Low/High - Finally normal!

Been ther done that
Butt? For nitetime? Going to bed with a 70
And Taking a Bsal bedtime shot?

2 Tabs Isn't enough for me
It has to be the 15/15 rule.. I take 15 carbs and wait the 15-20 min and test to make sure they're comming up.. Esepcailly if I have Some Bolus Insulin still in my system.. It last about 3 hrs for me..

I have to be min 100 -120 at bedtime

Drinking OJ drink- Little Bottles have 13 carbs in them and a glucose tab chaser..
Get and Drink Fruit Juice - Find the Little Bottles with 10-20 carbs in them

I also have a 2nd Meter on my NiteTable.. and extra Carbs.. Tabs and Those Choc. Mini Bars ( have 10 carbs each )

and Add some Nitelights-- I have a Low wattage Light On a Timer for the Kitchen it's On all nite..

And another Nitelight with a 7 watt bulb, not 4 w., in it for the Hallway..

another issue with running Hypo over nite? Notice how you have lower or no Bowel Movents in the AM?

High At Bedtime?
-If I am Upto 175, I will take a Full Correction Bolus and call it a nite
-If I am Above 175? I take a Full CB, but set my alarm for 3 hrs and Test again.
-Takes less than 1 min to wake up, lean over, test and Take a Bolus is Needed..
And I keep a Hand Written Chart-Index Card I made up as to How Many Units to take per what the BG # is..So I don't have to think at time of nite waking up and make a Serious mistake.

-I found , when High At Bedtime? My usual CB is not effective enough vs during daytime
I figure that is due to sleeping and not being physically activie during the daytime and if above 175 at bedtime, I will normally Need a 2nd CB 3 hrs later..

I edited my post to add my latest problem! This just isn't my day!!

Hello Zoe, I have some remarks:

a) I think lows should be treated with the same respect and care as the highs. We should not accept that a low is the price to pay for good control. Lows are suspected to cause complications too: memory loss, higher cardiological risks due to increased stress levels, risk to develop chronic anxiety, dead-in-bed syndrome due to sudden seizure (although I think the number 1:20 of the JDRF is exaggerated), negative even lasting impact on performance of nerves, risk of high fluctuations in blood glucose, in addition: risk of having a deadly traffic accident, risk of high costs due to need of ambulance. This is why we should identify the driver behind the development of the low. Not that I am in any way perfect with that but it should be our goal to minimize lows and highs equally. Mentally we should set 200 on the same level as 60 mg/dl = no good control.

b) The I:C factor is supposed to keep our blood glucose at the same level. Our bolus has always to components: the carb component and the correction component.

Target level (110): carb component without correction
Higher level (200): carb component + correction to get back to target level
Lower level (60): carb component - correction to get back to target level

Situation: you have 60 and you eat something and cover it with normal I:C. Even if you give the carbs a head start you are still supposed to keep the 60. The I:C is always neutral to your levels.

The negative correction could work by reducing the dosage. This can be done by calculating the neutral carbs you can eat to get your level up to the target. For this you need to know how much one gramm of carbs will increase your blood glucose. This is normally something around 3 mg/dl (0.16 mmol/l) per gramm. If you like to eat 30 gramm of carbs you can substract 16 gramm [= (110 - 60) / 3]. This means you will bolus for 30-16 = 14 gramm. Our Glucosurfer will support this kind of calculation. The problem with covering the low with your meal is that the carbs in your meal are too slow. This means your low would prolong longer than necessary and I do not think this is recommendable. I do not want to get used to low numbers to keep my awareness.

Because of that I always treat the lows with additional carbs like glucose tabs. I can then use the normal I:C factor without any correction. I will inject the insulin after or in the middle of the meal.

c) over the years you will experience many lows. But some will be very different from the normal and easy ones. They can be so scary that they can even haunt you for some time. From these I collected a hand full in the last 24 years. If things get really rough on the low side I try to recall those: it will get over soon, just stay calm.

Thanks for your response, Holger. It's pretty late here so I think I need to consider it tomorrow to see what I feel applies to me. But I definitely appreciate your words of calm.

Right now, as I added above, I'm dealing with prolonged highs (bouncing from the high 200s into the 300s which is very rare for me). I just now got my first 216; I'm hoping it's finally coming down as I'm reluctant to bolus more so close to bedtime. In your experience have you seen radical highs for this long (20 hours) after a low of 34 (without losing consciousness)? I've also changed my site a couple times but haven't rotated my area. That's the next thing I'll try if it doesn't stabilize soon.

I've been racking my brain trying to figure out why I'm having these highs that won't come down. These severe highs are just today but I've had more medium highs than usual lately, that didn't make any sense. I just suddenly wondered if I've been having absorption problems in my hips which is what I usually use. I'm going to switch to my stomach (though I hate it) and see if that makes a difference. I hate when my control that's normally pretty decent makes no sense at all. And like HOlger says, scary lows stick with you a bit emotionally so not knowing what's going on is scary. All I can do is try all the variables, and site is one I haven't switched in awhile. Stay tuned to Zoe's ongoing saga. Yeah it's 2AM and I'm basically talking to myself!

I hear you, Zoe. But I don't know what to say. I avoid stacking insulin like the plague so I do my best calculation for my Novolog injection and then I just buckle in wait the full four hours before I try to do more (rinse, repeat...) I don't know how that applies to pump-dom. Sorry.

Here's a cyber (((hug))). I hope you figure it out and get back on an even keel soonish.

That is annoying! Not just "looking for something" but someone who, despite years of study and treating patients w/ diabetes, feels the obligation to add something clueless. I haven't gotten there yet but I always feel like I'm inches away from getting my diagnosis revised if something freaky happens? I agree w/ Zoe and would probably consider "firing" the medical group and shopping around for a new diagnosis. Or maybe shop first and fire later?

Maybe getting sick? I've had some decent luck "correcting" post-parandial highs with basal bumps, 150-200%, instead of correcting? Sometimes it seems a bit smoother.

You are not that used to lows and the low came by surprise. I would suppose that the highs you are now experiencing are just related to higher levels of stress. To that the liver will react with a higher release of glucose than normal. Please keep in mind that 34 is just a number on the meter. Due to the inaccurracy of the meter this might have been 40 or higher - even lower I must admit. In most cases a low is not an unforeseen disaster. Keep in mind that you are in charge here. Next time you will do better.

Hi Zoe. Hope today is going better for you. When I can't bring my bg down while on the pump, I always wonder what is really going on. Areas losing the ability to absorb well (hopefully temporarily) as you suggested is certainly one possibility. The vial of insulin might have gone bad is another. I give a correction by syringe -- if that works, then probably something with the infusion/absorption. If the correction by syringe does not work, then the vial of insulin has probably gone bad.

While that advice may not be new to you, maybe this idea is: I keep Virgil Root Beer Zero around to drink when high -- a treat when you're high is hard to come by!

Update: Thanks everyone for your thoughts and suggestions. I am back to normal as of this morning (actually late last night). I had come down from a ridiculous 327 at 11PM to 211 by 2AM and then switched to my stomach so not sure if it was just coming down slowly as a reaction to the low or its stress as Holger says. But I switched to my stomach at 2AM and by 3AM was 122 and 4AM when I went to sleep 111! So it well might have been an absorption problem with my hips and I'll be anxious to see if the moderate highs I've had off and on for over a week now subside.

It's interesting to me when you switch a problematic site and the numbers go down almost immediately! Why is that? The small amount of basal can't make that difference. Could it be that when you "release" the problem site, the insulin you had bolused then is able to be absorbed? Interesting.

Anyway, thanks again all. I even got some unexpectedly good news that my cat's lab results that I was expecting to suck were very good, so it's a better day for me for sure! I just wish I hadn't wasted god knows how many sets and insulin before I thought "hmmm...absorption - switch area"

By the way thanks to those who suggested their favorite "treat" treatment for a high, but I haven't eaten sugar in 17 years. Yep, I know glucose tabs are pure sugar, but I think of them as medicine!

Hi Zoe. I'm very happy that today has turned out to be normal. Post Script on my comment: Virgil's Zero Root Beer is sweetened with stevia, so has no sugar. I don't like water much, but I do like Root Beer.

Oh, thanks, Trudy, I'm enjoying a non-frantic day!

I wondered about the "zero" but I'm used to people recommending "treats" for lows. I actually don't eat artificially sweetened things either, not through any principal or aversion, though. When I stopped eating sugar, everyone offered me their favorite sugar free items. I thought they all tasted bad and they set off my craving for sugar, so I got in the habit of just avoiding sugar substitutes. I understand that in the last 17 years they have improved greatly, but now it's a habit. I do miss Crystal Geiser Juice Squeeze sodas though which are sweetened only with fruit juice, but now too carb loaded for my D.

I actually meant "treat treatment for a low" above, but just realized you did say for a high - which makes more sense for something sugar free..maybe I'm not totally over my disorientation....oh, this is my normal..lol

Wow! This thread has seen some changes!

Hang in there Zoe!!