Ree, a correct basal dose would have left you in the 230-290 range. So your basal is way high.
When you are that high I would recommend not eating. You do not need it to keep you from going low.
Definitly need to do the basal testing, Break it into three parts,
start with over night first, then morning into afternoon. then afternoon into late night.
Rules are in think like a pancreas and also on gary’s website he has lots of good info and also links to get help with your management if you find you endo is less than helpful.
Ideally you should start a basal test with a "normal" blood sugar and your drop overnight should average zero. But it may take a number of steps to hone in on a proper rate. If you have been running high blood sugars your body will likely be a bit insulin resistant and you may find that as your blood sugar normalizes you don't need as much basal.
In Fresno actually but there is a place in Coarsegold that sells the True Test test strips for 16.00 for 50 so I've been resorting to that. The closest Walmart is in Fresno or Madera...Yeah, pretty rural...Beautiful terrain but nothin' real convenient. I should probably make a trip to Walmart and stock up on some cheap testing supplies. Thank you for the suggestion.
Ree, excellent information from 2Hobbit! An important detail there is that the things like IC and CF can and do vary through the day.
However, getting this all understood and working for you should start simple. Don't worry about variations in your IC and CF. Rather, figure out what they are from mid-day -- i.e. lunch -- and use that to start. You're so far out of control right now that the improvements from accounting for variation in these parameters is a second-order problem right now.
So, what do you do? First, read this article about basal testing. It's excellent, and will give you all you need to perform the tests and determine our basal requirements.
Find a weekend (or other 2-day period) where you can dedicated the time to this testing. You will need to take a lot of BG measurements.
I just read the article....does this apply to MDI users as well? It looks like they are speaking to pumpers.....one thing I have noticed and that is sometimes I can take 16 units of Lantus with no snack and it holds steady through out the night, then there are other times where it drops significantly....
yes it applies to MDI users as well. It speaks to having a steady basal on board - that will be your lantus.
Then having no active food digesting to send you up or active rapid on board to bring you down.
You want to find a lantus dose that will keep you flat.
You will get to you target BG with your bolus - humolog - not with the basal.
Once you get a better lantus dose then you can work on getting closser to that with your humolog.
As Dave has mentioned, once you get closer to normal for longer periods of time you basal and bolus may decrease but that will take some time.
So I had 16 carbs for breakfast and 16-18 for lunch...2 hour post meal (lunch) is 248....urine ketones are presently 80 (lg) and blood ketones 1.2 mmol.....is that a concern?
What were your pre meal BG numbers? And how much rapid did you take for each meal? The before to after difference will help you figure out if the rapid dose was enough. Also do you take your rapid 15-20 minutes BEFORE you start your meal?
Carbs convert to sugar much faster than insulin starts to kick in so you need to give the insulin a head start if you want to keep the post meal rise within the 40 point range recommended.
In the middle of a basal testing right now..>VERY HUNGRY.....went to bed at 10pm bg of 240....3am -201mg/dl....5am-173........7am 172....8am.....159...I am checking every hour and will do it until about 11 then I will eat....any feedback?
The way I would do overnight basal testing is to simply go to bed with a normal blood sugar and see what number I wake with. Based on your test you dropped 70-80 mg/dl which suggests that your basal was too high overnight. You don't have to keep fasting and testing. The next step is to reduce your basal insulin (lantus?) by a modest increment (5%) and retry. Sometimes it is suggested that you do the overnight test several times because there is so much variability.
Eventually you really need to try to go to bed with a normal blood sugar (hopefully 70-140 mg/dl) and get your basal set so that you wake without a rise or fall on average. You should get to the point where your basal is pretty close even though everyday is different the average should be no rise overnight.
I just had an appt with my Endo....because of the numbers of 200s that I presented to him he wants me to start out with 18 units of Lantus per evening....and he doesn't want me splitting the dose....he wants me to also increase by 2 units every week....he said I don't have enough insulin on board and that is why I struggle with ketones.....I told him about the drops from midnight to 6 am and still wants me to do it his way..I don't want to be viewed as non compliant, I don't want to put myself at risk in anyway.....I need to show him some lower numbers....this is very nerve racking for me....mind you I have lost 23 lbs in 3 months.....I am only 5ft 3inches and weigh 156 lbs
It is important that you follow your endo's recommendations. He is absolutely correct that you need lower numbers and he is correct you don't have enough insulin. My assessment simply suggested that your overnight basal was dropping you and was too high, but it may be more complicated than that and you should follow your endo's advice.
Don't hesitate to send him your numbers and ask for his advice. Test a lot and definitely, if you have hypos consult him for advice.
Thank you......I am really working hard at this and so far holding steady between 150 and 160 (which is an improvement for me)...I think I will eat at around 11 ish.....I haven't eaten since 6:30 last night
