If you tested ketones first thing in the morning, it’s not unusual to have some. This is just from fasting overnight. Eating & drinking water will take care of this.
Frustrating to hear it’s ok to be in the 200’s. The CDE may be wary of you going low, but there’s still a better middle ground than 200’s. Timing of injections to meals is important also. You’re right to change your ratios. 1:30 is definitely too little insulin with a resulting 325. The best way I know to test bolus ratios is with 15 carb meals or less. Smaller numbers to start with will give you a clearer picture.
You can test correction doses yourself by taking 1 unit when you’re high. Don’t correct for at least 2 hours after bolus to avoid stacking insulin, or if you’re exercising. Most rapid acting peaks in about 2 hours & is gone in 4-5 hours. After correcting, test after 1 hour & then again at 2 hours. Don’t correct before bed until you’re sure of your correction ratio.
Hi Lynne, I agree with Gerri- that is a pretty low carb ratio, I do 1:15, but I know we are all different. Still- if you are getting that high, it is not so good- but it could also be (like gerri said) a timing issue. I have a dexcom, so I have a better sense of when my bolus starts working- but with humalog it did not start working for 2 hours and apidra starts working after 1. Your novolog could be not working for a couple hours, so if you are eating soon after the shot, you will spike. Try waiting at least an hour to eat (and test as much as possible to be careful of lows). I don’t eat until my blood is less than 120 and dropping.
Low carb is fine, but your body NEEDS some carbs and a lot are healthy (fruits, vegetables). I don;t eat bread or pasta or anything, but I do eat fruit (esp. berries) and starchy vegetables like artichokes and squash which have carbs.
No correction? Then what do you do if you have high blood sugars and they don;t drop? That could be dangerous to your body.
Also agree that 200’s is not healthy.
I know it is so frustrating and hope it all gets figured out for you.
What was wrong with the lantus for you again? I find it to be much more stable and easy to predict.
yes, exactly. if I eat 7 grams carbs, I do half a unit. I am 105 now, just took 2 units of carbs because I plan to eat a thing of blueberries and an apple (about 30 carbs). 19 grams is tough, yeah I kind of try to eat an even amount of carbs. Will eat in about an hour (when apidra starts dropping my sugars). I have dexcom though, so it is safer to prevent lows since I can see my numbers constantly.
I definitely think it is always better to wait though if you are high, you don;t want to get any higher before the insulin starts and no insulin will work before an hour, so you are safe.
Just (especially in the beginning) test a LOT while you are waiting.
Sounds like your CDE is really concerned about lows, which I know are dangerous, but you also don’t want to get too high either.
YAY for getting dexcom tomorrow- I love it and helps with all this stuff.
yes, levemir gave me huge bumps- I hated it. I only inject on butt/stomach though since not enough fat anywhere else. When I was a kid, I injected in upper thigh and I still have a huge indent there (that I hate) and can only fix it with plastic surgery (which is crazy expensive). I was much skinnier then too, so had basically no body fat. Just try to inject into fat if at all possible.
I bolus and eat about 15 minutes later, Lynne. We are all different, but I’d say that is the most common length of time people use. If I’m high I will wait a bit longer or correct and wait, if I’m low I’ll bolus and eat right away. You just have to find what works for you.
Your question about ratios and parts of a whole number, is why many of us eventually go on the pump so we can actually do the exact amount. But when I was on shots, I would generally round up or round down depending on where I was starting. I would never add stuff to eat to even out the numbers, because I worry about weight gain. I don’t eat low carb, only moderate low, so I rarely would have a circumstance when my carbs were that much less than one unit. My only example was if I’d have a cappuchino in the afternoon and I never bolused for it.
The bottom line is trial and error. Many of us started testing I:C ratios at 1:15 (that’s what Walsh suggests) and then go up or down by a unit until we get good results. You started with 1:30 so you got some scary results, but don’t let it throw you. You just need to keep trying until you get to the right place, and most of us do find our meals are different. (Mine are 1:6, 1:7 and 1:18 for the three meals.
The whole trial and error thing can be frustrating but it’s the only way to find out what works for you. Once I got my I:C ratios down, they only changed every few months by a tad. So it WILL get easier!
Was there anything on the salmon? Broccoli does have some carbs… not a whole lot, but still some (1/4 cup should be about 2 grams carbs).
sugar free banana pudding has LOTS of carbs- milk has a lot of carbs and there is starch in the pudding mix. You may want to buy a carb counting book or talk to nutritionist about all that.
My dexcom is same place as yours - lower back/upper but area.
“No insulin will work before an hour so you are safe??” Per Apidra’s website, Apidra starts working in 15 minutes and peaks at an hour. We each have different experiences of course, and you have found what works for you, but that is the actual timing of Apidra, so it wouldn’t be very safe for someone just starting to assume she had an hour before it kicks in!
woops, sorry Zoe, yes everyone is different- Lynne, yeah listen to Zoe if that is the case, the last thing I would want is to give you dangerous advice.
Lynne, I am confused about the heavy whipped cream- does it not have dairy?
Mornings are the most trying for me also & for many others. I eat practically no carbs for breakfast & it’s still my smallest ratio of the day. For what I inject, I should be able to eat waffles & cinnamon rolls:) I kept upping morning bolus for weeks to keep from going sky high. Soaring BG is not the way to start out the day. I was actually glad when my short honeymoon ended because it was exasperating! Know how you feel.
Will be interesting to see the CGM readings. Aside from the dose, I’m wondering if you may need to take bolus earlier than 15 min before eating to catch the high. Have you ever tested at 1 hour after eating? I can see where your endo believes Levemir may be too high for your BG to come down quite a bit by 4 hours. That’s probably not the result of just the bolus. Levemir is more effective in split doses. Ugh, it’s so damn complex. I feel your pain.
Lows are inevitable because of the ever changing nature of diabetes. I’ve never passed out, had dangerous call 911 episodes or had seizures. Any combo of what you mentioned is a possible cause. People can have hypo unawareness, can’t feel themselves dropping & end up dangerously low. Over correcting highs is probably responsible for a good number of hypos. You correct, numbers don’t budge & correct again. It’s tempting because it’s so frustrating.
What helps me, not that I don’t make mistakes (heaven knows!), is eating low carb because insulin doses are lower. Chances of making a serious error in either direction are reduced. Keeping to a fairly consistent amount of protein & carbs also helps because I know what to expect. Too many variables that we can’t control, so I do what I can to control the ones I can.
