Novarapidboi is correct any change in BI should be given a few days to take effect. If you keep changing up and down on alternate days you won't see the real results.There was only one day (09/11) when you were low in the morning, the rest of the time your BG's seem pretty steady overnight. I notice that a couple of evenings you had CP's before bed but no QA, is there a reason for this ? |
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Nov 15, 2010
grandma carol
61 posts
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Topic: General Discussion / help please thanks vic what gets me is that my controle was not to bad before I did DAFNE and now with trying to do what they told me I am everyware and noware. Everone says how good this DAFNE IS but not for me I just want to get back to what I was before but they keep telling me to keep at it and things will be fine. But this has gone on since September now and I am just getting a bit confused with it all. Thanks for your input and its good to talk to others THANKS |
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Nov 15, 2010
vic demain
87 posts
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Topic: General Discussion / help please Carol,I have very similar experiences, complete days of low readings followed by days of high reading and the odd all over the place day. Like you, I take one hit of Lantus before bed. Never associated this with the problem but perhaps it could be. Hope you get some answers as it is a nightmare doing all you have been taught is right only to get results which are either blue or red. Good luck. Vic. |
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Nov 15, 2010
MelissaF
56 posts
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Topic: Questions for HCPs / Levemir issues Thanks Marke - that makes sense. I'll try and get that code. |
- no hypo during the night (12). Had breakfast and morning BI - didn't do any adjustments because of hypo yesterday. Before bike assessment at 8.29, was 19.2 (assumed caused by food). After got home again and lunchtime: 17.2 - I almost adjusted here but I didn't. Had nothing but an omelette. Around 15.24, I was 14.7 with a trace of ketones... because of the trace, I took one unit.... and at 16.00, I was heading up clearly with a blood of 15.3 and ketones of +. I have applied the sickday rules again, including the 1 unit from the 15.24 blood result and ketones.