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I droped my BI agen last night to 16 and at 3.00 this morning I was 4.1 so I had dextro tablets and when I got up this morning I was 1.9 even after I had 1CP at 22.00 before bed so gess I will have to drop it agen tonight. I am not going to give up Ill just keep at it untill I get it right. Thank you

Nov 17, 2010

Garry 328 posts

Took flu jab here at work last week to save me the bother of making appointment for nurse at my GP surgery. Have tried to get one every year for the last 5 or 6.
Some insulin resistance evident over the last few days....which is pretty much what happens to me every time I get even a mild bug.

Bit surprised as this is the first that I've heard about a pnuemonia jab. Never been offered one - even though my doc is very diligent. Lung capacity very good so maybe that is the fortunate reason?

Regards Garry

Nov 17, 2010

JayBee 587 posts

I've actually had a decent moment to get some bloods input into the database on this site so you can see things from the last few days after the results I posted in my long post a bit easier.

I currently plan to put my during day BI dose up by 1 or 2 after seeing what happens today (most likely 2 considering how high I regularly am and taking extra +2 of QA in most places).

The plan today is to do everything 1:1, do no meal time corrections and see what happens and then I'll apply the BI change tomorrow morning.

Nov 17, 2010

JayBee 587 posts

I think I will go back to the doctors and see if their details have been updated enough yet so they know if I've had it before or not. The nurse who did my flu jab wanted me to make the decision. :/

Nov 17, 2010

meltow 78 posts

Yes JWo, a few years back, I was also recommended a jab for pneumonia prevention, and I took it. I think it was called pneumococcal vaccine? If I remember correctly, one jab was sufficient for your lifetime.

Mixed in with this year's 'flu jab was also prevention against Swine 'flu. Goodness only knows which strain! All done and dusted, and no side effects. Worth it, just for peace of mind.

Nov 17, 2010

novorapidboi26 1,819 posts

I have had it once a few years back, but I havnt had it since, simply down to being lazy............ Sad

Nov 17, 2010

caroline15 45 posts

I'm pretty sure that I had it (the pneumonia jab) when I was diagnosed with diabetes. It was meant to last for life I think.

Nov 17, 2010

JayBee 587 posts

I have my flu jab every year... as soon as I'm aware that they're available.

I have heard about non-diabetic family members related to a diabetic can be entitled to a free flu jab too. I had moved out of my parents' house by the time I learnt this, so I can't see how true it is any more. Does anyone exercise this or is it just rumour?

Oh! When I changed doctors recently and went in for my flu jab this year, I was asked if I also wanted to have another jab - unfortunately I don't have the leaflet in front of me, but I think it was for Pneumonia - if so, has any one else here had it? Any idea how often you're supposed to have it?

I just gave Wikipedia a look about Pneumonia:

http://en.wikipedia.org/wiki/Pneumonia#Prevention

Vaccination is important for preventing pneumonia in both children and adults. Vaccinations against Haemophilus influenzae and Streptococcus pneumoniae in the first year of life have greatly reduced the role these bacteria play in causing pneumonia in children. Vaccinating children against Streptococcus pneumoniae has also led to a decreased incidence of these infections in adults because many adults acquire infections from children. Hib vaccine is now widely used around the globe. The childhood pneumococcal vaccine is still as of 2009 predominantly used in high-income countries, though this is changing. In 2009, Rwanda became the first low-income country to introduce pneumococcal conjugate vaccine into their national immunization program.[18]

A vaccine against Streptococcus pneumoniae is also available for adults. In the U.S., it is currently recommended for all healthy individuals older than 65 and any adults with emphysema, congestive heart failure, diabetes mellitus, cirrhosis of the liver, alcoholism, cerebrospinal fluid leaks, or those who do not have a spleen. A repeat vaccination may also be required after five or ten years.

It's a bit worrying that I don't recall being offered it before but I may have been too young to remember. Has any one here been offered it and did you accept the offer?

Nov 17, 2010

caroline15 45 posts

I always have the flu jab, our GP practice sends a letter to all of those eligible.

In our house 50% of diabetics had the jab, (my daughter wouldn't have it and you can't make them have it).

Nov 17, 2010

vic demain 87 posts

Had it for as long as it has been available, illness on top of diabetes is a nightmare and one I would personally do everything to avoid. Mine was done best part of a month ago, the doctors surgery phone around and ask if you want it.

Nov 17, 2010

maria51 22 posts

I've had Type 1 for 16 months and have not fallen ill yet. My worst fear is the flu and getting a flu jab would NEVER have crossed my mind ! Thanks meltow for your post, now I can strike that fear off my list as I'll be having a flu injection every year from now on.

Nov 16, 2010

meltow 78 posts

Ever since I was diagnosed in January 2000, I have taken advantage of the annual 'flu jab. I'm in my 40's. I don't know that I have ever had 'flu, but have always thought it sensible to keep as protected as possible from any potential health risks.

I wondered what proportion of diabetics take advantage of the 'flu jab?

Anyone know? Or any other comment to add?

Nov 16, 2010

JayBee 587 posts

Topic: Questions for HCPs / BGL's prior to menstration

I'm glad we could help. Smile

Good luck with keeping on top of things during our naturally awkward time of the month! XD

Nov 16, 2010

Karl 83 posts

its a 10% - 20% adjustment of BI - 2 will be just over 10% (1. Cool

- so 1 b4 and another tonight and see how you go.

Nov 16, 2010

JayBee 587 posts

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.

Nov 16, 2010

JayBee 587 posts

Shall warn you now - this is a massive post! XD I shall try to break it up into sections....

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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. Smile

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 Razz

).

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.

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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:

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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. Sad

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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? Smile

The afternoon hypos may disappear as a result of removing the over corrections! Good luck! Very Happy

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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).

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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.

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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):

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Date Time Blood / Ketones / Insulin taken in Response to Ketones

11/14/2010 16:01:43 15.32 / + / +2 (yesterday's total came to 36 - took 3 has a hypo preventive measure)
11/14/2010 15:24:56 14.71 / T / +1
11/14/2010 12:47:32 17.15
11/14/2010 08:29:06 19.21
11/14/2010 07:38:48 14.76
11/14/2010 03:14:26 12.04

11/13/2010 21:05:08 3.83
11/13/2010 18:01:57 10.71
11/13/2010 15:04:21 15.43 / ++ / +4 (yesterday's total came to 42)
11/13/2010 14:04:16 13.15
11/13/2010 07:33:00 14.1

11/12/2010 23:04:22 21.65
11/12/2010 22:35:06 20.09
11/12/2010 19:05:09 12.04
11/12/2010 13:08:24 11.49
11/12/2010 07:03:13 13.93

11/11/2010 21:52:19 13.43
11/11/2010 20:38:24 8.71
11/11/2010 18:39:53 7.6
11/11/2010 18:14:53 7.33
11/11/2010 17:44:55 7.6
11/11/2010 16:11:24 3.55
11/11/2010 13:10:35 10.66
11/11/2010 06:39:09 14.88
11/11/2010 03:04:37 13.77

11/10/2010 22:16:27 7.66
11/10/2010 21:16:45 9.6
11/10/2010 19:05:55 3.61
11/10/2010 17:31:41 4.22
11/10/2010 12:10:29 10.16
11/10/2010 06:30:59 19.32

11/09/2010 22:30:30 5.83
11/09/2010 21:46:36 3.66
11/09/2010 18:37:03 5.05
11/09/2010 15:43:24 3.11
11/09/2010 13:07:53 7.99
11/09/2010 10:57:18 2.83
11/09/2010 07:10:53 16.32

11/08/2010 21:22:50 5.22
11/08/2010 20:04:00 3.33
11/08/2010 19:05:30 6.11
11/08/2010 15:04:54 2.89
11/08/2010 13:10:13 11.49
11/08/2010 10:27:01 3.16
11/08/2010 06:59:32 8.94
11/08/2010 03:04:24 12.16

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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):

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I appreciated the chat the other week but for some reason since my period calmed down, I have managed to get back down the path of regular hypos and ketone problems again. Just to touch on it, looking at my book, there doesn't appear to be any particular pattern when it comes to my period which is disappointing. I had spells of going only has high as 10 and other times 14 and the hypos started making an appearance on the 8 Nov 2010, 4 days after the expected 'high time'.

I have no guess work on record and so I feel 100% on my carb counting.
I have always been under the impression that hypos are valid one day changes to prevent them happening any more - though I know I sometimes forget this.

It began on Mon 8th Nov 2010 with a spell of regular hypos after every meal and so I responded to this after two days of the same results by putting my background down during the day (the morning injection from 10 to 9). My waking blood was still high at this point as we recognised this when we had our chat - I felt this would have to wait now this had started happening.

On Weds 10 Nov 2010, in the morning I was still high and as the day went on, I hypo'd around 17.05 which is outside the lunchtime meal working time. Based on the fact I was still hypo-ing, I decided from this that I would be best to put my morning background down again by one unit - from 9 to 8.

On Thurs 11th Nov 2010, still consistently high but I hypo'd around 16.10 ... this lead me to make the decision to put my lunchtime ratio back down because that was the main one working at the time that hypo occurred.

On Fri 12th Nov 2010, I was hitting very high numbers - particularly in the evening before the evening BI was done. I had no ketones.

On Sat 13th Nov 2010, the ketones starting appearing. In the morning, I didn't feel like eating anything so I just took +2 QA. Ketones were ++ around 15.04 despite further adjustments after being 13.2 at lunchtime. I applied the sick day rules as they are in the book; this resulted in quick recovery and a hypo at 21.05. With the very regular highs in the morning, I put my evening BI injection up again from 8 to 9.

On Sunday (today) I woke up as the usual high (14. - 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.

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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

Nov 16, 2010

grandma carol 61 posts

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

Nov 16, 2010

Karl 83 posts

Hi

No 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!

Nov 16, 2010

grandma carol 61 posts

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.

Nov 16, 2010

MelissaF 56 posts

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?

Nov 16, 2010

karaway 7 posts

Topic: Questions for HCPs / BGL's prior to menstration

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!!!!!

Nov 16, 2010

MelissaF 56 posts

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.

Nov 16, 2010

JayBee 587 posts