I need suggestions... If I want my blood sugar to be good at 2 hrs then my ratio seems to be 1:16...but I always go low at 1hour and have to just wait it out shaky and all because it eventuality goes up to a good number at 2 hours.. But if I increase my carbs then I go high at 1 hour and 2 hours... I dont know what to do to avoid the low. If I treat it skyrockets so I usually just wait it out unless it gets in low lows...It sucks though because I hate feeling shaky for an hour or so.
So have you talked with your endo about this?
My immediate reaction is that you are having a mis-match between insulin getting into your bloodstream at the same time as glucose digested from your meal. To me, this sounds like a possible gastroparesis problem (essentially delayed digestion).
My first suggestion would be to delay taking your meal bolus.
I would always treat a low though, but I might treat it with fewer glucose tabs.
Can you tell us what blood sugars you are seeing at the one hour point? Sometimes if you're used to being high, numbers that are not technically lows feel that way.
I agree with Mike about changing the timing of your meal bolus. if you take it 15-20 minutes ahead, take it right before you eat. If you already do that, maybe take it after you begin to eat until you find the right timing.
My own personal choice wouldn't be to treat the low unless it is seriously low, because if you take glucose tabs and then the food hits you will go high.
Finally, I wouldn't increase carbs because that is "feeding the insulin" but have you tried changing the ratio to say 1:17? If that takes you to a reasonably in target pp (though maybe a few points higher than you've been seeing) without feeling low at one hour that might work well..
One more comment, as I suggested before, you might want to not test at one hour and see if you still feel "shaky". You might be driving yourself nuts by looking at numbers that most of us don't even see unless we feel "off"
It is really hard to know what is happening if you don't test. Sometimes, we can feel hypo if your blood sugar drops fast. For all you know, you could be high and drop fast at 1 hr and are fine at 2 hrs. If you do go low, then high, then it is a timing issue. If you bolus 15 minutes before your meal, then move it up to right before you eat. If you bolus when you eat, then bolus right after you eat.
I was waiting 15 minutes then eating, but I changed it a few days ago and it still doesn't seem to make a difference. So I think i'll try eating it like 5 minutes after I eat and see if that helps? And Zoe thats what I meant by eating more carbs makes it high...I meant different ratio sorry I was doing 1:18 when it was making me high though so maybe 1:17. My doctor said when I went last week that i'm in honeymoon stage so I'm guessing maybe that throws me off sometimes? ugh. I think i'll try waiting 5 mins then taking it after I've started eating and if that doesn't work after a few days i'll change the ratio thanks.
Also one more question... I take 6u of levemir in morning and 4u at night and it really seems to be good during the day because I always go down to a good number right before lunch sometimes a little lower then I even like or I have to eat lunch early, and my number is good between meals between lunch and dinner. But my 3 hours after dinner number is when it seems to be going up and then it goes high by bedtime. I don't know how to fixx this...If I change the morning dose it seems it would make me go low between my earlier meals...but it doesn't seem to be helping after dinner before bedtime. Any suggestions?
You could try moving the timing of your morning basal dose up a bit (not changing the amount)to see if that reduces those highs later in the evening.
Are you sure your dinner I:C is good? If I recall you are using the same ratio for all three meals which isn't always the case. How are your two hour PP's at dinner? Also if you eat a higher fat meal for dinner you could be having later spikes so that it would be your bolus rather than your basal responsible (just a possibility).
If none of this helps then all you can do is correct for the highs. Have you calculated your ISF yet? it sounds like you're doing much better btw!
Actually all my ratios are different. My breakfast is 1:4 but still going a little high...not changing yet though, trying to see if I fix the before bedtime number if it will fix the fasting which will then fix the breakfast number, so waiting that one out. Lunch I take 1:16. And dinner is 1:13 because I was going low with 1:12 and actually not noticing until it was low 50's but 1:13 seems to give me 120's 2 hrs after a meal for dinner. I will try moving it up I usually take it between 8 and 9 every morning so should I try like 10? And have only figured out my correction for breakfast since I seem to be so insulin sensitive other parts of the day have been to afraid to try it other times. So if 3 hours after dinner I'm high would I try to correct or would that be to late ? I eat usually around 6 so that would be like 9 or 10 when I would usually go high.
Also thanks I've been trying really hard when I went to the endo last week she said she was very impressed. She said I've done as much and as my improvement as it take some people in 1 year.. I still feel like I have a long way to go before I have a comfortable spot and I still feel frustrated like I don't got it yet, but i'm trying lol.
Hey, even when it becomes routine, it isn't always perfect - far from it!
Your I:C's sound similar to mine - I'm 1:5 1:10 and 1:18.
Yes, I would give the 10AM basal time a try and see how that works. No, I don't think 3 hours after dinner is too late to correct, especially once you get confident about your ISF, but be conservative, then check at bedtime and if it seems headed down you might have to treat to go to bed at a safe number (I know backwards!). I remember early on I was nervous about correcting close to bedtime so didn't do it unless I was seriously high. So if I was say 140 or even 160 I wouldn't correct especially when I only could use whole units. Now I am confident of my ISF and my pump basals are perfect so if I was 140 I would correct so I didn't wake up at 140 (ish). My ISF is definitely different at night - it is 1:62 vs 1:42 during the day.
Also,you say you're high before breakfast sometime, so remember you can add a correction to your breakfast bolus.
Hi Denise -
First off -- I'm just a finger-sticker so you can assign my comments the value of the price you paid to receive them.
I won't bore you with my experiences, but now that I've got my glucose under control (the last two A1c's were 5.3 then 5.6) I'd say you need to track the numbers until you feel like a "data-geek".
You talk about "high" and "low" and "feeling shaky".
1. You need to quantify the highs and lows, how high-or-low, when does it hit and what have you eaten, exercise, etc., etc., etc.
2. I've had a few lows, and in one case actually fainted before I got some sugar into my system, which "scared the ... out of me".
You don't mention testing and record keeping. I've recently posted a windows-based program to help with the record-keeping and monitoring that I wrote ( http://www.WeLoop.com/HATS.html ) because I couldn't find anything that met my requirements. You are welcome to it, at no cost.
Until you have solid data to work from, I'd label changes to dosage and timing "guesses".
If there is anything I can do, drop me a line.
See ya later
When are you taking your Basals? Maybe you need to tweek when you are giving yourself your Levemir? Are your numbers after breakfast high and then go low or two a good spot before Breakfast?
I always test at 1 and 2 hrs right now just to get data, actually I probably test to much much because sometimes more then that lol. I write down everything. And by lows I mean low 60's upper 50's.
Ok I have one more issue... I made a mistake at dinner I usually take 2u of Novolog at dinner time because i'll have around 26carbs but tonight I had more and I meant to take3u and I guess because I'm in such a habit of 2 I took 2 instead of 3u. Now i'm high 3 hours later 192, I even went for a 20 min walk :(. Should I attempt a correction? I'm so nervous.
Personally, I would. You can always do it very conservatively, but I wouldn't just hang out all night at 192. If you do one unit then even if your night time ISF is 1:60 that only takes you down to 132. Just test a couple times so you can start to accumulate ISF data.
The absolute worst that can happen is if you're really nervous just set an alarm for during the night to test.
One suggestion is to always think in terms of I:C not of "I take two units at dinner time" - that way you can eat less, more, or whatever and dose accordingly!
Personally I increase my carb intake before that meal or else I would simply reduce my fast-acting insulin by a unit(and then not alter the meal/carbs).Likewise you could reduce your long-acting insulin ,for example if you were on 15 unit lower it to 13 and see if your blood levels fall at a slower pace after the meal the following day.That's how I would approach it ,nevertheless if your not that used to this transition contact your doctor or just ring a diabetic help-line :)
I do take a correction with the 1u for breakfast so I take 2u usually if my fasting is high. It's the only time I've felt comfortable doing it since my blood sugar seems most stubborn in the morning. I just took a ISF too try to bring this number down guess i'll be testing, testing, testing for a few hours lol.
Thank you everyone for all the advice it;s been very helpful. :)
I take my leveimir usually between 8 and 9 in morning and same as night.
And right now my breakfast is pretty high at 1 hr kinda high 2 hours like 150's and then it drops quite a bit 3 or 4 hours later. I usually always have to eat by noon because by then there seems to be a steady drop. But if I take anything less then my blood sugar goes up between lunch and dinner increase it to 6u was what seemed to fix the problem there.
Again, talking only from my experience.
I wonder if you are going overboard.
I tested before each meal, and before going to bed.
Before each meal I'd test glucose then estimate my glucose intake. Calculate the insulin (Humalog) and shoot it. I tried to be 15-20 before the meal. Then don't worry about it until the next meal.
Before bed it was the same (Lantus) every-nite.
190 is high, but when I started I was running in the 200-240 range. It took a while to get it in line. Then I got it into the 100-140 range and had to fight the 60-70 lows.
The lows scare me. Just relax girl, if you work at this thing you WILL WIN!
Ok I don't know what to do. My blood sugar was at exactly 200 when I took my ISF now 3 hours later it's at 100. Wow....I'm sure maybe my levemir I took around the same time maybe brought it down some too. But really 100 points I really hope it's done because I'm getting nervous now. I honestly don't feel comfortable going to bed at this and if it goes down even more then I really won't. So what should I do? If it gets even lower do I eat something ...with carbs or no carbs? If it goes low do I treat low blood sugar or just eat something? I'm lost again..lol
One unit, I assume brought you down 100 points? That's very sensitive, but not impossible. No, your levemir which is a long acting insulin would not have contributed. I would just check it again before going to bed or set an alarm if it is still going down and you are sleepy. You are fine at 100. If it does go low, just treat it like any low with glucose tabs. I am more conservative in treating lows before bed of course. Normally, I don't treat unless I'm below 60, but at bedtime I will treat if I'm in the 70s. But there is a good chance you won't go lower.
You said you'd figured out your ISF for daytime,just out of curiosity, what is that?
I really hope I don't... Yea 100 pts seems really sensitive.... Now I'm going to be nervous all night lol.
I figured out my ISF for breakfast ...breakfast `u drops me 21pts. Obviously nighttime is way different....